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.
Groundwater Quality Assessment in Western Libya: Spotlight on Nitrate, Nitrites and Public Health Risks
Groundwater is the primary source of drinking water in Libya, especially in arid regions where surface water is scarce. However, increasing agricultural activities and poor environmental regulations have contributed to groundwater contamination, particularly by nitrates. This study evaluated the physicochemical properties of groundwater from four regions in western Libya—Janzour, Ain Zara, Gharyan, and the Artificial River—focusing on nitrate and nitrite levels due to their significant health risks. Water samples were collected and analyzed using standard methods for parameters such as pH, electrical conductivity, total hardness, and nutrient pollutants. Results showed that while samples from Ain Zara and Janzour met national standards, the Gharyan sample exhibited alarmingly high nitrate (111 mg/L), total hardness (780 mg/L), and electrical conductivity (1720 µS/cm), exceeding Libyan and WHO guidelines. Nitrite was not detected in any sample. Elevated nitrate levels pose a serious health threat, particularly to infants and pregnant women, due to risks of methemoglobinemia and carcinogenic nitrosamine formation. The findings underscore the urgent need for enhanced water monitoring, public education on fertilizer use, and implementation of treatment technologies. This study provides evidence-based recommendations to guide policymakers in safeguarding groundwater quality and protecting public health in Libya
Groundwater Contamination, Nitrate Pollution, Drinking Water Quality, Libya
Copyright (c) 2026 Attahadi Medical Journal
Inguinal Hernia Containing Uterus and Adnexa in a Female Infant: A Rare Case Report from Libya
Inguinal hernias containing reproductive organs represent an exceptionally rare clinical presentation in female infants. While ovarian herniation occurs in approximately 15–20% of female inguinal hernias, concurrent uterine involvement is extraordinarily uncommon, with fewer than 50 cases documented worldwide. This presentation carries significant implications for long-term fertility and reproductive function. A 40-day-old term female infant presented with acute-onset painful right inguinal swelling. Ultrasonography with colour Doppler assessment revealed an irreducible inguinal hernia containing the right ovary, fallopian tube, and uterine fundus, with preserved vascular perfusion. The anesthetic management employed a rapid sequence induction with ketamine to ensure cardiovascular stability, complemented by rigorous thermoregulatory strategies to maintain neonatal normothermia. Surgical exploration via open inguinal approach confirmed complete herniation of Müllerian structures through a widely patent processus vaginalis. All organs were successfully reduced with meticulous preservation of vascular supply. Postoperative recovery was uneventful except for a superficial wound infection on postoperative day 5, managed successfully with conservative local care without systemic antibiotics. No hernia recurrence was observed at one-month follow-up. This rare presentation underscores the necessity of high clinical suspicion and prompt diagnostic imaging with Doppler assessment in female infants presenting with inguinal swelling. Urgent surgical intervention with organ-preserving techniques and specialized neonatal anesthesia management remains essential to prevent complications, including vascular compromise, torsion, and long-term reproductive morbidity. When managed appropriately, excellent outcomes can be achieved while preserving future fertility potential
Inguinal Hernia, Ovary, Uterus, Fallopian Tube, Female Infant
Clinical Profile, Management, and Outcomes of Pediatric Pneumonia Patients Admitted to the Intensive Care Unit: A Retrospective Cohort Study
Geographical and socioeconomic factors affect the incidence and outcomes of pneumonia, which is a major cause of severe illness and mortality in children globally. There is a dearth of information on the characteristics and consequences of severe pediatric pneumonia in Libya, a growing upper-middle-income nation with a healthcare system with limited resources. The purpose of this study was to describe the clinical characteristics, course of treatment, and results of pediatric pneumonia patients hospitalized to an intensive care unit (ICU) in Libya. 139 consecutive pediatric patients (age ≤18 years) hospitalized to the intensive care unit at Zawia Medical Center between January and December 2023 were the subject of a retrospective cohort study. Patients were split into two groups: those with pneumonia (n = 48) and those without (n = 91). Study variables focused on the outcomes, clinical course, and demographics. The main "severe outcomes" for the patients in this study were demand for mechanical ventilation or fatality. The cohort's median age was 24 months (IQR: 0-88). For 48 patients (34.5%), pneumonia was the main reason for admission. Patients with pneumonia exhibited a clear seasonal peak in the winter and were substantially younger than those without pneumonia (median age, 12.6 vs. 85.7 months, p < 0.001). The pneumonia group required more mechanical ventilation (25% vs. 6.6%, p = 0.004) and had a significantly higher mortality rate (20.8% vs. 6.6%, p = 0.012). younger age was the most significant risk factor for mortality, with an average age of 12.6 months vs. 85.7 months for mortalities and survival cases, respectively (p = 0.012). The presence of comorbidities (65.2% vs. 32.0%, p = 0.02) and a positive C-reactive protein (CRP) level> 30 mg/L were substantially linked to the pneumonia group, with worsening (p = 0.01). Pediatric pneumonia results in severe morbidity and high mortality and is a significant cause of ICU admission. Important risk factors for poor outcomes include younger age, elevated CRP, and underlying comorbidities. To improve patient treatment and inform national standards, these findings emphasize the need for further multicenter research, protocolized management, and improved seasonal planning.
Intensive Care Units, Critical Care Unit, Pediatric Pneumonia.
Biochemical Alterations in Liver Function Parameters among Entamoeba Histolytica–Positive Patients at Al-Bayda Medical Center, Libya
Entamoeba histolytica infection remains a major public health problem in endemic regions and may lead to extraintestinal complications, particularly hepatic involvement. While amoebic liver abscess is well recognized, biochemical alterations in liver function among E. histolytica–positive patients without clinically evident hepatic disease remain insufficiently characterized. This study aimed to evaluate liver function parameters and their interrelationships among patients diagnosed with Entamoeba histolytica at Al-Bayda Medical Center, Libya. A laboratory-based cross-sectional study was conducted in 2025 and included 30 patients with confirmed E. histolytica infection. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin, and direct (conjugated) bilirubin were measured using routine clinical chemistry methods. Data distribution was assessed using the Shapiro–Wilk test. One-sample t-tests or Wilcoxon signed-rank tests were applied to compare observed values with reference limits, and Spearman’s rank correlation analysis was used to assess associations among biochemical parameters. Elevated aminotransferases were common, particularly AST (56.7%) and ALT (40.0%), indicating frequent hepatocellular stress. In contrast, elevations in ALP (36.7%) and direct bilirubin (30.0%) were less frequent, while total bilirubin elevation was rare (6.7%). Strong positive correlations were observed among ALT, AST, and ALP, whereas total and direct bilirubin were strongly correlated with each other but showed weak associations with liver enzymes. In conclusion, Entamoeba histolytica infection was associated predominantly with hepatocellular enzyme alterations, with minimal disruption of bilirubin metabolism. Routine liver function testing may aid in the early detection of hepatic involvement in amoebiasis, even in the absence of overt liver disease
Entamoeba Histolytica, Liver Function Tests, Aminotransferases, Hepatic Involvement, Amoebiasis.
