Abstract Introduction: The World Health Organization (WHO) Health Systems Framework (HSF) with its 6 building blocks is a widely accepted tool for accurate evaluation of health systems. However, its role in the developing world has not been widely assessed yet. Methods: Six Questionnaires with 5-point Likert-scale were designed and distributed to all the attendees of Libya Health 500 (LH500) Conference, and collected just before the group discussion of Libyan health system’s session. Results: There were high levels of agreement of the respondents to the questionnaires items about the 6 building blocks. The application of evidencebased medicine and equal provision of health service to all, received the highest levels of agreement. Most of the attendees agreed that health services should be paid by the health insurance system, as it has many advantages, including the peace of mind for the public. The fairness and efficiency of the workforce and the establishment of regulatory mechanisms to address the needs of the health workforce had a high level of agreement. Moreover, a functioning health technology requires an effective supply and distribution system of technology elements. The participants agreed that health information technology is important to improve healthcare services and to prevent financial and administrative corruptions. Conclusion: It is feasible to adapt the WHO-HSF to identify the needs and ways to enhance health systems in the developing world. The Libyan healthcare providers were fully aware and committed to the need for the applicability of the WHOHSF to the National Health Service in Libya. arabic 18 English 100
Nabil A Alagili(7-2016)

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic kidney disorders with the incidence of 1 in 1,000 births. ADPKD is genetically heterogeneous with two genes identified: PKD1 (16p13.3, 46 exons) and PKD2 (4q21, 15 exons). Eighty five percent of the patients with ADPKD have at least one mutation in the PKD1 gene and fifteen percent of the patients have one mutation in PKD2 gene. Direct sequencing of one patient and his sequence of PKD1 gene demonstrated a missense mutation GCC----CCC substitution in exon 13 with cause change amino acid of Alanine to Proline at codon 1029. Three brothers have deletion mutation in exon 15, one patient missense mutation GGC---GCC in exon 19 which cause change amino acid of Glycine to Alanine at codon 2530. Molecular diagnostics of ADPKD relies on mutation screening of PKD1 and PKD2, which is complicated by extensive allelic heterogeneity and the presence of six highly homologous sequences of PKD1. PCR strategy was used to screen sequence variants with heteroduplex analysis and several affected individuals were discovered to have clusters of base pair substitutions in exons 13 and 19 with del 20 pb (3601-3620) in exon15. arabic 14 English 81
Refaat Tabagh, Ahmed Zaid(1-2018)

Preterm neonates are highly vulnerable and most susceptible to Infections. Gram-negative bacterial (GNB) infection is an increasing problem among hospitalized neonates. It is showing periodic and geographic variations in the distribution and antibiotics resistance which necessitate continuous surveillance. In present study surveillance of Gram-negative bacterial colonization and infection among preterm neonates was carried out between July, 2008 and January, 2009 at AL Jala Hospital of Obstetric and Gynecology, Tripoli. This study aimed to determine the prevalence of Gram negative infections among preterm neonates, correlate colonization with the onset of subsequent infection, and to determine the antibiotics susceptibility of Gram-negative isolates. Surveillance swabs from mouth, nose, rectum, axilla and umbilicus were collected from 112 preterm neonates twice at first week, the first swab was taken before the preterm receive any antibiotics, then once per week. Clinical samples from preterm neonates who developed infection were collected according to the site of suspected infection. Samples transport, isolation and identification of GNB were conducted according to standard microbiological methods. Infection is the cause of death in 25% of cases. 19.6% of neonates colonized at the first day, 63.2% at third day and 66.7% at the second week. 25 of 74 colonized neonates and one of 38 noncolonized neonates developed infection. Rectum was the commonest site of colonization. A. baumannii is a permanent colonizer, K. pneumoniae and E. coli are early colonizers and E. cloacae and Pseudomonas spp. are late colonizers. Isolates specially K. pneumoniae and E. coli showed high resistance to most used antibiotics mainly ampicillin and gentamicin. 26 (23%) neonates developed infection mainly caused by E. coli and K. pneumoniae. Only eight cases using microbiological culture proved infections. In conclusion Gram-negative infection could be a major cause of death among preterm neonates. Acquisition of GNB increased with hospitalization and it is an important step in developing infection. Preterm neonates were heavily colonized at 3rd day of hospitalization by most GNB. K. pneumoniae and E. coli were found to be the most resistant strain to antibiotics and were associated with high rate of infection. Rectum could be used as a surveillance site instead of the other sites.
زينب عبد الله كريمه (2013)