Lebda Medical Journal

The contents of total phenolic, flavonoid, and antioxidant activity of ethyl acetate extract of Juniperus phoenicea L. (Cupressacees) leaves growing in East Libya

2021-12-12

Background: the harmful effect of antioxidative stress can be inhabited by the natural antioxidants present in many medicinal plants. These plants contain compounds including phenolics and flavonoids responsible for reducing the effects of free radicals, that can be used as a substitute to treat many diseases.

Aim: This study aims to quantitively determine the total phenolic contents (TPC), total flavonoids contents (TFC), and the reducing power assay of ethyl acetate extract leaves extract of Juniperus phoenicea L. plant. Juniperus is a member of the Cupressaceae family which has been used as a folk medicine in Libya. the plant was collected from the Al-Jabal Al Akhdar area, east Libya.

Methodology: The powdered dried leaves of Juniperus were extracted continuously by the Soxhlet extractor, the extract was obtained and evaporated to dryness by a rotatory evaporator. The extracts were investigated for reducing power and the presence of phenolic and flavonoid compounds. The TPC was determined using the colorimetric method, expressed as pyrogallol equivalents and the absorbance was measured at 765 nm. The TFC was determined calorimetrically and the results were expressed as quercetin equivalents and the absorbance of color was determined at 510 nm. While the reducing power was measured spectrophotometrically at 700 nm, ascorbic acid was used as standard and expressed as (Âµg/ml).

Results: the levels of TPC, TFC, and reducing power increased with increasing concentration of extract.

Conclusion: The extracted contents of phenolic compounds, flavonoid compounds, and reducing power were lower than the standard pyrogallol, quercetin, and ascorbic acid respectively.

Necrotic Encephalitis associated with a Toxoplasma-like Protozoan Infection in Lambs

2021-12-18

Introduction: A total of 32 young (1-3 months-old) lambs suffered from mortal neurological signs in a period of three months. The lambs were among the offspring of a herd of 300 sheep, in Tarhouna city, Libya. The affected lambs were initially treated with antibiotics, multivitamins and mineral supplements, however, none of these treatments attenuated the death toll among the small lambs.Â

Methods: Three lamb carcasses were submitted to the National Center for Animal Health (NCAH) for post mortem examination. Gross pathological examination of the brains detected hydatid cysts and yellowish lesions within the cerebral cortex.

Results: The histopathologic examination of the brain showed the presence of inflammatory lesions and necrotic features surrounded by granulomatous inflammatory patterns, which are accompanied by a few parasitic cysts. Ordinary and modified Ziehl-Neelsen stains for bacterial infection were performed, but the results did not strongly indicate bacterial infection. Toxoplasmosis, particularly T. gondii, and Neospora were first suspected. Immunohistochemistry testing for T. gondii did not show any conclusive indication for the presence of this pathogen. However, meticulous microscopic examination (100x) of the histopathologic features and the patterns of host-pathogen interaction of toxoplasmosis indicate that these lambs may have suffered from necrotic encephalitis associated with a different type of toxoplasmosis.

Role of Combination Therapy on no-reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction.

2021-12-12

Background: No-reflow is a complex process with multiple pathogenetic components that may lead to major complications and higher mortality in patients with ST-segment elevation acute myocardial infarction (STEMI) after performing percutaneous coronary intervention (PCI).This study aims to evaluate the role of combination treatment in the prevention of occurrence of no- reflow and major cardiac adverse effects in patients with STEMI undergoing primary PCI. Subjects and methods:This is an interventional study including 100 patients with STEMI who underwent emergency primary PCI and had a high risk of no-reflow (no-flow score â‰¥ 8), patient were randomly divided into a controlled group (n = 50) received conventional treatment, and a combination therapy group (n = 50) received high dose 80mg atorvastatin pre-intervention, platelet membrane glycoprotein IIb/IIIa receptor antagonist (tirofiban, 10Î¼g/kg bolus followed by 0.15 Î¼g/kg per minute) and thrombus aspiration. Six months follow up recording of major adverse cardiac events.

