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.

Background: Hypoparathyroidism is the most common complication after thyroidectomy and the main reason for frequent outpatients' visits; however, there is a poor understanding of its outcomes, and no clear follow-up strategies are available. We aimed to evaluate the frequency and risk factors of post-thyroidectomy hypocalcemia hypoparathyroidism in Libyan patients. Methods: A case series study was conducted. The serum calcium and parathyroid hormone level (PTH) were measured at least 8 months post thyroidectomy. Results: 124 patients were reviewed in this study; 19 (15.3 %) were males and 105 (84.7 %) were females. 30.6 % of males and 13.7% of females developed hypocalcemia and hypoparathyroidism. Total thyroidectomy (TT) was performed in 62.9 % of all patients, while 24.2% of all patients underwent near total thyroidectomy (NTT). 12.1% of all patients underwent bilateral subtotal thyroidectomy (BST) and 1 patient underwent hemi thyroidectomy (0.8%). The risk of hypocalcemia was higher in patients with malignant thyroid disease in comparison to benign thyroids (45.8 % vs. 27% of patients). Papillary thyroid carcinoma (PTC) was the most common cause of both hypocalcemia and hypoparathyroidism (45.5% for both) followed by Graves' disease (22.2% and 14.8% for hypocalcemia and hypoparathyroidism respectively). Hypocalcemia and hypoparathyroidism were more frequent in patients who underwent TT (19.2%), as compared to patients who underwent NTT (6.6 %). Among nine patients who were operated on twice, three patients had hypocalcemia, and two of them were found to be hypoparathyroid; one case is diagnosed with Graves' disease, while the other was diagnosed as PTC. Conclusion: Total thyroidectomy, and re-operation are associated with increased prevalence of permanent hypocalcemia and hypoparathyroidism when compared to less extensive thyroid resection modes.

No abstract

Self-harm is a major public health concern, with community studies reporting a lifetime risk of 13%-18%, [1] it is a key risk factor for suicide, and it is important to have contemporary information on the extent of risk [2] and is relatively common among young people with prevalence rates in adolescent samples which range from 6.9% to 15.9%. [3] One review of the literature showed that 13.2% of adolescents reported engaging in self-harm at some stage in their lives. [4] Voluntary drug intoxication is a major medical and social problem in most countries all over the world. It is expected to be 10-20 times more frequent than suicide. Conventionally, it has been more common among females than males, but some recent studies showed similar rates across genders and even higher rates among males. [5] The incidence varies from 4% in Taiwan [6] to 13.8% in Australia. [7] The objective of the present article is to record all cases of drug intoxication defined as voluntary drug overdosing or taking of toxic substances voluntarily, hospitalized to the medical department. Moreover, we have studied the incidence rate and distribution in terms of age, gender, marital status, employment, type of toxic substance, outcome, and the causes.