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[Rhythm disorders in acute myocardial infarct at the National Hospital of Zavia in Libya over a 2-year period].
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Hair selenium content during infancy and childhood.
Hair selenium content was estimated by instrumental neutron activation analysis in Libyan infants and children. There was no significant difference between the values of young infants from North and South Libya. The hair selenium content rapidly decreased from 1071 +/- 75 ng/g in newborns to 301 +/- 99 ng/g in 7-10 months old infants in North Libya and to 557 +/- 204 ng/g in South Libya. In North Libya the values of preschool children were 409 +/- 117 ng/g and those of school children 464 +/- 124 ng/g.
Zinc status of Libyan children -- a pilot study.
Hair zinc has been investigated in children of North and South Libya. The hair zinc content amounts to 213 +/- 36 micrograms/g in newborns. There is no difference between the values of newborns from North Libya and newborns from South Libya. The hair zinc values decrease during infancy. In toddlers and school-children the hair zinc content is 88 +/- 35 micrograms/g, 89 +/- 25 micrograms/g resp. These values are as low as those reported in American children with low height percentiles or nearly as low as those found in dwarfs with poor zinc status from Egypt and Iran.
Allergen skin weal/radioallergosorbent test relationship in childhood populations that differ in histamine skin reactivity: a multi-national survey.
BACKGROUND: Histamine skin reactivity (HSR, the dimension of the skin weal elicited by histamine 10 mg/mL) is a variable that differs in children from different European countries and increases over time in the same place (Italy). OBJECTIVE: In this epidemiologic study, we investigated to what extent differences in HSR influence the relationship between positive allergen skin prick tests (ASPTs) and serum-specific IgE concentrations. METHODS: Between October 2001 and February 2002, 591 unselected 9-10-year-old schoolchildren drawn from five small towns in central Poland (Starachowice), central Italy (Ronciglione, Guardea) and Libya (Al-Azyzia, near the Mediterranean sea and Samno, 900 km south of the coast) were analysed for histamine, common ASPT and for serum total and specific IgE. RESULTS: HSR differed markedly in children from the three countries (Libya>Italy>Poland) whereas serum total IgE concentrations remained the same. The prevalence of children with measurable serum specific IgE (> or = 0.35 kU) or with a positive ASPT for five common allergens was high in Italy, lower in Poland and far lower in Libya. A 3-mm ASPT weal corresponded to a serum-specific IgE concentration that was two to threefold higher in children with low HSR compared with children with high HSR (P = 0.008). CONCLUSION: These findings suggest that HSR--a variable that differs in schoolchildren populations from the three countries studied--independently influences the results of ASPT and its influence should be considered when ASPT are assessed in international studies. The HSR differences found in the populations reported here probably reflect a complex, dynamic, environmental interaction that should be monitored in the different parts of the world.
Faunal correlation of Wadi Moghara, Egypt: implications for the age of Prohylobates tandyi.
Wadi Moghara, Egypt, is an early Miocene fossil locality with a mammalian fauna that includes Prohylobates tandyi, one of the earliest known representatives of the Cercopithecoidea. Faunal correlations were conducted between Moghara, Gebel Zelten (Libya) and a series of East African fossil sites with established radiometric dates in order to estimate the age of the Moghara mammals, including P. tandyi. Results confirm hypotheses proposed in some previous studies that: (1) Moghara is about 18-17 Ma, approximately the same age as the Hiwegi fauna from Rusinga Island (Kenya); (2) Moghara is slightly older than Gebel Zelten (Libya) (17-15 Ma); and (3) the cercopithecoid tooth presently identified as Victoriapithecus sp. from Napak V (ca. 19 Ma) is currently the oldest known record of a fossil Old World monkey, followed by P. tandyi from Moghara (Egypt) (18-17 Ma) and Prohylobates sp. from Buluk (Kenya) (>17.2 Ma), P. simonsi from Gebel Zelten (Libya) (ca. 17-15 Ma), and V. macinnesi from Maboko (Kenya) (ca. 16-14.7 Ma).
Present situation of echinococcosis in the Middle East and Arabic North Africa.