Copyright (c) 2025 Attahadi Medical Journal
Demographic, Seasonal, and Temporal Determinants of SARS-CoV-2 Infection and Serological Status in Al-Bayda City, Libya: A Cross-Sectional Study Employing Multinomial Logistic Regression
This cross-sectional study examined the demographic, seasonal, and temporal determinants of SARS-CoV-2 infection and serological status among individuals tested in Al-Bayda city, eastern Libya, between 2021 and 2025. Despite the global transition toward endemic circulation of SARS-CoV-2, region-specific evidence from North Africa remains limited, particularly with respect to multi-year serological patterns. By applying a multinomial outcome framework, this study aimed to provide a nuanced characterization of population-level exposure beyond binary infection classifications. Laboratory-based serological records were obtained from the Al-Bayda Specialized Diagnostic Laboratory. Individuals were classified into four mutually exclusive serological categories—no exposure, early infection, active infection, and past infection—based on combined IgM and IgG antibody results. Descriptive analyses summarized demographic characteristics and serological distributions, while age differences across outcome categories were evaluated using analysis of variance with post hoc testing. Seasonal and calendar-year patterns were assessed to capture temporal heterogeneity in testing and exposure. To evaluate independent associations of age, gender, season, and calendar year with serological outcomes, multinomial logistic regression with LASSO regularization was employed. Penalized modeling was used to address outcome imbalance, sparse event counts, and potential multicollinearity. Model tuning was conducted using cross-validation, and a conservative regularization parameter was selected to prioritize model stability and generalizability. A total of 309 individuals were included, with a mean age of 32.5 years and an approximately equal gender distribution. Past infection was the most prevalent serological outcome, whereas active and early infections were rare. Unadjusted analyses demonstrated significant age-related differences across serological categories, with older individuals more frequently classified as having active or past infection. However, after adjustment and penalization, none of the examined predictors showed strong independent associations with serological outcomes, as relative risk ratios were approximately unity. These findings suggest that SARS-CoV-2 serological status in this population reflects cumulative and multifactorial exposure processes rather than being driven by isolated demographic, seasonal, or temporal determinants. The use of multinomial ridge regression provides robust region-specific evidence and highlights the importance of advanced analytical approaches in interpreting serological data from resource-limited settings.
SARS-Cov-2; COVID-19 Seroprevalence; Multinomial Logistic Regression; Cross-Sectional Study, Libya.
The Contents of Fatty Acids, Phenolic Acids, Metals, and Antimicrobial Studies of Leaves and Fruits of Juniperus Phoenicea Plant
This study aims to determine of Fatty acids, phenolic acids, minerals, metals, and phytochemical screening in leaves and fruits of the Juniperus phoenicea plant. The extracts are also used for antimicrobial investigation against different species of bacteria. Different methods were used in the experimental part: the GC-MS instrument was used to analyze fatty acids and phenolic compounds, atomic absorption was used to estimate metals, and the spectrophotometer was used to determine phosphorus and Nitrogen in the extracts. The results of this study showed that some phenolic acids were detected in the samples, including: the types of phenolic acids in the leaves and fruits of Juniperus phoenicea were as follows: Juniperus phoenicea leaves: 4,5-Dicaffeoylquinic acid, Cinnamic acid, Gallic acid, Geraniol, Phloridzin, Quercetin, and Catechin. Juniperus phoenicea fruits: 3,4-Dicaffeoly guinic acid, Gallic acid and Catecin. On the other side some of fatty acids were detected and can show as following: The saturated fatty acid in leaves and fruits of Juniperus phoenicea as following: Juniperus phoenicea leaves: Hexanoic , Octanoic.Decanoic , Undecanoic ,Dodecanoic , Tridecanoic , Tetradecanoic , Pentadecanoic, Hexadecanoic , Octadecanoic and Eicosanoic Juniperus phoenicea fruits: Decanoic , Undecanoic , Decanoic , Tetradecanoic , Hexadecanoic and Octadecanoic .The high concentration of saturated fatty acid was recorded for Octadecanoic ,while the low concentration was recorded for Decanoic and Undecanoic in fruits of Juniperus pheonicea; and Octanoic in fruits of Pistacia lentiscus. The contents of metals were fluctuated as follows: the contents of Na, K, Ca P, and N were as follows 1.50, .40, 2.16, 2.40, and 0.02 in leaf samples, respectively; on the other hand, these mineral contents in fruits were 0.41, 14.44, 1.33, 2.41, and 0.11. The contents of metals of Zn, Cu, Cr, and µg in leaves were 012, 0.84, 0.076, and 1.64 ppm, where the contents of the same metals in fruit samples were 0.13, 0.91, 0.095, and 1.89 ppm, respectively. The antimicrobial activities showed different effects of the fruits and leaves of extracts against different species of bacteria, including Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Klebsiella Pneumoniae, Escherichia coli, and Salmonella typhimurium.
Leaves, Fruits Juniperus Phoenicea Plant, Chemical, Biological, Fatty Acids, Phenolic Acids.
Epidemiological Landscape of Oral Tumors in Benghazi: A Retrospective Analysis
The oral mucosa can be affected by non-neoplastic and neoplastic lesions, which significantly contribute to patients' mortality and morbidity, particularly with late detection. The study aimed to evaluate the demographic features, clinical presentations, histopathological features, and risk factor associations of oral cavity tumors. The study was a retrospective study at the Faculty of Dentistry, University of Benghazi, using the records of 164 patients who had been diagnosed with oral cavity tumors, which were clinically and by biopsy in the period from 2016 to 2019. The results showed that benign oral cavity tumors accounted for 74.4%, and premalignant oral cavity tumors were 9.7%, while malignant oral cavity tumors15.9%. The mean age of patients was approximately 40 years old. The major clinical presentation of oral cavity tumors was painless swelling (73.8%), affecting the jaw (29.9%) commonly. According to the tumor origin, 75% of cases had non-odontogenic tumors, with benign tumors being predominantly of mesenchymal origin (98.1%), and premalignant lesions were more significantly associated with mixed tissue origin (26.7%). Malignant tumors occurred most commonly associated with tissues derived from salivary glands (68.7%). We conclude that histopathological analysis is important in the establishment of the definitive diagnosis and early detection of oral cavity tumors.
