The Libyan Journal of Medical Research is an international, peer-reviewed, open-access journal that provides a fast-track, high-quality peer review process for original research articles, review articles, short communications, and case reports in all areas of Medical and applied Sciences. Submissions are accepted in the English language. LJMR operates under an open access publication model, meaning that all interested readers are able to freely access the journal online without the need for a subscription fee. Please note that there is an article processing and publishing charge of 100 US Dollars for international and 350 DL for local each accepted manuscript in order for the journal to continue its high performance. All papers are subjected to a peer-review process. Moreover, with the presence of international referees, the process of decision-making on the acceptance/rejection of all submitted manuscripts will be done rapidly and to the highest standards. Articles in Libyan Journal of Medical Research are open Access Under Creative Commons Attribution-Noncommercial-No Derivatives 4.0 International License (CC BY). This license permits use, distribution, and reproduction in any medium, provided the original work is properly cited, is not changed in any way, and is not used for commercial The Libyan Journal of Medical Research has obtained the Arab Impact Factor 2024. and 2025 The journal is owned by the Libyan Medical Research Center, and the management of the journal is made by the editorial team
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Unusual MRI characteristics of Posterior Cranial Fossa Dermoid Cyst Associated with Klippel-Feil syndrome: A Case Report and Literature Review.
Intracranial dermoid cysts are rare inclusion cysts characterized as well-defined cystic lesions with typically distinct Magnetic Resonance Imaging (MRI) features. However, in rare cases, their imaging features can be atypical because of their variable components. This case report highlights unusual radiological findings of a posterior cranial fossa dermoid cyst that deviates from typical presentation patterns and reveals a rare association between these lesions and Klippel-Feil syndrome (KFS). We detail the case of a 50-year-old female patient who presented with progressive weakness, persistent headaches, and deteriorating vision. MRI of the brain displayed a 6X4.5 cm well-defined cystic lesion in the posterior fossa, showing hyperintensity on T1-weighted images (T1WI) and profound hypointensity on T2-weighted images (T2WI), along with cervical vertebrae fusion indicative of KFS. These atypical imaging findings of posterior cranial fossa dermoid cyst challenge conventional diagnostic patterns and underline the necessity for further exploration of these lesions to avoid misdiagnosis. Also presence of posterior cranial fossa dermoid cysts should be considered in a patient diagnosed with KFS.
Copyright (c) 2026 Mohamed Shaka, Mohamed Sherfad, Bashir Ayad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Avian Haemosporidium Effects on some blood parameters of free range chickens.
Background: Avian hemoparasites pose a major risk to poultry farming in North African nations; however, there is limited information on their prevalence and effects in Libya.. Objective: This research aimed to assess the occurrence of blood parasites in domestic chickens across Libya and to analyze their influence on complete blood count (CBC) and bilirubin levels. Materials and Methods: A total of 50 domestic chickens were studied, collected from different regions of Libya. Blood samples were taken and analyzed using the Giemsa staining method for parasite detection. Hematological parameters, including red blood cell (RBC) count, white blood cell (WBC) count, hemoglobin, and packed cell volume (PCV), along with total bilirubin levels, were recorded. The chickens were divided into infected (n=27) and non-infected (n=23) groups. Results: Microscopic analysis identified three types of hemoparasites: Leucocytozoon spp. (11.1%), Haemoproteus spp. (18.5%), and Plasmodium spp. (14.8%). Infected chickens exhibited a marked decrease in RBC count (2.1±0.4 vs 2.9±0.5 ×10⁶/μL, p<0.01), hemoglobin levels (9.2±1.8 vs 11.8±2.1 g/dL, p<0.01), and PCV (24.3±4.2 vs 31.5±5.1%, p<0.01) when compared to non-infected ones. Moreover, total bilirubin levels rose significantly in infected chickens (0.68±0.15 vs 0.32±0.08 mg/dL, p<0.001), and the WBC count was higher in the infected group (23.4±3.2 vs 16.8±2.5 ×10³/μL, p<0.01). Conclusion: Blood parasites are widespread among domestic chickens in Libya, leading to significant changes in hematological parameters such as anemia and elevated bilirubin levels. These findings suggest a potential negative impact on poultry health and productivity.
Copyright (c) 2026 Nagia A. S. Abdalsalam, Hana. A. Ali, Ahmad, Boulabyidh (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Hematological and biochemical abnormalities among women with breast cancer
Background: Breast cancer is a complex and heterogeneous disease characterized by the abnormal proliferation of breast tissue, leading to tumor formation. It is the most common cancer diagnosis among women worldwide. Assessment of hematological and biochemical parameters can predict the severity, mortality, and follow-up treatment in women with breast cancer. The aim: The study aimed to evaluate hematological and biochemical parameters as useful markers among patients with breast cancer compared to healthy individuals. Methods: A total of 124 women diagnosed with breast cancer attended The Department of National Cancer Institute Sabratha (NCI), from November 2024 to March 2025, and 50 healthy controls from The Libyan Medical Centre at Zawia city were also involved in this study. Demographic and clinical data, including complete blood count, liver function, and kidney function, were obtained from these patients. Results: A significant decrease (P< 0.001) was observed in patients in terms of RBC HGB, HCT, MCV, and MCHC. On the other hand, platelet count (PLT) and lymphocytes were significantly higher in the patient groups than in controls (P<0.001 and P<0.5), respectively. Glucose and sodium levels were significantly lower in breast cancer patients (P 0.013 and P>0.001, respectively. Conclusion: Routine blood testing represents one of the most accessible and essential diagnostic tools. Hematological and biochemical parameters may serve as valuable indicators to differentiate breast cancer patients from healthy individuals.
Copyright (c) 2026 Fathia G. Jaat, Marwa F Alqallali, Nadia. M. Kermani, Sedik. A. Abokdeer, Omar. A. Murgham (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Municipality-Specific Determinants of Chronic Kidney Disease in Southern Libya: Comparative Analysis of Clinical, Behavioral, and Environmental Risk Factors"
Background: Chronic Kidney Disease (CKD) poses a major public health challenge worldwide, with Diabetes Mellitus (DM) and Hypertension (HTN) being the leading drivers of progression to End-Stage Renal Disease (ESRD). In Southern Libya, preliminary reports from Tasawa, Al-Qatrun, Traghen and Obari indicate an alarming rise in ESRD cases requiring dialysis.Objective: This study aims to compare clinical, behavioral, and environmental determinants of CKD across four Southern Libyan municipalities, identifying localized high-risk patterns to inform targeted prevention strategies.Methods: An integrated risk-assessment framework was applied, evaluating clinical factors (glycemic and blood pressure control), behavioral factors (obesity, chronic analgesic use, herbal remedies), and environmental exposures (groundwater quality, Total Dissolved Solids [TDS]). Comparative analyses were conducted to detect inter-municipality variations in CKD risk profiles. Results: Preliminary findings suggest heterogeneous distribution of risk factors, with specific municipalities exhibiting higher prevalence of uncontrolled DM, HTN, obesity, and exposure to poor-quality drinking water.Conclusion: Municipality-specific risk profiling provides essential evidence for targeted interventions and early CKD prevention strategies, reducing progression to ESRD in resource-limited settings.
