The pattern of diabetic deaths in the medical wards of Tripoli Medical Centre was retrospectively studied. During a three‐year period, 575 diabetic deaths occurred, accounting for 26.2% of all medical deaths. The mean age at death was 65.33±12.7 years. Cardiovascular disease (183 [31.8%]), cerebrovascular accidents (102 [17.7%]) and infection (83 [14.4%]) were the most common complications associated with diabetic deaths. Other causes were malignancy (10%), liver cirrhosis (5.6%), and acute diabetic complications (5%). Forty‐five (7.8%) deaths unaccountable for may be due to other unknown causes. Factors predictive of mortality, such as admission diagnosis of hyperosmolar non‐ketotic state, cerebrovascular disease, acute coronary syndromes or infection were associated with poor prognosis. Admission hyperglycaemia, old age, renal dysfunction and prior stroke were also associated with poor admission outcome. The excess mortality, mainly due to atherosclerotic complications, is potentially preventable through implementation of serious approaches to the management of cardiovascular risk factors. arabic 8 English 64
Hawa Juma El-Shareif(7-2010)

Preterm infants have a high risk of neonatal white matter injury (WMI). WMI leads to reduced myelination, inflammation, and clinical neurodevelopmental deficits for which there are no effective treatments. Ionotropic glutamate receptor (iGluR) induced excitotoxicity contributes to oligodendrocyte (OL) lineage cell loss and demyelination in brain models of neonatal and adult WMI. Here, we hypothesized that simulated ischemia (oxygen‑glucose deprivation) damages white matter via activation of iGluR signaling, and that iGluR inhibition shortly after WMI could mitigate OL loss, enhance myelination, and suppress inflammation in an ex vivo cerebellar slice model of developing WMI. Inhibition of iGluR signaling by a combined block of AMPA and NMDA receptors, shortly after simulated ischemia, restored myelination, reduced apoptotic OLs, and enhanced OL precursor cell proliferation and maturation as well as upregulated expression of transcription factors regulating OL development and remyelination. Our findings demonstrate that iGluR inhibition post‑injury alleviates OL lineage cell loss and inflammation and promotes myelination upon developing WMI. The findings may help to develop therapeutic interventions for the WMI treatment.
Mohamed A. Al-Griw, Michael G. Salter, Ian C. Wood(1-2021)

In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/μL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality. 24
Nader S Shalaka(10-2015)