Criminal Violence in Libya: A Descriptive, Autopsy-Based Study of Deaths by Firearms in Tripoli

Abstract The uprisings in some Arab states during the past several years developed into armed conflicts. Therefore, the incidence of violent crimes has become more common with no reliable data on their patterns. The present study aimed to estimate the magnitude of that problem by studying the frequency and pattern of firearm deaths in Tripoli, Libya. A retrospective descriptive study of autopsy cases of firearm deaths was conducted. The data was retrieved from medico-legal reports of cases that were referred to the Forensic Medicine Department of the Judicial Expertise and Research Center, Ministry of justice, Tripoli, Libya during two years from the 1st of January 2014 to the end of December 2015. Structured data sheets were produced. Out of 4,342 unnatural deaths that were autopsied, 774 cases (17.82 %) were due to firearms. Males were commonly targeted. The mean age of victims was 31.7 ± 11 years with significant predominance in the middle age group. Incidence of firearm deaths in non-Libyans increased in 2015 to 8.5%. Homicidal cases represented 92.12% of cases. There was a significant relationship between manner of firing and sex (p ≤ 0.001). In 95.9% of cases, the firing was from a far range. Rifled weapons were used in 98.32% of cases. Head and neck were targeted in 30.8% of cases. There is a high incidence of illegal firearm use and firearm related deaths in Libya. Societal and international efforts are needed to decrease the illicit use and trafficking of such weapons

PR and QRS interval changes after transcatheter pulmonary valve replacement in children

Abstract Background Changes in PR intervals after transcatheter pulmonary valve replacement (TCPVR) have not been thoroughly evaluated in children. This study evaluated the changes in PR and QRS intervals six months after TCPVR in children with congenital heart disease. Results This study included 41 patients who underwent TCPVR from 2010 to 2022. ECG of patients was reviewed before and six months after TCPVR, and the PR and QRS intervals were reported. Right ventricular systolic pressure (RVSP) was retrieved indirectly from echocardiography and compared pre- and 6-months after TPVR. The median age was 13 years (25th–75th percentiles: 11–16), and 61% were males. The preoperative diagnosis was tetralogy of Fallot (n = 29, 71%), transposition of great vessels (n = 4, 10%), common arterial trunk (n = 3, 7%), pulmonary valve stenosis (n = 3, 7%) and pulmonary atresia (n = 2, 5%). The Melody valve was used in 30 patients, and Edwards Sapien was used in 11 patients. RVSP was significantly reduced six months after the procedure (pre-RVSP 40 (30–55) mmHg vs. post-RVSP 25 (20–35) mmHg; P < 0.001). The PR interval was 142 (132–174) msec before TPVR and 146 (132–168) msec post-TCPVR (P = 0.442). Post-TPVR PR was positively related to the pre-PR (β: 0.79 (0.66–0.93), P < 0.001) and inversely related to the right ventricular outflow tract size (− 1.48 (− 2.76 to − 0.21), P = 0.023). The pre-TPVR QRS was 130 (102–146) msec, and the post-TPVR QRS was 136 (106–144) msec (P = 0.668). Conclusions In children undergoing TCPVR, the PR and QRS intervals did not change significantly during a 6-month follow-up