Copyright (c) 2025 Ail Abd Alahrash, Abdusalam M. Abdull, Hind Ghaziti, Khaled. M.Aburas, Osama H. Almjdoub, Asmahan Abukhdir, Hajer Rashed, Nasrin Elfarrah, Salah Bahron (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Lipid Profile and Glycemic Control in Type 2 Diabetic Patients in Zawia, Libya: A Cross-Sectional Study
Background: Diabetes mellitus (DM) is a prevalent endocrine disorder commonly associated with dyslipidemia, a major cardiovascular risk factor. This study evaluated total cholesterol and triglyceride levels among patients with type 2 diabetes mellitus (T2DM) in Zawia city, Libya. Methods: A cross-sectional study was conducted at the Diabetes Center in Zawia city, including 100 adults (50 T2DM patients and 50 non-diabetic controls). Fasting blood sugar (FBS), HbA1c, total cholesterol, triglycerides, and uric acid were measured using standard assays. Statistical analyses included independent t-tests, one-way ANOVA, and Pearson correlation (p<0.05). Results: Compared with controls, T2DM patients had significantly lower total cholesterol (p=0.015), whereas triglycerides did not differ (p=0.47). FBS was markedly higher in the diabetes group (p<0.001). HbA1c showed a positive correlation with body weight (r=0.259, p=0.039) and was positively associated with age, with no significant sex difference. Conclusion: In this cohort, diabetic status was associated with lower total cholesterol but similar triglycerides compared with non-diabetic controls. Findings support prioritizing comprehensive risk reduction—glycemic optimization and weight management—while assessing lipid fractions beyond total cholesterol. Larger, multicenter studies with detailed lipoprotein profiling are recommended.
Copyright (c) 2025 Abdalrauf Al-Fourti, Khayri A. Ali, Mahmoud B. Agena, Almabrok D. Saeed, Mohamed T. Saad, Mohamed D. Said (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Knowledge, Attitudes, and Practices among Health Care Workers in Misurata towards Pap smear Screening Test for Cervical Cancer “A Public Women’s Health Concern.”
Background: Cervical cancer is the fourth most common cancer in women globally, which is caused by persistent infection with the human papillomavirus. Pap smear is still the easiest way and primary screening tool to detect early precursors to cervical cancer. Aim: The current study aims to assess the level of knowledge, attitudes, and practices (KAP) regarding Pap smear screening among healthcare workers in Misurata. Material and Method: A quantitative cross-sectional study was conducted involving 221 healthcare workers in Misurata public hospitals using a self-administered KAP online questionnaire. Results: out of the 221 participants, only 11% demonstrated good knowledge of Pap smear screening, while 70.9% had moderate knowledge. 58.8% of them exhibited a negative attitude toward the test. However, only 12.2% reported practicing Pap smear screening. Knowledge levels were significantly associated with economic status, education level, age, and profession (p = 0.001, 0.002, 0.036, and 0.029), respectively. The attitude was not significantly affected by socio-demographic, pregnancy, or contraceptive use. Practice of the Pap smear test was significantly associated with contraceptive use and profession (p=0.026 and 0.014), respectively. Higher education, professional level, use of contraceptives, and higher knowledge scores were positively associated with Pap smear testing. (P-value 0.025 OR= 0.074, p-value 0.011, OR = 0.241, p-value= 0.043, OR= 0.367, and p-value 0.037, OR- 0.133 respectively). Conclusion: The majority of healthcare workers in Misurata demonstrated poor knowledge and low practice levels regarding Pap smear screening.
Copyright (c) 2025 Rehab. Eltayeb , Muftah Elbahloul , Osama H. Almajdoub (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Diagnostic Accuracy of Fine-Needle Aspiration Cytology in Thyroid Lesions: A Comparative Study with Histopathological Examination
Background: Fine-needle aspiration cytology (FNAC) is a rapid, minimally invasive, and cost-effective method for evaluating thyroid Lesions. However, its diagnostic performance varies depending on sampling technique, adequacy, and cytological interpretation. Aim: This study aimed to assess the diagnostic accuracy of FNAC compared with histopathological examination (HalPE). Materials and Methods: A retrospective cross-sectional study was conducted on patients who underwent thyroidectomy at the Department of General Surgery, Head and Neck Surgery, between June 2023 and October 2024. FNAC results were classified using the Bethesda system and compared with the final HPE. Diagnostic indices, including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV), were calculated using Jamovi. Results: Thirty-five patients were included (mean age 43.5 ± 13.6 years; 94% females), FNAC showed a sensitivity of 77.8%, specificity of 52.9%, accuracy of 65.7%, PPV of 63.6%, and NPV of 69.2% when compared with HPE. The majority of malignant lesions were papillary thyroid carcinoma. Conclusion: FNAC continues to be a valuable first-line diagnostic tool for thyroid nodules, demonstrating good sensitivity but moderate specificity. HPE remains crucial for a definitive diagnosis. Larger, multicenter studies are recommended to validate these findings and to enhance diagnostic reliability through better sampling and cytological expertise.
