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Sitagliptin is a drug used in treatment of type 2 diabetes mellitus. Incretin hormones, including glucagon-like peptide-1 analogue and dipeptidyl peptidase-4 inhibitor have recently been found to regulate glucose metabolism. Thus, the aim of this study was to evaluate the effect of sitagliptin on glycemic control and it is associated side effects in Libyan patients with type 2 diabetes, who had inadequate response to existing anti-diabetic drugs. Hundred patients with a known history of type 2 diabetes were recruited in this study during the period of 2019 and 2020. Sitagliptin (100 mg daily) was added on to the pre-existing therapy for type 2 diabetes and the main outcome measures were a change from the base line in glycated hemoglobin and fasting plasma sugar as well as the incidence of symptomatic hypoglycemia. All patients were engaged from outpatient clinic of National Diabetes and Endocrinology Center at Tripoli, Libya. The findings show that the actions of dipeptidyl peptidase-4 inhibitors improve glycaemic control in the patients, and glycated hemoglobin as well as fasting plasma sugar. Thus, sitagliptin is a profound drug for a comprehensive treatment of patients with type 2 diabetes with a low incidence of hypoglycemia.

Background: The World Health Organization (WHO) recommended exclusive breastfeeding for the first six months of life, and continued breastfeeding until the age of 2 years and even beyond depending on the mother's wishes. Objective: Assess the knowledge of mothers on the practice of exclusive breastfeeding. Patients and Method: This was a prospective and descriptive study for 4 months from July 2019 to October 2019 performed in the pediatrics department of N’Djamena Mother and Child University Hospital about mothers’ knowledge and practice of exclusive breastfeeding. Studied variables were: profile of breastfeeding mothers, profile of infants, and type of breastfeeding and mothers' knowledge of exclusive breastfeeding. Results: 203 Mothers were interviewed. The age group from 20 to 30 years represented 70%. Mother’s characteristics were: married (97%), housewives (64.5%), unschooled (35.5%). Infant’s characteristics were: male (55.7%), mean age (27.29 days). Predominant breastfeeding was the main type of breastfeeding with 50.2%. Hypogalactia was the main reason for mixed or artificial breastfeeding with 22.1%. Lack of milk flow was the main reason (23.1%). One hundred and forty-four mothers (70.9%) had not received any information about exclusive breastfeeding. According to 32% of mothers, exclusive breastfeeding was of no benefit. The majority of mothers (91.6%) knew the sign of an effective breastfeeding. Conclusion: Breast milk is better and more suitable than any other replacement milk for newborns and infants. The overall results of our survey show that the exclusive breastfeeding is only practiced in a small proportion.

No Abstract

Polycystic ovary syndrome (PCOS), also known as the Stein-Leventhal syndrome, is one of the most prevalent endocrinopathies amid women of reproductive age. Hyperinsulinemia in combination with pancreatic beta cell dysfunction consequences in an augmented risk of numerous diseases, including type 2 diabetes, hypertension, dyslipidemia, endothelial dysfunction, atherosclerosis and cardiovascular diseases. Insulin also encourages the theca cells of the ovary to make excessive testosterone, which is responsible for the clinical manifestations of hyperandrogenism, 200 Sudanese housewives with fertility problems joined in the study, 39.5% of them exhibited polycystic ovarian syndrome. Further studies are required with large sample size.

Background and objective: The Laryngeal Mask Airway-Supreme is a single-use supraglottic airway device that offers gastric access. The present study compares the safety and efficacy of LMA Supreme with Endotracheal tube (ETT) in adult patients undergoing laparoscopic procedures. Methods: In this prospective study eighty patients of either sex, ASA grade I & II, were randomly assigned to LMA-Supreme and ETT for airway management and intraoperative ventilation. After induction of general anesthesia, devices were inserted, correct placement was verified, airway leak was noted, and a gastric tube was inserted. Insertion success rates and time, ventilatory capability, efficacy of seal, risk of gastric distension and hemodynamic responses were investigated. Results: The insertion of LMA-S was comparatively easier and required lesser time for insertion than ETT.Ventilation parameters and airway pressure during peritoneal insufflations, for LMA-S and ETT were comparable.LMA-S and ETT show similar efficacy during laparoscopic surgery with controlled ventilation. No gastric distension or signs of regurgitation were detected in both groups. The hemodynamic responses to insertion and removal were greater for the ETT than LMA-S.Complications or pharyngo-laryngeal morbidity was less with LMA-S as compared to ETT. Conclusions: The LMA-S is a safe, efficacious and easy-to-use, supraglottic airway device during general anaesthesia for normal as well as laparoscopic procedure. It provides a functional airway seal with minimum adverse events.

Background: Pancytopenia is an important clinicohaematological entity encountered in our day to day clinical practice. Pancytopenia refers to reduction in all the three major formed elements of blood, red blood cells, white blood cells and platelets. It’s not a disease entity but a triad of findings that may result from a number of disease processes primarily or secondarily involving the bone marrow. The severity of pancytopenia and the underlying pathology determines the management and prognosis of patient. Objective: To study the etiopathology of pancytopenia, spectrum of haematological changes in various causes of pancytopenia. Methods: Study carried out on the patients admitted in the Dept. of Medicine, VIMSAR, Burla who had HB<10mg/dl, TLC <4000/cmm and Platelets <1lac/cmm. Haematological and other investigations: CBC, Peripheral smear examination, Reticulocyte count, Urine routine & microscopy, Renal function test, Serological investigation, Blood culture, HIV, HBV, HCV, Abdominal USG, Serum electrophoresis was done. Bone marrow aspiration using standard method was done whenever indicated avoiding the cases where causes of pancytopenia was obvious. A written informed consent obtained from all the patients after fully explained the purpose and procedure. Results: The observations are based on 100 cases of pancytopenia reported on routine haematological investigation in the Department of Medicine of VIMSAR, Burla having male to female ratio 0.92:1. 62% of patients presented with fever, easy fatigue were the 2nd most common complain present in 57%. Primary or idiopathic aplastic anemia was the most common etiological factor followed by malaria and sepsis which was sharp contrast with most of other study conducted in our country. Conclusions: Pancytopenia is not an uncommon haemotoligical problem encountered in clinical practice and should be suspected on clinical ground when a patient presents with unexplained anemia, prolonged fever and tendency to bleed.