Libyan Medical Journal

Maternal Risk Factors and Neonatal Outcomes of Preterm Birth in Benghazi, Libya

Marleen Alamrouni — 2026-09-01

Preterm birth is one of the leading causes of neonatal morbidity and mortality worldwide and remains a major public health challenge. Identifying maternal risk factors and evaluating neonatal outcomes are essential for improving pregnancy care and neonatal survival in Libya. This study aimed to identify the maternal risk factors associated with preterm birth and evaluate neonatal outcomes among preterm infants admitted at Benghazi Children’s Hospital, Libya. A retrospective cross-sectional study was conducted using medical records of 100 preterm neonates and their mothers admitted to Benghazi Children’s Hospital between 2023 and 2025. Data on maternal characteristics, pregnancy-related risk factors, neonatal complications, and clinical outcomes were collected and analyzed using descriptive and inferential statistical methods. The mean maternal age was 33.25 ± 5.12 years, while the mean gestational age and birth weight were 34.05 ± 1.48 weeks and 2.00 ± 0.50 kg, respectively. Maternal infection was the most frequently identified risk factor (34%), followed by multiple gestation (20%) and antepartum hemorrhage (9%). Respiratory distress syndrome was the most common neonatal complication (60%), followed by neonatal jaundice (33%), sepsis (7%), and anemia (5%). A strong positive correlation was observed between gestational age and birth weight (r = 0.749, p < 0.001). The neonatal survival rate was 92%, while the mortality rate was 2%. Associations between individual maternal risk factors and neonatal complications were generally weak and did not reach statistical significance. Maternal infection and multiple gestations were the predominant risk factors associated with preterm birth in Benghazi. Although respiratory distress syndrome remained the predominant neonatal complication, the overall survival rate was high. These findings highlight the importance of strengthening antenatal infection screening, providing specialized care for multiple pregnancies, and continuing to improve neonatal intensive care services to reduce the incidence of preterm birth in Libya.

Evaluation of Pure Tone Audiometry in Paediatric Patients with Otitis Media with Effusion: A Retrospective Study

Nagat Belkasem — 2026-09-01

Otitis media with effusion (OME) frequently impairs sound transmission in children, yet the severity and shape of the resulting hearing loss are not uniform. How effusion volume and viscosity contribute to this variation remains insufficiently defined. To investigate how middle-ear effusion characteristics relate to frequency-specific air-conduction thresholds in children with OME. Records of 180 children aged 3–12 years with persistent OME who underwent myringotomy, with or without ventilation tube insertion, were reviewed retrospectively. Air-conduction thresholds at 250, 500, 1000, and 2000 Hz were available for 360 ears. Operative descriptions classified effusion volume as partial, half, or full and viscosity as serous, mucoid, or purulent. Generalised estimating equation (GEE) models accounted for correlation between ears within the same child and included age, sex, OME duration, and ear side as covariates. The mean four-frequency hearing threshold increased from 20.02 ± 3.12 dB HL in ears with partial effusion to 23.38 ± 8.14 dB HL with half effusion and 48.61 ± 3.85 dB HL with full effusion. After adjustment, full effusion was associated with a 28.21-dB higher threshold than partial effusion (95% CI, 27.20–29.22; P < 0.001). Serous effusion showed predominantly low-frequency threshold elevation at 250–500 Hz, whereas mucoid effusion was associated with a nearly flat audiometric profile across 250–2000 Hz, with mean thresholds of approximately 48–49 dB HL. Purulent effusion showed its highest mean threshold at 2000 Hz (51.25 ± 3.54 dB HL), although this finding was based on only eight ears. Frequency-specific hearing profiles differed significantly across effusion viscosity groups (interaction P < 0.001), with a significant frequency-by-volume interaction also observed (P < 0.001). Age, sex, and OME duration were not independently associated with hearing threshold after adjustment for effusion characteristics. The auditory effect of childhood OME was not uniform across effusion characteristics. Increasing effusion volume was associated with poorer hearing thresholds, while serous and mucoid effusions showed different frequency-specific profiles. These results support detailed audiological assessment in persistent OME while recognising that the observed audiometric patterns cannot be attributed to viscosity independently of effusion volume.

