Derna Universiry Journal of Medical Sciences
Derna University Journal of Medical Sciences (DUJMS) is an international, peer-reviewed, open-access journal published by the University of Derna. It is dedicated to disseminating high-quality original research, reviews, and clinical studies across all medical, pharmaceutical, and health science disciplines. The journal is free to publish and does not charge any Article Processing Charges (APCs).
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Assessing Recurrence of H. pylori Infection in Treated Patients
Helicobacter pylori infection is a globally prevalent bacterial infection linked to various gastrointestinal diseases, the recurrence of H pylori after eradication remains a critical challenge due to factors such as treatment failure, inadequate follow up and exposure to persistent factors. The aim of the study is to evaluate the recurrence rate following H. pylori eradication therapy and evaluate the most risk factors that are associated with H. pylori infection among previous treated patients.. Methods: Data was collected via structured self-reporting in the form of an online questionnaire. The participants must have been previously diagnosed and treated for H. pylori infection at the time of the survey and must have been at least 18 years of age. For access to the sample for the study, evidence of diagnosis and treatment at least six months in advance of the survey was required. According to the data, the female represents the majority of participients 83%. By 47 of individuals 89% had a previous H. pylori infection, 42% had a current infection, and 36% of these cases were recurrent. 92% reported adherence to medical instructions regarding dose and duration of H. pylori treatment protocol.. Importantly, 81% of infected family members did not receive proper treatment. In addition, 58% had dental or gum disease. There is a high recurrence of H. pylori infection, this study highlights the need for improved diagnostic followup, patient education, screening household contacts, improving oral health and optimizing management strategies.
Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
Four-Year Trends of Uropathogen Prevalence and Antimicrobial Resistance in Eastern Libya
Urinary tract infections (UTIs) are among the most common bacterial infections, and increasing antimicrobial resistance (AMR) has become a major challenge to effective treatment. This study evaluated the prevalence of Uropathogen and their antimicrobial susceptibility patterns at Tobruk Medical Centre, Libya, over a four-year period. A retrospective analysis was conducted on 6,032 urine samples collected between January 2021 and December 2024. Bacterial isolates were identified using standard microbiological methods, and antimicrobial susceptibility testing was performed by the Kirby–Bauer disk diffusion method according to CLSI guidelines. Of the 6,032 samples, 1,264 (20.95%) yielded significant bacterial growth. Gram-negative bacteria predominated (81.8%), with Escherichia coli (49.36%) as the most common isolate, followed by Klebsiella spp. (16.85%) and Staphylococcus aureus (14.79%). Nitrofurantoin demonstrated the highest overall activity against most Uropathogen, whereas resistance to several commonly prescribed antibiotics increased during the study period, indicating an emerging multidrug-resistant trend. Uropathogen isolated at Tobruk Medical Centre showed substantial antimicrobial resistance, highlighting the need for routine culture-based susceptibility testing, continuous local AMR surveillance, and strengthened antibiotic stewardship to optimize empirical treatment strategies.
Floristic, survey and Identification of Marine Algae in the Coastal Zone at Sidi Khalifa Coast, Benghazi - Libya
This study was for three months ( May, June and July), research offers a comprehensive taxonomic evaluation and comparative ecological examination of marinealgal species along the shoreline of Sidi Khalifa, northeast of Benghazi, Libya, including an extensive examinationanalysis of historical and modern regional literature. Algal and crystalline inorganic matriceswere collected from two hydrodynamically influenced settings: Station 1 (Open Wave-ExposedLittoral Rocks) and Station 2 (Enclosed, Low-Energy Lagoon Pool that is Semi-Isolated). Employing elevatedIn resolution light microscopy, a 17-panel digital system was examined to elucidate filamentous structures.cellular branching structures, diversity of pennate diatoms, and dynamics of secondary crystals. The open oceansector displayed a strong, varied biological profile led by resilient chlorophytes (Cladophora spp.),expanding leaf-like structures (Ulva lactuca), and slowly-growing brown algae (Cystoseira spp.), along withabundant siliceous pennate diatom communities (Navicula spp.). In contrast, the limited basin exhibited indicationsof significant ecological strain, leading to widespread filament breakdown, plasmolysis, and substantialthe formation of acicular, dendritic, and prismatic crystals influenced by hyper-salinity and cultural factorseutrophization. Comparison of these findings with previous Libyan studies suggests that the proliferation of Ulva and Cladophora, together with the decline of brown algae, serves as a reliable bioindicator of localized ecological degradation along the southern Mediterranean coast.)for localized ecological decline along the southern Mediterranean shore.
