Libyan Medical Journal

Cigarette Smoking Among Libyan Adolescents: Prevalence, Initiation Factors, And Prevention Implications

Halima Buni — 2025-07-12

Tobacco smoking among adolescents remains a critical public health challenge, with profound implications for long-term health outcomes and societal well-being. This study aimed to assess the prevalence of cigarette smoking among school students in Tripoli-Libya and explore the key initiation factors to inform locally tailored prevention strategies. A school-based cross-sectional study was conducted across six randomly selected governmental middle and high schools in one of the largest Municipalities in Tripoli, targeting 379 students aged 10–18 years. A pretested, anonymous, self-administered questionnaire was administered to assess current and lifetime cigarette smoking, sociodemographic characteristics, and self-reported reasons for initiation. Data were analyzed using the SPSS version 22. The total prevalence of current cigarette smoking was 10%, while the prevalence of cigarette smoking ever use was 26.6%. Ever use of cigarette smoking was significantly higher among male students (32%) compared to females (3%). Students in grades ten and twelve had the highest prevalence, followed by those in grade nine. Male gender was a statistically significant factor associated with cigarette smoking (p<0.05). The most common self-reported reasons for cigarette smoking included imitating smokers, curiosity, and expressing masculinity (p<0.05). This study contributes to the growing body of evidence on adolescent cigarette smoking patterns, with higher rates among males and older students, suggesting smoking may symbolize a transition to adulthood.

Anatomy and Biomechanics of the Knee

Mohamed Rashed — 2025-07-13

The knee joint, as the largest synovial joint in the human body, functions as a pivotal component for lower extremity motion and load bearing. Its intricate anatomy and biomechanics are essential for maintaining stability, mobility, and overall limb function. This chapter will elaborate on the anatomical structures, biomechanical principles, and clinical implications pertinent to the knee, providing a comprehensive framework for board candidates in orthopedics and sports medicine. The knee joint's stability is a product of interacting factors, including ligaments, muscular forces, bony structure, and load. The joint, one of the body's largest and most complex, involves four bones and an extensive network of ligaments and muscles. These elements work together to facilitate movement and bear weight while maintaining stability. Understanding these components is crucial for comprehending knee function and the potential for injury. The interplay between the static and dynamic elements is particularly important in biomechanics.

Role of Doppler Ultrasound in Diagnosis of Invasion of Placentation Tissue

Huda Khalif — 2025-07-22

Placenta previa is a severe complication of pregnancy and is the most common cause of postpartum hemorrhage, which often endangers the lives of pregnant women. In patients with malignant placenta previa and placenta accreta, ultrasound can display obvious blood flow changes, such as abnormal blood flow in the placental cavity, abundant blood flow signals, placenta accreta, a thinned echo zone between the uterus and placenta, an enlarged cervix, and thinned myometrium. Color Doppler ultrasound can accurately identify whether it is complete placenta previa. This study was conducted to assess the role of Doppler ultrasound in the diagnosis of invasion of the placental tissue. The study was a retrospective descriptive study conducted at Aljala Maternity Hospital in Tripoli during the years 2020-2021. Among 120 pregnant women were selected from medical files, and a predesigned questionnaire was formed to collect data from patients by simple random sampling methods. The data was coded and analyzed by using SPSS (Statistical Package for the Social Sciences) version 20. All variable results were considered statistically significant with a P value less than 0.05. Among 120 pregnant women who were diagnosed with placental invasion, the mean age group was 29.45 ± 5.345 SD, the minimum age was 18 years, and the maximum age was 45 years. Regarding the obstetric history, the mean gravidity was 3.37 ± 1.942 SD, the mean parity was 1.76 ± 1.559 SD, the mean miscarriage rate was 1.71 ± 0.454 SD, and the mean gestational age at time of diagnosis was 6.21 ± 2.111 SD. Regarding the prior experience with abnormal placentation in previous pregnancy, 66.3% had experienced it. Regarding the Doppler ultrasound approach, 73% of patients had abnormal Doppler findings on assessment. Regarding the prevalence of complications among participants who were diagnosed with placental invasion and the most commonly recognized complications were wound infection and thromboembolism, which both account for 63.5%. On assessing the placental invasion by Doppler ultrasound, this approach had a significant impact on evaluating pregnancy. Therefore, early utilization of Doppler is recommended, particularly in high-risk groups, to evaluate and detect serious health outcomes related to placental invasion.

