ABSTRACT Chronic rheumatoid arthritis (RA) is a systemic inflammatory disease that leads to cartilage and bone erosion. Untreated disease is linked with joint deformity and substantial health care related costs. Conventional disease-modifying anti-rheumatic drugs (DMARDs) are the main tool to treat any form of RA. Methotrexate (MTX) is the key conventional DMARDs. It is recommended as a first-line treatment for patients with RA. However, MTX is potentially associated with various toxicities. No clear pattern of MTX use in patients with RA in Libya, since no national guideline has been implanted so far. The aim was to investigate the prescribing patterns of MTX in Libya. A hundred and twenty patients who were on treatment with MTX and follow up in RA clinic of Tripoli University hospital were evaluated for therapy during the period of 2018 and 2019. Patient distribution data, disease duration, other related diseases and drug prescribed as well as adverse drug reactions were considered to analyze the pattern of drug use. The demographic distribution findings indicate that female patients are more than male patients and the ratio of disease among female to male was 1:9. A range of age between 41 - 60 years was the highest affected compared with other ages. Among of these about 75% of patients were no occupational works. RA related diseases were found to be more with diabetes mellitus, hypertension and osteoporosis. Low use of NSAIDs in this group of patients but with high use of steroid. A high group of patient's use of low dose of MTX for up to five years. This study concludes that MTX is an effective drug in controlling the disease with less and tolerated incidence of side effects. 

Abstract: Sitagliptin is a drug used in treatment of type 2 diabetes mellitus. Incretin hormones, including glucagonlike 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.

Abstract: The most effective treatment for severe acne is isotretinoin. However, it carries major side effects as teratogenicity, dryness, lipid profile disturbance and constipation. Although it is commonly prescribed with and without prescription in Libya, little date are available regarding patients understanding and awareness of isotretinoin. Aims: This study was conducted to explore the awareness of acne patients about the use of isotretinoin. It aims to measure how much acne patients know about the side effects of the drug especially the teratogenic effects, how to deal with them and how the drug influence their daily activities. Plus, to identify how patients get their information about the drug and whether they consult professional or ordinary people. Methods: A verified and validated questionnaire addressed to acne patients (n = 50, Sept. - Dec., 2019) who were under and over 20 years of age in Tripoli city was used in this study. Results: Data shows that acne patients do not have enough information about the drug. They take their information from other patients and do not usually consult doctors or pharmacists. The only side effects that the patients complained from are dryness. In addition, they are not aware that this drug can cause teratogenic effect. Conclusion: A good understanding and awareness the Libyan patients about isotretinoin help in increasing compliance and minimize adverse effects. 

Abstract: Hypertension is a challenge for public health professionals all-over the world. It is the leading and most important modifiable risk factor for coronary heart disease, congestive heart failure, stroke, renal diseases, retinopathy and many other diseases. The aim of the present study is to evaluate and study the most identifiable risk factors for patients with diseases of hypertension and diabetes mellitus such as age, gender, marital status, tobacco smoking, life style and with associated diseases (dyslipidemia and diabetes) treated at city hospital in Tripoli (Tripoli Medical Centre). This was a cross sectional prospective study which was carried out during October 2013 and January 2014. The study included 200 consecutive patients (102 females and 98 males) who are older than 30 years and who came for a regular follow up at the OPD of Tripoli medical centre. During this study, variables like age, gender, diabetes, smoking and dyslipidemia were taken into account in relation to hypertension. In addition, it is assorted some important biochemical parameters such as total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein and fasting blood glucose in the studied population and compared them with available data. The findings revealed that Libyan population not only old age and male gender are potential threat for an early hypertensive but other variables like diabetes, cardiovascular diseases, dyslipidemia, obesity, migraine and obstructive apnea are also playing an important role in hypertension complications. It is concluded that this population is more prone to hyperglycemia and high pulse pressure with hypertension in the majority of survey population

 Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and 

its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects 

of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. 

CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. 

Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more af￾fected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince 

(P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm 

workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have 

occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult 

CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face 

(P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of ro￾dents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Be￾ing engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL 

suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species 

responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species re￾sponsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.