Echinococcosis is one of the major zoonotic parasitic diseases in the Middle East and Arabic North Africa from Morocco to Egypt. Both cystic and alveolar echinococcosis has been reported from these areas. However, cystic echinococcosis is more prevalent and has been reported from all countries in the Middle East and Arabic North Africa. Alveolar echinococcosis is less prevalent and has been reported only from Iran, Turkey, Iraq and Tunisia. Present situation of echinococcosis in dogs and other definitive hosts, animal intermediate hosts and humans in the Middle East and Arabic North Africa has been reviewed. Echinococcus granulosus is highly prevalent in Iran, Turkey, Iraq, Morocco, Tunisia, and Libya. In the Levant countries, the cystic echinococcosis is also highly endemic. In Oman, it is endemic with low prevalence and a very low level in Cyprus. Various surveys have indicated that hydatid cysts are commonly found in sheep, cattle, goats and camels throughout the Middle East and Arabic North Africa. Sheep are the most infected animals of these regions. Most of studies on human have been focused on surgical reports although several population studies have been performed using serological and imaging techniques. Human cystic echinococcosis (CE) is prevalent in the Middle East and Arabic North Africa. It is hyper endemic in Iran, Turkey, Iraq, Jordan, Morocco, Libya, Tunisia, and Algeria, and endemic in Egypt. Studies on the strain specificities of E. granulosus in the Middle East revealed sheep strain (G1) present in sheep, goats, cattle, camels and humans, and the camel strain (G6) in camels, sheep, cattle as well as humans. Dog/sheep strain seems to be more prevalent in the foregoing regions in documented reports from Iran and Jordan. However, a strain of E. granulosus, which resembles the horse strain (G4) strain, has been reported from Jordan. Strain specifications of E. granulosus in Arabic North Africa showed that sheep/dog strain (G1) have been reported from Tunisia and Libya both from humans and animals. However, in Egypt the human cases reported are of camel/dog strain.
The modified Blalock-Taussig shunt: a 6-year experience from a developing country.
Since 1992 we have performed the modified Blalock-Taussig shunt (MBTS) for cyanotic children in Libya. This retrospective study reviews our results as a developing country, comparing them with those in the literature, and makes suggestions to improve our results. Between May 1992 and May 1998, 94 children (58 males and 36 females) underwent 100 MBTSs in Mesallata Cardiothoracic Centre, Libya. The age ranged from 4 days to 15 years, (median 12 months) and 25 patients were neonates. Patients' weights ranged from 3 to 31 kg (median 6.4 kg). Eighty-nine shunts were performed on the left side and 11 on the right. A 6-mm polytetrafluoroethylene graft was used in 68 children and a 4-mm graft in 32 cases. Tetralogy of Fallot (TOF) comprised the majority of cases (63; 67%), the remaining 31 (33%) included tricuspid atresia (13), pulmonary atresia (9), univentricular heart complex (6), and others (3). Acute shunt failure occurred in 3 cases (2 with 4-mm and 1 with 6-mm grafts), all of which had not received perioperative heparin. Hospital mortality was 6% (6 patients); risk factors were neonates, a diagnosis other than TOF, and emergency surgery. There were 12 late deaths, 6 of which were due to sepsis. Follow-up was achieved in 82 of 88 early survivors for a period of 2 to 60 months (median 26 months). All surviving patients had subjective and objective improvement. We conclude that MBTS is an excellent palliative procedure for children requiring a systemic-pulmonary shunt in developing as well as developed countries. This series shows an early mortality rate comparable to that of other studies, but the late mortality is higher, mainly due to sepsis, which warrants further attention.
Analysis of neutralizing antibody responses against poliovirus types 1, 2 and 3 in the Tripoli area of the Socialist People's Libyan Arab Jamahiriya.
Analysis of the records available show that the introduction in Libya of a compulsory immunization programme against poliomyelitis was followed by a substantial decrease in the incidence of paralytic poliomyelitis. Nevertheless, the annual incidence is still higher than in many western industrialized countries. We have conducted a survey of neutralizing poliovirus antibodies in human sera. In the group aged 19 years and upwards, i.e., those born before compulsory immunization, 65% had detectable neutralizing antibodies against the 3 viruses, and on average 73% were positive for 2 of the 3 virus serotypes and 85% for only one. The overall proportions in schoolchildren 6-18 years old were lower than in adults. In adults and schoolchildren from 6-18 years old, the highest proportion of positives was against type 2 poliovirus. For infants up to 5 years old the figures overall were higher but the type 2 serotype did not predominate. Surprisingly, the anticipated increase in proportions of positive antisera in 7 year olds, following a booster immunization at the time of school entry, was not apparent, implying inadequate coverage. The results appear to show that stricter measures to control the rate of coverage of immunization are required to reduce the relatively high incidence of paralytic poliomyelitis in Libya.