Global Research Trends in Medical Imaging for Breast Cancer: A Bibliometric Analysis (2000–2025)
Background: Breast cancer remains the most common malignancy among women globally, making early detection and accurate diagnosis vital for enhancing patient outcomes. Advances in breast imaging modalities have played a pivotal role in improving diagnostic accuracy over the few decades. This study aims to summarize published literature in PubMed between 2000 and 2025 on breast cancer detection and diagnosis using various imaging modalities. A comprehensive PubMed search strategy was conducted using MeSH terms and keywords associated with breast neoplasms and breast imaging modalities (mammography, ultrasound, MRI, virtual breast tomosynthesis, assessment-stronger mammography, molecular breast imaging, and thermography). The seek became restricted to check articles posted between 2000 and 2025, yielding a total of 4,107 studies. Mammography remains the cornerstone of breast most cancers screening applications, with ultrasound and breast MRI serving as complementary gear, especially in dense breast tissue and excessive-danger populations. In recent years, rising modalities which include digital breast tomosynthesis, assessment-superior mammography, and molecular breast imaging have won increasing interest for his or her capability to enhance sensitivity and specificity. Moreover, the integration of synthetic intelligence into breast imaging is highlighted across the literature as a promising method to enhance diagnostic performance and decrease fake-high-quality fees. The body of evidence suggests significant advancements in breast imaging technologies over the past 25 years. The future detection of the most breast cancers imaging lies in combining conventional modalities with innovative techniques and AI-driven evaluation to optimize early detection and personalized care.
Impact of Energy Drinks Consumption on Renal Functions in Female Mice
This study investigated the effects of energy drink consumption on kidney function in female mice. Fifteen mice were divided into three groups, with five animals in each group. The control group received a normal diet and water, while the second and third groups were administered 1.2 ml and 2.4 ml of an energy drink, respectively, in addition to their regular diet. Renal function was assessed by measuring selected biochemical parameters, and behavioral changes were monitored throughout the experimental period. The findings revealed significant increases in renal function biomarkers in both treated groups compared with the control group. In addition, mice exposed to energy drinks exhibited reduced daily activity and altered social behavior. These effects were more pronounced at the higher dose level.
Assessment of Drinking Water Quality in Derna, Ain Mara, and Al-Quba (Al- Jabal Al- Akhdar Basin) following Storm Daniel
The city of Derna and the surrounding areas located within the Al- Jabal Al- Akhdar basin, one of the most important water basins in Libya, experienced a severe environmental disaster as a result of Storm Daniel, which struck the region in September 2023. This event led to devastating floods and the collapse of infrastructure, including water supply and sewage networks, raising concerns about the potential contamination of drinking water sources with chemical and microbiological pollutants. This study focuses on evaluating the quality of drinking water in three areas within the Al- Jabal Al- Akhdar basin: Derna, Ain Mara, and Al-Quba. Fieldwork was conducted during different periods following the disaster (from November 2024 to April 2025) to assess the extent to which water quality was affected by environmental factors resulting from the floods. The analyses included physical parameters (such as temperature and turbidity), chemical parameters (such as nitrates and chlorine), and microbiological parameters (such as coliform bacteria). The results were compared with the Libyan Standard Specification No. 82 of 2013, as well as the World Health Organization (WHO) guidelines of 2011. The results showed that all samples complied with the Libyan standards, with no indications of serious or persistent contamination. This suggests that the ecosystem of Al-Jabal Al-Akhdar has the capacity to absorb environmental shocks, as well as the effectiveness of the efforts made by the relevant authorities to contain the negative impacts of natural disasters. The study concluded with several recommendations, including the need for continuous periodic monitoring of water quality, expanding the geographical scope of assessment, and developing an environmental water emergency plan for future disasters.
Assessment of Radiation Dose and Diagnostic Accuracy of Contrast-Enhanced CT Urography for Urinary Tract Imaging
Computed Tomography Urography (CTU) is a cornerstone imagingmodality in the evaluation of urinary tract pathology, providing high-resolution cross- sectional visualization of the kidneys, ureters, andurinary bladder. Despite its strong diagnostic performance, CTU isassociated with relatively high radiation exposure, making doseoptimization a key priority in modern radiological practice under the ALARA principle. This study aimed to evaluate radiation dose levelsand assess the diagnostic performance of contrast- enhanced CTurography in a real clinical setting. A descriptive analytical study wasconducted at Tobruk Medical Center and Al- Afia Outpatient Clinic on30 patients between November 2025 and March 2026. Radiation dosemetrics, including CTDIvol and Dose Length Product (DLP), wereobtained, and the effective dose (ED) was calculated. The analysisrevealed that the mean CTDIvol was 12.33 ± 2.33 mGy, while the meanDLP was 1930.50 ± 874.52 mGy.cm, resulting in an average effectivedose of 28.95 ± 13.11 mSv. The study population demonstrated a broadrange of pathologies, including calculi, -tumors, and congenitalanomalies, with CTU achieving a high diagnostic accuracy of 93.3%. The study concluded that the recorded radiation doses were optimizedand aligned with international diagnostic reference levels, achieving asuccessful balance between diagnostic yield and patient safety.
