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Oral hygiene, gingivitis and periodontal status of Libyan school children.

There is relatively little information about the dental health of Libyan children, so this study was initiated to assess the level of oral hygiene and the gingival and periodontal status in children living in urban and rural parts of Libya. Two thousands and fifteen children aged 7-16 years were examined during 1987 using World Health Organization criteria. The oral hygiene was found to be good (mean oral hygiene index = 0.12); boys demonstrated significantly worse oral hygiene than girls (P less than 0.001). Overall, gingival inflammation was categorised as mild (mean gingival index = 0.05). Boys had more gingivitis than girls (P less than 0.001). Periodontal pockets of more than 3.5 mm were found in 4.1 per cent of 15-16-year-old children.

Adolescent↗

Torture of a Norwegian ship's crew. The torture, stress reactions and psychiatric after-effects.

During the summer of 1984, 14 seamen, the entire crew of a Norwegian ship, were seized upon arrival in Libya. They were kept under arrest for 67 days and subjected to psychological and physical torture because they were suspected of being enemies of the Libyan state. Within the first few days of imprisonment one seaman had been murdered, another had been abducted and was believed to be dead, and a third had been severely physically maltreated. The immediate reactions to the extreme stress were fear, depression and rage. Not a single seaman gave in to the torture. Shortly after their release, all the seamen underwent thorough medical examinations. Six of them suffered from clear-cut post-traumatic stress disorder (PTSD) and one more seaman developed the disorder two months later. In spite of comprehensive treatment, the same seven sailors, or 54% of the crew, still suffered from post-traumatic stress disorder six months after their release. Used in conjunction with clinical interview, general mental status rating scales (GHQ 20, STAI, State Anxiety Inventory), and specific post-traumatic rating scales (Amnesty Score, IES intrusion subscale, PTSS-10) had a high sensitivity and specificity in discriminating between cases and non-cases.

Adaptation, Psychological↗

[Rheumatic fever in a developing country in North Africa].

In a catchment area with population of approximately 60,000 in Libya for a period of two years and three months a group of 38 children aged 7-12 years with the diagnosis of rheumatic fever was followed up. An incidence of cca 60 attacks of rheumatic fever per 100,000 children per year was recorded. The clinical picture of primary attacks did not differ from the clinical picture of primary attacks in technically advanced countries in the sixties and also the development of the finding on the heart in rheumatic patients with penicillin prophylaxis was equally favourable.

Adolescent↗

Cross cultural study of productive phenomenology of schizophrenia.

A study of 97 cases of schizophrenia in Libya and 100 in Malta. Clinical analyses have showed differences of the content of the delusions and hallucinations as a result of cultural pathoplastic influences. The pattern of delusions and hallucinations was studied. In comparison with the Maltese the Libyan schizophrenics had less described and less systematized productive symptoms.

Adult↗

North American blastomycosis in Africans.

Two young adults, one a native of Libya and one a Sudanese from Saudi Arabia, were referred at different times to the chest service at Westminister Hospital in London with a diagnosis of tuberculosis. They both had neurological deficits due to vertebral lesions. In spite of the fact that neither patient had ever been to North America, diagnoses of North American blastomycosis were established; both patients made remarkable recoveries on amphotericin B therapy.

Adult↗

Myasthenia gravis (MG): a preliminary report.

Eighteen cases of MG admitted to the Neurology Unit, 7th April Hospital, Benghazi, Libya, over a period of three years October 1991 to December 1994 were reviewed. The female to male ratio was 2.6:1 (13 females and five males). The mean age of presentation was 13.3 years later for male patients compared to females (mean age of presentation in females was 26.5 years and in males 39.8 years). The average time interval between the onset of symptoms and diagnosis was 2.5 years. At the time of diagnosis 94.5 pc (17 cases) of the cases had generalized MG and 5.5 pc (one case) had ocular symptoms only. In 11.1 pc (two cases) of patients an association with thyroid disorder was observed. Repetitive nerve stimulation (RNS) test was abnormal in 83 pc (15 cases) of our cases. All cases were initially treated with anticholinesterase and 22.2 pc (four cases) also additionally required steroid therapy. Thymectomy was performed on eight cases, four of which had thymus hyperplasia. None of our cases had any thymoma. Of these eight cases, one case (12.5 pc) had complete remission, five cases (62.5 pc) were doing well with a reduced dose of anticholinesterase and +/- steroids. However, two cases (25 pc) required intermittent plasmapharesis and immunosuppressants in addition to anticholinesterase and steroids. These patients are obviously being followed up for long term outcome.

