Attahadi Medical Journal
type: channel
description: Attahadi Medical Journal (AMJ) ISSN: 3078-6991, is a peer-reviewed journal published by Attahdi University, Tripoli, Libya. The journal's full text is available online at https://attahadi.ly/journal/index.php/amj/index. The journal allows free access (Open Access) to its contents and permits authors to self-archive the final accepted version of the articles on any OAI-compliant institutional/subject-based repository. The journal publishes in continuous mode, gathered into 4 issues per year (March, June, September, and December) The purpose of the Journal is to promote excellence in the practice of medicine and medical sciences. The Journal aims to promote the knowledge, attitudes and practice of all aspects of comprehensive health care (preventive, curative and rehabilitative) as well as facilitate the development of medical research, education and health services. Original papers, review articles (both systematic and narrative), short communications, brief reports and letters to the editor are all welcomed. Case reports with substantial significance may also be considered for publication. Most of the content of AMJ is submitted at the authors' initiative, but all editorials are solicited by the Editors. Editorial contact amjeditorial@gmail.com 0910737929
publisher: Attahadi University
language: en
publication name: Attahadi Medical Journal
issn: 3078-6991
items: Impact of Salinity on the Growth of Tomato Plants (Solanum lycopersicum ) Cultivated under Laboratory Conditions
items: Evaluating the Awareness of Parents Toward Space Maintainers in Misurata, Libya
items: Clinical and Laboratory Predictors of Continuous Positive Airway Pressure Failure in Pediatric Intensive Care Unit Patients: A Retrospective Study
items: Experimental Evaluation and EGSnrc Monte Carlo Modeling of Barium Sulfate Cement Composites for Sustainable Diagnostic X-Ray Shielding
items: AI vs. Human: The Accuracy of Deep Learning in Detecting MB2 Canals
items: Cervical Chondrocutaneous Branchial Remnant: A Case Report highlights the Essential Role of Histopathology in Diagnosing Congenital Neck Lesions
items: Knowledge, Attitudes, and Practices of Parents Regarding Emergency Management of Pediatric Dental and Maxillo-Facial Injuries in Misrata, Libya
items: The Application of Spectroscopic Techniques to Detect Mycotoxins in Bovine Blood Samples and Their Impact on Liver Function
items: Comparative Analysis of Mean Platelet Volume and Platelet Distribution Width in Type 2 Diabetic Patients and Healthy Controls
items: Consumer Awareness of the Sugar-Sweetened Beverages Levy and Its Influence on Consumption Patterns in Kwara State, Nigeria
items: Prevalence of Carbapenem-Resistant Gram-Negative Enterobacteriaceae among Patients in Sebha Medical Center
items: The Sunshine Paradox: A Systematic Review and Meta-Analysis of Vitamin D Deficiency Burden and Modifiable Risk Factors in Libya
items: Proline-Mediated Growth Regulation and Antioxidant Defense Enhancement in Lettuce under Salinity Stress
items: Association of Red Cell Distribution Width with Cardiovascular Complications and Risk Factors in Hypertensive and Cardiac Patients: A Retrospective Study
items: The Relationship Between Renal Stones and Parathyroid Hormone
items: Biochemical and Hormonal Alterations in the Rat Thyroid Gland Following Chronic Ultraviolet-A Exposure: A Duration-Dependent Study
items: DNA Barcoding Reveals a Distinct Mediterranean Mitochondrial Lineage of Lasiocampa tripolitania from Libya Based on COI Sequences: Implications for Taxonomy, Conservation, and Forensic Identification
items: Scio-demographic Determinants of Visceral Leishmaniasis in Eastern Sudan: A Cross-sectional Study from Gadaref State
items: Comparative Analysis of Thyroid Hormone Profiles and Vitamin D Status between Males and Females in Al-Bayda City, Libya: A Cross-Sectional Biochemical Study
items: Comparative Analysis of Breast Cancer According to Age, Histological Type, Hormonal Status, and Disease Characteristics
items: Association Between Hyperlipidemia and Uterine Fibroid Size
items: Experimental and Computational Evaluation of Alloy-Reinforced Glass Ionomer Cement: Erosion Resistance, Maturation Behavior, and Predictive Modeling
items: Epidemiological Patterns of Oral Squamous Cell Carcinoma and Its Variants in the Libyan Population: A 20-Year Retrospective Study
items: Determination of Carboxymethyl Cellulose, Total Dissolved Solids, pH, and Microbiological Quality of Ice Cream Samples Collected from Libyan Markets
items: Nephroprotective Effects of Ginger against Oxidative Stress
items: Diagnostic Utility of Complete Blood Count Parameters and C-Reactive Protein as Early Indicators in Febrile Children: An Outpatient Study from Tobruk, Libya
items: Calciphylaxis in A Patient with Chronic Renal Failure: Report of A Libyan Patient and Review of the Literature
items: Transforming the Patient-Pharmacist Relationship in Libya: A Perspective on Digital Health and AI Integration
items: Prevalence and Determinants of PSA Screening Among Men Aged 70 and Older in a Tripoli Outpatient Clinic: A Pilot Cross-Sectional Study
items: Prevalence and Behavioral Trends of Electronic Nicotine Delivery System Use Among Youth in Tripoli, Libya

Impact of Salinity on the Growth of Tomato Plants (Solanum lycopersicum ) Cultivated under Laboratory Conditions
type: item
description: Globally, soil salinity is becoming a bigger issue that jeopardizes agricultural productivity. This study was conducted to address this problem by examining the " impact of Salinity on the Growth of Tomato Plants (Solanum lycopersicum) Grown in Laboratory Conditions." In the summer of 2022, the study was conducted in the Faculty of Science laboratory at Omar Al-Mukhtar University in Libya. Five different concentrations of sodium chloride were utilized as treatments in the study, which employed a completely randomized design: zero mM (Control), fifty mM, one hundred mM, one hundred and fifty mM, and two hundred mM. Examining different growth parameters, including plant height, leaf count, leaf size, and fruit production per plant, was the aim. Four tests were conducted on each treatment. Examining different growth parameters, including plant height, leaf count, leaf size, and fruit production per plant, was the aim. The results demonstrated that all of the growth variables assessed were significantly harmed by increased salt levels. For instance, plant height dropped by roughly 29.6% at the maximum salt concentration (200 mM). Similarly, other measures like the number of leaves for each plant, leaf area, and fruits per plant also showed a discernible decline, as did other variables like the number of leaves on each plant, the size of the leaves, and the number of fruits they produced.
subject: Articles
  topic: section
subject: Salinity, Tomato, Solanum Lycopersicum, Laboratory
  topic: keywords
creator: Faraj Atiyah
creator: Ebtihaj Saleh
creator: Munyah Hammad
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-27
publication date: 2026-07-27
starting page: 344
ending page: 347
doi: 10.69667/amj.26312

Evaluating the Awareness of Parents Toward Space Maintainers in Misurata, Libya
type: item
description: Primary teeth serve essential functions in the oral cavity, facilitating chewing, speech, and maintaining space for permanent teeth. However, premature loss of these teeth due to caries, trauma, or pathology can lead to complications such as drifting teeth and orthodontic issues. Space maintainers, which preserve the arch space for the eruption of permanent teeth, are effective in preventing these issues but are underutilized due to low awareness, particularly in developing countries like Libya. A descriptive cross-sectional study was conducted in Misrata, Libya, from January to March 2026. Data were collected from 350 parents accompanying their children (aged 4-12 years) during routine dental visits. The study aimed to assess parental awareness regarding space maintainers using a structured, self-administered questionnaire. Statistical analysis was performed using SPSS version 26.0. The study found that only 26.6% of parents were aware of space maintainers, with most information sourced from dentists (48.4%) or social media (30.1%). A significant correlation was observed between higher education levels and increased awareness (p < 0.01), but no gender-related differences were noted. Furthermore, 74.9% of participants reported never receiving information from their child’s dentist about the consequences of early tooth loss, and only 11.7% of children had used a space maintainer. The study highlights a significant gap in parental awareness of space maintainers in Misrata, Libya. Despite their importance in preventing long-term orthodontic problems, most parents are unaware of their purpose and benefits. Increased education from dental professionals, particularly during pediatric visits, and targeted public health campaigns are essential to improving awareness and the adoption of preventive dental practices.
subject: Articles
  topic: section
subject: Primary Teeth, Space Maintainers, Parental Awareness, Pediatric Dentistry, Libya, Dental Education, Orthodontic Prevention.
  topic: keywords
creator: Refaat Elnajar
creator: Ibrahim Erfida
creator: Khalid Elmaghrawy
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-23
publication date: 2026-07-23
starting page: 340
ending page: 343
doi: 10.69667/amj.26311

