Libyan Medical Journal

Frequency of Sternal Variations and anomalies in an Libyan population Using Computed Tomography

Osama Ambarak — 2026-06-01

Introduction:. The sternum is one of the skeletal elements that most frequently exhibits morphological variability in cross-sectional imaging and autopsy series. Congenital anatomical variations of the anterior chest wall can closely mimic, or be obscured by, acquired pathologies such as malignancies, fractures, or severe chest trauma. Therefore, a precise understanding of these benign variants is critical to prevent diagnostic errors. This study aimed to identify the prevalence and morphological diversity of anatomical variations of the sternum within a Libyan population in Benghazi using multi-detector computed tomography (MDCT) scans.

Material and method: This retrospective cross-sectional study was carried out from September 2024 to March 2026. The information was collected from 320 randomly chosen chest CT scans of patients who came to the Benghazi Medical Center (BMC). Patients are male and female Libyan patients (159 women and 161 men) aged 10 and above. Two examiners examined each scan. The data collected was analyzed and results were obtained.

Results: This retrospective cross-sectional study evaluated the prevalence and morphological diversity of sternal variations using MDCT scans of 320 Libyan patients (161 males, 159 females) at the Benghazi Medical Center. The findings revealed that anatomical variants are relatively common, occurring in 26.25% (n = 84) of the total population, with a higher overall prevalence observed in males (32.3%) than in females (20.1%). Variations of the xiphoid process heavily dominated the cohort, with a double-ended (bifid) xiphoid process emerging as the single most common anomaly (33.3%, n = 28), followed by the sternal foramen (17.9%, n = 15), which uniquely demonstrated a female predominance. Furthermore, complex or rare anomalies such as triple-ended and four-ended xiphoid processes, bilateral suprasternal bones, and manubrial foramina were observed exclusively in male subjects, while 10.7% of all variant cases presented with multiple co-occurring anomalies.

Conclusion: These regional baseline data underscore the clinical importance of pre-procedural thoracic imaging to prevent diagnostic errors or inadvertent iatrogenic punctures during invasive chest wall interventions.

Phylogenetic Placement of Libyan Mycteroperca rubra Based on Mitochondrial COI Gene Sequences and Comparative Mediterranean Reference Data

Tarek Shoeib — 2026-06-01

The mottled grouper, Mycteroperca rubra, is a Mediterranean and eastern Atlantic serranid fish with ecological, fisheries, and conservation importance. In Libya, molecular data for this species remain limited, and its relationship with surrounding Mediterranean populations is poorly documented. This study examined the phylogenetic placement of one Libyan M. rubra mitochondrial COI sequence, KX255748.1, 661 bp, together with 11 Mediterranean GenBank reference sequences. Sequences were aligned and analysed in MEGA 10 using the Tamura 3-parameter model. Maximum Likelihood and Neighbor-Joining trees were reconstructed with 1000 bootstrap replicates. Pairwise genetic distances were calculated under the same model. The Libyan sequence was grouped within the main Mediterranean M. rubra lineage and showed very low distance from supported M. rubra references, especially two Spanish sequences, MH707832.1 and MH707833.1, with zero pairwise distance. Three nominal M. rubra records from Italy, Spain, and Tunisia formed a separate divergent lineage and are treated here as probable misidentified Epinephelus costae-like records requiring taxonomic rechecking. The Libyan sequence represents a distinct local COI haplotype branch within Mediterranean M. rubra. These findings support the value of COI barcoding for Libyan grouper taxonomy, reference library correction, and future conservation monitoring

Prevalence and Determinants of Iron Deficiency Anemia Among School-Aged Children in Tobruk, Libya: A Community-Based Cross-Sectional Study

Khadeejah AL-Khurum — 2026-06-08

Iron deficiency anemia (IDA) remains a major public health problem among school-aged children, particularly in low- and middle-income countries, where it adversely affects growth, cognitive development, and immune function. This study aimed to determine the prevalence of iron deficiency anemia and its associated factors among school-aged children in Tobruk, Eastern Libya. A community-based cross-sectional study was conducted between January and June 2025 among 366 children aged 6–14 years attending four primary healthcare centers in Tobruk. Data were collected using structured questionnaires and laboratory investigations. Hematological parameters were measured using an automated hematology analyzer (Sysmex KX-21N), and serum ferritin was assessed to evaluate iron status using an automated biochemical analyzer (Siemens Dimension P Plus). Anemia was defined as hemoglobin <12 g/dL, and IDA as hemoglobin <12 g/dL with serum ferritin <15 ng/mL. Data were analyzed using SPSS version 26.0. The Chi-square test was used to assess associations, and a p-value <0.05 was considered statistically significant. The overall prevalence of anemia was 56.2% (95% CI: 51.1–61.2). Iron deficiency anemia was observed in 32.7% (95% CI: 28.0–37.4) of participants, while 10.3% had iron deficiency without anemia, and 23.4% had other types of anemia. IDA was significantly higher among males (40.0%) compared to females (25.0%) (p = 0.002). A significant association was also found between age group and IDA (p = 0.034), with the highest prevalence among children aged 6–7 years (42.6%). No significant association was found between gender and overall anemia (p= 0.548). Low serum ferritin (<15 ng/mL) was present in 43.2% of children, with no significant difference between genders (p = 0.091). Iron deficiency anemia is highly prevalent among school-aged children in Tobruk, particularly among younger children (aged 6–7 years) and males. These findings indicate a moderate-to-severe public health problem requiring urgent intervention. School-based nutritional programs, routine screening for anemia and iron deficiency, iron supplementation for high-risk groups, and public health education are strongly recommended to reduce the burden of IDA in eastern Libya