Copyright (c) 2025 Aiesha Imbarek Ibrahim, Abdussalam Mohamed Hounki, Yousef M Ali Hasen, Magbula Moraga Kaziri, Alshareef Jummah Salim, Hamza Alqantry Emhalhel (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Efficacy and Safety of Probiotic Supplementation in Preventing Necrotizing Enterocolitis in Preterm Infants: A Systematic Review and Meta-analysis
Background: Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition that affects preterm infants and is still linked to high levels of illness and death. Despite advances in neonatal care, effective prevention methods remain limited. Probiotic supplementation has garnered attention as a promising intervention, but uncertainty persists regarding which strains are most effective. This systematic review and meta-analysis aimed to evaluate the safety and effectiveness of probiotics in preventing NEC and to identify the regimens that offer the greatest protective benefits. Material and Methods: A thorough search of PubMed, EMBASE, the Cochrane Library, and Web of Science was conducted to find randomized controlled trials assessing probiotics for NEC prevention. Primary outcomes included NEC incidence (≥ Stage II), all-cause mortality, and late-onset sepsis. Random-effects models calculated risk ratios with 95% confidence intervals. Subgroup analyses were performed based on probiotic strains, feeding type, birth weight, and baseline NEC risk. The GRADE method was used to assess the quality of evidence. Results: Fifty-one trials involving 10,664 infants and 29 probiotic regimens were included. Probiotics significantly lowered NEC incidence, mortality, and late-onset sepsis. The most effective regimens combined Bovine lactoferrin with Lactobacillus rhamnosus GG and Lactobacillus acidophilus LB. Multi-strain probiotics outperformed single-strain formulations. Benefits were observed in both human milk-fed and formula-fed infants, and no cases of probiotic-associated sepsis were reported. Conclusion: Probiotic supplementation is a safe and effective strategy for reducing NEC, mortality, and sepsis in preterm infants. Multi-strain regimens, especially those containing Lactobacillus rhamnosus GG or Bovine lactoferrin, show the highest efficacy and could be considered for standard use in neonatal care settings.
Copyright (c) 2025 Amani EH Bidalla, Ahmed S Mkeal, Rasha J Abraheem, Shadin Jummah Abraheem, Mahmoud A. Aloriby, Mohamed K A Elkawafi, Hamza A Osman, Abdulmunaim A.M Elkarimi, sabah salah abd alaleam (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
"Safety assessment of dexamethasone administration during pregnancy: A Cross-Sectional study"
Background: Dexamethasone, a glucocorticoid drug, is used to treat a variety of conditions, including rheumatism, severe allergies, asthma, chronic obstructive lung disease, croup, brain swelling, eye pain after eye surgery, superior vena cava syndrome (a side effect of some types of cancer), and tuberculosis in conjunction with steroids.Aim of the study: The present study aims to evaluate the extent of the safe use of the drug dexamethasone, its effectiveness, and its side effects on pregnant women. Material and Method: 484 participants were surveyed using a paper questionnaire that included several information about social and drug side effects. The data were analyzed statistically by using SPSS v. 27. Results: our results suggest that there is no statistically significant association between taking dexamethasone during pregnancy and the occurrence of hypertension, diabetes, need for hospitalization, or depression and psychological pressure. However, there is a statistically significant association between taking dexamethasone and the awareness of lung acupuncture. Conclusion: Dexamethasone use during pregnancy is not substantially linked to an elevated risk of common pregnancy-related problems, such as gestational diabetes mellitus and hypertensive disorders of pregnancy, according to the study's findings. Hospitalization due to pregnancy, psychological anguish, or depression.
Copyright (c) 2025 Suhila Alhadi Atwier, Hager Tahir Ali , Entesar Rajeb Knaz , Asmahan. A.Abukhdir , Rabab Almabrok Alhade. (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Clinical, Radiological and Procedural Perspectives on Pediatric Foreign Body Aspiration: A Retrospective Analysis from Benghazi Children’s Hospital, Libya
Background: Foreign body aspiration (FBA) is a major cause of morbidity and mortality in preschool-aged children, especially in low-resource areas where diagnosis may be delayed. This study aimed to describe the clinical, radiological, and procedural features of paediatric FBA in a single tertiary centre in Libya. Material and Methods: A retrospective review was conducted for all children aged 16 years and younger with suspected FBA at Benghazi Children’s Hospital in 2019. The data included demographics, symptoms, imaging results, and bronchoscopy findings. All of the patients in this study underwent rigid bronchoscopy under general anesthesia. Results: Sixty-six children (mean age 2.9 years; 62.1% male) were analysed. Cough (90.9%) and observed choking (86.4%) were the most prevalent symptoms. Chest X-rays were normal in 72.7% of cases. Rigid bronchoscopy revealed FBA in 69.7%, mainly vegetative material like peanuts and seeds. The right main bronchus was the most common location (50%). Fever, wheezing, and a history of previous infections were associated with a significant delay in diagnosis (P < 0.05). Operative success was greater than 95% and complications were rare. Conclusion: In pediatric FBA, normal radiographs are not predictive of non-aspiration. Diagnosis is still established through rigid bronchoscopy, and treatment is also performed through this method. A high degree of clinical suspicion is necessary, in particular in low-resource settings. This study offers critical regional data to inform practice and prevention.
Copyright (c) 2025 Yosef Hassan Saeed, Mohammed Shultami, Rugaia Adris Alfdly, Salem Aldrsy, Mahmuod Aloriby, Yousef M Ali Hasen, Farag A Bleiblo, Moutaz F. Gebril, Tarik Ali Alghoj, Ahmed .S.Mikael, Nada. M.Heebah (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Prevalence and Risk Factors of NSAID-Induced Respiratory Reactions Among Asthmatic Patients: A Cross-Sectional Study in Zawia City, Libya.
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for managing pain and inflammation. However, they may provoke respiratory reactions in asthmatic patients, with limited data available from Libya. Objectives: This study aims to assess the prevalence, patterns, and risk factors associated with NSAID-related respiratory reactions among asthmatic patients in Zawia City, Libya.Material and Methods: A cross-sectional study was conducted involving 158 asthmatic patients. Participants completed a structured questionnaire that collected data on demographics, comorbidities, NSAID usage, and respiratory symptoms. Statistical analyses were performed using chi-square tests and logistic regression. Results: Among the participants, 91.8% reported NSAID use, with 64% experiencing shortness of breath following consumption. The frequency of NSAID use, along with comorbid conditions such as rheumatoid arthritis and heart disease, was significantly associated with an increased risk of respiratory reactions. Conclusion: NSAID-related respiratory reactions are prevalent among asthmatic patients in Zawia City. These findings underscore the importance of patient education, clinical monitoring, and cautious NSAID prescribing to mitigate potential respiratory risks.