Prevalence and Predictors of Depression and Anxiety among Healthcare Workers in Benghazi Hospitals in the Context of the COVID-19 Pandemic

Asma Alfallah — 2025-07-25

During the COVID-19 outbreak, health care workers faced significant psychological challenges while fighting the pandemic on the front lines. This research evaluated the mental health of front-line health workers following four years of COVID-19 efforts. This study aimed to investigate the anxiety levels and depression in HCWs in Libya after the COVID-19 pandemic and to assess the main predictors of elevated anxiety levels among them. A cross-sectional study included healthcare workers (doctors and nurses) in Benghazi hospitals who had been working during the COVID-19 pandemic and were willing to give consent. Female nurses reported the highest level of anxiety, followed by doctors. The three most critical variables that may explain the distress level were loss of control or vulnerability, worry for one's health, and the spread of the infection. Strategies for early detection and treatment of depression and anxiety should be developed for medically ill people.

Prognostic, Clinical, and Demographic Features in SCN1A Mutation-positive Dravet Syndrome

Eman Awen — 2025-07-25

Dravet syndrome typically manifests after the first year of life with prolonged febrile and afebrile seizures in previously developmentally normal children. The epilepsy is often refractory to standard anti-seizure medications, and by age two, most children develop epileptic encephalopathy. This retrospective study aimed to identify predictors of treatment response and developmental outcomes, as well as characterise demographic and clinical features in patients with SCN1A mutations. We reviewed clinical records of patients meeting Dravet syndrome diagnostic criteria, extracting data on demographics, clinical phenotype, and treatment history. Seventeen patients were included (male-to-female ratio 0.54:1; mean age 10.03 ± 5.8 years). All had normal birth histories, and 94.1% experienced their first seizure before six months of age, with fever as the precipitating factor in 70.6%. All patients had a history of prolonged seizures or status epilepticus. Initial interictal EEGs were normal in 76.5% during the first two years, and brain MRI was normal in 88.2%. While all children were developmentally normal before seizure onset, 76.5% later exhibited developmental delay and cognitive decline. Seizures worsened in 52.9% of patients when treated with phenobarbital, carbamazepine, lamotrigine, or vigabatrin (as mono- or polytherapy). After genetic confirmation, 94.1% received a combination of stiripentol, valproate, and clobazam, resulting in >50% seizure reduction in 88.2%. Dravet syndrome should be considered in children with refractory epilepsy, infantile-onset recurrent seizures (including febrile seizures/status epilepticus), and normal early development. Genetic testing enables early diagnosis and guides appropriate treatment, improving outcomes. However, no statistically significant predictors of treatment response or developmental outcomes were identified in this cohort

Prevalence and Associated Risk Factors for Anaemia amongst Pregnant Women Attending Gynecology and Obstetrics Department in Tobruk Medical Center, Tobruk, Libya

Salem Zaed — 2025-08-03

Anemia during pregnancy is a major public health issue, particularly in developing countries, with significant health, social, and economic consequences. This study aimed to assess the prevalence of anemia among pregnant women attending the Tobruk Medical Center and identify associated factors. A cross-sectional analytical study was conducted from January 2024 to June 2024 on 2187 pregnant women attending the Gynecology Department at Tobruk Medical Center in Tobruk, Libya, to gather data on social and demographic characteristics, reproductive health status, and the prevalence of anemia. Logistic regression was used for statistical analysis. The overall prevalence of anemia among pregnant women was 49.7%, with 42.9% experiencing mild anemia. Parity and gravidity were significantly associated with anemia. The anemia prevalence was higher among multiparous women (51.4%). Other factors, such as age, employment status, and abortion history, did not show a strong association. The prevalence of anemia among pregnant women in Tobruk is high and coincides with WHO’s definition of a severe public health problem. This highlights the need for greater awareness of balanced diets, regular antenatal checkups, and the consistent use of iron and folic acid supplements to address anemia in pregnancy in Libya. Future research should explore these additional factors to better address maternal anemia.

