Background: Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients. Objectives: The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. Materials and Methods: The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. Results: The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs & platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (P<0.01) decrease, and MCV was a significant (P<0.01) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (P<0.05) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (P<0.01) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (P<0.01) positive correlation was recorded between uric acid with platelets count. A significant (P<0.05) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (P<0.01), creatinine, and uric acid, and Hb (P<0.05). A significant (P<0.01) negative correlation was observed between blood groups with serum uric acid. A significant (P<0.01) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (P<0.05) negative correlation was recorded between durations of hemodialysis with body weight, and MCHC. Conclusion: It can be concluded that a higher prevalence of moderate, normocytic hypochromic anemia among hemodialysis patients. Also, results showed a significant variation in hematological parameters among the anemic hemodialysis patients. So, hemodialysis patients advice to examine the hematological parameters and treated from anemia if detected.Full article

Background: Cigarette smoking is one of the 10 greatest contributors to global death and disease. Cigarette smoking is the most common type of tobacco use. In average, to date 47.5% of men and 10.3% of women are current smokers. Tobacco continues to be the second major cause of death in the world. It consists of many chemicals, including cytotoxic, carcinogenic and free radicals, therefore it affects many organs if not all. Objective: The aim of this study is to assess the extent of adverse effect of cigarette smoking on blood pressure, liver function, and hemoglobin concentration in male population on the West Coast of Libya. Methods: This study was conducted on (200) healthy male subjects, their ages ranged from 15 to 85 years. They were divided into four groups; 50 non-smokers as control group (age between 15-35 years), 50 smokers (age between 15-35 years), 50 non-smokers as control group (age between 36-84 years) and 50 smokers (age between 36-84 years). The blood was collected in EDTA tubes to test the Complete blood count (CBC) and in plain tubes for biochemical assay (activities of liver enzymes). The Blood pressure of subjects was measured directly after sample collection. Result: The blood pressure among the group of age 36-84y was significantly higher (P < 0.05) when compared between the smokers and the nonsmokers group, while among the group of age 15-35 was not significant. The results of liver enzymes activities among the group of age 36-84y showed that ALT and ALP were significantly high (P <0.05) in the smoker group when compared with the nonsmoker group, while serum AST was not significant (P>0.05). However, among the group of age between 15-35 years, the results showed that statistically significant differences (P<0.05) were observed in ALT and AST activities for the smoker group when compared with the nonsmoker group. Regarding RBCs count and hemoglobin concentration among both of groups (age between 15-35 & 36-84 years), the results showed that a significant difference in mean RBCs count and hemoglobin concentration were noted between the smokers and the nonsmokers. Conclusion: It can be concluded that exposure to cigarette smoking leads to an increase the blood pressure. Cigarette smoking can lead to an increase in liver enzymes activities, RBCs count and Hb concentration.Full article

Introduction: Stroke is associated with high mortality. It is the main neurological cause of mortality and the most important cause of disability worldwide. In the year 2007, Stroke was the third cause of admission at the Korle-Bu Teaching Hospital, and the number one cause of death. Objective: To determine the probability of survival (case-fatality rates) of stroke patients admitted at the Korle- Bu Teaching Hospital during the period 2007. Method: A Retrospective descriptive study of Surgical/Medical Emergency, SME and the Medical wards admissions and discharges from 1st January 2007 to 31st December, 2007. Results: A total of 250 hospitalized stroke patients were identified, of which 68(27%) were from the SME and 182(72%) from the medical wards. The mean age (SD) was 57.6(14.7) and 52% were males. Case fatality rate was 52% at the SME versus 35% at the Medical wards) whilst the risk of death in males expressed as risk ratio (RR) was 2.1, (95% CI 0.70-5.6) vs. RR=1.3, (95% CI 0.73-2.5) in females and the median survival time was 2days (95% CI 1.5-2.4) versus 7 days (95% CI 6.3-7.6) at the SME and Medical respectively. The type of admission and stroke outcome was significant P=0.01 (95%CI 0.02-0.14). Conclusion: Stroke was associated with high mortality. The risk of dying from stroke was higher at the SME Findings were independent of stroke subtype, stroke onset and any associated co-morbidities.Full article

Exercise is an important factor of rehabilitation in heart failure patients, improving several indicators of disease prognosis and functional capacity. The aim of the present study was to examine the effect of a cardiorespiratory rehabilitation program on the physical and mental fatigue, general health and anxiety in patients suffering from heart failure. Thirty-one patients with heart failure [(M±SD) age: 67.59±7.60 years] participated in a cardiorespiratory rehabilitation program. The program included aerobic exercise on cycle ergometers and muscle strengthening for 3 months (12 weeks), 3 times/week. Before and after the program, patients' fatigue, general and mental health were assessed using the following self-reported questionnaires: a) Fatigue Assessment Scale (FAS), b) Goldberg's General Health Questionnaire (GHQ-28) and c) Spielberger's Anxiety Questionnaire. Data analysis showed a statistically significant tendency of reduction in social dysfunction (from 1.99±0.42 to 1.75±0.45, p=0.05), while anxiety (from 27.10±7.61 to 26.40±4.35) showed no change (p>0.05).Also, evaluating the changes in the health level after attending the program, there was a trend of improvement in physical activity and functioning with the appearance of fewer physical symptoms (from 1.38±0.43 to 1.24±0.31, p=0,13). These results show that exercise can contribute to increasing the general well-being of these patients and reducing feelings of helplessness, making them able to cope with their daily activities and tasks.Full article

Alterations in the cardiac electrical system are the cause of morbidity and a wide variety of symptoms – from mild to those requiring urgent intervention – because of the risk of sudden cardiac death. The most prevalent of these types of electrical disturbances is atrial fibrillation, the incidence of which is growing as the average age of the human being increases. Among many other electrical heart alterations is one I describe in this document: "The presence of short PR and QTc intervals together in the same ECG tracing”. Methods: A cardiac calibrator was used by four different cardiologists in blinded fashion to document a distinct ECG pattern, that of a short PR and QTc intervals together in the same ECG tracing from more than 2.500 cases assessed for this condition (more than two thousand five hundred cases evaluated since 2.007 to date). Results: Here we describe the clinical features of 330 patients with a documented short PR and QTc intervals together in the same ECG tracing along with descriptions of their symptoms and ancillary investigations. Conclusions: ECG tracing must be studied carefully in patients with suggestive symptoms before declaring normal an ECG tracing with certain defined characteristics.Full article

An arrhythmia, or abnormal heart rhythm, usually means that the heart is beating too fast, too slowly, or irregularly. Few people do not feel discomfort when they notice that their heart is beating faster or irregularly or if they feel their heart pounding in their throat. Arrhythmia is an abnormal heart rhythm. The heart is controlled by a conduction system that transmits electrical impulses. This causes the heart to beat. This system works automatically, so outside of human will. The heart generally works rhythmically throughout life.Full article