Knowledge and Attitude towards Basic Life Support Among Healthcare Professionals in Primary Health Care Centers in Hai Al-Andalus, Tripoli

Ali Ghareba — 2026-09-02

Basic Life Support (BLS) is a critical component of the chain of survival in cardiac arrest management. In Libya, healthcare professionals are the first line of defense, yet empirical data regarding their BLS proficiency in primary care settings is limited. This study evaluated the knowledge of and attitudes toward Basic Life Support (BLS) guidelines among various healthcare professional categories in primary healthcare (PHC) centers within the Hai Al-Andalus municipality in Tripoli, Libya. A prospective, descriptive cross-sectional study was conducted between August and December 2022. A self-administered questionnaire was distributed to a random sample of Libyan healthcare providers, including doctors, dentists, pharmacists, nurses, and laboratory workers. Data were analyzed using independent t-tests and Chi-square tests, with statistical significance set at p < 0.05. A total of 399 participants completed the survey (99.75% response rate), with a female majority (90.5%) and a mean age of 37.9 ± 8.0 years. While a positive attitude and a strong desire for further BLS training were expressed by over 75% of participants across all specialties, the overall knowledge scores were below average. Doctors demonstrated the highest proficiency (51.6% good knowledge), whereas laboratory workers and nursing staff exhibited significantly lower scores (45.6% and 37.6% below average, respectively; p = 0.001). A critical gap was identified, as a vast majority had never received formal or recent BLS training, primarily due to busy clinical schedules. There is a significant deficiency in theoretical BLS knowledge among PHC professionals in Tripoli, despite highly positive learning attitudes. Immediate institutional interventions are essential to integrate mandatory, regular BLS certification and in-situ simulation training into the primary healthcare professional framework to ensure patient safety and improve survival outcomes.

Comparative in vitro Anti-Inflammatory Potential of Fresh and Stored Methanolic Leaf Extracts of Myrtus communis L.: An Egg Albumin Denaturation Study

Salwa Eltawaty — 2026-09-05

Myrtus communis L. has been documented to have pharmacological characteristics, including the ability to reduce inflammation. However, little is known about how long-term storage affects the biological activity of the leaf extracts. This study aimed to use an egg albumin denaturation model to compare the in vitro protein-stabilizing and initial anti-inflammatory potential of freshly prepared and stored methanolic M. communis leaf extracts. The anti-inflammatory potential of M. communis methanolic leaf extracts was assessed at doses of 0.125–2 mg/ml by use of the egg albumin denaturation assay. The reference medications utilized were ibuprofen and diclofenac. IC50 values were estimated from the concentration–response data; absorbance was measured at 660 nm, and percentage inhibition was computed. Every experiment was carried out three times. Although the fresh extract exhibited significantly more activity than the stored extract, both extracts showed protein-stabilizing action. The fresh extract showed an estimated IC50 of 0.158 mg/ml and inhibition of 40.3–89.5% across the tested doses. With an estimated IC50 of 0.656 mg/ml, the old extract demonstrated 0–76.5% inhibition. As a result, the efficacy of the stored extract was around four times lower than that of the fresh preparation. With estimated IC50 values less than 0.125 mg/ml, diclofenac and ibuprofen showed greater efficacy than both plant extracts. The protein-stabilizing activity of fresh methanolic M. communis leaf extract was higher than that of the stored one, indicating that the biological activity of the extract may be influenced by storage conditions. However, because comparable chemical profiling was not done, the observed difference cannot be directly linked to phytochemical breakdown. These results encourage additional phytochemical, cellular, and in vivo studies and emphasize the significance of storage and extract stability in the repeatability of plant-derived preparations

Precision Medicine in Lung Cancer Brain Metastases: Integrating Novel Therapeutics and Radiotherapy for Optimal CNS Control

Soufiane Khelifi Touhami — 2026-09-07

Cerebral metastases develop in nearly half of patients with lung cancer, substantially impairing both survival and quality of life. Historically, poor blood–brain barrier penetration and modest intracranial activity of systemic agents limited treatment options. However, recent advances in immune checkpoint inhibitors and next‑generation CNS‑penetrant targeted therapies have reshaped the therapeutic landscape, achieving superior intracranial disease control and improved patient outcomes. Concurrently, stereotactic radiotherapy has emerged as a precise and effective local modality with a more favorable toxicity profile than whole‑brain irradiation. The integration of systemic and local approaches, guided by molecular profiling and clinical risk stratification, offers new opportunities to optimize CNS disease management. Nevertheless, these advances raise key challenges regarding treatment sequencing, patient selection, and risk‑adapted strategies. This review summarizes the contemporary management of lung cancer brain metastases and highlights future directions for clinical trial design, emphasizing the incorporation of multidimensional clinical, biological, and radiological tools to guide individualized treatment decisions

