العدد الأول - الجزء الانجليزي
تحميل العدد كامل


Granulation/Tabletting of Highly Dosed Drugs Using Different Techniques: A Comparative Study
تاريخ النشر: 2014-12-31
عزالدين كليب (Department of Industrial Pharmacy, Faculty of Pharmacy, Tripoli University, Tripoli, Libya)
ezdink@hotmail.com

أسماء عباس (Department of Industrial Pharmacy and Medical Microbiology, Faculty of Pharmacy, Misurata University, Libya)
فرج أبوشعالة (Department of Microbiology, Faculty of Science, Misurata University, Libya)
فتحية الريشي (Department of Obstetrics & Gynaecology; Misurata Teaching Hospital Misurata-Libya)
رمضان باوه (Department of Chemistry, Faculty of Science, Misurata University)
محمد سرفراج (Faculty of Pharmacy, Misurata University, Misurata, Libya)
عبدالله جويد (Surgical Oncology Department, Misurata Cancer Center, Misurata, Libya)
وسام عبدالله الصغير (Department of Pathology, Misurata Cancer Center, Misurata, Libya)
إسماعيل أبوشعالة (Department of Pediatrics, Misurata Central Hospital)

Abstract... Paracetamol tablets and cimetidine tablets were prepared by single-step
granulation/tabletting and by compression after high shear granulation. The addition of
PVP (polyvinylpyrrolidone) was essential for single-step granulation/tabletting of
formulation containing high concentrations of paracetamol or cimetidine. Paracetamol
tablets without and with PVP obtained by single-step granulation/tabletting exhibited a
significantly higher tensile strength, a significantly lower disintegration time, a lower
friability and a faster dissolution compared to those prepared by compression after high
shear granulation. Cimetidine tablets with PVP obtained by single-step
granulation/tabletting exhibited a significantly lower tensile strength, a significantly lower
disintegration time and a faster dissolution compared to those prepared by compression
after high shear granulation. Single-step granulation/tabletting allowed to produce tablets
containing up to 80% paracetamol or cimetidine with a dissolution profile complying with
the USP requirements. For pure paracetamol or pure cimetidine the addition of
crospovidone as a disintegrant was required to obtain a dissolution profile that complied
with the pharmacopoeial requirements. Long term and accelerated stability studies of
paracetamol tablets produced by single-step disintegration time was observed, it remained
below 10 min. These results indicated that single-step granulation/tabletting could be an
efficient technique for the production of highly dosed drugs such as paracetamol and
cimetidine.


Keywords : Granulation/tableting; Dissolution; High dosage drugs; Paracetamol; Cimetidine

Prevalence of Bacterial Hemolytic Strains and Their Antimicrobial Resistance Pattern in Relation to Antibiotic Misuse by Misurata Dental Patients
تاريخ النشر: 2014-12-31

Abstract... Fifty gum infected patients were swabbed for oral cavity to report the prevalence of
heamolytic and non-heamolytic bacterial strains and their drug resistance condition against
commonly used antibiotics. Obtained results revealed the predominance of heamolytic
strains than non-heamolytic ones. In addition, both types showed high antimicrobial
resistance patterns against most tested antibiotics. Positive correlations were observed
between incidence of drug resistances and many unhealthy attributes like smoking,
infrequent teeth brushings and mainly; uncontrolled use of antibiotics. Noteworthy was also
that antimicrobial resistance was noticed mainly against amoxicillin/clavulonic acid,
cefoxitin and trimethoprim/sulphamethoxazole. This study highlighted the hazard of misuse
of antibiotics and the necessity of both controlling and awareness programs among both
physicians and community


Keywords : Antibiotic misuse; Antimicrobial resistance; Dental problems

Evaluation of the Effectiveness of Hepatitis B Vaccine among Vaccinated Adults in Misurata, Libya
تاريخ النشر: 2014-12-31