Adolescent↗

Tuberculous parotitis: two cases in Libyan patients.

Two patients with tuberculous parotitis are described. This condition is rare, and has not previously been recorded in Libya. Unilateral tuberculous parotitis is clinically indistinguishable from a parotid tumour, and imaging techniques may also fail to reveal the true diagnosis. If other features point to tuberculous parotitis, fine needle aspiration allowing bacteriological confirmation is the most useful investigation.

Adult↗

Respiratory effects of occupational exposure to asbestos.

Ventilatory capacities of 73 Libyan men working in the Asbestos-Cement Pipe factory in Jenzur, a residential area near Tripoli, Libya and those of 73 age-matched healthy Libyan men unexposed to asbestos were determined. The mean values of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) for men unexposed to asbestos were 3.89 +/- 0.084 and 3.64 +/- 0.082 liters respectively. The respective values for men exposed to asbestos were 3.62 +/- 0.082 and 3.29 +/- 0.097 liters. Thus, there has been a significant decrease in the ventilatory function of the men exposed to asbestos as compared with age-matched unexposed counterparts.

Adult↗

Dental caries in children from two Libyan cities with different levels of fluoride in their drinking water.

The aims of this study were to (1) demonstrate the feasibility of collecting dental epidemiological data suitable for planning purposes in Libya and (2) record the caries prevalence in Benghazi so that, following an increase in the fluoride concentration of the drinking water, potential changes in dental caries prevalence could be assessed. Random sampling resulted in the examination of 833 six-year-old and 704 twelve-year-old children from Benghazi (0.8 mg/t F-) and Jardinah (1.8 mg/t F-). For both six- and twelve-year-old children the caries prevalence in Jardinah was significantly lower than in Benghazi. Within Benghazi the caries prevalence was lower in state than private schools for the six-year-old children. Little evidence of dental treatment was found for the six or twelve-year-old pupils at either examination site.

Chi-Square Distribution↗

Parkinson's disease in Africa: A systematic review of epidemiologic and genetic studies.

Parkinson's disease (PD) occurs worldwide, but little is known about PD in Africa. We systematically reviewed publications on PD in Africa, with emphasis on epidemiologic and genetic studies. Articles published between 1944 and December 2004 were identified using several strategies. The studies emanated from 13 African countries (Kenya, Uganda, Tanzania, Ethiopia, Nigeria, Senegal, Ghana, Togo, Libya, Tunisia, Algeria, Zimbabwe, and South Africa). The publications fell into four categories: clinical series (n = 17), prevalence studies (n = 7), incidence studies (n = 1), and genetic studies (n = 3). The clinical series documented the occurrence of PD in Africa and described its clinical characteristics. The prevalence studies suggested some intracontinental geographic variation in PD prevalence. Overall, the prevalence figures and the incidence rates of PD in Africa appeared lower than those reported for European and North American populations. Few genetic studies of PD have been reported from Africa, and none in blacks. There are no case-control or cohort studies of PD reported from Africa. This review provides a summary of PD research in Africa over the past 60 years and highlights the information gaps and potential areas for future research.

Africa↗

Creutzfeldt-Jacob disease associated with the PRNP codon 200Lys mutation: an analysis of 45 families.

