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West Nile virus (WNV) is a globally significant mosquito-borne Flavivirus that causes West Nile disease (WND). In Libya, evidence of WNV circulation has been reported in humans but never in animals. The aim of this study was to determine the seroprevalence of WNV infection in horses and dogs in Libya. In total, 574 and 63 serum samples were collected from apparently healthy, unvaccinated horses and dogs, respectively, between 2016 and 2019. A commercially available competitive enzyme-linked immunosorbent assay (c-ELISA) kit was initially used to test the collected samples for the presence of WNV Ig-G antibodies. Positive and doubtful sera were also tested using a more specific virus neutralisation assay to confirm whether the ELISA-positive results were due to WNV or other Flavivirus antibodies. The seroprevalence of WNV IgG antibodies according to ELISA was 13.2% out of 574 of total horses' samples and 30.2% out of 63 of total dogs' samples. The virus neutralisation test (VNT) confirmed that 10.8% (62/574) and 27% (17/63) were positive for WNV-neutralising titres ranging from 1:10 to 1:640. Univariable analysis using chi-square tests was conducted to measure the statistical significance of the association between the hypothesized risk factors including city, sex, breed, and age group and were then analyzed using the subsequent multivariable logistic regression model for horse samples. Age group was found to be the only significant risk factor in this study. The results of the present study provide new evidence about WNV circulation in Libya. [ABSTRACT FROM AUTHOR]

Background: There is a scarcity of data on thyroid function abnormality in coronavirus disease 2019 (COVID-19) outpatients in the world literature since previous studies were done on admitted patients. Aim: The objective of this study was to assess thyroid function tests in Libyan outpatients with COVID-19 as well as the possible association between them and some routine hematological, inflammatory, and biochemical markers. Methods: Laboratory results were retrospectively reviewed for a total number of 246 patients, where 214 patients with laboratory-confirmed COVID-19 and 32 non-COVID-19 patients were included in the study as a control group. The majority of the patients were females 179 (72.8%) and age range between 18 and 88 years old. They were registered in the outpatient department of COVID-19 at Zaweit-Dahmany Polyclinic in Tripoli, Libya between May and October 2021. Serum levels of thyroid-stimulating hormone, thyroid hormones (THs) [triiodothyronine (T3), thyroxine (T4), and free fractions], complete blood count, C-reactive protein (CRP), lactate dehydrogenase (LDH), liver function test, and renal function test were measured. Results: Abnormal thyroid function was seen in 17.8% of 214 patients with COVID-19. Twelve patients had isolated low total or free triiodothyronine (FT3), suggestive of nonthyroidal illness syndrome, ten patients had hypothyroidism that was subclinical in six patients and overt in the remaining four patients. Three patients had hyperthyroidism. Thirteen patients had different isolated THs abnormalities. Low FT3 was associated with older age (p = 0.035), and it has a weak negative correlation with CRP (−0.335) and LDH (−0.245) (p = 0.001). The thyroid dysfunction (TD) group presented a statistically significant reduction in lymphocytes (p = 0.000), increased neutrophil (p = 0.000), increased CRP (p = 0.000), increased urea (p = 0.014), increased alkaline phosphatase (p = 0.007), a slight reduction in hematocrit (p = 0.010), low mean corpuscular volume (p = 0.019), and low mean corpuscular hemoglobin (p = 0.019) but no significant difference in hemoglobin, red blood cells, white blood cells, and platelet count when compared to euthyroid control. Conclusion: Clinicians should be vigilant about the possible presence of thyroid function abnormalities among COVID-19 patients, especially elderly patients, and those with increased inflammatory markers. [ABSTRACT FROM AUTHOR]

This study was undertaken to determine the accuracy of splenic palpation for the diagnosis of splenomegaly, and to determine whether the frequency of individuals with a palpable spleen in an endemic area can be considered as an index of morbidity of schistosomiasis. For the clinical diagnosis of splenomegaly, two criteria have been tested: (A) presence of a palpable spleen and (B) presence of a palpable spleen whose border could be felt more than 4 cm below the costal margin. In an area of high prevalence of the disease (66.3%) 285 individuals aged 18 years or more have been submitted to abdominal ultrasonography and physical examination. Splenomegaly was defined as a splenic length greater than 120 mm by ultrasound and the sensitivity, specificity, positive and negative predictive values of criterion A were 72.2%, 90.5%, 35.1% and 97.8%. The values for criterion B were 27.8%, 98%, 50% and 95%, respectively. In an non endemic area, 517 individuals were submitted to the same protocol and 22 individuals had a palpable spleen, but no patient fulfilled criterion B for splenomegaly, and only one met the ultrasonographic criterion for splenomegaly. The authors concluded that abdominal palpation is a poor method for the diagnosis of splenomegaly.

West Nile virus (WNV) is a globally significant mosquito-borne Flavivirus that causes West Nile disease (WND). In Libya, evidence of WNV circulation has been reported in humans but never in animals. The aim of this study was to determine the seroprevalence of WNV infection in horses and dogs in Libya. In total, 574 and 63 serum samples were collected from apparently healthy, unvaccinated horses and dogs, respectively, between 2016 and 2019. A commercially available competitive enzyme-linked immunosorbent assay (c-ELISA) kit was initially used to test the collected samples for the presence of WNV Ig-G antibodies. Positive and doubtful sera were also tested using a more specific virus neutralisation assay to confirm whether the ELISA-positive results were due to WNV or other Flavivirus antibodies. The seroprevalence of WNV IgG antibodies according to ELISA was 13.2% out of 574 of total horses' samples and 30.2% out of 63 of total dogs' samples. The virus neutralisation test (VNT) confirmed that 10.8% (62/574) and 27% (17/63) were positive for WNV-neutralising titres ranging from 1:10 to 1:640. Univariable analysis using chi-square tests was conducted to measure the statistical significance of the association between the hypothesized risk factors including city, sex, breed, and age group and were then analyzed using the subsequent multivariable logistic regression model for horse samples. Age group was found to be the only significant risk factor in this study. The results of the present study provide new evidence about WNV circulation in Libya.

Opportunistic diseases in HIV-infected patients have changed since the introduction of highly active anti-retroviral therapy (HAART). This study aims at evaluating the frequency of associated diseases in patients with AIDS admitted to an university hospital of Brazil, before and after HAART. The medical records of 342 HIV-infected patients were reviewed and divided into two groups: group 1 comprised 247 patients before HAART and, group 2, 95 patients after HAART. The male-to-female rate dropped from 5:1 to 2:1for HIV infection. There was an increase in the prevalence of tuberculosis and toxoplasmosis, with a decrease in Kaposi's sarcoma, histoplasmosis and cryptococcosis. A reduction of in-hospital mortality (42.0% vs. 16.9%; p = 0.00002) has also occurred. An agreement between the main clinical diagnoses and autopsy findings was observed in 10 out of 20 cases (50%). Two patients with disseminated schistosomiasis and 2 with paracoccidioidomycosis are reported. Overall, except for cerebral toxoplasmosis, it has been noticed a smaller proportion of opportunistic conditions related to severe immunosuppression in the post HAART group. There was also a significant reduction in the in-hospital mortality, possibly reflecting improvement in the treatment of the HIV infection.