Abstract... Hepatitis B virus (HBV) is a blood-borne and sexually transmitted virus. Rates of new
infection and acute disease are highest among adults, especially medical staff. Hepatitis B
vaccination is the most effective measure to prevent HBV infection and its consequences
particularly unvaccinated adults at increased risk for infection. This study was planned to
evaluate the effectiveness of HBV vaccine among adults in Misurata city, Libya and to
identify personal factors associated with serologic evidence of the immune response. This
field trial study was conducted on 143 randomly selected adults attending Shohada
Almakasba and Central Public Dental Clinic hospitals at Misurata city during the period
from March 2013 to February 2014. They were classified into 3 catigories; 56 non health
care worker adults (30 males and 26 females), 67 medical staff member (34 males and 33
females), in addition to twenty controls (10 males and 10 females) who did not receive any
dose of hepatitis B vaccine). The hepatitis vaccine (Engerix ™ -B) used in Libyan
vaccination centers, were chosen to vaccinate the participants. Serum samples for each
participant were tested for the quantitative determination of anti-HBs antibody using
Enzyme Linked Fluorescent Assay (Biomeureux). In our study, after vaccinating the
studied group by three doses of HB vaccine, majority of them achieved a protective level of
anti-HBs (84% and 86.3% for males and females respectively). While, only 16% of
vaccinated males and 13.7% of vaccinated females showed immunoprophylaxis failure.
The percentage of negative response to the first and second dose of hepatitis-B vaccine was
41% and 27% in males and 59.3% and 47.5% in females respectively. There is a statistical
significant difference in the Mean (SD) of the expression of Hepatitis Bs antibodies titer
after 1st , 2nd and 3rd doses of vaccination from that of control group. There is a strong
negative correlation between Hepatitis Bs antibodies titre after vaccination (1st dose, 2nd
dose, 3rd dose) and age. Also there is no statistical significant difference between health
care workers and non health care groups as regard response to vaccination after1st, 2nd or 3rd
dose of vaccination. Finally, univariate analysis illustrated that there is a high statistical
significant association between age and expression of Hepatitis Bs antibodies titre. While,
other factors (gender, co-morbidity, parent vaccination, smoking habit); showed no
significant association. These results suggested that Hepatitis B vaccination is the very
effective measure to prevent HBV infection especially when given at younger age. All
adults should be vaccinated by Hepatitis B vaccine with focusing on high risk groups


Keywords : Hepatitis B virus; Vaccination; Antibodies, Univariate analysis.

Histopathological Findings in Libyan Women with Postmenopausal Bleeding
تاريخ النشر: 2014-12-31

Abstract... postmenopausal bleeding is likely due to a benign cause in woman of postmenopausal
age, but this bleeding is the most common presenting symptom of endometrial cancer and
should always be regarded with suspicion and must be evaluated at the appointed time. to
investigate the histopathological causes of postmenopausal bleeding, and estimate the
prevalence of malignancy in patients have presented with postmenopausal bleeding. we
investigated the histopathological findings in women presented with postmenopausal
bleeding by conducting a three-year retrospective study of gynecological surgical
specimens from 110 women accessed in the Department of pathology at Misurata Teaching
Hospital. the mean age for women with postmenopausal bleeding was 56.7 ± 9.8 years old
and 80.9% of them had benign pathology. Endometrial polyp was the commonest
pathology representing 46.4% of the total specimens while endometrial atrophy
representing 10.9%. Of the total cases; 5.5% had simple cystic endometrial hyperplasia.
Leiomyoma was reported in 10% of the cases associated with other pathology including
chronic nonspecific cervicitis and adenomyosis. Three patients (2.7%) were diagnosed to
have premalignant changes. The frequency of malignancy among these women was 11.8 %,
most of them reported histopathologically to have endometrial carcinoma. benign pathology
is more frequent cause of postmenopausal bleeding, but we must always evaluate and rule
out malignancy by oriented biopsy.


Keywords : Postmenopausal bleeding, Histopathological studies, endometrial carcinoma

Synthesis and Antifungal Study of Some Azo Cresols
تاريخ النشر: 2014-12-31

Abstract... Three azo cresol derivatives consisting of anthracene moiety were synthesized by
coupling 9-anthryldiazonium slat with o-, m- and p-cresols. The synthesized compounds
were screened for their antifungal activities against Aspergillus niger (A. niger). The results
were compared with two commercially available antibiotics and showed moderate to high
levels in inhibitory.


Keywords : Azo cresols, synthesized, screened, antifungal activities, Aspergillus niger