Clinical and Laboratory Predictors of Continuous Positive Airway Pressure Failure in Pediatric Intensive Care Unit Patients: A Retrospective Study
type: item
description: Continuous positive airway pressure (CPAP) is widely used in pediatric intensive care units (PICUs) to manage acute respiratory distress in conditions such as bronchiolitis, pneumonia, asthma exacerbations, and post-extubation support. While CPAP reduces the need for invasive mechanical ventilation (MV), a proportion of patients experience CPAP failure, necessitating escalation to MV. Early identification of predictors of CPAP failure is essential to optimize outcomes. This study aimed to determine the rate and timing of CPAP progression in PICU patients, identify clinical and laboratory predictors of CPAP failure, and compare outcomes between patients with different CPAP durations. A retrospective cohort study was conducted by reviewing medical records of children aged 1 month to 16 years admitted to the PICU over a 12–24-month period. Data collected included demographics, admission diagnosis, vital signs, CPAP settings, arterial blood gas parameters, lactate, and C-reactive protein (CRP). Outcomes assessed were CPAP success or failure, time to failure, length of PICU stay, and mortality. Statistical analyses included descriptive statistics, chi-square and t tests, logistic regression to identify predictors, and Kaplan–Meier survival analysis for time to intubation. Most patients progressed within 2–3 days of CPAP support. Prolonged CPAP (>3 days) was associated with higher complication rates, longer PICU stay, and increased mortality. Predictors of CPAP failure included lower weight, acidosis, hypercapnia, elevated lactate, and raised CRP. Early recognition of clinical and laboratory predictors of CPAP failure can guide timely escalation to invasive ventilation, reduce complications, and improve pediatric critical care outcomes.
subject: Articles
  topic: section
subject: CPAP, Pediatric ICU, Respiratory Distress, Predictors of Failure, Non‑Invasive Ventilation.
  topic: keywords
creator: Fadila Gadban
creator: Ahmed Elbousfiy
creator: Heba Ali Alsaid
creator: Elhussein Jwan
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-23
publication date: 2026-07-23
starting page: 335
ending page: 339
doi: 10.69667/amj.26310

Experimental Evaluation and EGSnrc Monte Carlo Modeling of Barium Sulfate Cement Composites for Sustainable Diagnostic X-Ray Shielding
type: item
description: The demand for non-toxic radiation shielding materials has intensified significantly due to severe environmental hazards, strict disposal regulations, and occupational health concerns associated with traditional lead-based protective barriers. Recent advances in composite material engineering have demonstrated that utilizing heavy mineral matrices enriched with barium sulfate (BaSO4) can serve as a highly effective, chemically stable, and eco-friendly attenuator for ionizing radiation, particularly across diagnostic medical X-ray energy spectra. In this study, BaSO4-cement composites were engineered and fabricated with a fixed filler concentration of 50% by weight and cast into multiple thickness profiles ranging from 0.2 cm to 1.0 cm. To evaluate their shielding efficacy, the fabricated composite blocks were exposed to typical clinical diagnostic radiation beams operating at low-energy (46 kV, 10 mAs) and high-energy (70 kV, 32 mAs) windows. To validate the physical measurements and establish a reliable framework for predictive barrier engineering, full-scale photon transport simulations were computationally executed utilizing the EGSnrc (Electron Gamma Shower) Monte Carlo software package. The experimental results revealed a sharp decrease in the transmitted radiation dose as a function of increasing sample thickness, showing exceptional alignment with the EGSnrc simulated attenuation profiles. Under the high-energy spectrum (70 kV), the 1.0 cm thick sample demonstrated the highest shielding performance, reducing the transmitted dose rate from a baseline of 442 μSv/h down to 26.1 μSv/h, which corresponds to an empirical attenuation efficiency exceeding 94%. Under low-energy conditions (46 kV), the same 1.0 cm configuration achieved near-complete beam absorption, letting through a negligible dose rate of only 0.99 μSv/h (99.58 % shielding efficiency). The computational EGSnrc models tracked these curves closely, yielding minimal relative deviations of +2.76 % and +…
subject: Articles
  topic: section
subject: Barium sulfate, Cement com-posites, Radiation shielding, Diagnostic X-ray, EGSnrc Mon-te Carlo simulation, Lead-free shielding, Sustainable shielding materials, X-ray attenuation
  topic: keywords
creator: Bsher Abour
creator: Rania Saad
creator: Ibrahim Othman
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-21
publication date: 2026-07-21
starting page: 327
ending page: 334
doi: 10.69667/amj.26309

AI vs. Human: The Accuracy of Deep Learning in Detecting MB2 Canals
type: item
description: Complex root canal anatomy and limitations of diagnostic tools and clinicians’ ability to accurately detect the MB2 canal in maxillary molars make successful root canal treatment challenging. Artificial intelligence (AI) has been used in various areas of dentistry and represents a potential tool to aid in detecting MB2 canals. This review aimed to evaluate the accuracy of AI in detecting the MB2 canal in maxillary molars and compare it with human performance. A literature review was conducted using PubMed and Google Scholar databases for studies published between 2010 and 2026, retrieving articles investigating AI-based detection of MB2 canals using CBCT imaging. AI models demonstrated variable sensitivity (53.8%–100%) with overall good diagnostic performance (AUC 0.80–0.90). AI models, image quality, and resolution had a significant impact on AI diagnostic accuracy. AI shows promising potential in enhancing MB2 canal detection; however, it should be used as an adjunct to support, not replace, clinical expertise.
subject: Articles
  topic: section
subject: MB2 canal, Mesiobuccal canal, Maxillary molars, Artificial intelligence, Deep learning.
  topic: keywords
creator: Nadia Elagab
creator: Eman Gaied
creator: Khawla Aboukraa
creator: Alaa Alghanymy
creator: Almarwa Albreki
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-17
publication date: 2026-07-17
starting page: 322
ending page: 326
doi: 10.69667/amj.26308

Cervical Chondrocutaneous Branchial Remnant: A Case Report highlights the Essential Role of Histopathology in Diagnosing Congenital Neck Lesions
type: item
description: Cervical Chondrocutaneous branchial remnant (CCBR) is an extremely rare, benign, congenital choristoma of the neck. Fewer than 120 cases have been reported to date, mostly as isolated case reports. Because of its clinical similarity to other congenital neck anomalies, such as branchial cleft cysts and thyroglossal duct cysts, establishing an accurate clinical diagnosis remains challenging for surgeons and pathologists. Differentiating CCBR is clinically significant because it influences surgical management and prognosis. We present the case of a five-year-old Libyan girl with a painless, unilateral congenital lesion on the left anterolateral neck, overlying the sternocleidomastoid muscle. The patient’s medical history was notable for a resolved atrial septal defect (ASD) and bilateral hearing loss, which may suggest systemic associations warranting further evaluation. Following complete surgical excision, histopathological evaluation confirmed the diagnosis of CCBR. Histopathological evaluation is essential to confirm CCBR and differentiate it from other congenital cervical masses. Given the potential clinical implications, correlating these findings with systemic anomalies is vital for comprehensive patient management.
subject: Articles
  topic: section
subject: Cervical Chondrocutaneous Branchial Remnant (CCBR), Congenital Neck Lesion, Histopathology, Hyaline Cartilage
  topic: keywords
creator: Wafa Alallam
creator: Sufyan Younes
creator: Ameerah Zayed
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-15
publication date: 2026-07-15
starting page: 312
ending page: 315
doi: 10.69667/amj.26306