Correlations of Serum Zinc with NLR, Lymphocyte Count and CRP in Tripoli, Libya: A Retrospective Analysis
Zinc is an essential micronutrient vital for immune function. Its deficiency can lead to immune dysregulation, but data from North African populations are scarce. This research aimed to investigate the correlation between serum zinc concentrations and primary immuno-inflammatory markers, including C-reactive protein (CRP), absolute lymphocyte count, and the Neutrophil-to-Lymphocyte Ratio (NLR), in an adult population in Tripoli, Libya. A retrospective cross-sectional analysis was performed utilizing data from 112 adult participants at Tripoli Medical Center. Serum zinc levels, complete blood count with differential, and C-reactive protein levels were documented. The NLR is determined according to the ratio of the absolute neutrophil count to the absolute lymphocyte count. The relationships among the variables were examined using Pearson’s correlation analysis, while group differences according to zinc status were evaluated through an independent samples t-test. Participants had an average age of 32.3±13.8 years. The analysis indicated a substantial negative association between serum zinc concentration and NLR (r = -0.485, p < 0.001). Conversely, serum zinc concentration demonstrated a considerable affirmative association with the absolute lymphocyte count (r = 0.398, p = 0.002). When stratified by zinc status, the zinc-deficient group (< 70 µg/dL) exhibited a significantly higher mean NLR (3.9 vs. 2.4, p < 0.001) and a decreased mean lymphocyte count (1.6 vs. 2.3 x10³/µL, p = 0.004) compared to the zinc-sufficient group. Lower serum zinc levels are strongly associated with an elevated NLR and reduced lymphocyte counts, indicating a pro-inflammatory and immune-compromised state. These results highlight how crucial it is to maintain sufficient zinc levels for immunological homeostasis. Screening for zinc deficiency may be clinically relevant in the administration of inflammatory disorders in the Libyan population.
Assessment of CKD-MBD Parameters for Hemodialysis Patients at Al Wahda Hospital in Derna, Libya
The World Health Organization and research centers have cautioned about the extraordinary expansion and growth of chronic renal failure. The fact that there are few, inconsistent, and hazardous studies on chronic renal failure in Libya is noteworthy for patients with renal failure in recent years. The study indicated to illness and how quickly it spreads. Data comprised a follow-up of 60 cases of both sexes and compared them to a group of healthy individuals. Estimates of calcium (ca+2) levels, phosphate (po4) levels, levels of vitamin D, and levels of parathyroid hormone (PTH) were measured. The findings revealed that the levels of vitamin D and calcium varied significantly, however parathyroid hormone and phosphate levels did not.
Prevalence of Helicobacter Pylori Infection in Adult Patients with Dyspepsia at the Gastrointestinal and Hepatology Clinic in Tobruk Medical Center, Tobruk, Libya
Dyspepsia is a highly prevalent gastrointestinal condition characterized by persistent or recurrent epigastric discomfort or pain. It represents a significant clinical burden worldwide and is frequently encountered in both primary care and specialized gastroenterology settings. The underlying pathophysiology of dyspepsia is complex and multifactorial, involving disturbances in gastric motility, visceral hypersensitivity, psychosocial factors, and infectious causes. Among these, infection with Helicobacter pylori has been widely recognized as an important contributor, particularly in developing countries where its prevalence remains high. This cross-sectional study aimed to determine the prevalence of Helicobacter pylori infection among adult patients presenting with symptoms of dyspepsia at the Gastrointestinal and Hepatology Clinic in Tobruk Medical Center, Tobruk, Libya. The study population consisted of adult patients aged 18 years and above who presented with clinical features suggestive of dyspepsia over the study period. A total of 205 patients were recruited, including 100 males and 105 females. Relevant demographic and clinical data were collected, and all participants were evaluated for Helicobacter pylori infection using appropriate diagnostic methods. Out of the 205 patients included in the study, 164 were found to be positive for Helicobacter pylori, yielding a prevalence rate of 80%. The findings of this study demonstrate a high prevalence of Helicobacter pylori infection among adult patients with dyspepsia in this setting, highlighting the need for routine diagnostic evaluation and targeted eradication therapy to improve patient outcomes.
The Role of Urodynamic Study in Evaluating Children with Refractory Nocturnal Enuresis
Nocturnal enuresis or bedwetting is the most common type of urinary incontinence in children. It has significant psychological effects on both the child and the family. The Aim of study was to evaluate the role of UDS in evaluation of refractory Nocturnal Enuresis in children. This Prospective Study was carried out in Urology Department, Tobruk University that included 30 Patients, 18boys and 12 girls. The patient ages was ranged from 10–18 years old with mean age (SD) of 11.91± 1.95 years. All patients were treated with mono pharmacotherapy (desmopressin). The duration of treatment before urodynamic studies (UDS) at last six months. Bladder sensation was intact in 41.7%, increased in 50.0% and decreased in 8.3% of patients. The value of a single test PVR was ranged from 20-150 ml. 21 of patients were no post voiding volume (87.5%) and 3 cases had post voiding volume (12.5 %). The filling cystometry was normal in 6 patients (25%) and abnormal in 18 patients (75%). Bladder sensation intact in 10 patients (41.7%) and decrease in 2 patients (8.3%) and increase in 12 patients (50%) with p-value (< 0.05). It is recommended to perform urodynamic studies in the form of uroflowmetry and cystometry for those with refractory nocturnal enuresis who failed ADHC ( desmopression ) for at last 6 months as initial monotherapy. Also a combination therapy of anticholinergics with desmopressin could be applied as treatment for those with refractory monosymptomatic nocturnal enuresis.