Prevalence and Antimicrobial Resistance of Gram-Negative Bacteria in Clinical and Environmental Samples: A Study from Libya

Jadalla Emhalhel — 2025-08-04

The prevalence of Gram-negative bacteria in hospital settings is a major public health concern, particularly in developing countries where healthcare infrastructure may be limited. This study aimed to determine the prevalence, distribution, and antimicrobial resistance patterns of Gram-negative bacteria in teaching hospitals in Libya. A total of [number] clinical samples were collected from hospitalized patients with suspected infections at [names of hospitals, if applicable] over a period of [duration of the study]. Standard microbiological procedures, including bacterial culturing, biochemical identification, and antibiotic susceptibility testing, were employed to identify and characterize the Gram-negative isolates. The results indicated a high prevalence of Gram-negative pathogens, with Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii being the most frequently isolated bacteria. A significant proportion of the isolates demonstrated resistance to commonly used antibiotics, including beta-lactams, aminoglycosides, and fluoroquinolones, with multidrug-resistant strains emerging as a major concern. The study emphasizes the urgent need for effective infection control measures, appropriate antibiotic stewardship, and regular surveillance to combat the spread of these resistant Gram-negative pathogens in Libyan healthcare settings. Further research is required to understand the underlying factors contributing to the high rates of antimicrobial resistance and to guide appropriate interventions

A Retrospective Analysis of FAST-Sonography Reliability for Blunt Abdominal Trauma Management at Abo-Slim Trauma Hospital: Surgi-cal Outcomes and CT Comparisons

Abdulhakim Glia — 2025-08-05

Blunt abdominal trauma (BAT) represents a significant cause of morbidity and mortality in emergency medicine. Accurate and timely diagnosis, along with appropriate intervention, is crucial in the effective management of trauma patients with BAT. Failure to identify occult injuries may result in preventable adverse outcomes. Focused Assessment with Sonography for Trauma (FAST) and computed tomography (CT-Scans) are essential diagnos-tic tools that aid clinicians in accurately diagnose and manage patients with BAT. This study aimed to evaluate the clinical utility of FAST-Scans performed by emergency surgeons at a regional trauma center (Abo-Slim Trauma Hospital) in the assessment of BAT patients. Additionally, it exam-ines the limitations of FAST and explores potential strategies to enhance its diagnostic efficacy. A hundred of consecutive BAT patients at a Level I trauma center from 2009-2012 were studied, retrospectively. FAST-Scan per-formance was evaluated against laparotomy/CT-Scan findings, with statis-tical analysis using Fisher's exact test and multivariate regression. FAST-Scan demonstrated excellent sensitivity (98.3%) and reliable accuracy (89.5%) for detecting hemoperitoneum, though with limited specificity (14.3%). While CT showed superior anatomical characterization (100% ac-curacy). FAST-Scan remains an indispensable first-line tool for rapid triage in blunt abdominal trauma when interpreted by trained clinicians.

Comparative Prospective Study on Prophylactic Antibiotics versus Empirical Antibiotics in the Prevention of Surgical Site Infection in Libya

Ahmad Abaidalla — 2025-08-10

Surgical site infections (SSIs) develop in or around a surgical wound after the operation depending on the type of procedure performed. One of the main strategies to prevent SSIs is the use of antimicrobial prophylaxis, which is the administration of antibiotics before, during, or after surgery to reduce the risk of wound infections. However, there is controversy about the optimal duration and regimen of antimicrobial prophylaxis. This study aims to investigate and compare the use of prophylactic antibiotics versus empirical antibiotics in preventing SSIs. A prospective observational study was conducted in secondary health center of Aljabal Alakhter in Libya from December 2020 to October 2022. A total of 96 cases were enrolled in the study. Out of whom,46 patients with a mean age of 40.59 (±13.848) years for Prophylactic group and 50 patients with a mean age 31.02 (±17.694) years for Empirical group. Prophylactic group had 17 males and 29 females, while Empirical group had 21 males and 29 females. There was statistically non-significant difference between gender distributions in the two groups. In conclusion: SSIs are one of the most common post operative complications in which a high risk of post operative morbidity and mortality, prolongs hospital stay and raises hospital cost to patients. In our study, the total incidence rate of SSI was 0.0%. While empirical use of antibiotics is of minimal benefit.