Libyan Medical Journal

The Relationship between Academic Stress and Selected Physiological Parameters among Undergraduate Medical Students at Tobruk Medical University, Libya

2026-08-11T21:25:24+02:00

Academic stress is common among university students and is theorised, through activation of the sympathetic nervous system and the hypothalamic–pituitary–adrenal (HPA) axis, to influence cardiovascular and metabolic parameters [1–3]. To examine the relationship between self-reported academic stress and heart rate, respiratory rate, blood pressure, and body mass index (BMI) among university students. A cross-sectional study was conducted in 121 university students. Academic stress was scored on a continuous scale and additionally categorised into low, moderate, and high stress groups. Heart rate, respiratory rate, blood pressure, and BMI were recorded for each participant. The Shapiro–Wilk test was used to assess normality of distribution; as all variables deviated significantly from normality, Spearman’s rank correlation and the Kruskal–Wallis H test were used, with Mann–Whitney U post-hoc comparisons (Bonferroni-corrected) where indicated. Academic stress score correlated significantly and negatively with both blood pressure readings (ρ = −0.568 and −0.474, both p < 0.001), and the high-stress group had significantly lower blood pressure than the low- and moderate-stress groups (all p < 0.001, Bonferroni-corrected). No significant associations were found between academic stress and heart rate, respiratory rate, or BMI (all p > 0.05). In this sample, higher self-reported academic stress was associated with lower rather than higher blood pressure, while heart rate, respiratory rate, and BMI showed no significant relationship with stress level. These findings, which run counter to the classical acute sympathetic stress response, are discussed in relation to the chronic and self-reported nature of the stress measure used and the cross-sectional design of the study.

Childhood Maltreatment Effects on the Serotonin Transporter Gene and Its Relation to Anxiety and Depression

2026-08-06T19:13:21+02:00

Childhood maltreatment is a major public health concern and represents one of the strongest environmental risk factors associated with the development of psychological disorders, including depression and anxiety. Increasing evidence suggests that genetic susceptibility may influence individual responses to adverse childhood experiences. The serotonin transporter gene (SLC6A4) contains a functional length polymorphism in its promoter region, known as 5-HTTLPR, which affects serotonin transporter expression and has been implicated in emotional regulation, stress response, anxiety, and depression, particularly among individuals exposed to childhood adversity. This study aimed to investigate the association between childhood maltreatment and symptoms of depression and anxiety among young adults. Additionally, the study explored the relationship between childhood maltreatment and family-related factors, including parental marital status and socioeconomic and educational conditions during childhood, within the context of genetic vulnerability associated with the serotonin transporter system. A cross-sectional study was conducted among 65 randomly selected participants (30 males and 35 females) aged 20–30 years in Misurata, Libya, from 21 June to 6 July 2023. Data were collected using a self-administered questionnaire to assess the severity of childhood maltreatment. Depressive symptoms were evaluated using the Beck Depression Inventory (BDI), and anxiety symptoms were assessed using a self-report questionnaire. Associations between childhood maltreatment, psychological outcomes, and demographic variables were analyzed. Childhood maltreatment was significantly associated with increased symptoms of depression and anxiety among participants. However, no significant association was observed between childhood maltreatment and parental marital status or the family's educational and economic status during childhood. Childhood maltreatment is strongly associated with depression and anxiety symptoms in young adults. These findings support the importance of considering both environmental adversity and genetic susceptibility factors, including serotonin transporter gene variation (5-HTTLPR), in understanding individual differences in vulnerability to stress-related psychological disorders.

Comparison between Ciprofloxacin and Amoxycillin /Clavulanic Acid in Treatment of Mild to Moderate Cases of Acute Exacerbation of Chronic Suppurative Otitis Media