Copyright (c) 2025 Abdulhakim Naffati, Fateh Mostafa Alsalami, Fathi Muftahi Naser , Rabab Almabrouk Salih, Emhamed Boras, Nasrien Elfarrah (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Impact of Early Iron Supplementation on Neurodevelopmental Outcomes in Infants: A Meta-analysis
Background: Iron deficiency during the critical window of early life can adversely affect long-term brain development. This systematic review and meta-analysis aimed to quantitatively evaluate the impact of early iron supplementation on neurodevelopmental outcomes in infants to inform clinical practice. Material and Methods: We systematically searched PubMed, Cochrane, and Embase databases from inception to May 2025. We selected randomized controlled trials (RCTs) evaluating iron supplementation in infants aged 0–24 months that reported neurodevelopmental outcomes. The primary outcome measured was the Mental Development Index (MDI), while secondary outcomes included iron status parameters and behavioral assessments. We assessed risk of bias using the Cochrane tool and evaluated the overall quality of evidence using GRADE criteria. Results: Fourteen studies met the inclusion criteria for qualitative synthesis; eight studies (n=561 infants) were eligible for meta-analysis. Iron supplementation was associated with significant improvements in MDI scores (Mean Difference [MD] 2.27; 95% CI: 1.43 to 3.12; I²=18%). Subgroup analyses revealed substantially greater benefits in preterm and low birth weight infants (MD 3.1; 95% CI: 1.8 to 4.4) compared to term infants (MD 1.2; 95% CI: 0.3 to 2.1). Interventions starting earlier (0–3 months) showed greater neurodevelopmental benefits than those starting later (4–6 months). Additionally, supplementation significantly reduced externalizing behavioral problems (Risk Ratio [RR] 0.36; 95% CI: 0.17 to 0.76) and improved hemoglobin levels (MD 0.42 g/dL). Adverse events were rare, with only constipation showing a significant increase (RR 1.23; 95% CI: 1.02 to 1.49). Conclusion: Early iron supplementation positively impacts neurodevelopmental outcomes, with the most pronounced benefits observed in high-risk groups such as preterm and low birth weight infants. Crucially, the timing of supplementation appears vital, with earlier intervention yielding superior cognitive results. These findings strongly support current recommendations for iron supplementation in infancy, specifically prioritizing at-risk populations.
Copyright (c) 2025 Nouri Mumash, Ahmed S. Mikeal, Mohammed M. Makhzom3, Ibrahim M. Altaib, Ebtihaj S. Durman, Asmaa M. Aqoub, Abdulnasir J. Yunus, Jamal A. Bilrrahal (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Factors Influencing Lower Respiratory Tract Infection in Adult Patients after General Anesthesia
Background: After surgery, the LRTIs are significant, as they can result in prolonged hospital stays, increased healthcare costs, and higher morbidity rates. Aim: This study investigated the risk factors in adult patients aged 20 to 40 who have undergone general anesthesia associated with lower respiratory tract infections (LRTIs). Material and method: Data were analyzed from 40 patients who underwent surgery with general anesthesia at Zawia Hospitals in Libya City between May and August 2023. Results: The analysis revealed that diabetes, intraoperative blood transfusions, and the type of surgery performed were significant risk factors for developing lower respiratory tract infections (LRTIs). Notably, diabetic patients were 0.04 times less likely to develop an LRTI compared to non-diabetic patients. Furthermore, receiving blood transfusions and undergoing cholecystectomy were associated with an increased risk of infection. Pathogen analysis indicated a diverse range of infections, with Klebsiella pneumoniae and Candida species being the most prevalent. Conclusion: This study highlights the importance of effectively managing diabetes, carefully considering blood transfusion needs, and choosing appropriate surgical procedures to lower the risk of LRTIs in patients undergoing surgery with general anesthesia.
Copyright (c) 2025 Rabab Almabrouk Salih, Fatima Ali Al AshkHam, Elham Mohammed Almurabet, Hala Moktar Elgziati, Ghada Emhemed Algblawi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The use of Spirometry in COPD diagnosis, auditing a snap shot of the current practice in a Libyan tertiary center’s Chest unit.
Background: Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent condition in Benghazi, Libya, and is well-known to impose a significant burden on global mortality and morbidity. International guidelines firmly establish spirometry as the gold standard for diagnosing and monitoring COPD. However, in routine clinical practice, it is often observed that a diagnosis of COPD is made on clinical grounds alone, without the crucial objective confirmation provided by spirometric testing. Objective: This audit aimed to explore the practice of using spirometry to diagnose COPD, as recommended by international standards, within the Chest Unit of Benghazi Medical Center (BMC). Material and Methods: We conducted a retrospective review of all patient files available in the chest unit during March 2023. Data about patients' demographics and diagnostic workups, particularly the rationale relied upon by physicians to make the diagnosis, including imaging and pulmonary function tests they were compared to the standard practice recommended by the GOLD guidelines for COPD diagnosis. Results: From a total of 1129 outpatient files, we identified 143 patients who had been labeled as having COPD. Their ages ranged from 36 to 85 years, and the vast majority were male. Our analysis revealed that only 88 of these 143 COPD patients (61.5%) had undergone spirometer testing, while the remaining 55 patients (38.5%) had been diagnosed without this essential investigation. Smoking status was not detailed in 41 patients (28.7%), chest radiographs were absent from the files in 67.8% of cases, and CT scans of the chest were documented in only 28.7% of patients. Conclusion: We, in total, achieved 62% of the audit's standard for spirometry use, leading to the inference that spirometry remains underused in the diagnosis of COPD in this snapshot.
Copyright (c) 2025 Ashraf M. Rajab, Khalid A. Gaber (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Prevalence of Dental Caries among Private School Children in Benghazi, Libya (2023)
Background: Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, greatly reducing quality of life for those affected. The most prevalent and consequential oral diseases are dental caries. Dental caries is considered a major public health problem in underdeveloped or developing countries. Therefore, the present study aimed at determining the prevalence of dental caries among school children.Material and Method: A cross-sectional survey was conducted in the city of Benghazi targeting children among seven private schools, both sexes, all ages, using a systematic sampling, a collection form containing information about socio-demographic characteristics of study participants was used and the children had examined for dental caries by the study investigators for the presence of dental caries depend WHO diagnostic criteria for caries.Result: A Total of 917 students included in this study were 56.5% of the student were male and 43.6% female; most of them were from the 5 - 10 age group with 63.6%, with a Mean = 9.95 ± 2.6 standard deviation. The prevalence of dental caries among school children was 43.9%. The dental caries prevalence was significantly associated with age and specific school; the study participants with higher prevalence in the age groups 5-10 years. There was no significant association between gender and dental caries. Conclusion: The study concluded that dental caries is common among school children, significantly varying by age and socioeconomic status. These findings highlight the urgent need for targeted prevention and intervention strategies to improve dental health and support overall well-being and academic success.