Prevalence and Risk Factors of Congenital Anomalies Among Live Births in Al-Bayda, Libya: A Five-Year Retrospective Study

Fatma Emragi — 2026-09-08

Congenital anomalies represent a major public health challenge worldwide, contributing substantially to neonatal morbidity and mortality. Despite extensive global research, data from Libya remain limited, hindering effective prevention and policy development. This study aimed to determine the prevalence of congenital anomalies among live births in Al-Bayda Medical Center and affiliated regional hospitals during the period 2020–2024, to identify critical maternal and neonatal risk factors, and to provide evidence-based insights for maternal and child health programs in Libya.

Assessment of Feto-Maternal Outcomes Following Abruptio Placentae: A Retrospective Cross-Sectional Study

Laila Almahdi — 2026-09-12

Abruptio placentae (AP) is defined as placental detachment before and during delivery. It is a major obstetric complication associated with an increased risk of foetal and maternal morbidity and mortality globally, especially in developing countries. This study was a retrospective cross-sectional study conducted from 2019 to 2021 at Aljala Maternity Hospital. Data were collected from 104 medical files of pregnant women diagnosed with abruptio placentae, using a structured, predesigned questionnaire. Multiple variables were used to assess the feto-maternal outcomes related to abruptio placentae. Data were coded and analysed using SPSS (Statistical Package for the Social Sciences) version 16. All variable results were considered statistically significant at a P value of less than 0.05. We studied 104 pregnant women diagnosed with abruptio placentae, whose age ranged between 17 and 48 years; the most frequent age group was 20-25 years, which accounted for 47% of cases. The mean gestational age at hospital admission was 36.81 ± 3.564 weeks (minimum 21, maximum 39 weeks), the mean parity was 2.97 ± 1.745, and the mean number of previous miscarriages was 1.90 ± 2.45. The most frequent blood group was B Rh-positive (39.42%), followed by A Rh-positive (34.62%). The mean number of previous caesarean sections was 2.71 ± 1.426. The most frequent risk factors for abruptio placentae were preeclampsia (43.5%), followed by previous abruptio placentae in the last pregnancy (32.7%) and bronchial asthma (17.6%). Regarding mode of delivery, 73.1% of women delivered by caesarean section (C/S), of which 91.45% were emergency procedures. Male neonates were more prevalent than female neonates (59.22% vs 40.78%). Maternal and neonatal mortality were 1% and 33.2%, respectively, and 26.4% of mothers were admitted to the intensive care unit (ICU), complicated by disseminated intravascular coagulation (DIC) and pulmonary embolism as causes of death. This study identified preeclampsia and previous abruptio placentae as the most important risk factors, occurring with the highest frequency. Early assessment and diagnosis of abruptio placentae are therefore critical to preventing adverse health outcomes for both mothers and neonates.

Prevalence of Toxoplasma Gondii Infection and Knowledge of Risk Factors among Female Medical Students in Tripoli, Libya

Fatma Alaribi — 2026-09-14

Toxoplasmosis is a widespread infection caused by the intracellular protozoan Toxoplasma gondii (T. gondii). Transmission occurs through the fecal-oral route, blood transfusion, and vertical transmission from mother to fetus. Although typically asymptomatic in immunocompetent individuals, T. gondii infection can lead to severe complications in immunocompromised patients and congenital abnormalities if acquired during pregnancy. This study aimed to determine the prevalence of T. gondii infection, knowledge about toxoplasmosis, behavioral and lifestyle risk factors, and medical history, including a history of abortion, and to find the association between the variables of the study among female students at the Faculty of Medicine, University of Tripoli, Libya. A cross-sectional study was conducted over five months, from August 2025 to January 2026. Two data collection instruments were employed: blood sample analysis to evaluate the seroprevalence of T. gondii and an adapted questionnaire to assess the sociodemographic characteristics of the participants, knowledge about toxoplasmosis, behavioral and lifestyle risk factors, and medical history and history of abortion among the participants. A total of 223 female students were screened for T. gondii antibodies using a standard enzyme-linked immunosorbent assay (ELISA). Demographic, socioeconomic, knowledge and behavioral, and risk factor data were collected using a pre-tested, adapted questionnaire administered through face-to-face interviews. The seropositivity rate for T. gondii was 78 (35%) positive for IgG and none for IgM. The majority of participants were aged 23-27 (84.8%); 184 (82.5%) of them had heard about toxoplasmosis, 197 (88.3%) knew the route of transmission, 75 (33.6%) do own a cat, and almost all of them, 73 (32.7%), handled a cat and changed a cat’s litter box, 9 (4%) participants were married, five of them (2.2%) had history of abortion. This study observed a significant association between the prevalence of the infection and wearing gloves when dealing with meat (p=0.032) and whether participants had heard about Toxoplasma before (p=0.019). This study documented that T. gondii was positive among female students at Tripoli University, Libya, identified the prevalence of the infection, and gave insight into risk behaviors among the participants. Enhanced sanitation practices, rigorous personal hygiene protocols, and targeted educational initiatives on responsible pet ownership may mitigate this pathogen transmission.