2026-08-18T19:30:49+02:00

Chronic Suppurative Otitis Media (CSOM) is a persistent middle ear infection associated with significant morbidity and hearing loss, particularly in low-resource settings. Its management commonly involves the use of topical or systemic antibiotics, among which ciprofloxacin and amoxicillin/clavulanic acid are widely prescribed. This study aimed to compare the clinical efficacy, follow-up behavior, and adverse effect profiles of ciprofloxacin versus amoxicillin/clavulanic acid in the treatment of CSOM. A comparative observational study was conducted on patients diagnosed with CSOM. Participants were assigned to two treatment groups: Group A received ciprofloxacin, and Group B received amoxicillin/clavulanic acid. Ciprofloxacin showed superior clinical efficacy with a higher complete cure rate (33.3%) and no treatment failures, compared to an 18.3% cure rate and 8.3% failure rate in the amoxicillin/clavulanic acid group (P = 0.030). Patients in the ciprofloxacin group also returned for follow-up significantly earlier, indicating faster symptomatic relief. Adverse effects were more frequent and severe in the amoxicillin/clavulanic acid group (P = 0.003); ciprofloxacin was better tolerated overall. At baseline, both groups had comparable symptom severity (p = 0.500). By day 14, ciprofloxacin demonstrated significantly greater clinical improvement, with 76.7% of patients achieving low symptom scores (0–2) compared to 43.3% in the amoxicillin/clavulanic acid group (p = 0.004). Ciprofloxacin demonstrated better clinical effectiveness, faster improvement, and fewer side effects compared to amoxicillin/clavulanic acid, making it a more favorable systemic treatment for CSOM.

Mathematical Modeling of Bone Growth and Regeneration After Fractures Using Differential Equations: Qualitative Analysis and Numerical Simulation

2026-08-23T16:45:17+02:00

Bone fracture healing is a coordinated, multistage process governed by interactions among cell populations, biochemical signaling, and the local mechanical environment. This paper develops a four-dimensional nonlinear autonomous system of ordinary differential equations describing the early and intermediate phases of secondary fracture repair. The model tracks the densities of mesenchymal stem cells ( ), chondrocytes ( ), osteoblasts ( ), and a generic osteoinductive growth factor ( ), representing morphogens such as transforming growth factor- (TGF- ) or bone morphogenetic proteins (BMPs). We model cell differentiation with saturating Holling type-II (Michaelis–Menten) functional responses rather than simple linear rates, reflecting the finite number of membrane receptors available for growth-factor binding. We show that all solutions with non-negative initial data remain non-negative and are uniformly ultimately bounded, so that the dynamics are confined to a compact invariant region . Three equilibria are identified: a trivial non-healing state , a fibrotic (cartilage/bone-free) state , and an interior healed state . Local stability is analyzed through the Jacobian matrix and the Routh–Hurwitz criteria, and a sufficient condition for global asymptotic stability of is obtained using a Volterra-type Lyapunov function together with LaSalle’s invariance principle. A fourth-order Runge–Kutta simulation illustrates the expected qualitative sequence of events: stem-cell recruitment, transient soft-callus formation, and its gradual replacement by bone.

Sleep Pattern During Ramadan among Libyan Adults: Changes and Factors Associated with Nighttime Sleep Duration

2026-08-24T18:34:31+02:00

Adequate sleep is an essential physiological need, and insufficient sleep is associated with adverse health impacts. Changes in daily routine during Ramadan may affect sleeping patterns. This study describes the pattern of sleep during Ramadan among Libyan adults and compares nighttime, daytime, and total sleep duration during and outside Ramadan. It also investigates the association of sociodemographic characteristics, physical activity sufficiency, and daytime sleep duration with nighttime sleep duration during Ramadan. A community-based, cross-sectional study was conducted in Tripoli, Libya, using a self-reported structured questionnaire developed as a part of a larger study on health-related behaviors. This analysis included 113 respondents. Their median age was 28.00 years (IQR: 23.00- 36.00), and females comprised 60.2% of the sample. Nighttime sleep duration was significantly shorter during Ramadan than outside Ramadan (mean difference = -3.12 hours, p<0.001, Cohen’s d= -1.124), while daytime sleep duration was significantly longer during Ramadan (mean difference= 2.20 hours, p<0.001, Cohen’s d= 0.742). Total sleep time was also significantly lower during Ramadan (Median= 8.00 hours) than outside Ramadan (Median= 8.50 hours), with a medium effect size (r=-0.46). Among all studied variables, only daytime sleep duration showed a significant association with nighttime sleep duration, with a strong negative correlation (r= -0.701, p<0.001). In conclusion, sleep patterns changed considerably among Libyan adults during Ramadan, with a marked reduction in nighttime sleep duration that was compensated for by increased daytime napping. Health education promoting adequate nighttime sleep during Ramadan is warranted.