Knowledge, Attitudes, and Practices of Parents Regarding Emergency Management of Pediatric Dental and Maxillo-Facial Injuries in Misrata, Libya
type: item
description: Parents and caregivers are typically the first responders when children experience oral or maxillofacial injuries. Their knowledge of appropriate first-aid measures can significantly influence the prognosis of traumatic dental injuries, particularly tooth avulsion, where immediate management is essential. Objective: This study aimed to assess parents' knowledge, attitudes, and practices regarding the emergency management of pediatric oral, facial, and dental injuries in Misrata, Libya, and to identify factors associated with better knowledge. A cross-sectional questionnaire-based study was conducted among 164 parents using a structured online survey. The questionnaire assessed demographic characteristics, knowledge of emergency management of dental and maxillofacial injuries, attitudes toward prevention, and educational needs. Descriptive statistics, independent-samples t-test, one-way ANOVA, and Chi-square tests were used for data analysis, with statistical significance set at p < 0.05. The mean knowledge score was 6.63 ± 2.1 out of 10. Overall, 39.0% of participants demonstrated good knowledge, 47.0% moderate knowledge, and 14.0% poor knowledge. Parents showed good awareness of tooth type according to age, soft-tissue injury management, and emergencies requiring immediate medical care. However, major deficiencies were identified in the emergency management of avulsed permanent teeth, particularly regarding immediate replantation and appropriate storage media. Parents who had previously received first-aid training achieved significantly higher knowledge scores than those without training (p = 0.001). Educational level, age, and gender were not significantly associated with knowledge. Most parents (82.7%) expressed interest in receiving educational programs, with short educational videos being the preferred learning method. Parents demonstrated moderate overall knowledge of pediatric dental trauma management, but clinically important gaps remain in the management of…
subject: Articles
  topic: section
subject: Pediatric Dental Trauma, Maxilla Facial Injuries, Traumatic Dental Injuries
  topic: keywords
creator: Hatim Abu Sheehah
creator: Nadin Elgandouz
creator: Ali Abukhattala
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-13
publication date: 2026-07-13
starting page: 298
ending page: 306
doi: 10.69667/amj.26304

The Application of Spectroscopic Techniques to Detect Mycotoxins in Bovine Blood Samples and Their Impact on Liver Function
type: item
description: This research was designed to examine the efficacy of spectroscopic methods — spectrophotometry in particular — in the quantification and identification of mycotoxins in bovine blood samples, as well as the effect these toxins had on the biochemical markers of liver function. To achieve this aim, the research was conducted using a chemical laboratory analysis approach that involved the spectroscopic analysis of the absorbance of toxin molecules obtained from serum according to the Beer–Lambert law, together with colorimetric analysis for measuring the activity of liver enzymes (such as AST and ALT) and bilirubin. Several significant findings were made during the research; the principal one was the demonstration of the efficiency and speed of spectrophotometric analysis for very low concentrations of mycotoxins in complex biological fluids, which confirmed the role of these toxins in stimulating oxidative stress and hepatocyte injury — manifested by the increased activity of serum enzymes — as well as the efficiency of feed adsorbents in preventing the bioavailability of toxins and in normalising the biochemical indicators of the liver.
subject: Articles
  topic: section
subject: Mycotoxins, Aflatoxin B1, Spectrophotometry, UV–Vis Spectroscopy, Beer–Lambert Law
  topic: keywords
creator: Hanan Shuaib
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-15
publication date: 2026-07-15
starting page: 307
ending page: 311
doi: 10.69667/amj.26305

Comparative Analysis of Mean Platelet Volume and Platelet Distribution Width in Type 2 Diabetic Patients and Healthy Controls
type: item
description: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by persistent hyperglycemia and an increased risk of vascular complications. Platelet activation plays a central role in the pathogenesis of these complications. Simple hematological indices, such as mean platelet volume (MPV) and platelet distribution width (PDW), may serve as accessible markers of platelet function and vascular risk. This study aimed to evaluate alterations in platelet indices (MPV and PDW) in patients with T2DM compared with healthy controls and to investigate their relationship with glycemic control, as assessed by HbA1c levels. This comparative cross-sectional study was conducted in August 2025 at Ghout Al-Shaal Medical Center, Tripoli, Libya. The study included 60 adults aged 30–60 years, comprising 40 patients with T2DM and 20 healthy controls. Venous blood samples were collected in EDTA tubes for complete blood count (CBC) analysis and HbA1c measurement using standardized laboratory analyzers. Independent t-tests were used for group comparisons, and Pearson correlation analysis was applied to assess the relationship between HbA1c and platelet indices. MPV was significantly increased in diabetic patients compared with controls (10.33 ± 1.04 vs. 9.41 ± 1.00, P = 0.0013), whereas platelet count and PDW showed no statistically significant differences between groups. HbA1c levels were significantly higher in the diabetic group compared with controls (9.00 ± 1.85 vs. 5.40 ± 0.33, P < 0.001). A positive correlation was observed between HbA1c and MPV in the overall sample (r = 0.2499, P = 0.0269), with a stronger association noted among females (r = 0.2586, P = 0.0470). Conclusion: Patients with T2DM exhibit increased MPV compared with healthy individuals, suggesting enhanced platelet activation in association with poor glycemic control. MPV may serve as a useful and cost-effective hematological marker for assessing platelet activity and potential vascular risk in diabetic…
subject: Articles
  topic: section
subject: Type 2 Diabetes Mellitus, HbA1c; Mean Platelet Volume, Platelet Distribution Width, Platelet Count
  topic: keywords
creator: Eman Abdulwahed
creator: Narjes Naser
creator: Yusra Amara
creator: Fatima Bakka
creator: Hedaya Algandouz
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-16
publication date: 2026-07-16
starting page: 316
ending page: 321
doi: 10.69667/amj.26307

Consumer Awareness of the Sugar-Sweetened Beverages Levy and Its Influence on Consumption Patterns in Kwara State, Nigeria
type: item
description: Sugar-sweetened beverages (SSBs) are fuelling a public health crisis worldwide; in Nigeria, rising obesity and diabetes rates point to growing risks to population well-being. This study investigated the relationship between consumer awareness of the sugar-sweetened-beverages-levy and consumption patterns among residents of Kwara State, Nigeria. Using a cross-sectional survey design, data were collected from 900 participants across various demographic groups, focusing on their awareness of the SSB levy and corresponding consumption habits. Results indicated that 427 respondents (47.4%) exhibited high SSB consumption levels, with a significant correlation between consumer awareness and consumption habits (r(898) = 0.66, p < 0.05). Demographic factors such as age, education, and income were significant predictors of consumption habits, collectively accounting for 51.1% of the variance in SSB consumption (R² = 0.511). The findings underscore the importance of enhancing consumer awareness regarding the health implications of SSBs and the objectives of the levy intended to reduce their consumption. While the levy has been instituted, its effectiveness is hindered by insufficient public knowledge, particularly among younger and urban dwellers whose habit is to consume high levels of SSBs. It is recommended that the Nigerian government implement comprehensive public health education campaigns to communicate health risks of SSB intake and the objectives of the levy, with initiatives tailored to cultural contexts and demographic variances to maximise impact
subject: Articles
  topic: section
subject: Sugar-Sweetened, Beverages (SSBs), Consumer Awareness, Levy, Public Health, Consumption Habits, Health Implications.
  topic: keywords
creator: Kafayah A. Jidda
creator: Kamalud-deen A. Uthman
creator: Adebusola O. Oyeyemi
creator: Adedamola Adisa-Oluga
creator: AbdulMajeed A. Jatto
creator: Abubakar K. Jidda
creator: Samuel A. Olawuyi
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-06
publication date: 2026-07-06
starting page: 278
ending page: 284
doi: 10.69667/amj.26302

