Background Burnout syndrome is recognized as a global issue, and as medical practice is stressful, healthcare workers are found to be burnt out and exhausted very soon, which is reflected negatively on the medical staff well-being, patients' outcome, and the overall organizational performance. Aim This study is planned to assess the magnitude of burnout among physicians in Benghazi-Libya. Methods This cross-sectional study was carried out in 2020 on a total of 150 physicians working at different departments of internal medicine in Benghazi-Libya. The Maslach Burnout Inventory collection instrument was used to assess the three components of burnout syndrome: emotional exhaustion, depersonalization, and reduced personal accomplishment. High scores in emotional exhaustion and depersonalization and low scores in personal accomplishment are indicative of high burnout. The statistical analyses of the data were performed using the SPSS version 21. The level of statistical significance was considered as p-value less than 0.05. Results 60% of the respondents were females and 40% were males. About 14.7% had high emotional exhaustion, 92% had high depersonalization, and 87.3% had low personal accomplishment scores. Statistical analysis showed no significant relationship between gender and burnout. Alternatively, a significant association was found between degree certificate and emotional exhaustion, as moderate- and high-level burnout were more prevalent among MBCHB participants than those with masters and board degrees. No association was found between degree certificate and depersonalization or personal accomplishment. Conclusion Burnout is prevalent among internal medicine doctors in Benghazi, with the newly graduated medical personnel scoring higher rates of burnout than doctors with higher degrees. No relationship was found between gender and burnout.

Type 2 diabetes mellitus (T2DM) is increasingly becoming a major chronic disease health burden in Africa. In 2011, about 14 million individuals were estimated to have diabetes in Africa, and this is expected to rise to 28 million by 2030. [1] In Libya, according to the STEPS study for Noncommunicable Disease Risk Factors Survey 2009 which done in Libya, the prevalence of known diabetic patients was 16.4%. [2] As 50% of T2DM patients are unaware of their diabetes "undiagnosed," the actual prevalence is probably higher.Benghazi is the second largest city in Libya with 670,797 inhabitants according to the 2006 census. The prevalence of DM in Benghazi was 14.1%, [3] with T1DM constituting about 6% of all cases.Diabetic peripheral neuropathy (DPN) is a debilitating complication of DM and accounts for significant morbidity by predisposing the foot to neuroischemic ulceration and lower limb amputation. Between 12% and 50% of people with Background: Diabetic peripheral neuropathy (DPN) is common among people with diabetes and can result in foot ulceration and amputation. Objective: The objective of the study is to estimate the prevalence and risk factors of DPN among patients with Type 2 diabetes mellitus (T2DM) at a diabetes clinic in Benghazi Medical Center (BMC), Benghazi, Libya. Patients and Methods: Three hundred and sixty-seven patients with T2DM (127 [34.6%] males and 240 [65.4%] females) were included in this cross-sectional study. The patients aged ≥18 years, and they attended the outpatient diabetes clinics at BMC from May 2015 to October 2016, for routine follow-up. Patients with T1DM, gestational diabetes, and latent autoimmune diabetes in adults were excluded. Data including gender, age, type of DM, duration of DM, history of smoking, history of hypertension, weight, height, glycosylated hemoglobin (HbA1c), total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, creatinine, and urea were obtained by a prepared pro forma. Peripheral neuropathy was diagnosed in the presence of numbness, paresthesia, 10-g monofilament examination, and loss of vibration and joint position sensations. The relationship between DPN and its risk factors, in addition to independent predictors of DPN, was explored using multiple forward stepwise logistic regression and presented as an odds ratio (OR) and 95% confidence interval (CI). Results: The prevalence of DPN was 30.5% in the studied group. A statistical significant association found between DPN and age (P = 0.014), duration of DM (P < 0.001), macrovascular complications of DM (P < 0.001), diabetic retinopathy (P = 0.001), diabetic nephropathy (P < 0.001), poor glycemic control (high HbA1c) (P < 0.001), hypertension (P = 0.011), uncontrolled blood pressure (≥140/90 mmHg) (P = 0.007), and insulin treatment (P < 0.001). Multiple forward stepwise logistic regression analyses revealed two independent risk factors influencing DPN: diabetic nephropathy (OR = 1.976, 95% CI: 1.289-3.027) (P = 0.009) and insulin treatment (OR = 3.430, 95% CI: 2.021-5.821), (P <...