Estimating the Minerals, Nitrogen, and Phosphorus Contents and Antibacterial Investigation of Fruits and Leaves of Lotus edulis Plant Extracts

2026-08-26T18:23:13+02:00

The present study investigated the mineral composition and antibacterial activity of leaves and fruits of Lotus edulis collected from Al-Marj, northeastern Libya. Mineral analysis revealed significant variations between plant organs, with potassium and nitrogen predominating in leaves (1319 ppm and 673.5 ppm, respectively) compared to fruits (919 ppm and 249 ppm). Phosphorus was slightly higher in fruits (111.91 ppm) than in leaves (98.96 ppm), while sodium and calcium were consistently greater in leaves. Antibacterial assays demonstrated concentration-dependent inhibition against selected bacterial strains. Leaf extracts exhibited stronger activity than fruit extracts, particularly against Bacillus cereus and Escherichia coli, with inhibition zones ranging from 14–8 mm and 10–5 mm, respectively. Notably, leaf extracts inhibited Pseudomonas aeruginosa (15–8 mm), whereas fruit extracts showed no effect. Neither organ extract produced detectable inhibition against Staphylococcus aureus. These findings highlight organ-specific mineral distribution and suggest that L. edulis leaves contain bioactive compounds with promising antibacterial potential. Further phytochemical characterization and standardized assays are recommended to identify active constituents and validate antimicrobial efficacy.

Comparative Study Between Laparoscopic Tubal Disconnection, Ultrasound-Guided Tubal Aspiration and Hysteroscopic Tubal Occlusion in the Management of Hydrosalpinx Prior to ICSI

2026-08-26T19:18:17+02:00

To compare the efficacy of laparoscopic proximal tubal disconnection, hysteroscopic tubal occlusion, and ultrasound-guided aspiration in the management of hydrosalpinx prior to intracytoplasmic sperm injection (ICSI). Sixty women with unilateral or bilateral hydrosalpinx undergoing ICSI were randomly allocated into three equal groups. Participants underwent laparoscopic proximal tubal disconnection, hysteroscopic tubal occlusion, or ultrasound-guided aspiration of hydrosalpinx fluid. The primary outcome was the clinical pregnancy rate, while the secondary outcome was the chemical pregnancy rate. Baseline demographic characteristics, hormonal profile, ovarian response, endometrial thickness, oocyte yield, and embryo quality were comparable among the three groups. Clinical pregnancy rates were 50.0% (10/20), 50.0% (10/20), and 40.0% (8/20) in the laparoscopic disconnection, hysteroscopic occlusion, and aspiration groups, respectively (p = 0.765). Chemical pregnancy rates were 55.0% (11/20), 50.0% (10/20), and 40.0% (8/20), respectively (p = 0.627). No statistically significant differences were observed among the three treatment groups regarding ovarian response, embryological outcomes, or pregnancy rates. Laparoscopic proximal tubal disconnection, hysteroscopic tubal occlusion, and ultrasound-guided aspiration demonstrated comparable reproductive outcomes in women with hydrosalpinx undergoing ICSI. All three approaches may be considered effective treatment options before assisted reproductive treatment.

Distribution of Minerals and Some Heavy Metals in the Leaves and Stems of Salvia, Ziziphus, Thyme, and Artemisia Plants

2026-07-23T02:47:55+02:00

Depending on the species and the organ of the plant, medicinal and aromatic plants can vary significantly in their mineral make-up. This experiment compared sodium (Na), potassium (K), iron (Fe), zinc (Zn), copper (Cu), and manganese (Mn) in the leaves and stems of Salvia, Ziziphus, thyme and Artemisia growing in the Al-Jabal Al-Akhdar region of Libya in spring 2024. Measurement of sodium and potassium was done by flame photometry, and Fe, Zn, Cu, and Mn by atomic absorption spectrometry, after acid digestion. The most common macro element in all the samples was potassium. It had a mean concentration of 4.98 ± 0.84 mg/g in leaves and 5.39 ± 1.20 mg/g in stems, versus 1.28 ± 1.09 and 0.897 ± 0.485 mg/g in sodium, respectively. The mean concentration of the trace elements in both organs had the same order: Mn > Zn > Cu > Fe. Artemisia leaves had the highest Na (2.84 mg/g), Zn (37.07 µg/g), Cu (15.09 µg/g) and Mn (66.39 µg/g) and Salvia leaves had the highest K concentration (5.57 mg/g). Artemisia had the highest K (6.53 mg/g), Zn (18.27 µg/g), and Cu (9.21 µg/g), Ziziphus the highest Mn (77.50 µg/g) and thyme the highest Fe (1.02 µg/g). The findings show apparent species- and organ-based variations in the distribution of elements. Since no analytical replicates, recovery, detection limits or certified reference-material results are reported in the dataset, the results should be considered as descriptive and cannot be used independently to determine dietary adequacy, toxicity, or safety.