Oral Cavity Tumors, Histopathology, Biopsy, Squamous Cell Carcinoma
Antimicrobial Evaluations of Juglans Regia Bark Against Oral Pathogenic Microorganisms
Oral pathogenic microorganisms significantly contribute to various diseases, impacting both oral and systemic health, including chronic periodontitis and dental caries. Natural plants, including Juglans regia (walnut tree), have gained momentum for their therapeutic potential due to their antibacterial properties, offering a promising avenue to combat antibiotic resistance. This study fundamentally aimed to validate the traditional use of Juglans regia bark in maintaining oral health; it sought to evaluate the antibacterial and antifungal effects of Juglans regia bark. The methanolic extracts of Juglans regia bark, imported from China, were prepared using the maceration technique, various microorganisms procured from the American Type Culture Collection (ATCC), including Gram-positive bacteria (Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus (MRSA)), Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa), and the local fungal strain Candida albicans. Antimicrobial activity was assessed using the agar well diffusion assay at concentrations of 250 mg/ml and 125 mg/ml, with chlorhexidine and phenol serving as reference standards. Minimum inhibitory concentrations (MIC) were determined using the microdilution technique, with serial dilutions ranging from 125 mg/ml down to 3.9 mg/ml. At 250 mg/ml, Escherichia coli exhibited the largest zone of inhibition (27mm), followed by Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans (25mm, 23mm, and 25mm, respectively). At 125 mg/ml, Candida albicans showed the best results (22mm). The lowest effective inhibitory concentration (MIC) for C. albicans was 15.6 mg/ml, while S. aureus and P. aeruginosa also showed equal MICs.
Juglans regia, Antimicrobial Activity, Oral Pathogens, Minimum Inhibitory Concentration, Phytochemicals, Natural Remedies.
CBCT Assessment of Root Canal Number in Maxillary Third Molars: A Retrospective Study in a Libyan Subpopulation (Zliten City)
This study aims to evaluate the number of roots of maxillary third molar teeth of the Libyan subpopulation at Zliten city, to compare the incidence of root number in different side locations, and to compare the prevalence of root number in different genders. Out of 2078 CBCT images, only 806 images that had been met the inclusion criteria of this study (the CBCT images were collected from Al-Tasneem Private Dental Poly-Clinics in Zliten city during the period January 2024 until May 2025). 432 (53.6%) of CBCT images were related to women, whereas 374 (46.4%) images were related to men. On another hand, 425 (52.7%) were right-sided teeth, while 381 (47.3%) were left-sided teeth. 367(45.5%) of CBCT images showed four root canals, which were the most common number of root canals of maxillary third molar teeth in the Libyan subpopulation at Zliten city, while five root canals were the lowest incidence. The incidences of single root canals and double root canals were higher in women than in men. Inversely, the prevalence of three and five root canals in men was higher than the women. The incidences of four root canals were almost equal in women and men (45.8% and 45.2% respectively). The incidences of all numbers of root canals were not significantly different based on tooth locations. The root canals of maxillary third molar teeth in the Libyan subpopulation at Zliten city ranged between 1 to 5 root canals. None of the five root canals had bilateral incidences.
Number of Root Canals, Cone Beam Tomography, Upper Third Molar, Libyan Subpopulation, Zliten.
Brief Review on Segregation and Treatment of Biomedical Waste in Medical Laboratories in light of WHO and CDC Guidelines
The proper management of biological waste in laboratory settings is a critical aspect of biosafety in microbiological and biomedical laboratories. Beyond protecting lab workers, biological waste management safeguards public health, protects the environment, and ensures compliance with legal and regulatory frameworks. Segregation, decontamination of liquid waste, decontamination of solid waste, and techniques for inactivating toxins are all main aspects of biological waste management that will be outlined, aligned, and summarised with the main institutional biosafety protocols for biological waste management, published by major authorities, including CDC and WHO. This research found that the information from the two institutions complements each other. Therefore, this brief review aimed to compile and unify information from both institutions to construct a single, coherent text that provides a practical summary for medical laboratory professionals seeking to enhance the implementation of international, harmonized protocols that strengthen biosafety, environmental stewardship, and regulatory compliance
Biomedical Waste Management, Segregation, Decontamination, CDC, WHO.
Influence of Anemia Status and ABO Blood Group on Hematological Parameters Among Pregnant Women
Pregnancy is a typical physiological condition that involves widespread changes throughout the body and in the blood system. Nevertheless, variations in certain blood-related measurements during this time can impact the mother's health and increase the risk of pregnancy-related complications. The study aims to examine the connection between hematological parameters in pregnant women and the condition of anemia, as well as to explore how these parameters relate to different blood group types. This cross-sectional study was conducted in the Gynecology Department of Tobruk Medical Centre, Tobruk, Libya. All pregnant women who were more than 28 weeks pregnant and at least 18 years old were included in this study. A total of 2141 pregnant women were enrolled. Clinical data for these women were collected using hospital electronic records. Blood samples were tested for complete blood count using the Sysmex Automated Hematology Analyzer, and blood group determination using indirect and reverse grouping tubes. Statistical analysis was performed using SPSS software, with independent samples t-tests comparing various hematological parameters and a p-value used to determine statistical significance. The Fisher–Freeman–Halton was used to analyze the association between two categorical variables, and the Phi coefficient was used to calculate to evaluate the strength of associations. Hemoglobin and hematocrit levels were significantly lower in the anemic group, showing a large difference in hemoglobin (d = 0.82) and a moderate effect for hematocrit (d = 0.43). Platelet counts were higher in 3.9% of anemic women compared to 1.2% of non-anemic women. Although this association was statistically significant (χ² = 18.965, p = 0.0001), the Phi coefficient (φ = 0.094) indicates that the relationship is weak. Similarly, there was a statistically significant but weak association between white blood cell (WBC) distribution and anemia (χ² = 5.041, p = 0.046; φ = 0.080) with 14.9% of anemic women having elevated WBCs versus 11.9% of non-anemic women. No association was found between ABO blood groups and red blood cell (RBC) or platelet counts, although a weak but statistically significant association was observed with WBC levels (χ² = 33.476, p = 0.006; φ = 0.125). The study found that pregnant women with blood group B were more likely to exhibit elevated white blood cell counts, followed by those with blood group O+ and AB+. This paper's findings help improve our understanding of how anemia status and ABO blood group traits affect important blood-related measurements such as white blood cell count, red blood cell count, and platelet count. The results highlight the need for more research in bigger and more varied groups of people to better understand the biological and genetic reasons behind these connections.
