Tripolitana Medical Journal

Hyperuricemia in Libyan Patients with Cardiovascular Diseases

Aisha Dugani — 2025-06-03

Hyperuricemia is a metabolic disorder characterized by elevation of uric acid (UA) in the blood. It is associated with a range
of commodities including gout, cardiovascular diseases (CVDs), kidney disorders, metabolic syndrome, and diabetes, among
others.
The goal of the study is to look into possible risk factors for hyperuricemia, specifically the possible impacts of age, gender, body
mass index (BMI), diabetes, and the use of various antihypertensive drugs on the incidence of hyperuricemia in Libyan patients
who also have cardiovascular disease.
In all, 59 patients with various CVDs were involved in the study. Each participant’s sociodemographic and health-related
lifestyle factors were recorded (age, BMI, diabetes, smoking, alcohol consumption). Serum urea, uric acid, triglycerides, serum
creatinine, low density lipoprotein were all measured. Patient’s complaint of hyperuricemia (urinary stones, arthalgia, arthritis,
or asymptomatic) was also recorded.
Thirty-three women (54.9%) and twenty-six men (41.1%) with hyperuricemia and cardiovascular disease, ages 28–86,
were recruited for the research. In 59.3% of cases, hypertension was the most prevalent cardiovascular illness, followed by
hypertension/heart failure with 13.6%.
Hypertension was the most common cardiovascular disease (59.3%), followed by hypertension/heart failure (13.6%). The
majority of patients with hyperuricemia (93.2%) had no complaints (asymptomatic), and kidney stones were recorded in
only 6.8%. Unknown cause of hyperuricemia was reported in 49.2%, drug-induced in 45.8%, and renal causes in only 8.5%.
The most frequently used drugs in these patients were thiazide diuretics, loop diuretics, and calcium channel blockers (23.7%,
22%, and 18.6%, respectively).This study adds to the growing body of research on the relationship between cardiovascular
disease and hyperuricemia. Our results regarding the asymptomatic nature of hyperuricemia, the prevalence of diabetes and
hypertension, and gender differences are consistent with previous studies. Our findings highlight the importance of regularly
testing uric acid levels in patients with cardiovascular disease to avoid complications, even in the absence of symptoms.

Effects of Oxytocin on Parkinson’s like symptoms Induced by Haloperidol in Mice

Suhera Aburawi — 2025-06-03

Antipsychotic drugs are mainly used for treatment of psychosis; they are more prone to produce extrapyramidal symptoms due
to their higher affinity to dopamine (D2) receptor, and they act as antagonists. Haloperidol as a high-affinity dopamine antagonist
predisposed toward a higher risk of extrapyramidal side effects. These adverse neurologic responses include catalepsy,
ptosis, akinesia and tremor. Oxytocin is a peptide hormone of the posterior pituitary gland; several studies had suggested
that oxytocin has broader effects on the central nervous system. Oxytocin regulates social behaviors, pain perception, anti
inflammatory responses, stress reduction and blood pressure modulation. It acts as a hormone in the peripheral circulation
and a neurotransmitter in the central nervous system. Recent research suggests that oxytocin may alter the progression of
neurodegenerative diseases due to its anti-inflammatory and antioxidant properties. Oxytocin may provide neuroprotection as a
potential therapy for neurodegenerative diseases. Therefore, this work aimed to find out the effects of oxytocin on Parkinson’s
like symptoms induced by haloperidol in mice. Mice were divided into six groups (n=6 each). Group 1, the control group
received 1% Tween 80 solution; group 2 treated with haloperidol at a dose of 2 mg/kg; group 3 received oxytocin at dose of 1iu/
kg; group 4 received oxytocin at dose of 10 iu/kg; group 5 received combination of oxytocin (1 iu/kg) and haloperidol (2 mg/kg)
and group 6 received combination of oxytocin (10 iu/kg) and haloperidol (2 mg/kg). Intraperitoneal sub-acute administration
was applied in three doses on 24, 5 hrs. and 1 hr. before scoring. Parameters scored were catalepsy, ptosis, tremor, akinesia and
righting reflex. Oxytocin at a dose of 10 iu/kg antagonized ptosis, akinesia and catalepsy induced by haloperidol; while loss of
righting reflex and tremor were not observed.

Breastfeeding Knowledge, Attitude, Practice and Influencing Factors among Libyan Women in Tripoli City: A Cross Sectional Study

