Prevalence, distribution, characteristics and associated factors of molar-incisor hypo-mineralisation among Libyan schoolchildren: a cross-sectional survey.

BACKGROUND AND AIM: This study aimed to assess the prevalence and clinical status of molar incisor hypomineralisation (MIH) and other enamel defects and associated factors in Libyan children. METHODS: A cross-sectional survey of a randomly selected sample of 8- to 10-year-old Libyan school children was conducted in the city of Benghazi, Libya in 2019. The children were assessed for the presence of MIH and enamel defects according to EAPD evaluation criteria. The survey was supplemented by a questionnaire, completed by parents, about potential associated factors occurring before, around and after birth. Association with risk indicators was assessed using chi-square and Mann-Whitney U tests. RESULTS: One thousand forty-seven children returned complete questionnaires and attended the clinical examination, with 87% response rate. MIH was the most common form of enamel defects, affecting 162 (15.5%) children. The average number of MIH affected teeth was 3.54 (SD = 1.82). There were no statistically significant associations between the prevalence of MIH and health or demographic characteristics except for the history of early childhood health problems (P = 0.047). CONCLUSIONS: In Libyan children, MIH appeared to be the most prevalent type of enamel defects affecting 15.5% of the participants. Although not statistically significant, MIH appeared to be associated with prenatal, perinatal and post-natal challenges.

Disseminated Cryptococcus neoformans in a cirrhotic patient.

Disseminated cryptococcal infection often occurs in the setting of an immuncompromised patient. We report a case of disseminated Cryptococcus neoformans in a cirrhotic patient, referred for Orthotopic Liver Transplantation evaluation due to acute hepatic decompensation.

A liver transplant center experience with liver dialysis in the management of patients with fulminant hepatic failure: a preliminary report.

Among extracorporeal liver support devices, liver dialysis is cleared by the U.S. Food and Drug Administration to be used for the management of fulminant hepatic failure (FHF). The outcomes of patients following liver dialysis need to be clearly evaluated. Among the 25 patients with FHF admitted to the Liver ICU between May 2000 and November 2002, 12 underwent liver dialysis, including 6 men and 6 women, of mean age 32 years. The causes of FHF were identified as acetaminophen (n = 10), herbal medications (n = 1) and autoimmune disease (n = 1). At presentation, the mean total bilirubin was 9.35 mg/dL (range, 0 to 1.3), mean ALT 3015 U/L (range, 0 to 48), mean AST 3457 (range, 0 to 42), mean ammonia 98 micromol/L (range, 10 to 60) and mean INR 1.88. A control group including 13 patients (2 men and 11 women), of mean age 27.8 years mean total bilirubin 5.66, mean ALT 3494, mean AST 3528, mean ammonia 113 and mean INR 3, were not treated with liver dialysis, due to the lack of machine availability or physician's choice. The causes of FHF were acute hepatitis B (n = 1), acetaminophen (n = 10) or unknown (n = 2). There was no statistically significant difference in the baseline characteristics of the two groups (P >.05). Among the liver dialysis group, 1 patient died, 2 underwent OLTx, and 9 were discharged home. Among the control group; 4 patients died, 2 underwent OLTx, and 7 were discharged home. Preliminary results seem to support survival benefit among patients who underwent liver dialysis compared to non-liver dialysis; however, further randomized control trials are warranted to verify this observation.

Fulminant hepatic failure and the potential role of liver dialysis.

Fulminant hepatic failure (FHF) carries a high mortality. We aimed to review the prognostic factors and explore the potential role of Liver Dialysis (LD). Fifty-two patients were reviewed. The etiologies were acetaminophen toxicity (33%), viral hepatitis (18%), autoimmune (10%), idiosyncratic drug reactions (8%), others (6%) and undetermined (25%). Patients with acetaminophen had a significantly higher survival compared to the non-acetaminophen group (p=0.04). Patients with grade 3 encephalopathy had a mortality of 68%, among 5 patients with grade IV encephalopathy, 2 survived and both had had treatment with LD. Chi-square with Fisher's exact test was used for statistical analysis. Our study confirmed that the diagnosis of non-acetaminophen induced FHF and reduced initial serum factor V level are associated with fatal outcome. Timely OLT significantly improved the survival. The role of LD in hepatic regeneration or as a bridge to OLT needs to be further studied with prospective control trials.

The course of pregnancy among mothers above 35 years and its outcome in Kafr-El-Zayat.

A group of pregnant mothers above 35 years old were collected from the MCH centre in Kafr-El Zayat during a period of 10 months (82). A control group of mothers aged 20-30 years old were also selected during the same period (62). Those with specific diseases from both groups were excluded. During the repeated visits of those mothers to the MCH centre they were subjected to complete history taking, physical examination plus urine analysis & haemoglobin levelling. A special visit was performed by the researcher to the mothers on 7th day after labour to report on the outcome of labour. The present study revealed significant differences between mothers over 35 years and those of 20-30 years in the course of pregnancy, labour and their outcomes where the former group showed greater tendency to be at a higher risk.

Serum gastrin in chronic renal failure: morphological and physiological correlations.

Elevated serum gastrin (SG) has been reported in chronic renal failure (CRF). We studied SG levels in relation to various humoral and gastroduodenal histopathologic findings in 20 controls, 12 uremics under conservative therapy (CT), 27 patients on regular dialysis (RDT) and 8 transplanted patients (Tx). SG and parathyroid hormone (PTH) levels were estimated by radioimmunoassay (RIA), in addition serum BUN, creatinine, Ca++PO4---and alkaline phosphatase (predialysis in RDT) were determined. 20 patients (12 on CT and 8 on RDT) underwent pentagastrin (PG) stimulation test and upper gastrointestinal endoscopy with biopsy of gastric and duodenal mucosa. The mucosal samples were stained for mucopolysaccharides (MPS), nucleic acid (NA) and alkaline phosphatase (AP), and divided into intense, normal or faint staining. Mean SG was 688.71 pg/ml (CT cases), 636.2 pg/ml (RDT cases) and 280.6 pg/ml (Tx cases), all values being significantly higher than controls (118.46 pg/ml). SG level had a linear correlation with serum creatinine in CT patients and predialysis creatinine in RDT patients, but not with other parameters studied (BUN, Ca++,PTH,PO4---AP). The incidence of gastroduodenal erosions (40%) had a significant negative correlation with SG. They were more frequent with normal MPS stain (p = 0.01) and NA staining (p less than 0.001) than faint staining of gastric mucosa biopsy. The acid response to PG stimulation was inversely correlated with SG. We believe that elevated SG is compensatory to a decreased response of the gastroduodenal mucosa to PG. Mere retention of SG does not explain its elevation as its correlation with serum creatinine existed not only in patients on CT, but also in RDT patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Phosphomonoesterases in the male genital system of some mammals.

The various male genital organs of the experimental animals used in this investigation (rat, guinea pig, rabbit, cat and dog) showed a widely different localizations of alkaline and acid phosphatases. Alkaline phosphatase was presented as secretory, stromal, nuclear and vascular, while with acid phosphatase, distinction was made only between secretory and nuclear phosphatases. Although the morphological distributions of both enzymes were sometimes overlapping, they were not identical.