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The Inhibitory Effect of Water and Alcoholic Extracts of Seed of Peganum Harmala on the Isolation of Bacterial E. coli and Staphylococcus aureus
This experiment was conducted to evaluate the inhibitory effects of aqueous and alcoholic seed extracts of Peganum harmala. The antimicrobial activity of both extracts was tested against Staphylococcus aureus (Gram-positive) and Escherichia coli (Gram-negative). Four concentrations were used: 2, 4, 6, and 9 mg/ml for both extracts. The results showed that the alcoholic seed extract of Peganum harmala exhibited stronger antimicrobial activity, with inhibition zones of 11 mm against S. aureus and 10 mm against E. coli. In contrast, the aqueous extract produced smaller inhibition zones: 4 mm against S. aureus and 2 mm against E. coli, indicating lower antimicrobial activity compared to the alcoholic extract.
Vitamin D Deficiency as a Risk Factor for Hypothyroidism: A Revised Evidence-Based Review
Hypothyroidism is a common endocrine disease characterized by insufficient synthesis of thyroid hormones, which has become a serious health problem worldwide. At the same time, deficiency of vitamin D, an endemic nutritional deficiency is increasingly being associated with a variety of AIDs and endocrinopathies. The aim of this review is to summarize the current literature in relation to vitamin D deficiency and hypothyroidism, with specific emphasis on immunologic mechanisms and clinical significance. A review of the newer literature (2020-25) was performed, including observational studies, meta-analyses and interventional trials. The findings indicate a notable correlation between decreased serum vitamin D levels and an elevated risk of hypothyroidism., especially autoimmune hypothyroidism like Hashimoto's thyroiditis. Mechanistically, vitamin D exerts immunomodulatory impacts by regulating the balance between T-helper cells, enhancing regulatory T cell activity while inhibiting pro-inflammatory cytokine production, thereby influencing thyroid autoimmunity. Large-scale population studies, comprising the National Health and Nutrition Examination Survey (NHANES), have documented adjusted odds ratios of 1.6 to 1.7 for hypothyroidism in vitamin D deficiency individuals. Meta-analyses support these findings, indicating significantly reduce serum vitamin D levels in hypothyroidism and Hashimoto's thyroiditis patients relative to healthy controls. Vitamin D supplementation has demonstrated potential in lowering thyroid autoantibody levels and enhancing thyroid function in certain studies, the clinical benefits remain heterogeneous and appear to be most effective in euthyroid individuals with baseline vitamin D deficiency. This review concludes that vitamin D deficiency is a significant risk factor for hypothyroidism and highlights the potential of vitamin D supplementation as an adjunctive therapy, especially in population with a high prevalence of both conditions, for instance, in the Middle East and North Africa. To create conclusive clinical guidelines, more extensive randomized controlled trials are required.
Role of Serum C-Reactive Protein and White Blood Cells in the Diagnosis of the Patients with Suspected Appendicitis: A Prospective Cohort Study
Uses of some laboratory investigations in the diagnosis of patients with suspected acute appendicitis have been widely used. However, white blood cell count (WBCC) and C-reactive protein (CRP) were routine requested in patients with suspected appendicitis. This work of prospective study aimed to assess the useful of WBCC and CRP value in diagnosis of patient with suspected appendicitis. A prospective cohort study were performed. WBCC and CRP were measured prospectively in patients presenting with lower right abdominal pain at the surgery department of Alwahda hospital in Derna city. The results were correlated with each patient’s outcome. It shown that uses of WBCC and CRP tests in combination had sensitivity ( 65%) ; specificity (75%) ; PV (+) 92.8% and PV (-) 30%. Also CRP had the highest degree of diagnostic accuracy than WBCC {sensitivity, 81.2%; specificity, 68.7%; PV (+), 92.8%; PV (-), 42.3% & sensitivity, 72.5%; specificity, 50%; PV (+), 87.8%; PV (-), 26.6%}, respectively. Despite of that the result may have an important clinical and economic implication. The diagnosis of appendicitis should be mainly depended on clinical examination finding and include others helpful investigations such as Ultrasound and CT scan.