200Lys mutation in the human PRNP coding region has been identified in 45 of the 55 CJD-affected families thus far presented to our NIH laboratory. These codon 200Lys families have a total of 87 patients, and originate from 7 different countries: Slovakia, Poland, Germany, Tunisia, Greece, Libya, and Chile. Forty-seven patients were neuropathologically verified, and brain tissue from 14 patients transmitted disease to experimental primates. The mutation was found by direct sequencing in 4 patients, and it was detected by restriction endonuclease analysis with BsmA 1 and/or the single nucleotide extension reaction in 36 other patients and 45 of 109 first degree relatives (1 parent, 14 siblings, and 30 children). The mutation is associated with all known geographical clusters of CJD (Slovakia, Libyan Jews, Chile) in which the annual mortality rate is tens or hundreds of times higher than the world average of 1 per million. All patients originating from the cluster areas carried the mutation, but it was seen in only 1 of 103 unrelated control individuals from the same areas, and in none of 102 controls from other areas, indicating a strong association between the mutation and disease. The penetrance of the mutation was estimated to be 0.56. Branches of some families migrating from cluster areas to other countries continue to have CJD over several generations, suggesting that CJD in these families is a genetic disorder, in which the 200Lys mutation is responsible for the disease.

Africa↗

Erythrocyte count and hemoglobin levels in diabetic women.

Fasting blood glucose, erythrocyte counts hemoglobin levels of 131 Libyan diabetic women of Tripoli , Libya were determined. The respective mean values were 223 +/- 7 mg X dl-1, 4.97 +/- 0.034 X 10(6) X mm-3 and 14.4 +/- 0.127 g X dl-1. Sixty-five percent of these diabetic women were obese. The highest percent of diabetics belong to the age group 46-55 years. The increase in prevalence of diabetes correlates with an increase in obesity. A significant positive correlation was found between body surface area and fasting blood glucose levels (r = 0.65; P less than 0.001). Elevated levels of erythrocyte count and hemoglobin were present in these diabetic patients. Significant correlations were found between body surface area and erythrocyte count, as well as between fasting blood glucose levels and erythrocyte count, indicating the effect of obesity and diabetes on erythrocyte numbers. A significant correlation was found between fasting blood glucose levels and hemoglobin (r = 0.35; P less than 0.001). The elevated levels of hemoglobin present in these patients may be the result of haemoconcentration due to polyuria, which is always present in poorly controlled diabetic patients. The results suggest a close relationship between diabetes and obesity. Regulation of body weight/surface area is an important factor in the control of diabetes. The elevated levels of erythrocyte count and hemoglobin reflect poor control of blood glucose levels in these diabetic patients.

Adolescent↗

Diagnosis of Johne's disease in sheep by counter-immunoelectrophoresis.

The use of counter-immunoelectrophoresis (CIEP) in the diagnosis of Johne's disease was investigated in flocks of sheep in Iran and Libya. In 50 sheep with no history of paratuberculosis none had antibodies to Mycobacterium paratuberculosis. Animals vaccinated as neonates were either negative or had reciprocal titres (RT) of less than 4 at 18 months of age unless exposed to infection. Among 105 non-vaccinated adults in an infected flock 91% had antibodies. Twenty-one animals that either died or were slaughtered were autopsied. Eight animals with RT of 8 or above and one with RT of 4 had gross lesions with demonstrable acid-fast organisms. Two animals with RT of 2 had clinical disease while three with RT of 4 and one with RT of 2 had histopathological lesions only. All animals found negative for M. paratuberculosis infection had RT of 2 or below. The critical interpretation of the test is discussed.

Animals↗

Serology of Orthopoxvirus cameli infection in dromedary camels: analysis by ELISA and western blotting.

An enzyme-linked immunosorbent assay (ELISA) was developed, together with a Western blotting technique, for the detection of total and IgG and IgM antibodies to camelpox virus (Orthopoxvirus cameli) in camel (Camelus dromedarius) sera and for identifying the seroreactive antigens of the virus. A total of 520 camels from different regions in Libya were tested. The overall seropositivity rate in the examined herds was 9.8%, and varied between herds from 0 to 30%. Two viral antigenic determinants (31 and 35 kDa) were shared by the Western blotting patterns of all the positive camel sera tested. The developed ELISA assay showed ability to differentiate between orthopox and parapoxvirus infections in camels. It is considered that the ELISA technique is justified for serodiagnosis of camelpox in the camel and could be easily modified and usefully applied to other species at risk of poxvirus infection.

Animals↗

Antigenic analysis of serotype O foot-and-mouth disease virus isolates from the Middle East, 1981 to 1988.