Prevalence of Carbapenem-Resistant Gram-Negative Enterobacteriaceae among Patients in Sebha Medical Center
type: item
description: Infections caused by multidrug-resistant (MDR) bacteria are a major cause of morbidity and mortality in hospitals. This study aimed to isolate MDR bacteria from intensive care units (ICUs) at Sabha Medical Center. A cross-sectional observational study was conducted in the period between September 2025 and March 2026 at Sabha Medical Center. A total of 128 samples were collected. Collected samples were pus swabs, urine, blood, and sputum. Identification and antimicrobial susceptibility tests were applied based on the recommendation of the Clinical and Laboratory Standards Institute. The total Gram-negative bacterial strains isolated were 59 (46%), with the predominance of Escherichia coli (45%) followed by Klebsiella pneumoniae (21%) and Acinetobacter (11%). Different antibiotics were used against these gram-negative isolates. Escherichia coli, Klebsiella pneumoniae, Acinetobacter, Proteus spp., Enterobacter spp., Pseudomonas aeruginosa and Pasteurella spp. showed a high resistance rate to the most used antibiotics and especially to carbapenems. This high prevalence of antibiotic resistance requires strict infection control, continuous monitoring, and collaborative action to monitor infection spread in hospitals.
subject: Articles
  topic: section
subject: Carbapenem-Resistant, Gram-Negative, Enterobacteriaceae, Patients, Sebha Medical Center
  topic: keywords
creator: Mohammed Nasr
creator: Khatema Moukhtar
creator: Haleemah Ishteewi
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-06
publication date: 2026-07-06
starting page: 271
ending page: 277
doi: 10.69667/amj.26301

The Sunshine Paradox: A Systematic Review and Meta-Analysis of Vitamin D Deficiency Burden and Modifiable Risk Factors in Libya
type: item
description: Hypovitaminosis D is an escalating global health concern, yet high-power baseline mapping of its epidemiological burden across North Africa remains limited. Despite Libya’s abundant solar irradiance, localized studies suggest widespread vitamin D depletion. This study systematically pooled nationwide prevalence, clinical stratifications, temporal trends, and publication bias for vitamin D deficiency in Libya. A random-effects systematic meta-analysis pooled data from 20 observational studies across Western, Eastern, and Southern Libya, including 7,167 participants. Deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] <20 ng/mL. Between-study heterogeneity was explored using univariable and multivariable random-effects meta-regression. Publication bias was assessed with Egger’s regression, Begg’s rank correlation, and trim-and-fill analysis. The pooled national prevalence of vitamin D deficiency was 71.07% (95% CI: 64.91%–76.81%), with substantial heterogeneity (I² = 96.2%; Cochran’s Q = 502.14; P < 0.0001). Pregnant women showed the highest subgroup prevalence at 80.02% (95% CI: 74.88%–84.31%), while the Southern desert region had the highest regional burden at 75.14% (95% CI: 71.05%–78.83%). Univariable meta-regression identified a significant temporal decline in prevalence (β = -0.041; P = 0.029). The multivariable model explained 24.15% of between-study variance. Bias testing showed no significant funnel plot asymmetry. The findings confirm a Libyan “Mediterranean solar paradox,” where abundant sunlight does not ensure adequate vitamin D status. National prevention should prioritize food fortification, antenatal and pediatric supplementation, and standardized diagnostic assays.
subject: Articles
  topic: section
subject: Hypovitaminosis D, Libya, Meta-analysis, Prevalence, Solar paradox
  topic: keywords
creator: Osamah Alrouwab
creator: Husam Eldaouki
creator: Yousof Amara
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-07-12
publication date: 2026-07-12
starting page: 285
ending page: 297
doi: 10.69667/amj.26303

Proline-Mediated Growth Regulation and Antioxidant Defense Enhancement in Lettuce under Salinity Stress
type: item
description: This study investigated the mitigating effects of exogenous proline application on lettuce (Lactuca sativa L.) plants subjected to salinity stress induced by NaCl. The experiment evaluated vegetative growth, photosynthetic pigments, chemical constituents, and antioxidant enzyme activity under varying proline concentrations (with 200 mg/l identified as the optimal treatment) and salinity conditions. Salt stress significantly impaired vegetative growth, reducing fresh weight by 6.73%, leaf number by 10.0%, and leaf area by 19.08% compared to control conditions; however, dry matter content increased under salinity. Foliar application of proline effectively alleviated these adverse effects, with 200 mg/l proline achieving the highest plant yield under non-saline conditions (5.00% increase over control) and substantially offsetting growth inhibition under NaCl stress. Photosynthetic pigments (chlorophyll a, chlorophyll b, total chlorophyll, and carotenoids) were significantly degraded by salinity, yet proline-treated plants exhibited marked improvement. The 200 mg/l proline treatment enhanced total chlorophyll and carotenoid contents by approximately 9.34% and 9.77%, respectively, relative to untreated controls. Regarding chemical constituents, NaCl stress reduced nitrogen (N), phosphorus (P), potassium (K), and the K/Na ratio while increasing sodium (Na⁺) and chloride (Cl⁻) accumulation. Proline application, particularly at 200 mg/l, counteracted these ionic imbalances by elevating N, P, K, and K/Na levels and suppressing Na⁺ and Cl⁻ uptake. Antioxidant enzyme activities—peroxidase (POD), superoxide dismutase (SOD), and catalase (CAT)—were significantly stimulated under salinity, increasing by 45.87%, 113.1%, and 58.5%, respectively, compared to control plants. Proline spraying further enhanced these enzymatic activities, reinforcing the plant's oxidative stress defense mechanism. In conclusion, foliar application of proline at 200 mg/l represents an effective strategy …
subject: Articles
  topic: section
subject: Proline, Salinity Stress, Lettuce, Antioxidant Enzymes, Photosynthetic Pigments, Ionic Balance
  topic: keywords
creator: Hanan Khalifa
creator: Mahmoud Abd El-Hady
creator: Elsaber Mekael
creator: Asmaa El-Bauomy
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-24
publication date: 2026-06-24
starting page: 261
ending page: 270
doi: 10.69667/amj.26223

Association of Red Cell Distribution Width with Cardiovascular Complications and Risk Factors in Hypertensive and Cardiac Patients: A Retrospective Study
type: item
description: This study addresses an overlooked clinical gap in Libya by evaluating baseline Red Cell Distribution Width (RDW)—a standard measure of erythrocyte size heterogeneity—as a zero-cost prognostic tool for predicting cardiovascular mortality and critical care escalation. While RDW traditionally classifies anemias, modern clinical pathophysiology demonstrates that fluctuating RDW levels actively reflect systemic inflammation and tissue hypoxia, both of which impair bone marrow function during cardiac stress. Currently, no published regional literature has established specific RDW thresholds for cardiac risk stratification in Libya, where managing cardiovascular crises is heavily complicated by strict budgetary constraints and chronic shortages of expensive diagnostic reagents. To provide an accessible predictive alternative, this retrospective investigation analyzed archived clinical and laboratory records of 350 adult cardiac patients at the Tajoura National Center for Cardiac Treatment. The baseline cohort (mean age 61.42 years, 55.7% male) exhibited high rates of hypertension (61.4%) and diabetes mellitus (56.0%), with an elevated overall mean RDW of 16.60%. RDW profiles remained statistically similar between isolated cardiovascular disease and concurrent hypertension (16.72% vs. 16.52%, p = 0.505) but varied significantly with myocardial infarction status (p = 0.035) and peaked in mechanical heart failure (17.33% vs. 15.78%, p < 0.001). Controlling for baseline age, diabetes, and smoking status via multivariate regression, elevated RDW independently outperformed these traditional covariates, emerging as a powerful predictor of death, with optimal thresholds fixed at 16.25% for mortality screening and 16.35% for ICU admission. In conclusion, this study provides the first definitive domestic data confirming that baseline RDW functions as an independent biometric predictor of patient mortality and critical care escalation, offering resource-strained hospitals an immedia…
subject: Articles
  topic: section
subject: Red Cell Distribution Width (RDW), Erythrocyte Size Heterogeneity, Cardiovascular Diseases, In-hospital Mortality, ICU Admission, Libya
  topic: keywords
creator: Narjes El Osta
creator: Afraa Alfairs
creator: Rawasy Alhamroni
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-24
publication date: 2026-06-24
starting page: 252
ending page: 260
doi: 10.69667/amj.26222