Awatef Samud — 2025-06-03

Exclusive breast feeding is considered the first contact between the mother and her infant. A community based cross-sectional
study was conducted in Tripoli city during July - September 2022 to evaluate the knowledge, attitude and practice of Libyan
women toward breastfeeding and to assess the factors associated with them. A total of 380 mothers, randomly picked and
interviewed, were shared in this study. Our data showed that, 32.63% of mother’s initiates breastfeeding immediately after
delivery, 28.42% were breast feeders up to 3-6 months, 22.89% did continue breastfeeding for 12 months and 56.58% starts use
of supplementary food 4-6 months of baby age. Among them 25.26% were reported to be exclusive breast feeders, 66.05% were
mixed feeders and 8.68% were practicing only infant formula feeding. In addition, 40% of women know that breastfeeding is
a contraceptive natural method and has benefits to both infants and mothers. The majority of women realized that breast milk
digested more easily than infant formula and increases mother’s relationship with her child. About half of mothers (48.68%)
have good knowledge about colostrum and acknowledge its benefit. Mothers agreed that breast milk possesses all the essential
nutrients required for infants and protect them from infection. Nonetheless, there were certain factors interfered with exclusive
breastfeeding including mothers believed that had insufficient milk by 29.39%, and there is no enough privacy for breastfeeding
in work places by 12.10%. Also, short maternity leaves, to somehow, created a negative impact on breastfeeding.
There is no difference between participants’ demographics and feeding plan regarding type of delivery, number of children and
education level of mothers. There is a need for programs that support and encourage for breastfeeding focusing on younger
mothers, and for providing facility items at work places to rise the duration of breast feeding and the percentage of breast feeder
mothers

Prophylactic Bilateral Internal Iliac Artery Ligation in Placenta Praevia Increta and Percreta Could Prevent Hysterectomies and Massive Blood Transfusion

Najwa Eljabu — 2025-06-03

Worldwide, caesarean section delivery is considerably increased; this resulted in increase in cases of pathological placental
adhesion which in turn has increased burden on obstetric units. Internal iliac artery ligation (IIAL) has been recommended as an
efficient means of managing intractable PPH and preventing maternal death. To evaluate the efficacy of prophylactic bilateral
hypogastric arteries ligation on maternal outcome in diagnosed cases of morbidly adherent placenta.
This retrospective study was carried out in a high risk pregnancy unit, Alryan private clinic and Gharian teaching hospital, Libya,
from April 2018 To Jan 2019.
A total of 65 patients diagnosed by color Doppler with an abnormally adherent placenta praevia were studied; 52 (52/65 = 80.3%)
of these patients presented with antepartum hemorrhage and 13 were diagnosed accidentally during routine ultrasound scanning
(Table 1). Sixty-two (95%) patients had undergone previous single or multiple CS. There was a history of previous placenta
praevia in two patients. Pregnancy was terminated in six patients because of antepartum hemorrhage before 36 weeks, whereas
59 patients (90.7%) completed their pregnancy beyond 36 weeks. Bilateral internal iliac artery ligation was performed in all
patients with morbid invasive placenta (59/65 = 90.7%), whereas uterine artery ligation was performed in five patients (6/65 =
9.23%) in who placenta praevia was not pathologically adherent. Satisfactory hemostasis was achieved in 54 patients (54/65 =
83%), whereas additional uterine compression suture was performed in one patient (1/22 = 4.5%). Hysterectomy was performed
in five patients with placenta praevia increta (6/22 = 27.2%) complicated by intraoperative uncontrollable hemorrhage (Table 2).
The mean intraoperative blood loss was 1255 ± 589 mm3. Blood transfusion was recorded in 49 patients (49/65 = 75%) during
the operation and in two patients (3/65 = 4.6%) on the first day after the operation. 9.8 + 1.3 and 31.4 + 2.3 are the results of
mean haemoglobin and hematocrit respectively one day postoperatively.
Abnormal placentation such as placenta accreta or increta is a potentially life-threatening hemorrhagic condition that carries a
high rate of maternal morbidity and mortality. Prophylactic bilateral internal iliac artery ligations before extraction of placenta
accrete seemed to be an effective and safe technique to decrease intrapartum and postpartum complications, and to avoid
emergent peripartum hysterectomy

Prevalence and Antibiotic Resistance of Enterobacteriaceae in Urinary Tract Infections: A Retrospective Study at Secondary Healthcare Center-Tripoli, Libya

Abdulkarem Tamer — 2025-06-03

Urinary tract infections (UTIs) are prevalent bacterial infections that affect millions globally and lead to significant morbidity.
UTIs are classified as uncomplicated or complicated, with various risk factors and causative agents, primarily uropathogenic
Escherichia coli (UPEC).
This study aims to determine the prevalence and antibiotic resistance patterns of Enterobacteriaceae in UTI patients at AL
Nokhba Medical Clinic, Tripoli, Libya.
A retrospective, observational study was conducted from September 2021 to September 2023, including patients with positive
urine cultures. Antibiotic susceptibility was tested using the disc diffusion method.
Out of 220 positive urine cultures with significant bacterial growth, 191 samples were identified as Enterobacteriaceae. The
most common pathogens were Klebsiella spp. (62.3%) and Escherichia coli (33.5%). Multidrug-resistant Enterobacteriaceae
(MDRE) constituted 16.75% of the samples. MDRE showed a high resistance rate to amoxicillin-clavulanic acid and third
generation cephalosporins, compared to carbapenems and fosfomycin.
The study highlights the prevalence of Enterobacteriaceae in UTIs and the significant antibiotic resistance, emphasizing the need
for appropriate empirical therapy based on local antibiogram data. Regular surveillance of microbial prevalence and resistance
patterns is crucial for guiding effective treatment.