Background: Systemic sclerosis (SSc) is a rare, heterogeneous autoimmune disease characterized by skin fibrosis, vasculopathy, and internal organ involvement. This study aims to determine the frequency of clinical manifestations of SSc among Libyan patients in Benghazi. Patients and Methods: Thirty patients (28 females) attended the Rheumatology Clinic at Benghazi Medical Center between January 2016 and December 2019. They were diagnosed to have SSc according to American College of Rheumatology/European League Against Rheumatism 2013 revised classification criteria and were classified into diffuse cutaneous systemic sclerosis (dcSSc) and localized systemic sclerosis (lcSSc) disease subsets. Results: We reviewed the data of the 30 patients, including 28 (93.3%) females and 2 (6.7%) males (female: male ratio 14:1); the mean age at diagnosis was 40.5 ± 21.5 years (17–62 years). Twenty-four (80%) patients were diagnosed as dcSSc, whereas 6 (20%) were diagnosed as lcSSc. On diagnosis, patients with dcSSc were comparatively younger than those with lcSSc. The frequency of musculoskeletal manifestations and organ involvement was more frequent among patients with dcSSc (P = 0.001). All the thirty patients had rheumatoid factor and anti-nuclear antibody positivity. Anti-Scl-70 was only positive in the dcSSC subset in all patients of dcSSc only, whereas anti-centromere Ab was positive in all patients of lcSSc only. Conclusions: This is the first study to assess the clinical manifestations of SSc in the Libyan population. Our disease cohort showed similarity to what was published in other cohorts with regard to the age at the time of diagnosis, gender, and autoimmune profile.

Lupus is associated with a considerable risk of fetal and maternal complications. The aim of this study was to assess the maternal and fetal outcomes in pregnant women with systemic lupus erythematosus (SLE) and likely predictors of adverse outcome in Benghazi, Libya. Patients and Methods: This was a retrospective review of the outcome of sixty pregnancies among 48 SLE patients attending the rheumatology clinics at Benghazi medical center, who were pregnant from January 2008 to December 2018. Each pregnancy was counted as a separate case. Results: The mean age to conceive was 30.6 ± 6.1 years (19-42 years). Nineteen (31.7%) patients were primigravida, and the patients' age at SLE diagnosis was 25.2 ± 5.6 years. Forty-eight of the pregnancies (80%) were planned, ten patients have preexisting hypertension (HTN), most cases were in clinical remission before pregnancy (53 patients; 88%), only seven patients were identified as having active disease, four of them had lupus nephritis based on clinical features. Secondary antiphospholipid syndrome was diagnosed in four patients. Most pregnancies (50; 83%) resulted in live birth babies, 3 (5%) of them were preterm due to preeclampsia, six pregnancies (10%) ended in spontaneous abortion, and there were four intrauterine fetal deaths. More positive cases for aCl antibodies were affected than negative cases (P = 0.005). Five pregnancies complicated by preeclampsia, three of them have preexisting HTN, thirty patients (50%) underwent vaginal delivery, twenty patients (33%) underwent cesarean section due to different obstetric indications (previous cesareans and preeclampsia). Thirteen neonates (26%) were born with low birth weight, and two neonates (3%) required neonatal intensive care unit admission; no neonatal cases of lupus or congenital cardiac problems were reported. Postnatal SLE flare was reported among 16 patients (53%); preexisting HTN was strongly associated with preeclampsia, preterm labor, and postnatal SLE flares (P-values were 0.001, 0.003, and 0.004, respectively), whereas secondary Antiphospholipid antibody syndrome (APL) was associated with preeclampsia and abortion (P = 0.005 and 0.002). Conclusion: Preexisting HTN and secondary APL are associated with an increased risk of pregnancy complications. Characteristics and outcomes in our series are comparable to previously published international cohorts.

Propofol is a short-acting medication that results in a decreased level of consciousness and lack of memory for events. Its uses include the starting and maintenance of general anesthesia, sedation for mechanically ventilated adults, and procedural sedation. It is also used for status epilepticus if other medications have not worked. It is given by injection into a vein. Maximum effect takes about 2 min to occur, and it typically lasts 5-10 min. Propofol is believed to work at least partly through receptor for gamma-aminobutyric acid. [1] Propofol was discovered in 1977 and approved for use in the United States in 1989. [1,2] It is on the World Health Organization's list of essential medicines, the most effective, and safe medicines needed in a health. [3] The aim of this study is to assess prevalence of different side effects of propofol use as anesthetic in different surgeries and to compare their prevalence between adults and pediatrics. MaterIals and MethodsA prospective cohort study of 100 patients, fifty adults and fifty pediatrics, who undergo different types of surgery and receive propofol anesthesia, in pediatric hospital, Benghazi medical center and Al-Hawari hospital from September to November 2019. Data collection included patient's age, gender, indication of surgery, and complications of anesthesia.

Introduction: Pulmonary involvement, such as Interstitial Lung Disease (ILD) and Pulmonary Hypertension (PH ), accounts for significant morbidity and is the leading cause of Systemic sclerosis (SSc)-related morbidity and mortality. The aim of the current study was to study the frequency of occurrence of ILD in SSc and to describe the clinical and radiological picture of pulmonary involvement in SSc. Patients and Methods: Forty patients attending different rheumatology clinics in eastern part of Libya between January 2018 and September 2020 were included. Basic details including age, gender, disease duration, detailed history, and clinical examination were noted. Autoimmune profiling included rheumatoid factor, antinuclear antibodies, and anti-Scl-70 antibodies. Pulmonary function test, chest X-ray (CXR), and high-resolution computed tomography of the chest (HRCT) in all patients were recorded. Data presented either as frequencies and percentages or as means ± standard deviation. Results: The male: female ratio was 1:9 with a mean age of 37.5 ± 9.6 years and duration of illness 6 ± 4 years. diffuse cutaneous SSc was seen in 62.5% of the patients. 77.5% of the participants had bilateral crepitation and 57.5% had loud P2. Presenting complaints included gastrointestinal reflux in 72.5%, digitalis ulcerations in 40%, and synovitis/arthritis of all patients. Other comorbidities included congestive heart failure in 12.5%, PH in 15%, and renal impairments in 7.5% of all patients. Anti-Scl-70 antibody was the most common in all patients (45%), followed by anti-centromere Ab (25%), anti-U3 RNP (10%), and anti-U1 RNP (5%). 72.5% of the participants had reticulonodular shadows on CXR. HRCT showed honeycombing as the predominant finding (37.5%). Echocardiograms showed that 15% of all patients have signs of PH. Duration of disease, dyspnea, cough, bilateral crepitations, and CXR were found to be significantly associated with extensive ILD (P < 0.05). Conclusion: ILD is a serious complication of SSc, it is more common among patients with dcSSc. Chest HRCT is very sensitive to detect ILD. A significant association was found in Libyan patients between the severity of ILD and the duration of disease, dyspnea, cough, bilateral crepts, and CXR.

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