The Relationship Between Renal Stones and Parathyroid Hormone
type: item
description: This study aimed to evaluate the relationship between biologic markers and parathyroid hormone (PTH) in stone patients. Two hundred patients (one hundred renal stones and one hundred healthy controls) formed this hospital-based case-control study. Tests for serum levels of PTH, calcium, phosphorus, and creatinine were performed and analyzed statistically. Phosphorus concentrations were significantly reduced while PTH and calcium concentrations were significantly increased in renal stone patients versus controls (p < 0.001). Creatinine levels showed no obvious differences. PTH had a moderately positive correlation with creatinine (r = 0.35), a negative correlation with phosphorus (r = -0.48), and a strong, positive correlation with calcium (r = 0.62). PTH excess stimulates renal stone formation by deranging calcium and phosphate metabolism. Conclusion: Regular PTH measurements could improve the diagnosis and management of nephrolithiasis
subject: Articles
  topic: section
subject: Parathyroid Hormone, Renal Stones, Nephrolithiasis
  topic: keywords
creator: Hussein Mahdi Kadhim
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-23
publication date: 2026-06-23
starting page: 247
ending page: 251
doi: 10.69667/amj.26221

Biochemical and Hormonal Alterations in the Rat Thyroid Gland Following Chronic Ultraviolet-A Exposure: A Duration-Dependent Study
type: item
description: Ultraviolet-A (UVA) radiation, the most prevalent component of solar UV reaching the earth's surface, is known to induce oxidative stress and cellular damage in various tissues. However, its specific effects on endocrine organs, particularly the thyroid gland, remain inadequately characterized. This study aimed to evaluate the biochemical and hormonal changes in the thyroid gland of rats following chronic exposure to UVA radiation for different durations. Twenty adult male albino rats (200-250 g) were divided into four groups (n=5 each): a control group (no exposure) and three experimental groups exposed to UVA radiation (8 hours/day) for 10, 15, and 25 days, respectively. Thyroid tissue levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and the antioxidant enzyme reduced glutathione (GSH) were measured. Chronic UVA exposure significantly altered thyroid hormone profiles. T3 levels initially increased at 10 days (3.65±0.92 vs. control 2.6±0.25) and 15 days (3.62±0.29), then declined towards near-normal levels by 25 days (2.9±0.53). T4 showed a non-significant fluctuation, while TSH exhibited a dramatic and sustained reduction from 0.8±0.14 (control) to near-undetectable levels (0.016±0 to 0.01±0) in all exposed groups. GSH levels varied, showing a non-significant decrease at 10 days (54.63±1.31), followed by an increase at 15 and 25 days (59.2±3.78 and 58.01±2.28, respectively). Chronic UVA radiation exposure induces duration-dependent disruption of thyroid hormonal homeostasis, characterized by marked TSH suppression and complex alterations in T3 and T4, accompanied by changes in antioxidant enzyme levels. These biochemical findings complement previously reported histological damage (Qabeeli et al., 2026) and suggest that UVA radiation may impair the hypothalamic-pituitary-thyroid axis
subject: Articles
  topic: section
subject: Ultraviolet-A radiation, Thyroid Hormones, TSH, Reduced Glutathione, Oxidative Stress, Rat Model
  topic: keywords
creator: Fatimah Qabeeli
creator: Eman Alsqyar
creator: Nesrin Ballaq
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-23
publication date: 2026-06-23
starting page: 242
ending page: 246
doi: 10.69667/amj.26220

DNA Barcoding Reveals a Distinct Mediterranean Mitochondrial Lineage of Lasiocampa tripolitania from Libya Based on COI Sequences: Implications for Taxonomy, Conservation, and Forensic Identification
type: item
description: DNA barcoding is widely used for organism identification because the mitochondrial cytochrome c oxidase subunit I gene, COI, usually separates closely related species and geographic lineages. In this study, we examined the COI barcode position of the Libyan moth Lasiocampa tripolitania using the GenBank sequence AM397633.1, reported from near Zuwara, Libya. The final aligned dataset included a 576 bp COI fragment, three closely related Mediterranean Lasiocampa sequences from Malta, 32 European sequences assigned to Lasiocampa quercus and Lasiocampa trifolii. Phylogenetic trees were reconstructed in MEGA 10 using Neighbor-Joining and Maximum Likelihood under the Tamura 3-parameter model with 1000 bootstrap replicates. Pairwise Tamura 3-parameter distances and ASAP delimitation were also used. The Libyan sequence clustered within a Mediterranean Lasiocampa lineage and was most closely related to Maltese Lasiocampa sequences, but it formed a distinct Libyan branch. Mean distance between Mediterranean Lasiocampa and European L. quercus was 0.163, while the distance from European L. trifolii was 0.119. These results support a distinct Mediterranean mitochondrial lineage, but broader sampling is required before formally finalizing the taxonomic revision
subject: Articles
  topic: section
subject: Lasiocampa tripolitania; COI; DNA Barcoding; Libya; Mediterranean Lineage; ASAP; Forensic Identification
  topic: keywords
creator: Tarek Shoeib
creator: Tawfeek Altawaty
creator: Omar Alqabbasi
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-21
publication date: 2026-06-21
starting page: 233
ending page: 241
doi: 10.69667/amj.26219

Scio-demographic Determinants of Visceral Leishmaniasis in Eastern Sudan: A Cross-sectional Study from Gadaref State
type: item
description: Visceral leishmaniasis (VL) remains a major public health problem in Sudan, particularly in Gedaref State. Understanding the socio-demographic determinants of VL is essential for designing effective control strategies. This study aimed to investigate the association between VL infection and socio-demographic factors such as age, sex, marital status, education level, and occupation in an endemic region of eastern Sudan. A descriptive cross-sectional study was conducted among 208 individuals suspected of VL infection in Gedaref State. Data were collected using structured questionnaires, and blood samples were tested using the rK39 rapid diagnostic test. Statistical analysis was performed using SPSS version 25. Of the 208 participants, 51 tested positive for VL. No statistically significant associations were found between VL infection and gender (P = 0.71), age group (P = 0.17), or place of residence (P = 0.17). Although no statistically significant associations were found, the persistence of VL cases in endemic regions like Gedaref highlights the need for continuous epidemiological monitoring. Further studies with larger sample sizes and consideration of environmental and behavioral risk factors are recommended
subject: Articles
  topic: section
subject: Visceral leishmaniasis; Sudan; socio-demographic factors; Gedaref; public health; cross-sectional study
  topic: keywords
creator: Wahaj Mohammed
creator: Ahmed Abdlla
creator: Ahmed Kabbashi
creator: Qutoof Taha
creator: Nawafel Yasir
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-18
publication date: 2026-06-18
starting page: 229
ending page: 232
doi: 10.69667/amj.26218

