Background: Asthma is a multidimensional disease with noticeable heterogeneity in its presentation and reaction to treatment. Noninvasive biomarkers to determine disease progression are highly desirable. This study sought to identify fractional exhaled nitric oxide (FeNO), FeNO as a prognostic biomarker for asthma exacerbations, as well as a predictive biomarker for change in other known asthma indicators. Materials and Methods: A prospective, longitudinal study was conducted with a cohort of adult patients with severe asthma who required daily treatment with inhaled corticosteroids. Patients underwent lung function testing using spirometry, sputum samples were taken for inflammatory cell count, and sputum supernatant and exhaled respiration were taken for FeNO, FeNO measurement. Forced expiratory volume levels were measured, along with immunoglobulin E (IgE), eosinophil count, asthma-specific health-related quality of life, asthma-exact signs scores, and time to treatment failure. These indicators were measured over the 22-week study period. Results: A total of 1800 participants were recruited, 56.7% were female, and 70% of the participants were aged 18–27 years. FeNO was valuable prognostic biomarker for asthma exacerbations, along with forced expiratory volume in 1 s reduction. A greater quantity of eosinophils was correlated with a reduced risk of exacerbation in females, with no correlation in males. Elevated serum IgE levels were correlated with an increased risk of lung fibrosis. We found no significant relationships between the investigated indicators and hospitalization. Conclusion: FeNO, in conjunction with other biomarkers, is a useful prognostic indicator of exacerbations of symptoms in asthma patients.

Background: The blood group refers to the blood grouping system and their specificity which is genetically determined; however, the “blood phenotype” describes the reactivity of blood to specific testing antiserum. Although racial and regional variations have been established in the prevalence of the blood groups, most of these studies were done among blood donors, but the blood transfusion recipients who actually need these transfusions have been poorly studied. This study seeks to determine the common blood groups encountered among blood transfusion recipients in Federal Medical Centre (FMC), Birnin Kudu. Materials and Methods: This study was a retrospective analysis of the blood grouping pattern among blood transfusion recipients in FMC, Birnin Kudu over a 2-year period from January 2011 to December 2013. Blood grouping is determined commonly using venous blood through tile agglutination method. Standard commercially produced anti-A, anti-B monoclonal grouping reagents and anti-D sera are used for the tests and performed at room temperature. Evidence of agglutination is substantiated microscopically after waiting for 2 min. Results: There were 4129 blood requests during the study period; however, 28 of the entries were excluded due to grossly incomplete data. Among the 4101 entries analyzed, there were 1206 (29.4%) males and 2895 (70.6%) females; male/female ratio of 1:2.4. Blood group O (44.1%) was the most common blood group whereas blood group AB (5.9%) was the least; however, majority (96.2%) of the recipients were rhesus positive. Conclusion: Group O and rhesus positive antigens remain the most common blood group distribution among blood transfusion recipients.

Background: Dyslipidemia covers the broad spectrum of lipid abnormalities. Subclinical hypothyroidism (SCH) is a clinical status of mildly elevated serum thyroid-stimulating hormone (TSH) levels with normal levels of free T4 and free T3. Aims: The aim of this study was to examine the impact of SCH in patients with dyslipidemia in Gaza City, Palestine. We also aimed to investigate the associations between TSH and lipid profiles. Settings and Design: In a case–control study, a total of eighty individuals are involved in the study, of them forty were patients with dyslipidemia and forty were healthy individuals who represented the control group. Patients were examined and diagnosed by a physician in the dyslipidemic clinic, Palestinian Medical Relief Society in Gaza Strip. Materials and Methods: Blood sample collected in plain tubes for the preparation of serum. The serum TSH, total cholesterol (TC), high-density lipoprotein (HDL), and triglycerides levels were measured using standardized assays. A prepiloted questionnaire was used to collect the demographic data and information about family history of dyslipidemia and remove fat from meat. Statistical Analysis Used: Data analyses were performed using the Statistical Package for the Social Sciences (SPSS) software (version 17). Continuous data were expressed as a mean ± standard deviation, whereas categorical data as number (%). Odd ratios were calculated using Win Episcope to find the association between selected variables and dyslipidemia associated with SCH.P < 0.05 was considered statistically significant. Results: Patients with dyslipidemia manifested significant higher TSH compared to controls (P = 0.049), whereas triiodothyronine and tetraiodothyronine levels were not showed significant differences between cases and controls. Moreover, TSH level was positively correlated with TC (r = 0.445,P = 0.000) and low-density lipoprotein-cholesterol (r = 0.415,P = 0.000) but negatively to HDL-cholesterol (r= -0.422 andP = 0.000). Logistic regression analysis showed that female, smoking, and positive history of dyslipidemia were risk factors for SCH in study participants. Conclusions: Findings from the present study reflect the association of dyslipidemia and SCH. The patients in case group showed significant lipids' alteration and higher TSH when compared to controls. Moreover, this study reported a strong relationship between dyslipidemia and clinical hypothyroidism.

Background: The relationship between pharmaceutical companies and health-care professionals has become a matter of debate and criticism concerning the real objectives and the potential impact on providing ethical and professional care of medicines. The aim of this study is to investigate the influences of pharmaceutical marketing on perceptions of physicians and pharmacists on their rational prescribing and health profession. Methods: A descriptive (noninterventional study), cross-sectional survey study conducted in Khartoum State during the period of September 15, 2013 TO March 20, 2014. Questionnaire was designed for this purpose and distributed to physicians and community pharmacists on a random basis. Results: Of the 200 doctors surveyed, 77 (38.5%) were physicians and 123 (61.5%) were pharmacists. Nearly 53.8% of physicians and 44.6% of pharmacists thought that they moderately influenced personally by pharmaceutical promotion. The main factors that affecting the prescribing behavior of physicians through their practice were product safety and effectiveness, i.e., 83 (76.9%) and the frequent visits by medical representatives about 54 (50.0%). While the main factors making the pharmacists ordering the product that is they have been prescribed 85 (78.7%) and the quality of the product 68 (63.0%). Discussion: The study shows that a variety of techniques were used to influence the prescribing and use of medicines such as free medical samples, gifts, journals, and direct marketing. The key role of these techniques is to increase the number of prescriptions. However; many health professionals underestimate the effects of pharmaceutical promotion on their beliefs and professional practice and believe that they are not personally influenced by promotion. Conclusion: The current quantitative study strongly suggests that the absence of regulated pharmaceutical promotion and competition results in the negative influence in the professional behavior and thus rational prescribing and use of medicines.

Background: Asthma remains an increasing cause of morbidity and mortality in adults, especially in developing nations. In Libya, no previous study has reported the diagnosis of asthma among adults. The primary objective of this work is to validate the diagnosis of asthma through a survey questionnaire for adult Libyans, by using a digital spirometer as a recommendation to diagnose asthma. The specific objective of this study included the search for a correlation between asthma symptoms and its diagnosis. Materials and Methods: An adapted International Study of Asthma and Allergies in Childhood questionnaire was distributed to 1800 participants >18 years. Results: Females comprised 56.7% of the sample. Pulmonary function tests (spirometry) were performed on respondents who reported wheezing and chest tightness at rest and during daily activity. Approximately, 17.6% of the participants reported having wheezes during the past 12 months, while 18.4% had chest tightness at rest and during daily activities. A significant correlation was found between wheezing and chest tightness (P < 0.001). About 44% of the participants showed a positive reversibility test. Conclusion: Chest tightness at rest and wheezing are more reliable for diagnosing asthma. The city of Sirte in Libya requires the establishment of the common pollens which trigger asthma.