مجلة تريبوليتانا الطبية

Prevalence of Peripheral Neuropathy in Libyan Patients with Type 2 Diabetes Mellitus Using SemmesWeinstein Monofilament Examination

2026-05-12T10:06:21+00:00

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM). However, there is very limited data
available about the risk factors of DPN in the Libyan population.
Objective: To investigate the prevalence of DPN in Libyan patients with type 2 diabetes (T2D) and to find out its relation with
patient demographics and associated risk factors including glycosylated hemoglobin (HbA1c), body mass index (BMI), duration
of the disease, comorbidities, biochemical data, vitamin D, and vitamin B12 levels.
A cross-sectional study recruited 117 patients with type 2DM. Demographics (age, sex, and duration of DM), and BMI were
all recorded. Laboratory results of fasting blood glucose (FBG), postprandial blood glucose (PPBG), Hemoglobin A1c, cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL-C), triglycerides, vitamin B12 and
Vitamin D levels were all analyzed. DPN was assessed using the 10-g Semmes-Weinstein monofilament examination (SWME).
Among 117 type 2 diabetes patients, we found that 16/117 (13.68%) tested positive for the 10 g monofilament examination
(DPN+ve). The mean age range was 57.53± 11.48 years, with a median diabetes duration of 10 years. BMI was 31.825.58± kg/
m2
, and HbA1c was 8.55 ±1.99%. The study found that age, diabetes duration, FBG, and PPBG were the most significant risk
factors for DPN. Binary logistic regression analysis revealed that only age, duration of diabetes, FBG, and PPBG were the only
significant risk factors for DPN in our population and they predicted 73.8% of the model correctly.
Conclusion: The 10g monofilament test was effective in detecting early symptoms of DPN in 13.68% of patients with type 2
diabetes mellitus with older age, longer duration of diabetes, higher FBG and PPBG, and higher HbA1c as independent predictors of risk for DPN.

Impact of the COVID-19 Pandemic on STEMI Presentation and Clinical Outcomes: A SingleCenter Experience from Tripoli, Libya

2026-05-12T10:13:26+00:00

The COVID-19 pandemic disrupted healthcare systems worldwide, potentially overshadowing other medical emergencies,
including ST-elevation myocardial infarction (STEMI).
This single-center observational study aims to assess changes in STEMI incidence, clinical presentation, risk factors, and the
timing of presentation (from symptom onset to first medical contact [FMC]). Additionally, it evaluates treatment guidelines and
in-hospital events between the pre-COVID-19 and post-COVID-19 periods. Acute STEMI cases were retrospectively identified
at the National Heart Center in Tripoli. The post-COVID-19 period (April 1, 2020, to December 31, 2021) was compared to the
pre-COVID-19 period (January 1, 2019, to March 31, 2020).
A total of 124 patients were enrolled: 76.6% were male, and 23.4% were female. Over half of the participants (52.4%) were
under age 60. This younger demographic was more prevalent in the post-COVID-19 period compared to the pre-COVID-19
period (60.6% vs. 43.1%; P=.07), which contrasts with the common association of STEMI with older age. Regarding the time
from symptom onset to FMC, only 36.2% of patients arrived after 12 hours in the pre-COVID-19 period, whereas 54.5% faced
similar delays post-COVID-19 a statistically significant increase (P=.02).
Conclusion: While there was a significant delay in seeking medical contact, admission trends, clinical parameters, risk factors,
and mortality rates showed no significant differences between the two periods. Our data suggests that the standard of care for
STEMI was maintained during the pandemic, resulting in non-significant changes in patient outcomes

Uterine Fibroids in Tripoli : A Study of Prevalence, Risk Factors, and Reproductive Health Outcomes

2026-05-12T10:20:21+00:00

Uterine fibroids (UF) (also called leiomyoma) are one of the commonest female benign tumors, particularly of women of reproductive age. Although, they are very common and affect women widely in a variety of ways, UFs have received very little attention regarding general awareness and epidemiology in Libya. Objective: The objective of this study was to establish the prevalence of uterine fibroids and evaluate their risk factors and complications in women in Tripoli, Libya. A hospital-based cross-sectional study was carried out in gynecology department of Tripoli Medical Centre from February to April 2023. Three hundred women were sampled using convenient sampling method and data was collected via a structured, self-administered questionnaire concerning demographic factors, reproductive history, clinic presentation and suspected risk factors. Diagnosis of uterine fibroid was based on clinical records and records available in records section. Data analysis was conducted using SPSS version 26 at P < 0.05 significance level. Uterine fibroids occur at 63.3% (190/300) and showed significant correlation with age and between 41-50 age groups of the women. There was also significant correlation with Obesity and mode of delivery. Most of the complaints were abnormal bleeding and heavy menstrual bleeding while infertility was found to be the commonest complication. Conclusion: Uterine fibroids are common in women of Tripoli and are associated with a lot of modifiable and non-modifiable risk factors like obesity and age. Awareness and early diagnosis along with effective health education program should be provided to lessen the burden and morbidities related to this disease.