Hematological, Pregnant Women, Anemia, Blood Group
Comparative in vitro Evaluation of Three Brands of Hydrochlorothiazide Tablets in Libya
Hydrochlorothiazide (HCTZ) is a diuretic of the thiazide class, which is used in the treatment of hypertension, edema, congestive heart failure, and different forms of renal and hepatic dysfunction. The aim and the objective of our present study are to evaluate the quality parameters of some marketed hydrochlorothiazide tablets and to compare the parameters among them. To assess the quality, three different marketed hydrochlorothiazide 25 mg tablets available on private pharmacies of Tripoli, Libya, are selected, and in vitro dissolution test, potency, and disintegration time are carried out. Other general quality parameters of these tablets, like weight variation, hardness, and friability, are also determined according to established protocols. All the brands comply with the requirements of the United States Pharmacopoeia as they show an acceptable weight variation range. Friability of Brand A brands is more than 1% so it does not pass the friability test. The hardness of all brands was below 4 kg/cm2. The limitation of the potency must be within 92.5- 107.5%. All three brands meet this specification. The mean disintegration times of all tested brands were within the pharmacopeia specification (30 minutes). In the case of dissolution profile, all brands show better dissolution time as they release more than 90% of the drug in 30 minutes. The difference factor (f1) and similarity factor (f2) values revealed that all brands maintained the quality and complied with the USP specifications, and are like the comparator product and could be used interchangeably in clinical practice
Hydrochlorothiazide, In Vitro, Quality Control, Dissolution, Pharmacopoeial Specification.
Advances in the Diagnosis and Management of Shoulder Instability: A Review
Shoulder instability, particularly anterior dislocation, is a common issue in younger, active individuals. The goals of nonoperative care include restoring mobility, alleviating discomfort, and preventing recurrence. After a brief period of sling immobilisation, intravenous analgesics, and intra-articular injections, physical therapy focusing on the rotator cuff and periscapular muscles is usually administered. Although they need further study, new tactics like immobilisation in external rotation show promise. The goals of nonoperative care include restoring mobility, alleviating discomfort, and preventing recurrence. After a brief period of sling immobilisation, intravenous analgesics, and intra-articular injections, physical therapy focusing on the rotator cuff and periscapular muscles is usually administered. Although they need further study, novel methods like immobilisation in external rotation show promise. Recurrent instability, particularly in athletes, should be treated surgically. Good results are obtained with less invasive arthroscopic techniques as well as open operations like Bankart repair. Following surgery, rehabilitation is crucial to regaining function and averting further instability.
Diagnosis, Management, Shoulder Instability.
Estimate the Antioxidant Capacity, Total Phenol Contents, Mineral Concentrations, and Total Carbohydrate of Capparis Spinosa L. (Kabbar), Ceratonia Siliqua L. (Kharuwb), and Juniperus Phoenicea L (Arar) Plants
In this research, some of the phytochemical compounds were detected by using phytochemical screening in leaves and stems of three different plants collected from Al-Gabal Al-Ahder region, Libya, and the concentrations of anti-oxidant capacity, total phenol content, minerals, and total carbohydrate were measured for the selected plants of Capparis spinosa L. (Kabbar), Ceratonia siliqua L. (Kharuwb), and Juniperus phoenicea L (Arar). The spectrophotometer was used to estimate the contents of antioxidants, total phenols, and total carbohydrates, whereas the Flame photometer was used to determine the contents of sodium, calcium, and potassium. The outcomes of this study found that, the levels of anti-oxidant were ranged as follows:(222.72 -302.64 ppm) in leaves and (307.62 -319.03 ppm) in stems, while the contents of total phenols were ranged from 307.62 to 319.03 ppm in stems, the total phenols contents were ranged from 9.07 to 10.59 ppm and from 9.95 to 10.65 ppm in stems, respectively while the concentrations of carbohydrate were ranged from 0.039 to 0.155 ppm and from 0.070 to 0.123 ppm for leaves and stems, respectively. . whereas the sodium, potassium, calcium were ranged from 0.958 to 2.625 ppm in leaves and from 0.88 to 4.08 ppm in stems, for potassium the values were ranged from 3.56 to 77.16 ppm in leaves, but for stems the values of potassium were ranged from 42.96 to 76.96 ppm. While the calcium contents ranged from 0.08 to 0.28 ppm in leaves, and for stems ranged from 0.375 to 0.875 ppm in stems. The phytochemical investigation showed the present important quantiles of sterols, flavonoids, alkaloids, tannins, anthraquinones, saponins, and phenols
Phytochemical. Carbohydrate, Antioxidant, Phenols, Minerals, Plants, Libya
Outcomes of Soft Palate Lengthening for Persistent Nasal Speech in Post-Palatoplasty Patients Over Five Years of Age
Having nasal speech due to velopharyngeal insufficiency (VPI) remains one of the most difficult complications to manage after cleft palate repair. Over early childhood, persistent hypernasality can impede the psychosocial and communicative development of a child. The purpose of this study was to assess the results of secondary soft palate lengthening surgery on children older than five years with a history of primary palatoplasty and persistent nasal speech. In this study, 60 non-syndromic patients with cleft palate whose nasal speech was persistent after cleft palate repair were included from January 2018 to December 2024 at Misurata Medical Center, Libya. Each of them underwent soft palate lengthening, most by intravelar veloplasty, and some by posterior pharyngeal flap. All the patients had preoperative and 12-month postoperative speech evaluation from both perceptual (Pittsburgh Weighted Speech Scale) and instrumental (nasometry) analysis. For statistical analysis, paired t-tests were used, with P < 0.05 considered significant. Of the total, 80% of patients had complete hypernasality correction, and 13.3% had partial correction. There was a significant improvement postoperatively on nasalance scores (48.5 ± 9.2% to 24.1 ± 6.8%, P < 0.001). 85% of the patients had improved speech intelligibility, with more than 86% of parents satisfied with the overall results. 10% had transient snoring and 5% had wound dehiscence, both classified as minor complications and were conservatively managed. For patients older than five years, soft palate lengthening is a secondary procedure that is both safe and effective for persistent nasal speech after cleft palate repair. It shows remarkable positive outcomes in resonance, intelligibility, and psychosocial confidence
Velopharyngeal Insufficiency (VPI); Hypernasality; Soft Palate Lengthening; Intravelar Veloplasty; Posterior Pharyngeal Flap.
