Haemonchosis in a winter rainfall area in Libya.
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A search for Libyan patients with multiple sclerosis (MS) was made in Benghazi, located on the southern Mediterranean coast at a latitude of 32 degrees N. Twenty-one clinically definite and probable cases were detected during the period July 1982-June 1984. On the basis of 2 probable incidental cases, the incidence for 1983 was 0.8 per 100 000 of the population at risk (10-50 years). On July 1st, 1984, the rough prevalence rate for the total population was 4 per 100 000 and the age-adjusted prevalence rate was 5.9 per 100 000. This study suggests that Benghazi falls within the medium frequency band for MS. High prevalence of brainstem involvement and cerebellar dysfunction and infrequent occurrence of the severe optic-spinal form and sphincter disturbance indicates that the present group of patients resembles Western pattern of MS as opposed to Asian MS.
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In a two-year study, from January 1977 to December 1978, 80 human cases of ophthalmomyiasis were recorded at the Benghazi Central Eye Clinic. Infections were due to larvae of the sheep nasal bot, Ostrus ovis. The annual incidence was estimated to be 10 per 100,000 population, with most of the cases occurring amongst males during the months of May, June and July. A typical case history is described to illustrate the clinical features and the treatment used.
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The effect of legislative actions taken in 1973 on the prevalence of primary and acquired drug resistance was studied from the records on the Regional Tuberculosis and Chest Diseases Centre in Benghazi during the period June 1971 to August 1976. There were available for analysis 771 culture-positive cases of newly diagnosed pulmonary tuberculosis in Libyan nationals, and 789 cases of both Libyan nationals and others with positive cultures during treatment. The legislative actions included screening of all foreign and local workers for tuberculosis before employment or in the course of employement for those already employed and strict control of the use of antituberculosis drugs, which were not made available to private practitioners, private pharmacies, general dispensaries and general hospitals. The proportion of newly diagnosed cases with resistance to one or more of the 3 drugs streptomycin, isoniazid, PAS (resistance to PAS was negligible, occurring in only 0.7% of the whole series) during the first 3 months of the survey was 16.6%. During the first 9 3-month periods there was a small decrease of 0.15% per quarter. However, after adoption of the antituberculosis measures in mid-1973 the rate of decline accelerated to 0.61% per quarter, a 4-fold increase over the earlier rates (P less than 0.001 for comparison of rates). If the rate of decline observed in the first 9 quarters had continued unchanged the expected proportion resistant at the end of the period would have been 13.5%, compared with the observed proportion of 8.6%. The proportion of patients under treatment from whom resistant cultures were isolated was 33.3% in the first quarter. It remained at about this level until the 14th quarter, approximately a year after the legislation came into force, when the proportion began to decline. By the end of the period it was only 14.7%.
The levels of lead in settled dust samples collected near small streets, playgrounds, gas stations and main streets in the Tripoli area have been determined by atomic absorption spectrophotometry. The overall mean values observed were 417, 533, 553 and 797 micrograms g-1 dry wt for the above locations respectively. The overall mean concentration for main streets was significantly higher (P less than 0.05) than for other sites. The data were also compared with those reported in the literature for other cities.
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During the period from 1 June 1984 to 1 June 1991, 988 pregnant diabetic patients were treated by a team of physicians and obstetricians in Benghazi Diabetic Clinic. Twelve patients were insulin-dependent (type 1) and 976 patients were non-insulin-dependent (type 2). Ninety patients were diagnosed for the first time during pregnancy. Thirty-nine patients defaulted. Eight hundred and seventy-six patients were treated with insulin and 112 patients were controlled by diet. The average daily insulin dose was 40.12 units. The majority, 64.5%, delivered vaginally and 35.5% by caesarean section. Rates of abortion, intra-uterine death and still birth were 7.99%, 3.28% and 2.6%, respectively. The mean birth weight was 3.78 +/- 0.89 kg. Congenital anomalies of infants were 3.4%. Perinatal morality was 11.44%. Poor metabolic control has been associated with increased rates of abortion, intra-uterine death and congenital anomalies. It was concluded that team approach and multiple insulin injections could improve the outcome of pregnancy in developing countries to near current western standards.
A total of 50 Escherichia coli strains isolated in a Libyan hospital (20 from children with diarrhoea and 30 from healthy children) were investigated for their pathotypes and virulence traits. Altogether nine eae-positive (enteropathogenic E. coli, EPEC) and nine aggR-positive (entero-aggregative E. coli, EAEC) strains were identified. Significantly (P=0.001) more EPEC strains were identified from diarrhoeal patients (n=8) than from healthy controls (n=1), while six EAEC strains were identified from diarrhoeal and three from healthy children. Typical (eae(+), EAF(+), bfp(+)) EPEC strains (n=6) belonged to classical EPEC serogroups O55, O114, O127 and showed localized adherence on Hela cells. EAEC strains revealed genetic heterogeneity but uniformly adhered to HeLa cultures in an entero-aggregative adherence pattern. Antibiotic resistance frequently, characterized the strains. Sixty-eight percentage of the strains were resistant against at least one antibiotic and 30% harbored a class 1 integron independently of their clinical background. This is the first report from North Africa demonstrating the significance of EPEC and EAEC.
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