Comparative Analysis of Thyroid Hormone Profiles and Vitamin D Status between Males and Females in Al-Bayda City, Libya: A Cross-Sectional Biochemical Study
type: item
description: Thyroid hormones and vitamin D play essential roles in regulating metabolism, growth, and overall health. Alterations in their concentrations may contribute to various endocrine and metabolic disorders. This study aimed to evaluate thyroid hormone profiles and vitamin D status among adults in Al-Bayda City and to investigate potential gender-related differences. A cross-sectional study was conducted on 40 adult participants (20 females and 20 males) from Al-Bayda City, Libya. Serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and vitamin D were measured. Descriptive statistics, Shapiro–Wilk normality tests, independent samples t-tests, and one-sample t-tests were performed using Minitab version 17. Statistical significance was considered at p < 0.05. The overall mean values of T4, T3, TSH, and vitamin D were 8.04 ± 1.55 µg/dL, 1.41 ± 0.15, 1.69 ± 1.18, and 20.75 ± 11.58 ng/mL, respectively. Females exhibited significantly higher T4 levels than males (8.53 ± 1.70 vs. 7.56 ± 1.25; p = 0.047), whereas males showed significantly higher vitamin D levels than females (24.44 ± 10.87 vs. 17.07 ± 11.34 ng/mL; p = 0.043). No significant gender differences were observed for T3 (p = 0.500), TSH (p = 0.979), or age (p = 0.221). Normality testing revealed that T4, T3, and age were normally distributed, while TSH and vitamin D showed non-normal distributions. Comparison with reference values indicated that vitamin D levels were significantly lower than the recommended reference level of 30 ng/mL (p < 0.001), whereas T3, T4, and TSH remained within normal ranges. The study demonstrated significant gender-related differences in T4 and vitamin D concentrations among adults in Al-Bayda City. Furthermore, vitamin D levels were markedly below the recommended reference value, suggesting a high prevalence of vitamin D insufficiency in the studied population. Regular screening and appropriate vitamin D supplementation strategies may be beneficial for …
subject: Articles
  topic: section
subject: Thyroid Hormones, Vitamin D, Gender Differences, Endocrine Profile, Adults, Al-Bayda City, Libya
  topic: keywords
creator: Siham Alsagheer
creator: Fayrouz Khaled
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-14
publication date: 2026-06-14
starting page: 224
ending page: 228
doi: 10.69667/amj.26217

Comparative Analysis of Breast Cancer According to Age, Histological Type, Hormonal Status, and Disease Characteristics
type: item
description: Breast cancer (BC) is the most common cancer among women worldwide and a significant public health concern in Libya. The incidence of BC, particularly among younger women in Libya, has been increasing, urging further investigation into the disease's characteristics, early detection, and treatment strategies. This study aimed to compare the clinicopathological and molecular characteristics of breast cancer patients from two datasets of women of different ages. This descriptive retrospective study utilized two datasets containing the medical records of breast cancer patients diagnosed and treated at Tripoli Medical Center. Data were analyzed using descriptive statistics. The variables assessed included age, histological type, molecular subtype, tumor stage, hormone receptor status, lymph node metastasis, and family history of BC. Patients were divided into two age groups to facilitate comparison between young and older women. Frequency distribution and comparative analyses were performed to identify associations with predominant disease patterns. The first group of participants included 524 patients with a mean age of 34.5 years, while the second cohort included 499 patients with a mean age of 43.6 years. Younger women comprised the majority of the first cohort, while the second cohort exhibited a broader age distribution. The results showed that invasive ductal carcinoma (IDC) was the predominant histological pattern in both cohorts. Younger patients were more likely to have aggressive tumor characteristics, higher rates of lymph node metastasis, and more advanced disease stages. Older patients showed a higher prevalence of hormone receptor-positive tumors, particularly luminal molecular patterns, which are generally associated with a better prognosis. In conclusion, this comparative study demonstrates that age significantly influences the distribution of BC subtypes, disease severity, and tumor biology. These findings underscore the importance of increased public aw…
subject: Articles
  topic: section
subject: Breast Cancer, Libyan Women, Invasive Ductal Carcinoma
  topic: keywords
creator: Manal Abuagela
creator: Jamal Elcosbi
creator: Eman Elgusbi
creator: Fadwa Mahanay
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-01
publication date: 2026-06-01
starting page: 212
ending page: 217
doi: 10.69667/amj.26215

Association Between Hyperlipidemia and Uterine Fibroid Size
type: item
description: Uterine fibroids (leiomyomas) are common benign tumors affecting women, mostly throughout their reproductive years and menopause. Their development is influenced by multiple factors, including age, race, metabolic conditions, lifestyle, reproductive history, genetics, and hormonal exposures. Although often asymptomatic, fibroids can cause uterine bleeding and pain. Lipid metabolism alterations have been implicated in fibroid pathogenesis, with estrogen and progesterone playing key roles in tumor growth and maintenance. This study aimed to investigate the association between uterine fibroid size and lipid profile abnormalities. A cross-sectional study enrolled 70 reproductive-age women with gynecological complaints from Albida City clinics (Nov 2023–Jan 2026). Cases had ultrasound-confirmed uterine fibroids; controls had normal ultrasounds. Data on medical history, BMI, and fibroid characteristics were collected. Fasting lipid profiles were measured. Analysis was done using SPSS v26, reporting percentages and means ± SD. This research involved 70 women with an average age of 34.8 years, predominantly aged 31–40 years. Most participants were overweight or obese (mean BMI 29.4 kg/m²). Over half reported no significant medical history, and the majority were not on regular medication. Lipid profiles revealed elevated cholesterol and triglyceride levels in a considerable portion of the sample. Submucous fibroids were the most common type (45.7%), followed by intramural fibroids (28.6%). No significant associations were found between fibroid size and age or BMI categories. Similarly, total cholesterol, HDL, LDL, and VLDL levels showed no significant relationship with fibroid size. However, triglyceride levels were significantly higher in women with large fibroids (≥5 cm) compared to those with smaller fibroids (p = 0.020). Pearson correlation analysis identified a weak but statistically significant positive correlation between LDL cholesterol levels and fibroid size (r = 0…
subject: Articles
  topic: section
subject: Uterine Fibroid, Leiomyomas, Fibroid Size, Hyperlipidemia
  topic: keywords
creator: Hanan El Daffri
creator: Khadeejah Abraheem
creator: Ola Mustafa
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-05-31
publication date: 2026-05-31
starting page: 203
ending page: 211
doi: 10.69667/amj.26214

Experimental and Computational Evaluation of Alloy-Reinforced Glass Ionomer Cement: Erosion Resistance, Maturation Behavior, and Predictive Modeling
type: item
description: Glass ionomer cements (GICs) are widely used restorative materials due to their chemical adhesion, fluoride release, and biocompatibility. However, their susceptibility to acid erosion—particularly during early maturation—remains a significant limitation affecting long-term clinical performance. Recent developments in reinforced GIC formulations aim to improve resistance to mechanical and chemical degradation, yet their behavior under dynamic erosive conditions requires further investigation. This study aimed to evaluate the erosion resistance of an experimental high powder-to-liquid ratio glass ionomer cement (EXPT) in comparison with a metal-reinforced glass ionomer cement (Hi-Dense), and to investigate the influence of maturation time on material performance using both experimental and computational approaches. Cylindrical specimens (4 mm diameter; n = 6 per group) were prepared and tested at three time intervals: 1 hour, 24 hours, and 6 months. Erosion resistance was assessed using a standardized lactic acid jet test (0.02 M, pH 2.7) under controlled temperature (37°C) and flow conditions (120 ± 4 ml/min) for 24 hours. Erosion rates were quantified using both weight loss (mg/h) and dimensional loss (µm/h). Statistical analysis was performed using the Mann–Whitney U test (α = 0.05). In parallel, computational simulations incorporating diffusion–reaction modeling and finite element analysis (FEM) were conducted to predict ion transport, stress distribution, and degradation behavior. At early maturation stages, EXPT exhibited significantly higher erosion rates compared to Hi-Dense (p ≤ 0.005). Mean height loss at 1 hour was 8.7 ± 1.0 µm/h for EXPT and 2.9 ± 0.3 µm/h for Hi-Dense, while corresponding weight loss values were 0.30 ± 0.04 mg/h and 0.16 ± 0.02 mg/h, respectively. A significant reduction in erosion rates was observed for both materials with increasing maturation time. After 6 months, no statistically significant differences were detected between the two …
subject: Articles
  topic: section
subject: Glass Ionomer Cement, Erosion Resistance, Finite Element Analysis, Dental Materials, Maturation
  topic: keywords
creator: Mohamed Abour
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-05-20
publication date: 2026-05-20
starting page: 194
ending page: 202
doi: 10.69667/amj.26213