Copyright (c) 2025 Amina Muftah Elsaid, Nadia AM Eldarogi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Infantile urinary tract infection, presentations and outcomes in General Hospital, Tripoli, Libya: A Single-Center retrospective analytical cross-sectional study
Background: Urinary tract infection (UTI) is a common cause of fever and hospitalization in infants. Early diagnosis and management are vital to prevent short and long-term complications. We aimed to describe clinical features, laboratory and imaging findings, risk factors, and short-term outcomes among infants <1 year hospitalized with UTI. Materials and Methods: A Single-Center retrospective analytical cross-sectional study was conducted at the Pediatric Department of Al-Hadaba Al-Khadra General Hospital, Tripoli, Libya. Data including fifty (50) infants hospitalized with a confirmed diagnosis of UTI between January and October 2024. Data were extracted from medical records, including demographics, presentation, laboratory results, imaging, risk factors, and outcomes. All infants received broad-spectrum intravenous antibiotics adjusted according to culture sensitivity. Statistical analysis was performed using SPSS version 25. Descriptive statistics are used to summarize infants' characteristics. Associations were tested using Fisher’s exact/Chi-square, and logistic regression was planned for independent predictors. P < 0.05 was significant. Results: Fifty infants were included. Fever (96%) and vomiting (68%), were the most frequent symptoms. Abnormal renal ultrasound was detected in (44%), and positive urine culture in (14%). Eight infants (16%) had identifiable risk factors: Spina bifida (2), antenatal hydronephrosis (1), renal hypoplasia (1), maternal antenatal UTI (2), prolonged rupture of membranes (2), and uncircumcised males (4). Prolonged stay occurred in (22%), recurrence in (24%), and sepsis in (8%). Abnormal ultrasound and positive culture were independent predictors of prolonged stay, while risk factors and abnormal imaging predicted recurrence. Conclusion: UTI in infants commonly presents with systemic symptoms and significant imaging abnormalities. Abnormal renal ultrasound is a key predictor of prolonged stay, recurrence, and complications, highlighting the need for early imaging and structured follow-up of high-risk infants to prevent renal damage.
Copyright (c) 2025 Fathia Hameda Ben Saleh, Zinab Ashour Saad, Aisha A. Sehari Gammodi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Prognostic Value of High-Sensitivity Cardiac Troponin in Stable Coronary Artery Disease: A Systematic Review and Meta-analysis
Background: High-sensitivity cardiac troponin (hs-cTn) assays can detect myocardial injury at significantly lower concentrations than conventional assays. While the diagnostic and prognostic value of hs-cTn in acute coronary syndromes is well-established, its prognostic significance in stable coronary artery disease (CAD) remains less defined. This systematic review and meta-analysis aimed to evaluate the prognostic value of hs-cTn for adverse outcomes in patients with stable CAD. Matrial and Methods: We conducted a systematic search of PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science from inception to May 2025. Studies reporting the association between baseline hs-cTn levels and clinical outcomes in stable CAD patients were included. The primary outcomes were all-cause mortality and major adverse cardiovascular events (MACE). Random-effects meta-analysis was performed to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Results: Ten studies comprising 14,938 patients with stable CAD were included in the quantitative analysis. Elevated hs-cTn levels were significantly associated with increased risk of all-cause mortality (pooled HR: 1.50, 95% CI: 1.43-1.57, I² = 24.0%) and cardiovascular events (pooled HR: 1.44, 95% CI: 1.38-1.51, I² = 50.8%). The prognostic value remained consistent across different hs-cTn assays (T and I) and was independent of traditional risk factors, renal function, and left ventricular ejection fraction. A troponin ratio >0.24 (relative to the 99th percentile upper reference limit) identified over 50% of patients at risk for death and heart failure hospitalization. Conclusions: Elevated hs-cTn levels are independently associated with increased risk of mortality and cardiovascular events in patients with stable CAD. Incorporating hs-cTn measurement into risk stratification algorithms may improve prognostic assessment in this population. Future research should focus on establishing optimal cutoff values and determining whether hs-cTn-guided management strategies can improve outcomes.
Copyright (c) 2025 Ahmed Abdelraso, Rasha J Abraheem, Ahmed S Mikael, Mahmoud A. Aloriby, Mohamed K A Elkawafi , Tarik Ali Alghoj, Yousef M. A. Hasen, Hamza A Osman, Amani Ibrahim (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of Groundwater Quality from a Chemical and Microbiological Perspective in Selected Domestic Wells in Al-Sarraj, Tripoli
Background: Access to safe drinking water remains a global challenge, particularly in arid regions such as Libya, where groundwater is the primary source of domestic water supply. This study assessed the chemical and microbiological quality of groundwater from selected domestic wells in western Tripoli and compared results with Libyan drinking water standards. Material and Methods: A total of 20 groundwater samples were collected from domestic wells (35–100 m depth) in Al-Sarraj, Janzour, Al-Swani, and Bu Ghubba. Physicochemical parameters, including pH, electrical conductivity (EC), total dissolved solids (TDS), major ions, and hardness, were analyzed. Microbiological analyses targeted total coliforms, Escherichia coli, and total bacterial counts. Statistical analysis was performed using ANOVA. Results: Most samples exceeded Libyan standards for TDS (>3000 mg/L) and total hardness (>1400 mg/L). Approximately 60% of shallow wells (35–60 m) exhibited the highest contamination rates. E. coli concentrations reached up to 129 CFU/100 mL. Overall, the majority of wells were unsuitable for human consumption. Conclusions: Domestic wells in western Tripoli exhibit significant chemical and microbial contamination, rendering them unsafe for drinking water. Urgent interventions, including regular monitoring, enforcement of drilling regulations, and public awareness campaigns, are required.
Copyright (c) 2025 Ibrahim E. Gharibi, Mohamad Orhuma, Abubaker Abutartour, Nour AlShamakhi, Lotfia El Majdoub, Hajar AlGhariani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Predictive Value of Fibrosis-4 Score Index for Cirrhosis-Related Complications in a Libyan Patient Cohort
Background: Liver cirrhosis is the end stage of chronic liver disease, and it's considered a major cause of morbidity and mortality. Early detection of complications such as esophageal varices is critical for improving outcomes. There are non-invasive markers that can reduce the need for unnecessary invasive procedures. The Fibrosis-4 Index (FIB-4) has shown promise in assessing liver fibrosis and predicting the risk of varices and other complications. Objectives: This study aims to investigate the utility of the Fibrosis-4 Index score as a predictor for the presence of complications (current or past) in patients with established liver cirrhosis. Methods: A cross-sectional, observational study was conducted at the outpatient hepatology clinics of Benghazi Medical Center. A convenience sample of adult patients (aged 18 years and above) with an established diagnosis of liver cirrhosis was consecutively included in the study. The Fibrosis-4 (FIB-4) Index score was calculated for each patient. Results: The study included a total of 101 patients (48 (47.5%) males and 53 (52.5%) females), with liver cirrhosis. The FIB-4 Index score was evaluated in three categories: <1.45, 1.45–3.25, and >3.25. A statistically significant association was found between a FIB-4 Index score >3.25 and the overall frequency of complications (Pearson Chi-square = 7.509, p = 0.006). Conclusions: The study findings add to the existing evidence supporting the clinical utility of the FIB-4 index score (and platelet count ) as a non-invasive marker of the presence of cirrhosis complications. It's particularly reliable in predicting the presence ( cut-off value of 3.25) or absence of complications during the evaluation of liver cirrhosis patients, depending on the score value. Further work-up (e.g. endoscopy) can be restricted to patients with a high risk of having complications, thus avoiding unnecessary tests and reducing the costs.