Optimizing Sedation for Upper GI Endoscopy: Propofol versus Midazolam: A Clinical Study at Sirte Oncology Central
Upper gastrointestinal (GI) endoscopy is a common diagnostic and therapeutic procedure, typically performed under conscious sedation to improve patient comfort and cooperation. However, the choice of sedative remains a topic of ongoing debate. This study aimed to compare the safety and efficacy of midazolam and propofol for sedation during upper GI endoscopy. A total of 80 patients scheduled for elective upper GI endoscopy at the Endoscopy Unit of our hospital between February 2023 and October 2023 were recruited for this prospective, randomized controlled trial. Patients were randomly assigned to two equal groups: one group received propofol, while the other received midazolam. The anesthesiologist was aware of the sedative agent being administered, but the patients were blinded to the treatment. Both sedatives were administered via intravenous bolus, with dosages adjusted as needed to maintain an appropriate level of sedation. The recovery time was significantly shorter in the propofol group compared to the midazolam group. While the propofol group exhibited a decrease in systolic blood pressure, this was transient and did not result in significant adverse effects. In contrast, the midazolam group experienced a notable reduction in oxygen saturation, with a higher incidence of hypoxia compared to the propofol group. No major adverse events, such as cardiac arrhythmias or respiratory depression, were observed in either group during the procedure. The sedation quality, as assessed by the Observer's Assessment of Alertness and Sedation (OAA/S) scale, was stable throughout the procedure in the propofol group, while some variability was noted in the midazolam group. The results of this study suggest that propofol is a more effective and safer sedative agent than midazolam for upper GI endoscopy. Propofol offers faster recovery times and more stable sedation, with fewer complications related to oxygen saturation. It is therefore recommended as the sedative of choice for upper GI endoscopy, although careful monitoring of blood pressure is essential
Upper gastrointestinal endoscopy, Propofol, Midazolam, Sedation, Recovery time, Oxygen saturation
Early-Life Antibiotic Exposure and Asthma-Like Symptoms Among Children in Sebha, Libya
Evidence links infant antibiotic exposure to asthma, but data from North Africa are limited. Methods: We conducted a cross-sectional survey of 100 children aged 0–5 years in Sebha, Libya. Early exposure was defined as any systemic antibiotic use before the age of 2 years, and intensity was grouped as 0, 1, 2–3, or ≥4 courses. The primary outcome was the presence of current asthma-like symptoms (wheezing, persistent cough, nocturnal cough, or shortness of breath). Proportions were compared using chi-square tests, and multivariable logistic regression was adjusted for age, sex, family history of atopy, household smoking, and residence. Sensitivity analysis excluded children with physician-diagnosed asthma. Results: Seventy percent of children received antibiotics by the age of 2. Overall, 25% had current asthma-like symptoms; the prevalence was 30% among the exposed and 10% among the unexposed (unadjusted OR 3.86, 95% CI 1.05–14.2; adjusted OR 3.5, 95% CI 1.11–11.2). A dose–response relationship was observed: symptoms in 15% with 1 course, ~30% with 2–3 courses, and 50% with ≥4 courses (p-trend <0.01). The first antibiotic before 6 months showed a higher symptomatic proportion among the exposed, but this was not statistically significant. Family history was strongly associated with symptoms (aOR ~4.0), whereas household smoking showed a non-significant trend (aOR ~1.8). The model fit was acceptable (Hosmer–Lemeshow p=0.88). The sensitivity results were similar (25% vs. 8%, p=0.04). Respiratory infections were the most common indication for use, and 57% of exposed children received broad-spectrum agents. In this Libyan cohort, early-life antibiotics were associated with a higher burden of asthma-like symptoms by age five years, with a graded increase across course counts. Although confounding by indication and cross-sectional design limit causal inference, the findings are biologically plausible and clinically relevant. Prudent stewardship in infancy and targeted respiratory follow-up for repeatedly treated children are warranted, and larger prospective cohorts with validated exposure and microbiome profiling are needed
Early-Life Antibiotic Exposure, Asthma-Like Symptoms, Children in Sebha, Libya
Renal and Metabolic Biomarker Profiles in Dialysis vs. Non-Dialysis CKD Patients: A Cross-Sectional Study.
This study investigated key renal and biochemical parameters in Chronic Kidney Disease (CKD) patients by comparing a cohort of 147 non-dialysis patients with 147 patients undergoing dialysis. Key findings indicate that while both groups exhibited elevated urea and creatinine levels, urea was lower in dialysis patients, whereas creatinine was significantly higher. Blood pressure was minimally increased in both groups, but was higher in the non-dialysis cohort. Uric acid levels were notably lower in patients on dialysis. Regarding electrolytes, potassium levels were higher in the dialysis group, while sodium levels remained normal and stable across both cohorts. Serum phosphorus was elevated in both groups, with slightly higher levels in non-dialysis patients. A significant difference was observed in serum calcium, which was normal in non-dialysis patients but below the normal range in the dialysis group. Both groups also showed elevated fasting blood sugar. As expected, Glomerular Filtration Rate (GFR) was sharply decreased in all patients, most severely in the dialysis group, consistent with end-stage renal disease. The results underscore the profound metabolic and physiological changes in CKD patients. The study concludes that enhancing dialysis efficiency and providing comprehensive patient education on medication, diet, and lifestyle are critical for improving quality of life, reducing complications, and lowering healthcare costs associated with CKD management
Chronic Kidney Disease, Electrolytes Urea, Creatinine Uric Acid, Glomerular Filtration Rate, Dialysis.