During the period 1981-88 foot-and-mouth disease virus (FMDV) serotype O continued to be isolated from outbreaks in the Middle East. Field isolates submitted to the World Reference Laboratory have been examined in relation to reference strains by either complement fixation, virus neutralization or enzyme-linked immunosorbent assays. Most isolates were related to the European type O1 reference strains although strains emerging in late 1987 and 1988 were more closely related to O1/Manisa. In addition, FMDV isolates from Libya in 1981 and Syria in 1987 have shown very little relationship to these reference strains, although evidence of their persistence and spread has not been demonstrated.

Animals↗

Identification of measles virus genotypes from recent outbreaks in countries from the Eastern Mediterranean Region.

BACKGROUND: Molecular characterization of measles viruses (MV) helps to identify transmission pathways of the virus and to document persistence or interruption of endemic virus circulation. In the Eastern Mediterranean Region, measles genotypes from only few countries have been documented. OBJECTIVES: This study reports the genetic characteristics of virus strains from recent measles outbreaks in Tunisia, Libya, Syria and Iran in 2002-2003. STUDY DESIGN: Virus sequences in the nucleoprotein gene were obtained by PCR amplification of virus isolates or serum samples. The sequences were compared to the reference ones for genotype identification and to other published sequences within the same genotype. RESULTS AND CONCLUSIONS: The Tunisian and Libyan epidemic strains belonged to genotype B3, they were closely related to each other and to isolates from Western Africa. The Syrian and Iranian viruses belonged to genotype D4, and differed from each other and from the other published sequences within this genotype. Our results provide valuable baseline and new tools for improved virological measles surveillance in the future, at country, regional and global levels.

DNA, Viral↗

Clinical characterization of idiopathic intracranial hypertension at the Detroit Medical Center.

BACKGROUND: Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri (PTC), is a condition characterized by increased intracranial pressure without clinical, laboratory or radiologic evidence of an intracranial space-occupying lesion, meningeal inflammation or venous outflow obstruction. Previous population-based studies evaluated the presenting clinical features of IIH in North-Eastern Libya, Iowa, Louisiana, Minnesota, Northern Ireland, Israel and Western Turkey. However, we report the demographic patterns of a metropolitan North American city. METHODS: We performed a retrospective study of all patients with an initial IIH diagnosis and follow-up at the Detroit Medical Center (DMC), Michigan from 1985 to 2002. Medical records of 174 patients were reviewed, with 77 patients fitting the diagnostic criteria. RESULTS: Seventy-seven patients, 71 females (92.2%) and 6 males (7.8%) were identified. Age ranged from 10 to 50 years, with a mean of 34 years. Fifty patients (65%) were African-American and 24 patients (31%) were Caucasian. The most common presentation was isolated headache (28.6%). Nineteen patients (24.7%) were asymptomatic. Obesity was described in 65 of 74 patients (87.8%) evaluated for body dimensions. CONCLUSIONS: We report an increased number of asymptomatic patients after routine ophthalmic examination. Obese females in metropolitan Detroit would benefit from routine eye evaluations to avoid potential visual loss related to papilledema.

Adolescent↗

Successful and currently ongoing parasite eradication programs.

The eradication of parasitic diseases is not a new concept. The most successful programs of parasite eradication have occurred with species of veterinary importance. The first such program, the eradication of Texas Cattle Fever from the United States, is one of the great success stories of disease eradication. The American screwworm eradication program is ongoing and is serving as a guiding impetus for many of the ongoing or proposed vector eradication schemes around the world. The success of these programs prompted similar successful operations in human health. Although they once led the way, veterinary parasitologists have taken second place in eradication planning. The only three parasitic diseases of veterinary importance that have been targets of recent eradication programs are Hypoderma species in Great Britain and Europe, Cochliomyia hominivorax after its introduction into Libya from the Americas, and Echinococcus granulosus in Tasmania, Australia. There is also work on the eradication of the tick, Amblyomma variegatum, from the Caribbean Islands. Some animal diseases are targeted under the auspices of the human eradication programs, most notably the eradication of the tsetse fly from parts or all of Africa. This paper reviews some of the past or ongoing successful eradication programs and presents a brief summary of the history of the programs, the methods used or planned, and potential controversies surrounding their success and implementation.

Animals↗