Copyright (c) 2025 Abdelhakim M. Elbarsha, Sahar H.Summad, Mabrouka M.Alshokri, Sami A. Lawgaly, Mussa G. Tuwati (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Pregabalin Misuse and Associated Adverse Events: A Cross-Sectional Study in Libya
Background: Pregabalin, a gamma-aminobutyric acid (GABA) analogue, is widely prescribed for neuropathic pain, fibromyalgia, anxiety disorders, and epilepsy. Despite its therapeutic value, pregabalin has been increasingly associated with misuse and significant adverse effects. Aim: This study aimed to evaluate the prevalence, severity, and pattern of adverse effects related to pregabalin abuse among adults in Western Libya. Materials and Methods: A descriptive cross-sectional study was conducted in Zawiya, Libya. Data were collected using structured questionnaires from 80 participants with a history of pregabalin use. Descriptive statistics were applied. Results: The majority of participants (55%) were young adults (20–30 years), and 57.5% reported non-medical use of pregabalin. High doses (≥300 mg) were commonly used without medical supervision. Reported side effects included blurred vision (75%), sleepiness (72.5%), dry mouth (65%), and cognitive impairment (45%). Withdrawal symptoms after discontinuation were severe, including headache (87.5%), stress (80%), sleep disturbance (77.5%), tachycardia (75%), and depression (60%).Conclusion: Pregabalin misuse is prevalent among Libyan adults, particularly young individuals with low educational levels. Adverse effects and withdrawal symptoms were frequent and severe, underscoring the urgent need for stronger regulatory measures, public awareness campaigns, and safer prescribing practices.
Copyright (c) 2025 Hanan Alhadi Thwer, Entesar Rajeb Knaz, Hager Tahir Ali , Sara M. El. Ahmed , Najway Ali Mohmmed, Wayel A. Almrabet , Suhila Alhadi Atwier, .Asma.M. bsheena (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of Nurses' Knowledge and Practices in Diabetic Foot Ulcer Care at Al-Zawia Medical Center – Libya.
Background: Diabetic foot ulcers are one of the most common diabetic complications found today. These ulcers can often lead to infection, gangrene, limb amputation, and even death. Objectives: The aim of this study was to assess the level of nurses' knowledge and practices concerning the care of diabetic foot ulcer patients. Material and Methodology: This was a hospital-based design study among one hundred (100) consented working nurses at Al-Zawia Medical Center, Western Libya, both gender (49 males and 51 females) were recruited during the period from December 2024, to April 2025, demographic data were collected by validated structured questionnaire, and analyzed, frequency and percentage calculated by known medical statistician. Results: The study indicated that half of the nurses were aged between 18 and 28 years, 51% of the participants were female, and most of them had a Nursing Certificate (39%). The study revealed that the participants gained a moderate level of knowledge among the nurses at Al Zawia Medical Center- Libya. However, regarding experiences and training, results were found that (56%) had less than 5 years of experience and (43%) did not receive training in diabetic foot care, highlighting a knowledge gap, particularly in duration and quality of training. Conclusion: The findings of this study revealed that the majority of nurses working in different wards at Al-Zawia Medical Center, with various educational levels, short periods of experience and practice, have a moderate level of knowledge concerning diabetic foot care, and generally, there are specific gaps, particularly in continuous training, knowledge, quality, and adequate period of practice.
Copyright (c) 2025 Siddig Bushra Mohamed, Salih A. Elmahdi, Abdelmoez Eshrif, Abdelkrem Mohamed Abdalla, Ibrahim H. Mohamed, Ahmed M. Aljnien, Elaf A. Almogwas, Hashem M. Abdelmola, Khalifa A.Almzalet (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Early Assessment of Rheumatoid Arthritis Using the Nørgaard Radiographic Method and Rheumatoid Factor Testing
Background: This comparative study was conducted between July 25 and December 31, 2022, at Abusurra Hospital and Zawia Teaching Hospital in Libya to assess the efficacy of the Norgaard radiographic method versus laboratory analysis in the early detection of rheumatoid arthritis. A total of 64 patients of varying ages and clinical presentations were examined using both diagnostic approaches. Material and Methods: Radiographic assessment was performed using the Norgaard method, which focuses on early joint deformities, particularly in the metacarpophalangeal and proximal interphalangeal joints, while blood samples were collected for serological testing, including markers such as Rheumatoid Factor (RF). Results showed that 3 cases were identified simultaneously by both methods, 12 cases were exclusively detected using the Norgaard radiographs, and 8 cases were identified through laboratory analysis alone. These findings suggest that the Norgaard method may offer superior sensitivity in the early diagnosis of rheumatoid inflammation, especially when radiographic signs precede serological changes. However, the combination of both methods may enhance diagnostic confidence and reduce false negatives in ambiguous clinical cases. Conclusion:. We recommend that future research include broader screening of suspected rheumatoid arthritis cases in outpatient settings using both radiological and laboratory approaches. Emphasis should be placed on standardizing radiographic criteria and correlating imaging findings with serological profiles and clinical symptoms to establish a more comprehensive diagnostic framework.
