Libyan Medical Journal

Investigating The Incidence of Intraoperative Hypothermia and Associated Risk Factors in Laparoscopic Cholecystectomy Patients: A Pilot Prospective Cohort Study

Moaad Abuhallala — 2026-04-01

Intraoperative hypothermia is a frequent and preventable complication during surgery. Despite international evidence, data from Libya remain scarce, especially for laparoscopic procedures. This study was conducted to assess the incidence of intraoperative hypothermia and identify associated risk factors in patients undergoing laparoscopic cholecystectomy. A prospective cohort study was conducted at a single hospital in Libya from October to December 2024. Twenty-seven adult patients undergoing elective laparoscopic cholecystectomy were enrolled. Intraoperative core temperature was recorded every 15 minutes. Demographic and clinical data were analyzed using appropriate statistical methods, including logistic regression. Hypothermia occurred in 77.8% of patients. Risk factors significantly associated with hypothermia included older age, lower BMI, greater intravenous fluid volume, lower operating room temperature, and longer surgery duration. Sex, ASA score, and fasting duration were not significantly associated. Intraoperative hypothermia is highly prevalent among laparoscopic cholecystectomy patients in Libya. Several modifiable risk factors were identified. Preventive measures should be implemented to reduce its occurrence and improve patient outcomes

Sex-Based Differences in Coronary Artery Anatomy and Clinical Outcomes in Acute Coronary Syndrome: A Multicenter Study from Tripoli, Libya

Wasim Khalifa — 2026-04-02

Acute Coronary Syndrome (ACS) exhibits significant sex-based disparities in presentation, management, and outcomes. Understanding anatomical and clinical differences between men and women is essential for optimizing diagnostic and therapeutic strategies. This study aimed to identify sex-specific anatomical and clinical variations in ACS patients, evaluate their influence on diagnosis and management, and assess their impact on short-term outcomes. A retrospective descriptive study was conducted from June to October 2025 at Tajoura Cardiac Hospital and Al-Khadra Hospital, Tripoli, Libya. Medical records of 100 ACS patients were analyzed for demographics, comorbidities, presentation, coronary involvement, and outcomes. A survey of 20 cardiologists assessed recognition and application of sex-specific anatomical considerations. Of 100 patients, 67% were male and 33% female. Typical chest pain was more common in males (36%), while females more frequently reported dyspnea (70%). The left anterior descending artery was most commonly involved (48%), with males showing a higher prevalence of proximal lesions and STEMI (27% vs. 13%). Females more often presented with NSTEMI and diffuse, distal disease. In-hospital major adverse cardiac events occurred in 20% of patients, slightly higher in males. All surveyed cardiologists acknowledged the impact of sex-specific anatomy on outcomes; however, only 10% reported adjusting treatment strategies based on sex. Significant sex-based differences exist in ACS presentation and coronary anatomy. Males typically present with obstructive focal lesions and classic symptoms, while females exhibit diffuse disease, microvascular involvement, and atypical symptoms. Recognizing these variations is essential for developing tailored management approaches to improve outcomes for all patients.

Accuracy of Transvaginal Ultrasound in Diagnosing Endometrial Polyps among Infertility Patients at the National Center for Diagnosis and Treatment of Infertility – Al Jabal Al Akhdar

Ramzi Mohamed — 2026-04-02

Endometrial polyps (EPs) are prevalent benign intrauterine growths associated with abnormal uterine bleeding, an increased risk of malignant transformation, & infertility. This is a prospective interventional study assessing the clinical efficacy of transvaginal ultrasound in the diagnosis of endometrial polyps. The study was conducted at the National Center for Diagnosis & Management of Infertility – AL Jabal Al Akhdar between July 2025 & December 2025, including 214 women with a history of primary or secondary infertility. Women with active pelvic infections, coagulation dysfunction, history of malignancy, severe cardiopulmonary disease, or any contraindications to anesthesia were excluded. The findings demonstrated that TVS had a sensitivity 59.42%, specifically 70.34%, a positive predictive value 48.81%, a negative predictive value was 78.46%, & overall diagnostic accuracy of 66.82%. These findings indicate that transvaginal ultrasonography has moderate sensitivity & has a high specificity for detecting endometrial polyps. Suggesting its reliability as an initial non-invasive screening modality to rule out endometrial polyps