Familial Isolated Hemihyperplasia Recurrence in a Non-Consecutive Brother and Sister Punctuated by Unaffected Children: A Case Series with 10-Year Follow-Up and Review of Clinical Diagnostic Thresholds

Ali Ghariba — 2026-09-14

Isolated hemihyperplasia (IH) is a rare congenital overgrowth disorder defined as regional body asymmetry involving bone, soft tissue, or both, without syndromic features. While predominantly sporadic with a postzygotic somatic aetiology, non-consecutive familial clustering within a single sibship is exceptionally rare and challenges conventional genetic paradigms. We report a unique familial case series of isolated hemihyperplasia affecting two non-consecutive siblings born to healthy, non-consanguineous Libyan parents with a negative family history. The pedigree includes five children, where the third child (Case 2, a 10-year-old female) and the fifth child (Case 1, a 1-year-old male) are affected, separated by healthy children. Case 1 presented at 12 months with left-sided lower limb hypertrophy exhibiting a 2 cm length discrepancy and a 13% thigh circumference mismatch (Left: 26 cm, Right: 23 cm), satisfying the >5% clinical diagnostic threshold. Case 2 initially presented at 7 months with right-sided lower limb hypertrophy. Over a 10-year longitudinal follow-up, she maintained a benign clinical course; serial abdominal ultrasonographies every 3–4 months and normal serum alpha-fetoprotein (AFP) profiles successfully ruled out embryonal malignancies. Her persistent 2.5 cm limb-length discrepancy and acral overgrowth were stably managed via a conservative custom shoe lift. Key pathognomonic markers of Beckwith-Wiedemann syndrome were consistently absent in both siblings. The recurrence of isolated hemihyperplasia in non-consecutive siblings suggests an underlying heritable germline susceptibility or parental mosaicism with incomplete penetrance. This series provides crucial 10-year prognostic data demonstrating that oncological risks diminish substantially toward late childhood. It underscores the clinical necessity of strict long-term tumour surveillance and early interdisciplinary orthopaedic management for active limb discrepancies.

Ameliorative Effects of Pistacia Atlantica on Methotrexate Induced Haematological Toxicity in Albino Rats. Part 1: Model Establishment

Anwar Abdalmula — 2026-09-14

Methotrexate (MTX) is an antifolate drug widely used in cancer chemotherapy and treatment of rheumatoid arthritis and other inflammatory diseases. The haematological toxicity of MTX is one of its major side effects. The present study is the first of a 2-part series investigating the ameliorative effects of Pistacia Atlantica on MTX-induced haematological toxicity in albino rats. This first part establishes the MTX-induced haematological toxicity model in albino rats in terms of MTX dosage and rats’ gender preference that is more susceptible to induction, while the second part evaluates the ameliorative effects of P. Atlantica on this model. A total of 30 rats were divided into 6 groups with 5 rats/group. Fifteen females and 15 males were each allocated to 3 groups: G1, G2, G3. The G1, G2 and G3 groups of both genders were injected intraperitoneally once with 40 mg/kg, 20 mg/kg and 10 mg/kg MTX, respectively. Blood samples were collected from all rats before MTX induction (baseline or day 0) and 7 days post-MTX induction (euthanasia day or day7) to determine haematological indices. Both rat genders that received low (G3) and medium (G2) MTX doses showed a reduction in RBC counts, Hb concentration and HCT values and an elevation of MCH, MCHC, MPV and PLCR values. Only the female group that received low MTX doses showed elevation in MCV, RDW-CV, RDW-SD, PLT counts and PCT values. The low dose of MTX also showed high PDW and P-LCC in both genders. The haematological changes observed in this study suggest that the female gender of rats and the low dose of MTX are the best variables to be used in the next trial in part 2 of this series.