The effect of desert conditions on the reactivity of Libyan schoolchildren to a range of new tuberculins.
This study was carried out to investigate the effect of desert conditions on the pattern of delayed hypersensitivity to mycobacteria in school children aged 6-10 and 11-18 years. A new range of tuberculins prepared from ultrasonic lysates of living mycobacteria belonging to 12 different species was employed. Three centres were chosen for study, a sea port and two desert towns differing greatly from each other. The results obtained were compared with those of a previous study using the same reagents in Kenya. As expected both the range of mycobacterial species to which the children reacted, the rate of acquisition of specific hypersensitivity with age and the total percentage of children reacting to individual reagents differed from centre to centre. The harsh desert conditions of Ajdabia produced the least, and the proximity of the people's dwellings to those of their farm animals in Kufra produced the most positive reactors to essentially environmental species. The greatest number of reactions to our Tuberculin were found in Benghazi where the cosmopolitan urban conditions probably lead to a high contact with open cases of tuberculosis. As assessed by skin test reactivity, immunization with BCG in Libya was much less effective than in Kenya. The interpretation of the differences between the results from the different test centres and between those for Libya and Kenya are discussed.
An objective study of two medicolegal Systems--Libyan and British.
This work presents important information about the medicolegal systems in two different countries through the author's personal experience during his work. In Libya, the Medicolegal Centres, attached to the Justice Department, receives all cases referred by the Director of Public Prosecution or by the Judge. These constitute a wide range of cases which include in descending order of frequency, age estimation, injuries, autopsies, sexual offences, criminal responsibility, medical mishaps, disputed paternity and nullity of marriage. In Scotland, the Department of Forensic Medicine and Science at the University of Glasgow receive only a proportion of the total number of cases investigated by the Procurator Fiscal in Glasgow. These are exclusively deaths that require medicolegal autopsies, which average 458 per year. The medicolegal Centre in Benghazi receives all referrals from the courts, which average 1780 cases per year, but autopsies constitute only 14.4% (256 cases per year). A total of 1144 autopsies performed in Glasgow during a period of 2.5 years, and 7121 medicolegal cases investigated in Benghazi during a period of 4 years (1022 of that were autopsies), are presented in 12 tables and duly discussed. The outstanding observation is the marked male preponderance in deaths from unnatural causes in Benghazi, (80% of the total), compared to less marked male preponderance in Glasgow, (60% of the total). This is explained by the fact that due to social custom in Libya, females have limited outdoor activities and lead a rather domestic life compared to females in Britain.
The Libyan Creutzfeldt-Jakob disease focus in Israel: an epidemiologic evaluation.
In a country-wide study of Creutzfeldt-Jakob disease (CJD) in Israel, we diagnosed 114 cases, among them 49 Libyan-born, with onset of their disease during the years 1963-1987. After age adjustment, the mean annual incidence rate per million population was 43 among Libyan-born and 0.9 in the rest of the population. Among Jews born in Egypt and Tunisia, neighboring countries of Libya, the adjusted rates were higher than in the other Israelis (3.5 and 2.3 per million, respectively). Among Libyan Jews, there was no association between incidence rate of CJD and age at immigration, ie, duration of exposure to hypothetical infectious factor in Libya. The percent of familial cases among Libyan Jews (41 to 47%) is one of the highest ever published. Genetic factors seem to be important for the high incidence of CJD among Libyan Jews.
Do Creutzfeldt-Jakob disease patients of Jewish Libyan origin have unique clinical features?
A focus of Creutzfeldt-Jakob disease is present in Israel among Jews born in Libya. The present study examines the clinical features in this particular group of patients. In a country-wide study of Creutzfeldt-Jakob disease, we identified 114 patients; 49 were Libyan immigrants, and 65 (three of whom had Libyan ancestors) were born in other countries. The clinical presentation and evolution of the disease is very similar in patients born in Libya and others without Libyan ancestors, but it tends to be more classical in the Libyan patients, with higher frequency of myoclonic jerks and periodic EEG and a progressive course of shorter duration. The Libyan patients tend to complain more often of headache, which is most probably an ethnic expression for depression and loss of concentration. There was no difference between the familial and nonfamilial cases.
Correlates of life satisfaction for old Libyans compared with the judgments of Libyan youth.