Evaluation of Honey as a Natural Binder in Pharmaceutical Granulation: A Comparative Study with Polyvinylpyrrolidone

Ahmed Abushrida — 2026-04-02

This study investigates the potential of honey, a natural and biocompatible material, as an alternative binder in wet granulation that can be particularly suitable for herbal and pediatric formulations. Lactose monohydrate was used as the model filler. Granules were prepared using wet granulation with distilled water as the granulating fluid. Five concentrations of synthetic binder PVP (1.5–3.5% w/w) and five concentrations of honey (1.5–3.5% w/w) were initially evaluated. Based on initial yield results, a subsequent optimization phase was conducted with honey concentrations ranging from 1.5% to 13.5% w/w at a fixed, lower water concentration (5.5% w/w). The properties of the resulting granules were investigated. The optimal honey formulation was then subjected to a reproducibility study over five batches. The initial results of this study were optimized by increasing honey concentration to 12.5% (with 5.5% water), which significantly improved the yield to 88.3%. This formulation exhibited excellent flow properties (angle of repose: 32.03°, Hausner ratio: 1.07, Carr’s index: 6.83%) and low friability (9.4%), comparable to high-concentration PVP granules. The reproducibility study confirmed the consistency of the 12.5% honey formulation, with minimal batch-to-batch variability. Therefore, in comparison to PVP, honey can be considered an effective and sustainable natural binder for pharmaceutical granulation because at a concentration of 12.5%, it produces granules with excellent yield, flowability, and mechanical strength.

Etiology of Acute Respiratory Infections during an Outbreak in Al-Marj City, Libya: A Descriptive Cross-sectional Study, November 2025

Miftah Awadh — 2026-04-04

Acute respiratory infections (ARIs) are a leading cause of morbidity and mortality worldwide, particularly during seasonal outbreaks. In November 2025, an unusual increase in respiratory illness was reported in Al-Marj City, Libya. A descriptive outbreak investigation was conducted. A total of 43 nasopharyngeal swab samples were collected from suspected cases and tested at the national reference laboratory for influenza A and B, SARS-CoV-2, and respiratory syncytial virus (RSV). Epidemiological data, including age, sex, residence, and clinical severity, were analyzed. Thirty out of 43 samples (69.8%) were positive for influenza A, while all samples tested negative for influenza B, SARS-CoV-2, and RSV. Most confirmed cases were reported from Al-Marj municipality (25 cases). Children under five years and adults aged 50 years and above were the most affected age groups. Sixteen cases were managed at outpatient clinics, seven required hospitalizations, and seven were admitted to intensive care units. Influenza A was identified as the primary causative agent of the outbreak. Strengthening laboratory-supported surveillance systems is essential for early outbreak detection and effective public health response in Libya.

Safety and Outcomes of Pediatric Male Circumcisions Using Ring Penile Block Local Anesthesia

Majdi Hamad — 2026-04-06

Male pediatric circumcision is one of the most commonly performed surgical procedures in Libya. Ensuring safe and effective anesthesia with minimal complications is essential, particularly in day-case settings. The aim is To evaluate the safety and complication profile of penile ring block anesthesia in children undergoing circumcision. This prospective observational study was conducted between July 1, 2020, and March 20, 2026, including 2200 male children undergoing circumcision under penile ring block anesthesia. Patients were divided into two age groups: Group A (7 days–6 months, n = 1633) and Group B (>6 months–7 years, n = 567). Parents monitored children for 24 hours postoperatively and reported complications, with additional follow-up thereafter. Outcomes assessed included lethargy, irritability, bradycardia, seizures, apnea, and hematoma formation. Complications were rare and self-limiting. Hematoma formation was reported in 40 patients (1.81%). Lethargy and drowsiness occurred in 9 patients (0.40%), while irritability was reported in 3 patients (0.13%). Bradycardia and seizure activity were each observed in 3 patients (0.13%). A single case (0.04%) of transient apnea occurred immediately following needle insertion. No severe complications or long-term adverse outcomes were identified. Penile ring block anesthesia is therefore a safe and effective technique for pediatric circumcision, with a very low complication rate. It is particularly suitable for high-volume and resource-limited settings