Acinetobacter baumannii is an opportunistic pathogen causing various nosocomial infections. The aim of this study was to characterize the molecular support of carbapenem-resistant A. baumannii clinical isolates recovered from four hospitals in Tripoli, Libya. Bacterial isolates were identified and antibiotic susceptibility testing was per-formed using automated system. Carbapenem resistance determinants were studied phenotypically using two dif-ferent techniques: E-test; chromogenic culture media. Polymerase chain reaction (PCR) amplification was used to determine the presence of bla OXA23 and blaOXA51 genes among isolates. A total of 119 isolates were characterized, overall the resistance prevalence was extremely high for aminoglycosides (79-96.6%), fluoroquinolones (94-96%), cephalosporins (96.6-100%) and carbapenemes (93.2-100%), all isolates were susceptible to colistin. In addition, 97.5% of isolates were identified as multidrug resistance (MDR). Varying degree of phenotypic detection of car-bapenemes was determined; highest levels of carbapenemes were detected using chromogenic media (76.5%) com-pared with E-test (45.4 %). The carbapenem resistance-encoding genes detected were blaOXA23 (84%) and blaOXA51 (73.1%); the highest occurrence of blaOXA23 was demonstrated in Tripoli’s Central Hospital (5/5; 100%) then in Tripoli Medical Center (44/51; 86.27%). The co-occurrence of these genes was demonstrated in (75/119; 63%) showing dissemination of carbapenemes resistance MDR A. baumannii in hospitals. This study shows that the high prevalence of OXA-23 contribute to antibiotic resistance in … arabic 14 English 113
Nada Elgrew, Abdulla Bashein(1-2016)

Background: The metabolic syndrome (MS) is defined as a cluster of cardiovascular risk factors, including central obesity, dysglycemia, hypertension (HPN), elevated triglycerides (TGs), and reduced high-density lipoprotein cholesterol (HDL-C). MS increases the risk of cardiovascular disease and all-cause mortality. Objective: This study aims to estimate the prevalence of MS and its components among nondiabetic Libyan females using the definition proposed by National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Methods: A total of 122 randomly selected nondiabetic Libyan females were included in the study. Detailed medical history was obtained from all participants. Blood pressure, weight, height, waist and hip circumference were measured. Body mass index and waist–hip ratio were calculated. Fasting blood glucose (FBG) and lipid profile were collected. Standard oral glucose tolerance test with 75 GM glucose was performed. The MS was defined by ATP III and International Diabetes Federation criteria. Results: According to NCEP definition, the prevalence of the MS in the study group was 42.6%. The most common component was abdominal obesity (67.2%). FBG was ≥ 100 mg/dl in 47.5%. The prevalence of both HPN and low HDL-C was 45.9%. About 26.2% of the participants have their TG ≥ 150 mg/dl; all were MS patients. Conclusions: The prevalence of MS and cardiovascular risk factors were high among Libyan females. Public health authorities and health-care providers should implement strategies for prevention, screening, and management of cardiovascular risk factors to reduce the burden of its potential complications
Hawa Juma El-Shareif(4-2018)

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)