Epidemiological Patterns of Oral Squamous Cell Carcinoma and Its Variants in the Libyan Population: A 20-Year Retrospective Study
type: item
description: Squamous cell carcinoma is the most common oral malignancy, accounting for more than 90% of all forms of oral cancer. This study aimed to determine the frequency and distribution of oral squamous cell carcinoma in the Libyan population, considering histological variants and grades. A retrospective analysis of all cases biopsied and diagnosed from 2000 to 2019 in the Department of Oral Medicine, Oral Pathology, Diagnosis, and Radiology was conducted. Information on the patient’s age and gender, tumour type, grade, and its anatomical site was recorded and analyzed. During the study period, 105 biopsies were histologically confirmed as oral squamous cell carcinoma. Males were more commonly affected than females, giving a male-to-female ratio of 1.67:1. Most patients were older than 50, with a mean age of 57.63 ± 14.569 years. The Lateral border of the tongue was the most common site for the lesion (39%), followed by the buccal mucosa (19%). The most common histological subtype was conventional oral squamous cell carcinoma (90%), primarily well and moderately differentiated. The other histological variants were uncommon (N=8): 4 cases of verrucous carcinoma, 2 of adenosquamous carcinoma, and 2 of spindle cell carcinoma. In conclusion, oral squamous cell carcinoma constituted a considerable proportion of oral and maxillofacial lesions, with the conventional type being the most common. A higher proportion has been noted in males aged 50 years and older, with the lateral border of the tongue being the most affected site.
subject: Articles
  topic: section
subject: Squamous Cell Carcinoma, Histological Variants, Verrucous Carcinoma
  topic: keywords
creator: Ghada Haroun
creator: Ali El Murtady
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-06-04
publication date: 2026-06-04
starting page: 218
ending page: 223
doi: 10.69667/amj.26216

Determination of Carboxymethyl Cellulose, Total Dissolved Solids, pH, and Microbiological Quality of Ice Cream Samples Collected from Libyan Markets
type: item
description: Ice cream is one of the most food consumer during different seasons, it contains different chemical compounds and food additives. This study aimed to estimate the contents of Carboxyl Methyl Cellulose (CMC) in many ice cream which found in the major supermarkets in some Libyan cities. Also, the pH and total dissolved salts. This study aims to measure the levels of Carboxyl Methyl Cellulose (CMC) in various ice cream samples collected from the local markets (Libya), where twenty-one types were purchased from different supermarkets, including imported and local ice cream samples. The spectrophotometric methods were used in this study for carboxyl methyl cellulose, while the total dissolved solids (TDS) and PH values were estimated by PH mater, including a sensor for TDS values. The concentrations of CMC of the ice cream samples fluctuated in the range of (207.33 – 1250.66 ppm ), the high contents of ( 1250.66 ppm ) were recorded in the samples of (Ice Queen, Jordan), whereas the low contents were recorded in the samples of (SNICKERS CRISP, France). The results recorded wide variations in the CMC of the studied samples. (Table 2 and Figure 4). The contents of TDS values ranged between (26.1 – 191 ppm), the high contents were recorded in the samples of (SNICKERS, Poland), whereas the lower values were observed in the samples of (AlMADHAKSTRA WBERRY, Libya). For the pH values, most of the samples gave acidic values (5.3 – 7.14). According to the results recorded in this study, there are wide variations in Carboxyl methyl cellulose in the studied samples of ice cream. The values of Total Dissolved solids /Salts showed wide variations, on the other side the pH values showed that most of the studied are lied in the acidic scale, which may be harmful to human health. The presence of CMC in the samples is very dangerous for the human consumer, where most of the recorded values are above 100 ppm, which is recommended by the WHO. For the microorganism study, the results recorde…
subject: Articles
  topic: section
subject: Ice Cream, CMC, pH, Tds, Microbial.
  topic: keywords
creator: Sajidah Aljamie
creator: Esra AlMalki
creator: Hamad Hasan
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-05-13
publication date: 2026-05-13
starting page: 182
ending page: 193
doi: 10.69667/amj.26212

Nephroprotective Effects of Ginger against Oxidative Stress
type: item
description: There have been growing indications of Zingiber officinale (ginger) acting as a nephroprotectant with antioxidant and anti-inflammatory effects. The extent and reproducibility of such effects in models of kidney injury, however, are unknown. The purpose of this systematic review and meta-analysis was to undertake a quantification of the impact of ginger on both renal performance and the levels of oxidative stress in experimental rat models of kidney injury. An extensive literature search was conducted to identify the preclinical research conducted on the actions of ginger supplementation in rat models of renal injury caused by diabetes, ethanol toxicity, exposure to cadmium, or ischemia/reperfusion. The information regarding the biomarkers of renal functions and antioxidant was extracted. Standardized mean differences (Hedges’ g) were pooled as the mean difference using a random-effects model. Between-study heterogeneity and risk of bias were measured according to the pre-established guidelines of preclinical meta-analysis. Quantitative synthesis showed that ginger therapy was indeed able to significantly change the renal functions through decreased serum creatinine, urea, blood urea nitrogen, cystatin C, and albuminuria when compared to injured controls. Meanwhile, ginger also augmented the antioxidant capacities of the kidneys notably, such as superoxide dismutase, catalase, and glutathione peroxidase. Although the heterogeneity between studies was moderate, sensitivity analyses revealed that the pooled estimates were strong, and no significant publication bias was found. This meta-analysis comprises unified preclinical studies that show that Zingiber officinale possesses considerable nephroprotective effects in various experimental kidney injury models, mainly by inhibiting the occurrence of oxidative stress. These results indicate the possible clinical translationability of ginger as a complementary therapeutic modality to protect against AKI and emphasize the n…
subject: Articles
  topic: section
subject: Ginger, Zingiber Officinale, Nephroprotection, Kidney Injury, Oxidative Stress.
  topic: keywords
creator: Sana Al-Zeen
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-05-13
publication date: 2026-05-13
starting page: 173
ending page: 181
doi: 10.69667/amj.26211

Diagnostic Utility of Complete Blood Count Parameters and C-Reactive Protein as Early Indicators in Febrile Children: An Outpatient Study from Tobruk, Libya
type: item
description: Fever is a common presenting complaint in pediatric outpatient settings, and differentiating between viral and bacterial infections remains a clinical challenge, particularly in resource-limited regions. Simple, cost-effective biomarkers such as complete blood count (CBC) parameters and C-reactive protein (CRP) may aid in early identification of bacterial infections. The Objective of this study is to evaluate the diagnostic utility of CBC parameters (white blood cell count, neutrophil count, lymphocyte count, hemoglobin, and platelet count) and CRP as early indicators of bacterial infection in febrile children presenting to an outpatient clinic in Tobruk, Libya. A prospective cross-sectional study was conducted on 290 febrile children aged 1 month to 14 years at an outpatient pediatric clinic in Tobruk, Libya, between January and April 2026. CBC parameters and CRP levels were measured at presentation. Associations between elevated CRP and CBC parameters were assessed using the Chi-square test. Sensitivity, specificity, and predictive performance were calculated for single and combined markers. Elevated CRP was observed in 64.1% of children, leukocytosis in 62.1%, and neutrophilia in 63.8%. Significant associations were found between elevated CRP and both leukocytosis (p = 0.0003) and neutrophilia (p = 0.0001). CRP alone achieved 74.0% sensitivity and 66.0% specificity. The combination of CRP, WBC, and neutrophil counts yielded the highest diagnostic performance, with 89.0% sensitivity and 80.0% specificity. Combining CRP with WBC and neutrophil counts significantly improves diagnostic accuracy for bacterial infection in febrile children compared to any single marker. This simple, cost-effective multiparametric approach may serve as a valuable tool for risk stratification in resource-limited outpatient settings.
subject: Articles
  topic: section
subject: Febrile Children, C-reactive Protein, Complete Blood Count, Bacterial Infection, Outpatient, Diagnostic Accuracy, Biomarkers, Tobruk, Libya, Pediatrics
  topic: keywords
creator: Yasmin Sulayman
creator: Khadeejah AL-Khurum
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-05-07
publication date: 2026-05-07
starting page: 167
ending page: 172
doi: 10.69667/amj.26210