Nanoparticles as Antituberculosis Drugs: A review
تاريخ النشر: 2014-12-31

Abstract... The aim of the present review demonstrates the translational potential of
nanotechnology to address the various challenges associated with the management of
tuberculosis and improve current therapeutic strategies. Nanoparticles as a diagnostic tool
include highly sensitive nanoparticle test which can potentially address many of the
challenges outlined by the World Health Organization for the delivery of rapid and
effective point of care diagnostics. The search for pioneering therapeutic approaches based
on the use of new chemical compounds is gaining immense attention in modern therapy
because of the increasing drug resistance. Tuberculosis (TB) in humans has been described
since ancient times and its causative agent, Mycobacterium tuberculosis (MTB) is widely
disseminated. The WHO estimates that approximately one-third of the global community is
infected with M. tuberculosis. Approximately one-third of the world population is infected
with Mycobacterium tuberculosis, resulting in more than eight million new cases and two
million deaths annually. Recent implementation of the World Health Organization`s strategy
has been problematic, and TB remains a major burden in many developing countries.
Despite mass Mycobacterium bovis BCG vaccination and the development of antitubercular drugs, tuberculosis still remains a major global public health problem. However
nanotechnology has provided a huge improvement to pharmacology through the designing
of drug delivery systems able to target phagocytic cells infected by intracellular pathogens,
such as mycobacteria. The increased therapeutic index of anti-mycobacterial drugs; the
reduction of dosing frequency; and the improvement of solubility of hydrophobic agents,
allowing the administration of higher doses, have been demonstrated in experimental
infections. Future research needs to include more comprehensive characterization, quality
control and identification of antituberculars of clinical exposure with regards to
composition and threshold. This review will shower the emerging vistas taken in this surge.


Keywords : Mycobacterium tuberculosis; Antitubercular; Nanotechnology; drug resistance

Extrahepatic Cholangiocarcinoma: Experience from Misurata Cancer Center, Libya (2012-2014)
تاريخ النشر: 2014-12-31

Abstract... Twenty five patientswere registered in Misurata Cancer Center between January, 2012
and June, 2014 to haveextrahepaticcholangiocarcinoma (ECC). The median age was 52
years (range from 32-78 years). Eighteen patients(72%) were males and7 patients (28%)
were females.Fourteen patients had ECOG performance status score 0 or 1 and 11 patients
had score 2 or 3. All the patients presented with obstructive jaundice. Fifteen patients
(60%) had perihilar (Klatskin) tumors, and the remaining (40%) had distal bile duct tumors.
Twelve patients had cytological or histological confirmatory diagnosis. Six patients
underwent preoperative laparoscopic evaluation before surgery, 2 of them proved to have
disseminated peritoneal deposits and rendered inoperable.Atotal 21 patient were rendered to
have unresectable tumor due to either extensive liver infiltration (6 patients), ornon regional
LN metastasis and/or distant metastasis (15patients).Four patients underwent Whipple
surgery, one patient died due to sepsis and hemorrhage,and 3 patients remained alive till
time of analysis, one of them received 6 cycles of adjuvant chemotherapy (gemcitabine and
cisplatin) due to lymph node metastasis. Of the remaining 21 patients, 18 patients
underwent biliary stenting guided by ERCP (16 patients) or PTC (2 patients). The bilirubin
was normalized in 15 patients. A total of 13 patients received palliativechemotherapy,
gemcitabine/cisplatin regimen. The total number of chemotherapy cycles was 67 cycles
(range from 2-9 cycles per patient). Eight of 13 patients (61.5%) who received
chemotherapy had any ≥ grade 3 (severe) toxicity. The most common severe chemotherapy
toxicities were neutropenia (6 patients 46%), anemia (4 patients 31%), thrombocytopenia (3
patients 23%), neutropenic fever (2 patients 15%), nausea and vomiting (3 patients 23%),
and lethargy( 2 patients 15%).Complete response (CR) was achieved in 1 patient (7.6%),
partial response (PR) in 3 patients (23%) and stable disease (SD) in 5 patients (38.4%)
while 4 patients (31%) had disease progression (DP) during therapy.The median
progression free survival (PFS) was 4.4 months. The median overall survival (OS) was 8.4
months.


Keywords : Cholangiocarcinoma, Gemcitabine, Cisplatin

Diffuse Large B-cell Lymphoma with Clear Cells Morphology: A rare Variant
تاريخ النشر: 2014-12-31

Abstract... Diffuse large B-cell lymphoma is a rare type of non-Hodgkin lymphoma composed of
diffuse proliferation of large neoplastic B lymphoid cells with a nuclear size equal to or
exceeding the normal macrophage nuclei. It has become clear that diffuse large B-cell
lymphoma is not a uniform category. Several recognizable variants have clinically distinct
features and, frequently, require specific treatment approaches. Recognition of these
variants and utilization of the appropriate treatments will improve the outcome for the
patients. We report a case of a clear cell variant of diffuse large B-cell lymphoma
involving a lymph node in the neck, which was clinically suspected of being metastatic
carcinoma. A 50-year-old Libyan woman from Misurata presented with cervical
lymphadenopathy and rapidly enlarging retrosternal mass which radiologically was 15.0 x
7.0 cm. Core biopsy of the cervical mass was performed at Misurata Cancer Center (MCC).
The biopsy showed a malignant infiltration exhibiting diffuse areas comprising large cells
with slightly irregular nuclei and clear cytoplasm admixed with a few mononuclear cells. In
these areas, there was high mitotic activity, staining for cytokeratins was negative. These
areas had the following phenotypes: cluster designation marker 20 (CD20) positive, CD10
positive, B-cell lymphoma (Bcl)-2 positive, Bcl-6 positive, CD5 negative, CD3 negative,
melanoma marker (S100) negative, cytokeratin-7 negative, and exhibited a high mitotic
index marker (Ki-67= 80%). According to the immunohistochemical (IHC) findings, we
concluded that this patient has a clear cell variant of diffuse large B-cell lymphoma of
germinal cell type. Our patient is undergoing R-CHOP chemotherapy


Keywords : Cancer; B-cell lymphoma; Cell morphology; Cytokeratins.

