Libyan Medical Journal

Serum Calcium to Magnesium Ratio in Preeclamptic Women: A Cross-Sectional Study

Zina Abdullah Hussein — 2023-02-24

Preeclampsia is a syndrome that adversely affects maternal and fetal outcomes. Despite extensive re-search, PE's exact pathogenesis is still uncertain. Micronutrients like calcium (Ca) and Magnesium (Mg) hemostasis were linked to many adverse health issues, including PE Herein, we aimed to verify the role of Calcium, Magnesium, and Calcium to Magnesium Ratio among PE cases vs. healthy controls for a possible application in preventive approach. The study enrolled 81 pregnant women whose age and body index matched and divided into two groups; PE cases and healthy controls. Their demographic, urine, and serum Calcium, Magnesium was compared. Analysis showed serum Ca2+ level, mean serum Ca2+-Mg2+ratio in the patients was considerably lower than in controls; P=0.01 and P=0.04, re-spectively. Reduced Mg levels were recorded only in PE cases. Correlation confirmed a positive cor-relation with maternal age and is inversely linked with gestational age, Ca 2+, Mg2+, and Ca2+-Mg2+ ratio. The diastolic blood pressure was negatively correlated to the Ca2+-Mg2+ ratio. Defining mi-cronutrients during pregnancy and how this may affect maternal health is a promising avenue for PE prevention. Micronutrient profiling might help characterize preeclampsia prevention options.

The Role of Thiamine in the Management of Refractory Hy-poxemia, Refractory Hypotension and Shock in Critically Ill Covid-19 Patients

Usama Bensaad — 2023-03-13

Dear editor, we would like to share you our experience regarding the management of re-fractory hypoxemia, refractory hypotension and shock in critically ill Covid-19 patients. We believe that, one of the main causes of the deterioration of Covid-19 patients could be malnutrition with vitamins depletion from the body. Many of these patients presented with loss of appetite and taste accompanied with poor oral intake for several days or even weeks. This will deplete the body resources from Macro-& micro-nutrients especially thi-amine, which can be deficient in 3-14 days particularly if the patient is already malnour-ished, taking anti-thiamine products (as coffee, tea), receiving Total Parenteral Nutrition (TPN), on Continuous Renal Replacement Therapy (CRRT), or had a bariatric surgery. From the daily practice, we have noticed that refractory hypoxemia, refractory hypoten-sion, or septic shock is exaggerated by Thiamine deficiency.

Anatomical Variations of Sphenoid Sinus Pneumatization in Libyan Adults Using Computed Tomography (CT) Scan

Menetallah El Gaddafi — 2023-04-28

Background and aims. With the help of endoscopic endonasal transsphenoidal approaches, lesions at the base of the skull can easily be accessed. The air in the nasal cavity and sphenoid sinus provides a physiological pathway for these procedures. Many factors determine the safety and course of action of the process. These include the anatomy of the patient’s sphenoid sinus and skull base. Knowledge of the different anatomical variants of this sinus may help predict and prevent complications as the extent and pattern of sinus pneumatization vary from person to person. The main aim of this study is to initially determine the anatomical variations of the sphenoid sinus pneumatization in the Libyan population. Methods. This retrospective study included computed tomography scans from 141 subjects attending healthcare centers in Benghazi, Libya, from May 2021 to March 2022. Their ages ranged from 18-80 years old, with a male-to-female ratio of (1.17:1). They were assessed for their type of sphenoid sinus based on the Güldner classification. The variability in the nature of the inter-sphenoid septum was also determined. Results. The most common types of sphenoid pneumatization were the sellar (54.6%) and postsellar (31.2%). Extensions of pneumatization were seen in the greater wing of sphenoid, pterygoid process, and anterior clinoid process in 39%, 33.3%, and 18.4% of patients, respectively. The in-tersphenoid septum was most frequently shown to be single, specifically in the midline with lateral de-viation. Conclusions. The pneumatization of the SS is variable among the Libyan population. The clinical and surgical significance of the anatomical variants has been discussed, highlighting the need for a thorough preoperative evaluation of the sinus.