Calciphylaxis in A Patient with Chronic Renal Failure: Report of A Libyan Patient and Review of the Literature
type: item
description: Calciphylaxis is a rare, life‑threatening disorder characterized by systemic arteriolar calcification, tissue ischemia, and painful ulceration, most commonly affecting patients with end‑stage renal disease and secondary hyperparathyroidism. We report the first documented case of calciphylaxis in Libya: a 54‑year‑old man with chronic renal failure on long‑term hemodialysis, who developed large painful ulcers on both calves. Laboratory findings revealed markedly elevated parathyroid hormone levels, while histopathology confirmed epidermal necrosis, vascular calcification, and ischemic fat necrosis. The patient responded to local wound care, systemic antibiotics, and debridement. This case highlights the importance of considering calciphylaxis in the differential diagnosis of chronic renal failure patients presenting with painful leg ulcers. Prompt recognition and aggressive management of mineral metabolism are essential to improve outcomes and reduce mortality associated with this devastating condition.
subject: Articles
  topic: section
subject: Calciphylaxis, Chronic Renal Failure, Libyan Patient, Review of the Literature
  topic: keywords
creator: Yaser Mustafa Garmadi
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-04-29
publication date: 2026-04-29
starting page: 162
ending page: 166
doi: 10.69667/amj.26209

Transforming the Patient-Pharmacist Relationship in Libya: A Perspective on Digital Health and AI Integration
type: item
description: The Libyan health sector faces structural challenges in regulating the patient-pharmacist relationship, most remarkably the overlapping roles in prescribing and dispensing medications, and the weak implementation of drug scheduling systems, which could pay attention to patients’ quality of life. This study aims to propose an integrated framework for regulating this relationship, grounded in recent technological developments and international standards, while respecting local specificities. The study employed a descriptive-analytical approach by reviewing the literature, previous studies, and media on the realities of pharmacy practice in Libya, analyzing recent national initiatives (such as the electronic insulin dispensing system), and aligning these initiatives with World Health Organization guidelines and pharmaceutical regulations in Arab, European, and American contexts. An integrated "Safe Dispensing" framework (Sarif Aaman integrated system) was established, built on five pillars: (1) Separation of prescribing and dispensing roles of the caregiver, (2) Implementation of a national drug scheduling system, (3) Expansion of the electronic system to cover all medications, (4) Legislation of an obligatory or commitment charter on the rights and duties of patients and pharmacists, (5) Incorporation of AI tools. Conclusions: The proposed framework is a viable solution that addresses current regulatory gaps, enhances patient safety, consolidates the pharmacist's professional role, and aligns with international standards, including those of the FDA, EMA, and WHO. Recommendations: It is recommended that the framework be adopted gradually, beginning with a pilot phase in the possible three main regions in Libya focused on high-risk medications, while developing digital infrastructure and continuous training programs for pharmaceutical personnel.
subject: Articles
  topic: section
subject: Pharmacy, Prescribing, Dispensing, Patient Rights, Medication Safety
  topic: keywords
creator: Esmaeil Musa
creator: Omran Alttir
creator: Salem Eghfayer
creator: Hanan Saber
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-04-27
publication date: 2026-04-27
starting page: 157
ending page: 161
doi: 10.69667/amj.26208

Prevalence and Determinants of PSA Screening Among Men Aged 70 and Older in a Tripoli Outpatient Clinic: A Pilot Cross-Sectional Study
type: item
description: Prostate-specific antigen (PSA) screening remains a widespread practice among older men, despite current guidelines advising against routine screening in individuals aged 70 years and older (9). In Libya, particularly in urban centers such as Tripoli, data on PSA screening prevalence and patterns are scarce. Although guidelines recommend caution, international studies from Spain, the USA, and Brazil have documented persistent PSA testing among elderly men (1–5). This study aimed to explore the prevalence and determinants of PSA screening in a Libyan context, providing local evidence to inform clinical practice. A cross-sectional, pilot study was conducted at the urology outpatient clinic of Tripoli Central Hospital. Thirty men aged ≥70 years were recruited using purposive sampling. Data were collected via structured questionnaires, medical record reviews, and semi-structured interviews. Descriptive statistics and chi-square tests were used to analyze associations between sociodemographic variables and PSA screening behavior. The study was exploratory and aimed to generate hypotheses for larger, representative studies. Of the 30 participants, 50% reported undergoing PSA screening at least once, primarily due to physician recommendation (47%). Further diagnostic procedures were followed in 30% of screened cases. Only 40% of participants reported being informed about the risks and benefits of PSA screening, and 30% felt fully involved in decision-making. No statistically significant associations were observed between screening and sociodemographic variables, although higher educational attainment showed a positive, non-significant trend (p = 0.08). Notably, 80% of participants expressed a desire for more information regarding PSA testing. Despite international guidelines discouraging routine PSA screening in men ≥70, half of the participants had undergone testing, largely influenced by physicians. Limited shared decision-making and gaps in patient education were eviden…
subject: Articles
  topic: section
subject: PSA Screening, Prostate Cancer, Elderly Men, Tripoli, Cross-Sectional Study
  topic: keywords
creator: Alaa Emtir
creator: Abdussalam Muftah
creator: Tarik Abulhul
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-04-24
publication date: 2026-04-24
starting page: 148
ending page: 152
doi: 10.69667/amj.26206

Prevalence and Behavioral Trends of Electronic Nicotine Delivery System Use Among Youth in Tripoli, Libya
type: item
description: The rapid global increase in Electronic Nicotine Delivery Systems (ENDS) use among youth represents a critical public health challenge. However, there is a complete absence of city-level epidemiological data from Libya. This study aimed to determine the prevalence, patterns, and predictors of ENDS use among students in Tripoli. A cross-sectional online survey was administered to a sample of 420 students aged 15–25 years in Tripoli, Libya. Data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression in IBM SPSS version 28. The lifetime prevalence of ENDS use was 44.0% (95% CI: 39.3–48.9). The current (past 30-day) prevalence of use was 20.5% (95% CI: 16.8–24.6). Current use was significantly higher among males (31.3%) than among females (5.6%). Male was the sole strong independent demographic predictor (Adjusted Odds Ratio = 8.41, 95% CI: 4.07–17.37). The primary motivation for use was curiosity or experimentation (73.3%). While 82.6% of current users expressed a desire to quit, 33.7% reported physical difficulty abstaining for 24 hours. This first city-level study reveals alarmingly high ENDS use among youth in Tripoli, characterized by a pronounced gender disparity and primarily experimental motivations. These findings highlight an urgent need for targeted prevention, cessation support, and specific regulatory action in Libya
subject: Articles
  topic: section
subject: Electronic Cigarettes, Vaping, Adolescents, Young Adults, Prevalence
  topic: keywords
creator: Moad Elyosfi
creator: Fatima Alzahra
creator: Ahmed Atia
creator: Yosra Sherif
rights: Copyright (c) 2026 Attahadi Medical Journal
date: 2026-04-24
publication date: 2026-04-24
starting page: 143
ending page: 147
doi: 10.69667/amj.26205