Comparison of Height and Dominant Hand Grip Strength Among Female Physiotherapy Staff: A Cross-Sectional Study
This cross-sectional study investigated the relationship between dominant hand grip strength and height among female physiotherapists. Hand grip strength is a fundamental function for daily activities and a common measure of upper limb function and general muscular health. The study included a small sample size (n) of 18 female physiotherapists. Two observers recorded participant height (in centimetres) and dominant hand grip strength (in kilograms) using a JAMAR hand dynamometer across three consecutive tests. Statistical analyses included descriptive statistics, correlation coefficients, and linear regression. A strong, significant positive correlation was found between the participants' height and their dominant hand grip strength, with correlation coefficients (r) ranging from 0.730 to 0.838 (p <0.005). This indicates that taller participants generally had stronger grip strength. However, linear regression analysis showed that height only accounted for a small amount of the variance in grip strength, with an R2 of 0.134. This suggests that while there is a positive relationship, height is a weak predictor of grip strength. The study also found that grip strength measurements varied moderately between the three tests, indicating variability in measurement. The results suggest that height may influence grip strength, but it is not the primary factor. Future research should employ larger samples and include additional variables to fully understand the factors determining grip strength in this population
Hand Grip Strength, Height, Dominant, Correlation, Dynamometer, Physiotherapist, Cross-sectional
Medical Waste Management in Primary Health Care Centers, Tripoli
Medical waste management (MWM) is a critical public health and environmental concern, given the potential hazards posed by improperly handled biomedical materials. Inadequate management of such waste can lead to severe consequences, including disease transmission, environmental contamination, and occupational risks for healthcare workers and waste handlers. To assess different medical waste management practices in primary health care centers (PHCCs) in Tripoli, Libya. A cross-sectional study for 35 primary health care centers in the seven municipalities of the Tripoli district was conducted between 1st February 2023 and to end of June 2023. The Majority of PHC (97%) have at least one trash bag in each room; however, only 20% of them use colored trash bags to collect infected medical wastes. Also, the majority of primary health care facilities use safety boxes for the collection of sharp medical wastes; however, they also use plastic tanks instead of or in addition to safety boxes. In addition, to majority of safety boxes were filled more than three-quarters. Medical waste management practices in Tripoli's PHCCs are inadequate, posing significant risks. Urgent intervention is needed, focusing on training, provision of supplies, and establishing a centralized waste management system
Medical Waste Management, Primary Health Care Centers, Tripoli.
Antibacterial Properties of Alchemilla vulgaris and Euphorbia helioscopia: Potential Natural Alternatives for the Treatment of Conjunctivitis
The emergence of antibiotic-resistant bacteria necessitates the exploration of alternative therapeutic agents. This study investigates the antibacterial potential of Alchemilla vulgaris and Euphorbia helioscopia extracts against bacterial strains associated with conjunctivitis, including Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus spp. Plant extracts were prepared using water, ethanol, hexane, and chloroform as solvents, and their antibacterial efficacy was assessed via agar well diffusion and broth microdilution minimum inhibitory concentration (MIC) assays. Ethanol extracts demonstrated the highest antibacterial activity in agar diffusion, with inhibition zones up to 17 mm for E. helioscopia and 12 mm for A. vulgaris (against Streptococcus spp.). Chloroform extracts showed moderate activity (zones ranging from 9–19 mm across both plants), while hexane extracts exhibited lower activity. Water extracts displayed no antibacterial effects. MIC analysis revealed that the ethanol extracts had the lowest MIC values (approximately 280 mg/mL) among all extracts, notably against S. aureus (for A. vulgaris) and P. aeruginosa (for E. helioscopia). All other solvent extracts showed higher MICs (≥550–750 mg/mL). Statistical analysis confirmed significant differences in the antibacterial activity of the extracts compared to the control antibiotic gentamicin (30 µg) (p < 0.05). These findings highlight the potential of Alchemilla vulgaris and Euphorbia helioscopia as sources of natural antibacterial agents. Future studies should focus on isolating bioactive compounds and evaluating their pharmacological properties to develop alternative treatments for ocular bacterial infections
Alchemilla vulgaris, Euphorbia helioscopia, Conjunctivitis.
Assessment of Carbapenem-Resistant Enterobacteriaceae and Other Gram-Negative Bacteria on Intensive Care Unit Surfaces and Among Healthcare Workers at Tobruk Medical Center
The emergence of carbapenem-resistant Enterobacteriaceae (CRE) and other multidrug-resistant Gram-negative bacteria (GNB) presents a serious threat to infection control, particularly in high-risk environments such as Intensive Care Units (ICUs). ICU surfaces and healthcare workers (HCWs) may serve as reservoirs and transmission routes for these pathogens. This study aimed to assess the prevalence and distribution of CRE, and other Gram-negative bacteria isolated from ICU environmental surfaces and from the nasal swab of healthcare workers. A descriptive cross-sectional study was used to study 127 collected samples: 36 from healthcare workers and 91 from surface smears. Samples were collected from four units of intensive care: Intensive Care Unit (ICU), Cardiac Care Unit (CCU), Pediatric Care Unit (PICU), and Neonatal Intensive Care Unit (NICU). Identified Enterobacteriaceae were confirmed by biochemical methods, and tested for carbapenemase production using three discs (EME, IMP, ETP). Resistance to Ertapenem, Imipenem, and Meropenem was considered carbapenem resistance. A total of 13 (36.1%) out of 36 HCW samples yielded clinical isolates: 3 Pantoea sp., 3 Klebsiella pneumoniae, 2 Acinetobacter baumannii, 2 Escherichia coli, 2 Flavimonas oriyzihabitans, and 1 Serratia marcescens. One (7.69%) isolate showed carbapenem resistance: 1 Klebsiella pneumonia. From 91 surface samples, 39 (43%) yielded isolates: 13 Flavimonas oriyzihabitans, 6 Acinetobacter baumannii, 5 Pantoea sp., 4 Escherichia coli, 3 Enterobacter cloacae, 2 Serratia marcescens, 2 Shigella sp., 1 Klebsiella pneumonia, 1 Leclercia adecarboxylata, and 1 Salmonella sp. Of these, 11 (28.2%) were carbapenem-resistant: 3 Escherichia coli, 3 Acinetobacter baumannii, 2 Pantoea sp., 1 Klebsiella pneumonia, 1 Citrobacter freundii, and 1 Enterobacter cloacae
ICUs, Enterobacteriaceae, CRE, Gram negative bacteria, Antibiotic resistance.