The Diagnostic Value of C-Reactive Protein Titer in Suspected Acute Appendicitis
Acute appendicitis is one of the most common causes of acute abdominal pain requiring surgical intervention. Despite its frequency, diagnosing appendicitis remains challenging, especially in atypical presentations or in early stages of the disease. Misdiagnosis can lead to unnecessary surgeries or delayed treatment with serious complications. While clinical examination and imaging are key components in diagnosis, laboratory biomarkers such as C-reactive protein titer (CRP T) have emerged as valuable supportive tools. Aim of this study is to assess accuracy of C-reactive protein titer in acute appendicitis. The prospective study will be conducted on patient have symptoms and sign of acute appendicitis with high CRP titer presenting to general surgery of alwahda hospital. This study are in strong agreement with the data collected through the prospective observational method. The data were gathered from 24 patients presenting with clinical features suggestive of acute appendicitis, that included demographic details, symptoms, CRP titers, and final through operative findings or follow-up evaluation. The consistency observed between elevated CRP levels (≥ 2.5 mg/dL) and confirmed cases of acute appendicitis (18 out of 18) validates the reliability and integrity of the data collection process. Additionally, the identification of 3 false negatives (CRP < 2.5 mg/dL but diagnosis confirmed) highlights the sensitivity of the dataset to variations, reinforcing the importance of comprehensive clinical assessment. This prospective observational study suggests that CRP titer, in conjunction with clinical features (especially abdominal pain, fever, leukocytosis), While not definitive alone.
Propofol versus Sevoflurane for Postoperative Pain following Open Cholecystectomy: A Randomised Controlled Trial
Postoperative pain (POP) remains a common challenge following open cholecystectomy (OC). In Libya, survey data report that more than 50% of patients experience significant pain within 24 hours, highlighting a critical need for improved analgesic strategies. As a key factor hindering recovery, effective pain management is essential. This randomized controlled trial evaluated whether propofol-based total intravenous anaesthesia (TIVA) reduces early POP compared to standard inhalational techniques in this population. A prospective, double-blind, randomised controlled trial enrolled 80 patients undergoing OC. POP intensity was quantified by applying the numerical rating scale (NRS) at 2-, 6-, 12-, and 24-hour intervals following surgery. Statistical analyses were conducted with SPSS version 26. Between-group comparisons using independent t-tests and one-way ANOVA indicated that participants receiving propofol-based TIVA exhibited significantly reduced pain scores at 2, 6, and 12 hours postoperatively relative to the sevoflurane-based inhalational anaesthesia (IA) group (p < 0.05). However, no statistically significant intergroup difference was observed at the 24-hour assessment (p > 0.05). This pattern suggests that the analgesic advantage of propofol TIVA is predominantly evident during the immediate postoperative period. At 24 hours postoperatively, propofol TIVA did not confer superior analgesic efficacy compared with sevoflurane IA in patients undergoing OC. Consequently, these results do not endorse propofol TIVA as the preferred anaesthetic strategy for attenuating POP in this surgical context.
Psychological Stress Triggered by Storm Daniel as a Catalyst for Vitiligo Activity : A post -Disaster Clinical Assessment
Vitiligo is a chronic autoimmune disorder in which psychological stress is recognized as an important trigger for disease activity. In September 2023, Storm Daniel caused catastrophic flooding in Derna, Libya, resulting in severe psychological trauma among survivors. This study aimed to assess the impact of disaster-related psychological stress on vitiligo activity among affected patients. A cross-sectional survey-based study was conducted in Derna involving patients with a confirmed diagnosis of vitiligo who experienced the storm. Data regarding disease characteristics, distribution patterns, and self-reported changes in disease activity following the disaster were collected and analyzed. A total of 49 patients participated, of whom 66.7% reported disease progression after the storm. Non-segmental generalized vitiligo showed a significantly higher rate of progression compared to localized and segmental forms (p = 0.003). These findings suggest that severe psychological stress following natural disasters may contribute to increased vitiligo activity, particularly in immunologically active non-segmental forms. Psychological support and close dermatological follow-up should be considered essential components of post-disaster healthcare for patients with vitiligo.
Prevalence and Indications of Cesarean Section at Tobruk Medical Center: A Cross-Sectional Study at Tobruk, Libya
Knowing the reason for the increase in cesarean births, their complications, and possible outcome. This study aims are to assess the rate and causes of cesarean section births at Tobruk Medical Center in Libya, in light of the increasing rates globally and locally, the results aim to provide data that will contribute to improving medical practices and developing effective strategies to promote maternal and newborn health. Retrospective cross-sectional study was conducted on 701 women who underwent caesarean sections at Tobruk Medical Center, Libya, between October 2024 and June 2025, after obtaining ethical approval. Data were collected from obstetric records and included maternal demographics, delivery type, indications for caesarean section, and outcomes. All women with complete records were included, excluding vaginal deliveries and abortions below the threshold for survival. The study included 701 women with a mean age of 32 years. Emergency cesarean sections accounted for 64.5% of cases, and 91% of newborns were alive. The most common indication for cesarean delivery was a previous cesarean section (36.7%) ،followed by fetal distress (12.8%) and maternal morbidity (12.7%). At Tobruk Medical Center, 22.6% of births were cesarean, mostly emergency cases. Previous cesarean, fetal distress, and maternal complications were the main causes. Improved obstetric practices and monitoring may reduce unnecessary emergencies.