The Association of Childhood Asthma and Breastfeeding and Other Independent Risk Factory
تاريخ النشر: 2014-12-31

Abstract... The aim of the study is to investigate the association of breastfeeding duration and
incidence of childhood asthma in misurata central hospital. To assess the effect of positive
family history (first degree), L.B.W, indoor smoking, socioeconomic states (maternal
education, family income) and the race in developing bronchial asthma. This study is
carried out in pediatric department and follow up clinics at misurata central hospital. Study
population was children who came to the hospital with different complain. Study carried
out during period of 6 months and special questionnaire was done as mentioned later on.
Study population divided to the 2 main groups; first group (children who have asthma) that
studied with different risk factor second group (children who have no asthma). Among the
studied groups, the incidence of childhood asthma is as a high as 23% of non breastfeed
babies compared to as a low as 7% of babies who were breastfeed for one year or longer.
Effect of other Risk factors on incidence of asthma were as follows: 1) 32% of the asthma
cases were attribute to the low birth weight; 2) children with environmental tobacco smoke
(ETS) exposure (39%) had higher incidence of asthma than did those from smoke free
homes; 3) there is no consistent correlation between family income and incidence of
asthma, asthma was equal in both girls & boys, the incidence was higher among Hispanic
children than whites & blacks and it was highest in the age group between 1-5 years; 4)
27% of patients had positive family history and 36% of patients had other atopic disorders.
The results of this study shows that breast feeding and in particular longer duration is
protective against childhood asthma, So New mothers should be encouraged to breast feed
as long as possible, since never breast feeding, breastfeeding for less them 3 moths (1-90
days) may be an independent risk factor for childhood asthma. Low birth weight children
and exposure to environmental tobacco smoke (ETS) are considered to be important
independent risk factors for development of later childhood asthma, so restrictive measures
should be taken to avoid any factor which leads to LBW infants and any steps to stop
smoke. There is no consistent relationship between childhood asthma and socioeconomic
state


Keywords : Childhood asthma; Breastfeeding duration; LBW; Socioeconomic state; Risk factors; Family history of asthma.

Diffuse Large B-cell Lymphoma with Clear Cells Morphology: A rare Variant
تاريخ النشر: 2014-12-31

Abstract... Diffuse large B-cell lymphoma is a rare type of non-Hodgkin lymphoma composed of
diffuse proliferation of large neoplastic B lymphoid cells with a nuclear size equal to or
exceeding the normal macrophage nuclei. It has become clear that diffuse large B-cell
lymphoma is not a uniform category. Several recognizable variants have clinically distinct
features and, frequently, require specific treatment approaches. Recognition of these
variants and utilization of the appropriate treatments will improve the outcome for the
patients. We report a case of a clear cell variant of diffuse large B-cell lymphoma
involving a lymph node in the neck, which was clinically suspected of being metastatic
carcinoma. A 50-year-old Libyan woman from Misurata presented with cervical
lymphadenopathy and rapidly enlarging retrosternal mass which radiologically was 15.0 x
7.0 cm. Core biopsy of the cervical mass was performed at Misurata Cancer Center (MCC).
The biopsy showed a malignant infiltration exhibiting diffuse areas comprising large cells
with slightly irregular nuclei and clear cytoplasm admixed with a few mononuclear cells. In
these areas, there was high mitotic activity, staining for cytokeratins was negative. These
areas had the following phenotypes: cluster designation marker 20 (CD20) positive, CD10
positive, B-cell lymphoma (Bcl)-2 positive, Bcl-6 positive, CD5 negative, CD3 negative,
melanoma marker (S100) negative, cytokeratin-7 negative, and exhibited a high mitotic
index marker (Ki-67= 80%). According to the immunohistochemical (IHC) findings, we
concluded that this patient has a clear cell variant of diffuse large B-cell lymphoma of
germinal cell type. Our patient is undergoing R-CHOP chemotherapy


Keywords : Cancer; B-cell lymphoma; Cell morphology; Cytokeratins.