Consultant Physicians’ Awareness, Prescribing Practices, and Safety Measures of SGLT2 Inhibitors in Tripoli, Libya: A Unicenter Domestic Study
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve glycemic control and provide cardiorenal benefits in type 2 diabetes mellitus (T2DM). Physician awareness and safe prescribing practices are critical to optimize outcomes. This study was conducted to evaluate consultant physicians’ awareness, prescribing practices, and safety considerations regarding SGLT2i in Tripoli, Libya. A cross-sectional study included 39 consultant physicians (21 cardiologists, 18 endocrinologists) with ≥1 year of SGLT2i prescribing experience. Data were collected via a validated self-administered questionnaire assessing demographics, prescribing patterns, observed benefits, adverse effects, monitoring practices, and awareness levels. Continuous variables were reported as median ± interquartile range (IQR); categorical variables as n (%). Associations were analyzed using chi-square, Fisher's exact test, and Spearman’s rho correlation; P < 0.05 was significant. Median prescribing experience was 5 years (IQR 3–8). High awareness was observed in 64% and moderate in 36%. Most physicians prescribed SGLT2i for both cardiac and diabetes indications (72%), predominantly empagliflozin (82%). Observed benefits included cardiovascular, renal, and metabolic outcomes. Awareness significantly correlated with safety measure implementation (r = 0.628, P = 0.038) and reporting of adverse effects (r = 0.661, P = 0.027). Specialty correlated with short-term risk perception (P < 0.002), while years of experience inversely correlated with long-term risk perception (r = -0.682, P = 0.021). Consultant physicians in Libya demonstrate moderate to high awareness of SGLT2i, strongly influencing safety practices and patient benefits. Clinical pharmacists play a pivotal role in updating healthcare professionals, supporting safe prescribing, and optimizing therapeutic outcomes
SGLT2 Inhibitors, Type 2 Diabetes, Physician Awareness, Safety Measures, Clinical Pharmacists.
Comparative Analysis of Flexural Strength between Heat Polymerized PMMA, Injectable Flexible Nylon-Based Resin, and CAD/CAM (PEEK) Denture Base Materials: An In-Vitro Study
This study aimed to compare the flexural strength of Heat Polymerized PMMA, Injectable Flexible Nylon-Based Resin, and CAD/CAM Polyether Ether Ketone (PEEK) denture base materials. A total of 36 rectangular samples with dimensions of (64mm x 10 mm x 3.3mm) were fabricated from Heat Polymerized PMMA, Injectable Flexible Nylon-Based Resin, and CAD/CAM (PEEK). These samples were divided into three groups of 12 samples. The three-point flexural strength test was carried out using a universal testing machine. A one-way analysis of variance (ANOVA) test was used for statistical analysis. Statistical significance was set at P ≤ 0.05. The flexural strength of CAD/CAM (PEEK) (137.92 ± 8.92555 MPa) was the highest, followed by Heat Polymerized Acrylic Resin (75.162 ± 9.40870 MPa), and the lowest was for Injectable Flexible Nylon-Based Resin (54.01 ± 20.29325 MPa). Considering the study’s limitations, CAD/CAM PEEK showed the highest flexural strength, followed by heat-polymerized PMMA, while injectable flexible nylon-based resin exhibited the lowest strength. These findings suggest that PEEK may provide more durable and reliable denture bases, potentially improving prosthesis longevity and patient satisfaction
Denture Base Material, Flexural Strength, Heat Polymerized PMMA, Injectable Flexible Nylon-Based Resin.
Ovarian Cancer Therapy in Transition, Innovation, Update, and Challenges: A Review Article
Ovarian cancer continues to be one of the deadliest cancers in women, with a poor prognosis despite many therapeutic advances; it has an ominous outcome. In the last decade, a giant leap in ovarian cancer therapy was made, which has reshaped ovarian cancer management and given hope for improved survival odds in some of the affected population. An online search was conducted through an electronic repository to find up-to-date reports and studies regarding newer and innovative therapies in ovarian cancer. We collected data regarding the method of action, efficacy, patient demographics, side effects, and suggested future work to address research gaps. Six therapeutic strategies were identified and discussed and comprehensively compared, including [Immune Checkpoint Inhibitors (ICIs, Poly (ADP-ribose) polymerase (PARP) Inhibitors, Anti-angiogenesis Drugs, Antibody-Drug Conjugates (ADCs), Oncolytic Viruses (OVs), and Cancer vaccines]. The analysis identified key areas that require attention, including biomarker development, rationale for combination therapy strategies, mechanisms of resistance development during treatment, immune modulation methods, and preventive approaches for ovarian cancer. Future studies are warranted to address the current gap in knowledge and validate optimistic cancer research results, especially for high-risk patients, to reduce ovarian cancer burden and improve survival odds.
Ovarian Cancers, Survival Rate, Mechanism of Action, Therapeutic Strategy, BRCA Mutation.
Assessment of the Efficacy of Aloe Vera Resin Extract as an Anti-Diabetic Foot Ulceration Agent
A diabetic foot ulcer is one of the most significant and devastating complications of diabetes. DFU is considered a major source of morbidity and mortality in patients with diabetes. Therefore, this study aimed to test the possibility of using Aloe Vera resin extract as an antibacterial agent (Libyan remedy) against isolated bacteria from a patient's foot. This study was concerned with the determination of the possible microbial causative of the diabetic foot ulcer; therefore, its design included microorganism isolation, identification, and finally, testing of the antibacterial activity of Aloe Vera resin against bacteria isolated from diabetic foot ulcers. Curiously, the results demonstrated that every antibiotic used in this experiment created inhibition zones against the bacteria that were isolated from patients' feet and had a pronounced resistance to the extract from aloe vera resin. In contrast, aloe vera resin extract created inhibition zones against bacteria isolated from healthy feet in comparison to the other widely used, well-known broad-spectrum antibiotics. The pathogen that was isolated from the patient's feet, according to our lab results, was Staphylococcus bacteria. Aloe Vera resin extract had no inhibition zones against Staphylococcus species bacteria that were collected from patient feet, which contradicted the hypothesis that Aloe Vera is a good antibacterial agent that could be used to prevent diabetic foot ulcers. Nonetheless, it demonstrated a slight antibacterial effect on normal flora foot bacteria. Bacterial resistance due to possible mutations could be the cause of this. It is also important to take into account the anti-inflammatory properties of aloe Vera resin extract
Studying Vertebral Column Cancer Cases in Tripoli Medical Center by Using PET/CAT Scan
Cancer remains one of the leading causes of morbidity and mortality worldwide. Among the most prevalent types are breast, lung, cervical, stomach, colorectal, and prostate cancers. This study aims to examine vertebral column cancer cases diagnosed at Tripoli Medical Center. Data were collected from patient records in the Radiology Department of Tripoli Medical Center, Libya, over a 12-month period from January to December 2023. The data were analyzed using Microsoft Excel. A total of 20 patients were identified with vertebral column cancer (100%),, comprising 15 males (75%) and 5 females (25%). The majority of patients were aged between 60 and 69 years (50%). Age distribution revealed that the sixth decade accounted for the highest number of cases (10 patients, 50%), followed by the fifth decade (6 patients, 30%) and the the fourth decade (4 patients, 20%). This epidemiological survey highlights 20 confirmed cases of vertebral column cancer at Tripoli Medical Center during the study period. Adhering to regional and national guidelines is essential to support the planning and development of cancer care services across Libya.