Comorbidities Associated with Hospitalized Heart Failure in Libya
Education about different comorbidities among heart failure patients is crucial for optimizing care and outcomes. This work is aimed to correlate age and sex to comorbidities of patients diagnosed with heart failure and to estimate the relation between commonest comorbidities to other comorbidities. A cross-sectional study was performed from 1st April 2024 to 1st October 2024. Data were collected data from Cardiology Department at Tripoli University Hospital (TUH). 40 patients were admitted and diagnosed with many health difficulties including heart failure, arterial hypertension, diabetes, hypothyroidism, Ischemic heart disease (IHD), atrial fibrillation, chronic obstructive airway disease (COPD), bronchial Asthma, cerebrovascular accident (CVA), anemia, chronic kidney disease (CKD), valvular heart disease (VHD), obstructive sleep apnea (OSA). Data showed that the most common comorbidity (>90%), was a primary risk factor for HF development (especially HFpEF). Chronic Kidney Disease (CKD) considered as a powerful independent predictor of mortality and readmission and represented about 40-50% of hospitalized HF patients. While, diabetes mellitus (DM) represented 30-45% of hospitalized HF patients. This might accelerate atherosclerosis, promote myocardial dysfunction (diabetic cardiomyopathy), complicates fluid/electrolyte management, and increase infection risk. Also, SGLT2 inhibitors had revolutionized the care for HF patients with diabetes mellitus. Moreover, 30-50% of hospitalized HF patients were diagnosed with anemia which contributed to reduced oxygen delivery, worsening symptoms (fatigue, dyspnea), and associated with increased mortality and readmissions. A strong healthy management is required to enhance health of patients with heart failure.
Study the Role of Glycemic Index Values of Some Foods in the Type 2 Diabetes Mellitus Control
The glycemic index (GI) classifies carbohydrates based on how they affect blood sugar levels. Foods with a high GI cause rapid spikes in blood glucose, while those with a medium or low GI lead to more gradual increases. This study explored how foods with different GI levels influence blood sugar control, metabolic health, and overall well-being in both healthy individuals and those with diabetes. In healthy individuals, consuming high-GI foods resulted in temporary spikes in blood glucose followed by sharp drops, which may trigger increased hunger and fluctuations in energy levels—rising from (204 ± 19.88)mg/dl to (320 ± 19.89)mg/dl after consuming high-GI foods. In contrast, medium and low-GI foods helped maintain more stable blood sugar levels, improving satiety and potentially lowering the risk of metabolic disorders. For people with diabetes, high and medium-GI foods like bananas and white bread can worsen post-meal blood sugar spikes, making it harder to manage glucose levels and increasing the risk of long-term complications, such as cardiovascular disease. Low-GI foods, such as whole grain bread, when consumed in controlled amounts, proved to be a safer option. They supported more gradual changes in blood glucose—from (200 ± 12.74) to (220 ± 10.0)—and enhanced insulin sensitivity. The study underscores the importance of tailored dietary strategies, recommending a focus on medium and low-GI foods to maintain stable blood sugar levels. It highlights the value of considering individual health needs, dietary habits, and glycemic targets in planning effective nutrition for both healthy and diabetic populations.
Effect of Antenatal Corticosteroids on Neonatal Outcomes in Term Planned Caesarean Deliveries: A Clinical Trial at Benghazi Medical Center
Respiratory distress syndrome is one of primary causes of early newborn morbidity and death, considerably contributing to the substantial costs associated with neonatal intensive care. Antenatal corticosteroids given at or near term can help reduce the risk of respiratory complications in newborns by accelerating lung maturation and promoting the clearance of alveolar fluid. This study is aimed to evaluate the effectiveness of the corticosteroid therapy prior to elective cesarean section at term in mitigating the respiratory morbidity in the neonates. The total participant are 400 pregnant women were admitted for elective C\S meeting with inclusion criteria, in each group 200 case group (IM Dexamethasone given) and 200 control group (not given Dexamethasone). The average age was 34.10 years (± 6.97). The minimum age was 20 years, while the highest age was 48 years. The mean Apgar scores at 1 minute were statistically substantially elevated in the case group relative to the control group. The occurrence of transitory tachypnea was considerably less in the group administered intramuscular dexamethasone compared to the control group. Maternal age, gravida, parity, and gestational age does not appear to have difference among both group. Intramuscular injection of dexamethasone before elective caesarean section at term pregnancy can reduce neonatal transient tachypic attack, and intramuscular injection of dexamethasone before elective caesarean section at term pregnancy has positive effect on neonatal Apgar score at 1 minute.