Two hundred fifteen Libyans-106 young male and female undergraduate students and 109 aged male and female relatives--responded to a questionnaire designed to measure correlates of life satisfaction in old age. It was predicted that current cultural and social changes associated with the industrialization of Libya would result in significant differences in responses between young and old men and women. The young Libyan men rated close ties with their children, social relationships with individuals outside the family, and having basic physical needs met as more important than did the old Libyan men who considered social prestige, living with their spouse, and independence as more important for satisfaction in old age. The young Libyan women also considered social relationships outside the family and having basic physical needs met in old age as more important than did their older counterparts. Health and adequate living conditions were rated more highly by the young Libyan women than by the old. All participants rated social prestige equally high, but old women rated it higher than any other aspect except belief in God and self-understanding. Findings and implications for services to Libya's elderly are discussed.
Rupture of the uterus in labor. A review of 96 cases.
Ninety-six cases of ruptured uterus in labor treated in the University Teaching Hospitals, Benghazi, Libya between 1977 and 1980 are reported. An incidence of 1 in 585 deliveries remained unchanged during the period of study. Twenty uterine ruptures occurred in a previously scarred uterus. Rupture of the unscarred uterus is a more catastrophic event. There is a marked difference in both fetal and maternal outcome between the group with a previously scarred uterus and the group without a previous scar. The incidence and causes of uterine rupture in Libya differ greatly from those in developed countries. High parity is a frequent cause. Other common etiological factors were cephalopelvic disproportion, fetal malpresentation, oxytocin stimulation of labor and unwise obstetrical interference. The fetal wastage was high, a perinatal mortality of 75% being recorded, but 95% of the mothers were saved. Hysterectomy was commonly performed in this group. Repair of the uterus and sterilization should only be performed when the rupture is simple and transverse in the lower segment and without any sign of infection.
Myiasis: the battle continues against screwworm infestation.
The New World screwworm fly (Cochliomyia hominivorax) caused myiasis extensively among livestock in Mexico and the southern third of the USA until eradication was achieved by repeatedly releasing sterile males of the species on a massive scale. The pest appeared in Libya in 1988, the first time it had become established outside the western hemisphere. Because of the threat of myiasis in animals and people, not only in Libya but also elsewhere in Africa and beyond, a concerted campaign of sterile male releases was mounted with strong international support, and the outbreak has been eliminated. Action is continuing against the pest in Central America.
Echocardiographic features of mitral valve prolapse in Libyan patients.
Echocardiographic observations in 200 subjects with mitral valve prolapse (MVP) are presented. The diagnostic criteria used were: (1) abrupt late systolic posterior motion of one or both leaflets of the mitral valve, and (2) holoor pansystolic posterior motion of 3 mm of one or both leaflets of the mitral valve. Most of the subjects were young--72% were aged less than 30 years. Prolapse of posterior leaflets was noted in 98% of subjects--69.5% late systolic, 28.5% pansystolic, and 2% had prolapse of the anterior mitral leaflet only. Mitral valve prolapse was considered to be primary--being the only abnormality in 78.5% of the subjects. In the remaining 21.5% MVP was associated with other cardiac lesions, the commonest being, atrial septal defect (2.5%), dilated aortic root (2%), bicuspid aortic valve (2%), cardiomyopathy (5%), rheumatic heart disease (4%) and ischaemic heart disease (1.5%). Mitral valve prolapse was considered to be important enough to result in haemodynamically significant mitral regurgitation in only 8% of subjects. Mitral valve prolapse was the commonest single echocardiographic abnormality (16%) observed in patients referred to this university hospital, which is the referral centre for approximately half of Libya. Although this does not indicate the prevalence of MVP in the general population, this study indicates MVP to be the commonest valvular abnormality seen in hospital practice in Libya.
Characteristic differences in the use of psychotropic drugs as a stigma of cultural influences.
The study aimed at investigation of the influence of the cultural and racial factors upon therapeutic response of the schizophrenic patients in Libya and Malta. The study revealed high frequency of polypharmacy, liberal use of minor tranquillizers and antiparkinsonian agents, and daily multiple administration of drugs. Long-acting preparations were not administered in Libya, while in Malta they were used in 37.5% of patients. Therapeutic response in both investigated groups were different. The Libyans responded to low doses of regular drugs. Maltese were treated in comparatively higher doses due to combinations of drugs. The number of chronic withdrawn and apathetic schizophrenics was a larger among Maltese and there the disintegration of personality was much more visible.