Background Dialysis adequacy is an important and effective factor in reducing mortality and morbidity among patients with end-stage kidney disease. This study aims to assess the current clinical situation of hemodialysis (HD) patients, to monitor the established quality-of-care indicators, and to identify the unachieved quality-of-care goals. Patients and methods This is an observational study in which all patients underwent chronic HD program (>1 year) at the nephrology center in Benghazi, Libya. It was conducted between January and June 2018. Mean levels were collected for the following indicators: hemoglobin, dialysis dose, serum calcium and phosphorus, parathyroid hormone, systolic and diastolic blood pressure, interdialytic hypotension, and vascular access. Results A total of 292 dialysis patients were reviewed and followed over a 6-month period. Overall, 170 (58.2%) were males and 122 (41.8%) were females. Mean age was 51.1±14 years. Hypertension was the most common cause of end-stage kidney disease in 76 (26.0%) patients followed by diabetes mellitus in 32 (11.0%) patients. Our patients failed to achieve adequate HD, as laboratory value results were as follows: mean hemoglobin level less than 10 g/dl in 61% of patients, serum Ca+2 was less than 8.4 mg/dl in 48.6%, serum PhO4 was more than 5.5 mg/dl in 50%, and serum parathyroid hormone was more than 300 ng/dl in 60.3%. Conclusion Dialysis insufficiency was seen in a significant percent of patients in this study. More extensive research studies for finding the causes of low dialysis quality are suggested.

Stroke is the second leading cause of death, accounting for 11.13% of total deaths, and the main cause of disability worldwide. According to the latest WHO data published in 2017, stroke deaths in Libya reached 3417 or 11.53% of total deaths. The age-adjusted death rate is 88.80/100,000 of population, which ranks Libya #87 in the world. [1] The major type of stroke is ischemic, which occurs in about 87% of all stroke cases. [2] According to the Global Burden of Disease (GBD) study in 2010, more than 11 million ischemic strokes occurred, whereas 63% of them were in low-and middle-income countries. Furthermore, near 3 million deaths occurred due to ischemic stroke. [3] About 13% of stroke is of a hemorrhagic type. [2] According to the GBD study in 2010, there were about 5.3 million hemorrhagic stroke cases, out of which about 80% occurred in low-and middle-income countries. Over 3 million deaths occurred from hemorrhagic stroke. [4] Stroke has different risk factors, which can be grouped into modifiable and nonmodifiable risk factors. Major risk factors for stroke include age, history of cerebrovascular event, smoking, alcohol consumption, physical inactivity, hypertension (HTN), dyslipidemia, diabetes mellitus,

Introduction: Central venous pressure (CVP) is a hemodynamic variable commonly used in the intensive care setting to estimate right arterial pressure for evaluation and monitoring a patient's volume status. Risks such as infection, arterial puncture, hematoma, and pneumothorax associated with central venous cannulation can outweigh its benefits. This study was undertaken to determine if peripheral venous pressure (PVP) predicts CVP in medical intensive care unit (ICU) patients. Materials and Methods: This study was conducted on patients admitted to the medical ICU at AlJamhoriya Teaching Hospital in the period from January to September 2009. Sixty-six patients (aged 40–70 years) who were required a central venous line (CVL) were included prospectively in the study. CVP measured through internal jugular vein or subclavian vein by three ways CVL set insertion; and CVL placement was confirmed by chest X-ray. We used the manometers for the measurement of PVP; and 66 paired recordings of CVP and PVP were made. The correlation and Bland-Altman analysis of agreement were performed. Results: The mean (standard deviation [SD]; range) CVP was 11.3778 cmH2O (±5.6; −1.0–27.0); the mean PVP was 15.80 cmH2O (±5.9; 0.0–33.0); offset (bias) of PVP > CVP was 4.42 cmH2O with SD ± 3.62. The correlation of PVP on CVP was r = 0.8059, (r 2 = 0.65), P < 0.0001. The 95% confidence intervals for the bias were 3.5352–5.3133 cmH2O. In the Bland-Altman analysis, lower and upper limits of agreement (95% LOA) were 2.7 (4.43–−7.20) and 11.63 (4.4–7.2) cmH2O. Four out of 66 points were outside the LOA. The dashed zero lies between the LOA. Conclusion: Measurement of PVP from both antecubital area and dorsum of the hand correlated with CVP measurement with acceptable agreement. PVP measurement may be a noninvasive alternative way for estimating CVP.