Role of Physiotherapy in Improving the Quality of Life of Dialysis Patients: Assessment of Functional Outcomes and Laboratory Biomarkers
The present study was conducted to determine the effect of the Exercise on the renal dialysis patient and their life. Sixty dialysis patients participated in this study; their age ranged from 30 to 60 years. All subjects participated in the study received the treatment program three times per week and were evaluated before and after eight weeks of the treatment program. The results obtained revealed significant differences of all measured variables; blood analysis, six minutes walking distance test, modified borg scale, short form 36 quality of life questionnaire (SF-36). A statistically significant difference was also found in improvements in physical function. Incorporating aerobic, resistance, and flexibility exercises into routine hemodialysis care is vital for reducing physical deconditioning, enhancing overall health outcomes, and improving performance in activities of daily life. Further studies are requirements to confirm this finding.
Effect of Nanotube Fillers on Impact Strength and Fracture Toughness Forces of PMMA Denture Base Material
The main goal of this research was to create nanocomposites of poly methyl methacrylate (PMMA) with improved mechanical strength. The study aimed to explore how different amounts of hybrid nano-fillers (4.25 wt% HNTs and 0.75 wt% MWCNTs) ranging from 1% to 6% affected the impact strength (IS) and fracture toughness (KIC) properties of these materials. Additionally, the research involved examining the surface characteristics of the PMMA nanocomposites using Field Emission Scanning Electron Microscopy, after treating the hybrid nanofillers with a silane coupling agent. The results showed a significant increase in both impact strength and fracture toughness as the loading of hybrid nanofillers increased. Particularly noteworthy was the substantial improvement in IS and KICvalues when the nanofillers reached a loading of 5 wt%, measuring 10.25 KJ/m2 and 2.58 MPa·m1/2, respectively. In comparison, the pure PMMA matrix had significantly lower values of 5.27 KJ/m2 for IS and 1.60 MPa·m1/2 for KIC. Consequently, the addition of hybrid nanofillers (HNTs/MWCNTs) into the PMMA matrix greatly enhanced the PMMA denture base material, indicating its potential for improving the longevity of dental composites.
Incidence of Diabetic Nephropathy among Patients in Kidney Department in Al-Wahda Hospital, Derna
This study aims are to find out the effect of diabetes and diabetic nephropathy on kidneys, and to identify age and gender of susceptible cases to these diseases. The study were performed in kidney and internal medicine departments in Al-Wahda Hospital in Derna, Libya. Approximately, 100 cases suffering from diabetes and diabetic nephropathy with varying ages were recorded. The results showed that females were more susceptible to developing diabetes, while males were more susceptible to developing diabetic nephropathy. The age group of most susceptible to developing diabetes and diabetic nephropathy was between 51-70 year. where data is found 31 cases were with diabetes nephropathy and 9 patients were diagnosed only with diabetes in this age group . This indicates that diabetes has an impact on kidney disease if the affected person does not practice a healthy lifestyle and does not receive regular follow-up of the disease.
A Study on the Prevalence of Thyroid Disorders Associated with Age and Sex in Derna, Libya
This study aims to determine the prevalence of thyroid dysfunction and its association with age and sex in the population of Derna City. In this retrospective cross-sectional study, we screened 5191 suspicious cases of thyroid diseases within two years from January 1, 2021, to December 31, 2022, retrieving the data about thyroid function test (TFT) including serum concentrations of TSH, Triiodothyronine (T3), Thyroxine (T4), from the computers of nine clinical laboratories of Derna City. The prevalence of thyroid dysfunction was determined in terms of number and percentage. Comparisons of the prevalence of thyroid abnormalities in subjects of different age groups and genders were determined in cross-tabulation. We concluded that thyroid diseases affect women more than men and increase with age. Also, the most prevalent type was hypothyroidism especially subclinical.
Ultrasound in the Detection of Chronic Liver Disease
Ultrasound imaging is a widely used, noninvasive diagnostic tool for liver diseases, offering real-time visualization of liver tissue structure and abnormalities. However, accurately characterizing liver conditions based on ultrasound images remains challenging due to variations in image quality and interpretation. This study proposes a system for analyzing and categorizing normal, fatty and heterogeneous liver conditions using textural analysis of ultrasound images, optimizing the selection of regions of interest (ROI) to improve diagnostic accuracy. The study aimed to determine the prevalence of liver diseases diagnosed via ultrasound between 2017 and 2024, categorizing cases based on age and sex. Data were collected from the Tobruk Liver Disease Center and included 59 patients diagnosed with liver disease: 26 males (44.07%) and 33 females (55.93%). The study focused on four primary liver diseases: fatty liver, cirrhosis, hepatitis C virus (HCV), and liver cancer. Cases not diagnosed via ultrasound were excluded. Diagnosis was performed using high-resolution ultrasound devices to assess liver tissue characteristics, size, the extent of steatosis or fibrosis, and the presence of abnormal masses. However, this study did not incorporate advanced imaging techniques such as Doppler ultrasound, histogram analysis, B-mode (Brightness Mode), M-mode (Motion Mode), elastography or harmonic imaging, which could have enhanced measurement precision. The results revealed that cirrhosis was the most prevalent condition (61.02%), followed by fatty liver (18.64%), viral hepatitis (5.08%), liver cancer (6.78%) and hepatomegaly (15.25%). Additional associated conditions included kidney stones (5.08%), splenomegaly (23.73%) and gallstones (6.78%). Notably, six cases (10.17%) were classified as normal. The most affected age group was between 50 and 70 years, though cases were also observed in children aged 1–10 years. The study highlights a significant increase in liver disease cases over the analyzed period, emphasizing the need for improved screening and early detection strategies to enhance patient outcomes.