Results: No-reflow was detected in3/50 cases (2.8%) in the combination therapy group versus 38/50 cases (35.2%) in the control group. TIMI grade 3 was found in 46 patients (92%) versus in 32 patients (64%) p=0.008. While MBG â‰¤ 1 was (14/50) 28% vs (15/50) 30% p=0.18 in the combination therapy group versus control group respectively. MACE at six months 9 events (18%) in the combination therapy group, versus 19 events (38%) in the control group p= 0.03. Conclusion: combination therapy with thrombus aspiration, high-dose statin and platelet membrane glycoprotein IIb/IIIa receptor antagonist prior to pPCI reduces the incidence of no- reflow, and major cardiac adverse events in patients with acute ST-elevation myocardial infarction.

Comparison between the breast preserving surgery and the ordinary breast surgery on breast oncoplastic surgeries in National Cancer Institute\ Misurata- Libya

2021-12-25

Objective: to determine the breast cancer recurrence rate, complications, and aesthetic outcome of breast oncoplastic surgery among patients managed in National Cancer Institute\Misurata-Libya (NCI) that they underwent breast oncoplastic surgery(BOS) also to analyze the results between two patients groups underwent breast reconstruction with Lattissimus Dorsi(LD) flap in 1st group and Transverse Rectus Abdominus Myocutaneous(TRAM) flap in 2nd group.

Methods: Retrospective study of 56 patients in oncological surgery department In the NCI between 1st January 2014 to 30th December 2018, have been included. In the study period, a total of 56 cases of breast cancer underwent BOS. 11 patient underwent modified radical mastectomy (MRM) with LDMF reconstruction and 17 case underwent modified radical mastectomy(MRM) with TRAM flap, 26 case underwent breast preserving surgery(BPS), 2 cases presented with phyllodes tumor and managed by subcutaneous mastectomy and implant reconstruction. Early results show acceptable cosmetic results of these cases.

Results: The most occurred complications in both groups (LD&TRAM ) are wound infection, hematoma & partial flap necrosis. In conclusion, we find that LD flap is a safe and low-morbidity technique with a relatively low complication rate.

Conclusion: Oncoplastic breast surgery combines the principles of surgical oncology with those of plastic and reconstructive surgery and our initial experience shows that BOS leads to aesthetically pleasing and oncological sound results.

Mucosal Brucella Infection in Human: a case report study during Covid-19 pandemic

2021-12-29

Brucellosis in human is an uncommon disease in Libya and usually diagnosed by serological assays. The clinical symptoms of this disease in many times are none specific and vague. This report describes a case of clinical human brucellosis in Libya. The patient was a sixteen years old girl, lives in a rural area. She was suffering from intermittent fever for several days associated with chills, mild cough, and headache. The patient had history of occasional drink of goatâ€™s raw milk during the previous two months. She had no history of travel abroad and direct animal contacts. Comprehensive physical examination revealed the patient was generally unwell, pallor and, had tenderness and mild hepatosplenomegaly. Laboratory investigations revealed that the patient had pancytopenia (low number of blood cells count) and a marked increase in C-reactive protein (CRP), Procalcitonin (PCT), Lactate dehydrogenase (LDH), Aspartate transaminase (AST). Viral screen tests were non-reactive for HCV, HBs Ag, HIV and covid-19. Provisional diagnosis on admission time was acute leukemia or aplastic anemia with common microbial infection. Empirical antibiotic (Meropenem 1 gm) was prescribed intravenously every eight hours for seven days. The patient was also given antipyretic, IV fluid hydration, and one unit of packed red blood cells. Following that, bacterial growth in aerobic blood culture was noticed and it was Gram-negative coccobacilli, non-motile. The bacterium was positive for catalase, oxidase and urease tests. It could not clearly be identified by phoenix bacterial identification system. It was provisionally diagnosed Haemophilus spp., but as it was able to growth on blood agar plate, it was finally diagnosed as Brucella spp. and that was confirmed by collection of patient serum and performing Rose-Bengal pate test (RBPT) as was significantly increased (1:640). The patient general condition was improved and blood count recovered over one week. The patient was then discharged and asked for routine follow ups during the next six months.