Copyright (c) 2025 Rajab M. Ben Yousef , Mohammed H. Joghlaf , Maryem M. Alswehly , Abdel Nafaa M. Altunsi , Fathi A. Awushah , Mohamed A. Wadan , Radouane A. Belfkih , Marwah M. Almabrok (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Effectiveness of Autologous Platelet-Rich Fibrin (PRF) in Enhancing Nerve Regeneration Following Mandibular Third Molar Surgery: A Meta-Analysis of Randomized Controlled Trials
Background: Mandibular third molar surgery can lead to neurosensory disturbances due to potential damage to the inferior alveolar nerve. Platelet-rich fibrin (PRF), an autologous blood-derived biomaterial, has been proposed as a potential adjunct to enhance nerve regeneration and improve clinical outcomes following these procedures. Objective: This meta-analysis aimed to evaluate the effectiveness of autologous PRF in enhancing nerve regeneration following mandibular third molar surgery based on available randomized controlled trials. Material and Methods: A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, Web of Science, and Embase for randomized controlled trials evaluating PRF application after mandibular third molar surgery. Studies were assessed for quality using the Cochrane risk-of-bias tool. Data on nerve regeneration outcomes and related clinical parameters were extracted and analyzed. Results: Four studies met the inclusion criteria, with only one study directly measuring nerve regeneration outcomes. This study demonstrated significant improvement in the brush directional stroke discrimination test (BDSD) in the PRF group (p < 0.001), though no significant differences were observed in two-point discrimination (TPD) and self-reported neurosensory disturbance (SR-NSD). The other studies focused on related clinical outcomes, including pain, swelling, trismus, and bone healing, consistently showing the benefits of PRF application. Meta-analysis of pain reduction showed a standardized mean difference of -0.74 (95% CI: -0.97 to -0.52) favoring PRF. Conclusions: While limited evidence suggests PRF may enhance nerve regeneration following mandibular procedures, more research specifically focused on neurosensory outcomes after third molar surgery is needed. PRF consistently demonstrates benefits for pain reduction, swelling control, and improved healing, making it a promising adjunctive treatment. Future studies should incorporate standardized neurosensory testing to better evaluate PRF's impact on nerve regeneration.
Meta-Analysis Randomized Controlled Trials (RCTs
Copyright (c) 2025 Taher Hamed Mahmud Al Khfif, Haytham, A. K. Matougs, Ahmed s Mikael, Rabab R.Elhassi, Aseel. k .sharif (Author); Rasha j Abraheem (Translator) https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of Serum Vitamin D and Calcium Levels among Patients with Hypothyroidism: A Comparative Study in Albayda, Libya
Purpose: Vitamin D is essential for the proper functioning of numerous organs, including the thyroid gland. Therefore, a deficiency in vitamin D is considered a potential risk factor for developing various thyroid disorders, particularly hypothyroidism. The present study aimed to evaluate the serum concentrations of vitamin D and calcium in individuals who have been diagnosed with hypothyroidism. Materials and Methods The research was conducted on a cohort of 150 patients with hypothyroidism at the Department of Internal Medicine, Albayda Medical Center, in Albayda, Libya. Serum levels of vitamin D, calcium, thyroid-stimulating hormone (TSH), and thyroid hormones (T3 and T4) were measured in all participants. A control group consisting of 100 healthy individuals was used for comparison. Vitamin D deficiency was defined as serum vitamin D concentrations below 20 ng/mL. Results: Our findings indicated that patients with hypothyroidism exhibited significantly reduced serum levels of both vitamin D and calcium compared to the control group (P<0.05). Conclusion: Based on these results, it is strongly advised that individuals with hypothyroidism be screened for vitamin D and calcium deficiencies and, if necessary, receive appropriate supplementation.
Copyright (c) 2025 Nusieba A. Ibrahim, Yahya Saber E. Mansour (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Prevalence and Practices of Self-Medication Among Pharmacy Students in Tripoli, Libya
Background: Self-medication (SM) is prevalent among university students, particularly in pharmacy programs, raising concerns about misuse and antimicrobial resistance. Aim: To assess the prevalence, conditions, treatments, and reasons for SM among pharmacy students in Tripoli, Libya. Material and Methods: A cross-sectional study was conducted from October 2023 to June 2024 at a Tripoli university. Of 140 invited students, 95 responded (67.9%) via a self-administered questionnaire. Results: SM prevalence was 90.5% (86/95), with 89.9% of females and 93.8% of males self-medicating. Headache and common cold (84.2% each) were the most treated conditions, with analgesics (82.1%), antibiotics (67.4%), and vitamins (74.7%) commonly used. The Internet was the primary information source (42.1%). Prior experience with illness (69.5%) and drugs (67.4%) drove SM. No significant gender differences were found (P>0.05). Conclusion: findings of high SM prevalence, especially antibiotic misuse (67.4%), highlight the need for educational interventions and stricter regulations in medicines and health care providers.
Copyright (c) 2025 Almabrok D. Saeed, Mahmoud B. Agena, Khayri A. Ali, Mohamed D. Said, Mohamed M. Mhimed, Ahmad B. Ajdidi (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Survey on Drug–Drug Interactions and Medicine Use in Hospitalized Patients
Background: Drug-drug interactions (DDIs) are a significant concern in hospitalized patients, as they can compromise treatment effectiveness and patient safety. Limited data exist regarding the prevalence, patterns, and awareness of DDIs in Libyan healthcare settings, where both hospital and private clinic patients often receive multiple medications, including prescription, over-the-counter, and herbal remedies. Understanding these patterns is essential for optimizing pharmacotherapy and preventing adverse outcomes. Aim of the study: This study aimed to investigate the prevalence of DDIs and patterns of medicine use among hospitalized patients in Libyan hospitals and private clinics, while also assessing patient awareness and attitudes toward DDIs. Material and Methods: A cross-sectional study was conducted from March to May 2025. Adult patients (≥18 years) admitted for at least 24 hours and prescribed two or more medications were included. Data were collected from medical records and prescribing charts and entered into SPSS version 26.0. Potential DDIs were identified using validated screening tools. Descriptive statistics, including frequencies and percentages, were applied to analyze demographic characteristics, medication use patterns, and awareness levels. Results: The study revealed a heterogeneous patient demographic, with widespread use of prescription, over-the-counter, and herbal medications. Awareness of DDIs was moderate (50%), yet 55% of patients believed that combining medicines could be harmful. Reported adverse effects due to drug combinations were noted by 52% of participants. Medication disclosure to healthcare providers was inconsistent, with only 36% always informing, 35% sometimes, and 29% never disclosing their use of additional medicines. Importantly, 57% of patients expressed a desire for more information about DDIs. Conclusion: This study offers foundational insights into the prevalence and awareness of DDI among hospitalized patients in Libya. The results emphasize the urgent need for enhanced medication safety strategies, including patient education, routine DDI screening, and strengthened patient-provider communication. Future research should focus on identifying specific DDI types, evaluating their clinical impact, and testing the effectiveness of preventive interventions to optimize pharmacotherapy and improve patient outcomes.