Carbohydrate Counting versus Fixed Insulin Doses in Children and adolescents with Type 1 DM
Diabetes mellitus incidence raising globally. Diet control is one of important aspects in children with type 1 diabetes. We aimed to compare glucose control in type 1 diabetic children and adolescents using the fixed insulin meal doses with those who counted carbohydrates precisely. So we do a across sectional study on diabetic children and adolescents with type I diabetes mellitus visiting Tobruk Diabetic Center in three months period , Data collected by author through questionnaire including demographic data of children, who using carbohydrate counting versus fixed daily prandial doses and last glycosated hemoglobin and any complications happened. So we divide the patients into two groups :carbohydrate counting and fixed insulin dose groups and compare blood sugar control in both groups. We found no any different in blood sugar control and glycosated hemoglobin in children and adolescent using either carbohydrate counting nor fixed daily insulin doses with poor glycemic control in most studied diabetic patients. Also gender not affecting on glycemic control and no correlation between the disease chronicity, complications and previous hospital admission and carbohydrate counting usage.
Diagnostic Radiology Challenges and Barriers During Daniel Storm in Derna, Libya
In September (2023) during flooding in Derna by Storm Daniel's, health system failure to get the demands of the disaster and hospitals possess cutting. The main purpose of this study is to explore the challenges and barriers faced radiology department. The questionnaires were distributed online, and a sample of 40 participants was obtained. SPSS was used to analyze the data and exploratory factor analysis (EFA) and Descriptive Statistical Analysis (Mean, Std. Deviation) were used to explore the challenges and barriers faced radiology department in Derna–Libya. The results showed that the most challenges faced the radiology department during the Storm Daniel disaster hindered their ability to effectively respond to the increased demand for imaging services during the disaster. Likewise, this study in Derna – Libya may provide a more in-depth understanding of what is needed for Libyan radiology departments, when crisis or disasters possibly arise. And, thus, permit the improvement of strategies to face any crisis or disasters. Future researchers can extend the understanding of this study in other crisis and more samples of radiology department, and its practices in response to issue storm Daniel.
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Examination of the Effects of Weight's Insulin Resistance on the People in Derna, Libya
This study aimed to identify the best single marker of insulin resistance using the gold standard method, focusing on its relationship with body weight. Conducted over three months (March to May, 2024). It included 159 participants (68.6% females, 31.4% males) who responded to paper and electronic questionnaires distributed among healthcare professionals and the public. The findings revealed that BMI was the strongest predictor of insulin resistance in adipose tissue, particularly in females, where 23% of obese women (BMI ≥29 kg/m²) exhibited insulin resistance. Among males, 62% of those with a BMI ≥30 kg/m² were affected. Waist circumference (WC) was also significantly linked to insulin resistance, with an 84% association in females (WC ≥96.55 cm) and a 50% association in males (WC ≥108 cm). These results highlight a high prevalence of insulin resistance in the city, with women being more affected than men. This study underscores the importance of BMI and WC as markers of insulin resistance, providing valuable insights into local health trends.
Comparison between Traditional and PCR Methods for Identifying Fusarium oxysporum f. sp. Melonis, the Causal Agent of Watermelon Citrullus lanatus Wilt
Fungal diseases have become a major threat to field crops, particularly watermelons, due to the escalating prevalence of Fusarium oxysporum. This soil-borne pathogen has been identified as a primary cause of significant yield losses in watermelon cultivation across various regions of eastern Libya, including Tobruk, Al Marj, and Tukrah. The study aimed to investigate the prevalence of F. oxysporum f. sp. melonis, the causal agent of Fusarium wilt in watermelons, and to establish a reliable and efficient diagnostic protocol.Visual symptoms such as leaf chlorosis, wilting, and root rot were observed in watermelon plants across the study sites. Fungal isolates were obtained from symptomatic tissues and subjected to morphological, microscopic, and molecular analyses. Morphological and microscopic characterization provided preliminary evidence of Fusarium infection; however, molecular identification using polymerase chain reaction (PCR) with specific primers confirmed the presence of F. oxysporum f. sp. melonis with a high degree of accuracy (99%).The study highlights the utility of PCR-based diagnostics in the rapid and accurate detection of F. oxysporum f. sp. melonis in watermelons. This molecular approach offers significant advantages over traditional methods in terms of sensitivity, specificity, and time efficiency. The findings underscore the importance of implementing integrated disease management strategies, including the use of resistant cultivars, crop rotation, and appropriate cultural practices, to mitigate the impact of Fusarium wilt on watermelon production in eastern Libya.