Cancer, Vertebral Column, Tripoli Medical Center
Post-COVID-19 Syndrome: Assessment of Short and Long-Term Post-Recovery Symptoms In Recovered Cases In Western Libya
The coronavirus disease 2019 (COVID-19) pandemic, first identified in late 2019, has caused extensive global morbidity and mortality. While most individuals recover from the acute illness, a considerable proportion develop post-COVID-19 syndrome, characterized by persistent symptoms lasting weeks to months. This study aimed to characterize the prevalence, type, and duration of persistent symptoms following COVID-19 recovery, and to examine their association with the severity of the acute infection. A cross-sectional, analytical observational study was conducted among 515 COVID-19 survivors in western Libya. Data were collected via face-to-face interviews and online questionnaires (Google Forms) comprising demographic information, COVID-19 illness details, comorbidities, and post-COVID-19 symptoms. Associations between symptom persistence and clinical/demographic factors were assessed using Chi-square tests. Persistent symptoms were reported by 72.0% of participants, with over 70% experiencing three or more symptoms. Recovery occurred within three months in 75.5% of respondents, within three to six months in 22.1%, and after more than six months in 2.4%. During acute illness, 78.8% required only home isolation, 21.2% were hospitalized, and 8.3% required intensive care. Most participants (91.7%) experienced mild-to-moderate acute disease, and 81.6% reported no comorbidities. Common persistent symptoms included fatigue, cough, anosmia, ageusia, joint pain, anxiety, and headache; less frequent but more severe sequelae included chest pain, pulmonary fibrosis, and myocarditis. A significant proportion of COVID-19 survivors experienced prolonged symptoms lasting up to 12 months post-recovery, independent of gender, smoking status, or vaccination history. Symptom severity correlated with the severity of the initial illness and the presence of comorbidities. Post-COVID-19 follow-up and targeted rehabilitation are recommended to address these long-term health effects.
COVID-19, Pandemic Coronavirus, Post recovery, Symptoms, Western Libya.
Diagnostic Significance of Tumor Markers CA 15-3, CA 125, TBARS, fasting blood sugar (RBS), and hemoglobin A1C (HbA1c) in Women with a Family History of Breast Cancer in Eastern Libya
Breast cancer remains one of the most prevalent malignancies among women worldwide, with family history being a major non-modifiable risk factor. Tumor markers such as cancer antigen 15-3 (CA15-3) and cancer antigen 125 (CA125), alongside oxidative stress indicators like thiobarbituric acid reactive substances (TBARS), can provide insights into subclinical molecular changes in at-risk populations. While CA15-3 is more closely associated with breast cancer progression, CA125 is primarily linked to gynecologic malignancies but may have secondary implications in breast pathology. Evaluating these biomarkers in women with a family history of breast cancer could reveal early molecular alterations preceding overt disease. This study was conducted to compare tumor marker levels (CA15-3, CA125), oxidative stress markers (TBARS), and glycemic indicators (fasting blood sugar [RBS] and hemoglobin A1C [HbA1c]) between women with and without a family history of breast cancer, and to assess correlations between these parameters from a molecular oncology perspective. This comparative cross-sectional study included two groups: women with a family history of breast cancer and matched controls without such a history. Serum levels of CA15-3 and CA125 were measured using immunoassay techniques, while TBARS concentrations were determined as a proxy for lipid peroxidation. RBS and HbA1c were quantified using enzymatic and chromatographic methods, respectively. Pearson’s correlation coefficients were calculated to examine relationships between tumor markers, glycemic status, and oxidative stress in both groups. CA15-3 levels were marginally higher in the family history group (15.07 ± 8.77 U/mL) compared to controls (12.81 ± 6.12 U/mL), suggesting subtle subclinical variations in mucin-1 antigen expression that may indicate early tumorigenic processes in genetically predisposed women. CA125 levels were notably lower in the family history group (9.56 ± 3.86 U/mL) versus controls (21.44 ± 22.44 U/mL), likely reflecting reproductive or hormonal factors rather than direct breast cancer risk modulation. TBARS levels were similar between groups (controls: 0.093 ± 0.009 µmol/mL; family history: 0.092 ± 0.010 µmol/mL), indicating comparable systemic oxidative stress. A strong positive correlation was observed between RBS and HbA1c (r = 0.809, p = 1.00), validating HbA1c as a reliable indicator of chronic glycemic exposure. Moderate positive correlations were observed between glycemic markers and CA15-3 (RBS: r = 0.417; HbA1c: r = 0.393), as well as between HbA1c and CA125 (r = 0.697); however, these associations did not reach statistical significance. TBARS showed weak negative correlations with most glycemic and tumor markers, suggesting that oxidative stress may be modulated by other biological or environmental factors.
Breast cancer, Family history, CA15-3, CA125, TBARS
B-Cell Non-Hodgkin’s Lymphomas of the Oral Maxillofacial Region: Narrative Review
B-cell non-Hodgkin lymphoma in the oral and maxillofacial region is a rare but serious condition that requires prompt diagnosis and aggressive treatment. Understanding the clinical features, staging, and treatment options is crucial for improving patient outcomes in this challenging area of oncology. This review aims to highlight the clinical presentation, diagnostic approach, etiology, and management of B-cell NHL in the oral and maxillofacial region, emphasizing the importance of early recognition in improving patient outcomes
B-cell NHL, Clinical Presentation, Etiology, Diagnosis, Management