Copyright (c) 2025 Ebtesam A. Beshna, Fadhil A. ALshareef (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Prevalence and Determinants of Consanguinity among the Libyan Population in Misurata as an Important Family and Child Health Issue
Background: Consanguineous marriage is a deeply rooted cultural practice in many Mediterranean and Middle Eastern populations, including Libya, and it plays a significant role in the burden of genetic diseases and public health. The aim of this study was to estimate the prevalence and patterns of consanguineous marriages in Misurata, Libya, and to assess their potential role in increasing the risk of inherited disorders. Material and Methods: A cross-sectional survey was conducted from May to June 2025 at zero-dose vaccine centers in Misurata. A total of 500 fathers accompanying their children for vaccination were interviewed using a structured, pre-tested questionnaire that gathered information on demographic characteristics, marital relationships, and consanguinity status. Results: Out of the 500 couples, consanguinity was observed in 180 cases (36%), including paternal first cousins (8.6%), maternal first cousins (6.8%), double first cousins (2.6%), second cousins from the father’s side (3.8%) and mother’s side (3.4%), and more distant relatives (10.8%). The average age was 31.4±6.9 years for wives and 39.7±7.9 years for husbands. A family history of inherited disease was reported in 9.6% of the couples. Conclusions: Consanguineous marriages, especially first-cousin unions, remain highly prevalent in Misurata. Targeted genetic counseling, culturally sensitive awareness programs, and updated research are urgently needed to reduce the incidence of inherited disorders in the Libyan population.
Copyright (c) 2025 Maryem Elbashir Ismail, Fatheia Ahmed Elrishi, Muftah Elbahloul, Osama H. Almajub, Malak Emad Elgubbi, Fatma Faraj Elsaghayer, Fatima Meftah alzalouk, Esraa Mahjoub Shagroun, Tasneem Mustafa Shaneshah (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Nephrogenic adenoma of the urinary bladder: A Histopathological case report
We report the case of a 31-year-old man presenting with painless macroscopic hematuria, a rare symptom in young adults that often requires a thorough evaluation to exclude an underlying malignancy. Initial uroimaging and cystoscopic examination revealed a papillary lesion originating from the bladder neck and extending to the prostatic urethra, strongly suggesting a neoplastic process. The patient underwent transurethral resection of the bladder tumor (TURBT), and histopathological analysis of the resected tissue revealed architectural and cytological features characteristic of a nephrogenic adenoma, a rare benign metaplastic lesion of the urothelium. Microscopic examination revealed tubular and papillary structures lined with cuboidal to nail-shaped epithelial cells, embedded in an edematous stroma. No cytological atypia, mitotic activity, or signs of urothelial carcinoma or other malignant transformation were identified. Nephrogenic adenoma is often misdiagnosed as carcinoma due to its histological resemblance to malignant entities, including adenocarcinoma and nested variants of urothelial carcinoma. This case highlights the critical importance of accurate histopathological interpretation to avoid overtreatment, particularly in young patients, for whom the psychosocial and physical consequences of a cancer diagnosis can be profound. This report aims to raise awareness among clinicians about this rare entity, highlight the diagnostic challenges it poses, and emphasize the need for clinicopathological correlation to ensure appropriate patient management. The patient's postoperative course was uneventful, and no recurrence was observed during short-term follow-up.
Copyright (c) 2025 Mohamed A. Elwafi , Rihab Abdlsalam Alweshahi , Khaled Abdulmola (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of the Physicochemical and Microbiological Groundwater Quality in the Jennawen, Shakshouk, and Jadu Agricultural Project Areas, Jadu City, Libya.
Background In arid regions such as Jennawen, Libya, groundwater is the primary source for drinking and irrigation, yet it is highly vulnerable to geogenic and anthropogenic contamination. This study aimed to assess the chemical and microbiological quality of 26 groundwater samples from wells and springs, including desalinated water. Material and Methods Physicochemical parameters (e.g., pH, salinity, major ions) and microbiological indicators (total coliforms, E. coli, total bacterial counts) were analyzed according to established guidelines. Results revealed that most untreated groundwater samples exceeded the permissible limits for salinity, hardness, and sodium. Furthermore, widespread bacterial contamination was identified, posing significant health risks. While desalinated water was free from microbiological contaminants, it was severely deficient in essential minerals. Conclusion: the groundwater in the Jennawen region requires urgent attention. Balanced water management strategies are critically needed to address both chemical and microbial contamination while maintaining an optimal mineral balance in potable water.
Copyright (c) 2025 Aisha Suliman Aldroujee, Abubaker Abutartour, Mailoud Omaro Abohanik, Lotfia Elmajdoub, Abdusalam M.Albdulla, Heba Ghurbal (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
A Comprehensive Review of Respiratory Failure: Pathogenesis, Clinical Strategies, Ethical Challenges, and Preventive Approaches: A Literature Review
Background: Respiration is a fundamental biological process that sustains life through the exchange of oxygen and carbon dioxide between the body and its environment. This perfectly balanced mechanism is vulnerable to disruptions from many causes, leading to various respiratory disorders. Among these, respiratory failure represents the most serious outcome, when the body is no longer able to maintain adequate gas exchange. Understanding this condition is crucial, as it lies at the intersection of physiology, pathology, and clinical care. Objectives: This review aims to clarify the principles of respiration and provide a clear definition of respiratory failure. It classifies the main types, examines the underlying causes and pathogenesis, and describes the symptoms patients may present with, as well as potential complications. It also addresses diagnostic methods, available therapeutic options, and prevention strategies. The ethical aspects of care are also highlighted, emphasizing the responsibility of clinicians in decision-making. Ultimately, this review aims to provide healthcare professionals with an integrated perspective that can improve patient outcomes and guide future clinical and research work. Conclusion: Our “Beyond Breath” journey redefines respiratory failure as a physiological crisis and a paradox. Three key insights define the way forward. First, the COVID-19 pandemic has blurred the line between acute and chronic respiratory failure, making integration essential. Second, while mechanical ventilation remains vital, its risks require AI-based lung-protective approaches aligned with natural physiology. Third, the inseparable link between mind and breath underscores the importance of psychological support in recovery. Looking ahead, respiratory medicine is entering a transformative era that unites science, technology, and humanism. “Breathing for others is the highest calling of medicine; our actions today shape our future, with Allah’s permission.”
Copyright (c) 2025 Rihab Abdlsalam Alweshahi, Mohamed A. Elwafi, Abofila MTM, Azab Elsayed Azab, Khaled Abdulmola, Mouni AAA (Author) https://creativecommons.org/licenses/by-nc-nd/4.0