Evaluating Infection Prevention and Control (IPC) Response in Medical Laboratory Wastewater Management

2026-05-12T10:29:29+00:00

Assessment of Infection Prevention and Control (IPC) Response in the Management and Disinfection of Wastewater from
Medical Laboratories. This study aimed to evaluate the extent to which medical laboratories adhere to infection prevention standards in handling liquid waste and to identify gaps between operational procedures and adopted policies. The study employed
a descriptive-analytical approach, with a sample of 150 specialists (4 department heads, representing 2.7%, and 146 laboratory
specialists, representing 97.3%). A validated questionnaire was used as the primary data collection instrument. The results revealed a sharp disparity in compliance levels; compliance with sewer network maintenance reached 100%, while compliance
(0%) was nonexistent in the areas of chemical disinfection, the existence of written policies, water classification, and annual staff
training. All participants (100%) agreed that the effectiveness of the current response is “very weak.” The study recommends
the development of mandatory policies for wastewater disinfection at the source, the implementation of specialized training
programs, and the integration of network maintenance with biological and chemical treatment protocols to ensure a safe and
hygienic environment

Effect of Artificial Saliva Aging on The Surface Properties of CAD/CAM and Heat-Compressed Molded PMMA Dentures

2026-05-12T10:35:29+00:00

This study simulates the oral environment by immersing the denture specimens in artificial saliva aging of the surface properties
- micro-hardness and surface roughness - of Poly Methyl Methacrylate (PMMA) denture bases fabricated using ComputerAided Design and Computer-Aided Manufacturing (CAD/CAM) and conventional compressed molded (CCM).
Methodology: CAD/CAM and CCM PMMA denture bases were fabricated and immersed in artificial saliva at 37ºC for a week.
Surface micro-hardness and roughness of the samples were subsequently measured. The data was analyzed statistically to draw
comparisons between the two fabrication techniques.
The CAD/CAM PMMA denture bases exhibited significantly higher surface micro-hardness (mean: 25.26) than the CCM
denture bases (mean: 18.76), suggesting enhanced abrasion resistance. Similarly, the surface roughness of CAD/CAM PMMA
was found to be within the clinically acceptable value (0.13), and significantly less than the CCM PMMA (1.61), indicating
better biofilm resistance.
Conclusion: Under one-week artificial-saliva aging at 37 ºC, CAD/CAM-milled PMMA denture base specimens showed higher
surface micro-hardness and lower surface roughness than PMMA, indicating better maintenance of surface properties under
the tested in vitro conditions.

Microbial Contamination on Elevator Buttons: A Three-Site Study in Tripoli Libya

2026-05-12T10:42:06+00:00

This study emphasizes the significance of surface hygiene and the impact of microbial contaminants on infections acquired in
healthcare settings and the community. Elevator buttons have been identified worldwide as high-risk surfaces that can harbor
bacteria, fungi, and, in certain instances, multidrug-resistant organisms.
This study aimed to examine microbial contamination on interior elevator buttons at different places such as clinics, hospitals,
and markets, at Tripoli, Libya, and to offer reference data for elevator disinfection and sanitation management to reduce
community-related infections.
A total of 20 elevator button samples were collected using sterile swabs and cultured on selective media including Blood Agar,
Mannitol Salt Agar, MacConkey Agar, and Sabouraud Dextrose Agar. Bacterial isolates were identified using the BD Phoenix™
system, while fungi were identified microscopically with Lactophenol Cotton Blue staining. Microbial growth was detected
across almost all sampled buttons, with variations between clinical and non-clinical settings.
Clinics showed both bacterial and fungal contamination on the surface of their elevators, while private clinics presented
predominantly bacterial growth. Market elevators displayed mixed contamination, with fungi dominating lower-floor buttons.
Identified bacteria included Staphylococcus epidermidis, Staphylococcus hominis, Acinetobacter baumannii, Pseudomonas
Pseudoalcaligenes, and Bacillus cereus, while fungal isolates included Aspergillus and Penicillium species. Several isolates
are known opportunistic pathogens and exhibit multi-drug resistance. It can be concluded that elevator buttons in Tripoli are
consistently contaminated with bacteria and fungi, including clinically significant resistant organisms, indicating that routine
cleaning alone is insufficient and improved infection control strategies are urgently needed

Phytochemical Screening and in Vitro Antibacterial and Antioxidant study of Pergularia tomentosa L. Collected from Southwestern Libya

2026-05-13T10:04:43+00:00

Libya is rich with wild range of medicinal plants, that represent a valuable source of bioactive compounds with potential
therapeutic applications, where many species remain underexplored. Pergularia tomentosa L., a plant widely distributed in arid
and semiarid regions of Libya, is subjected to investigation in this study for its phytochemical composition, antibacterial activity,
and antioxidant potential. Whole plant material was extracted with Soxhlet method using three solvents of varying polarity
(nhexane, chloroform, and methanol) in order to compare the biological effects of the resulting extracts. Antioxidant activity
was evaluated through the DPPH radical scavenging assay relative to an appropriate reference standard. Antibacterial activity
was assessed using the disc diffusion method against selected Grampositive and Gramnegative bacterial strains, using
ciprofloxacin as a positive control and DMSO as negative control. Preliminary phytochemical screening revealed the presence
of tannins, flavonoids, cardiac glycosides, steroids, and terpenoids. Notably, the plant was free of alkaloids, coumarins, and
saponins. Biological assays showed that the nonpolar and semipolar extracts recorded the highest antibacterial activity against
Staphylococcus aureus, whereas all extracts demonstrated a weak inhibitory effect on Escherichia coli. Conversely, the nonpolar
extract exhibited the lowest antioxidant activity, while the semipolar and highly polar extracts demonstrated significant antioxidant
potential. This study provides an initial framework for understanding the chemical profile and biological potential of the
Pergularia tomentosa L. plant

The Therapeutic Potential of Ascorbic Acid in Enhancing Health-Related Quality of Life and Modulating Relapse Rates in Multiple Sclerosis Patients: A Clinical Study in West Libya

2026-05-13T10:14:24+00:00

Multiple sclerosis is a chronic inflammatory autoimmune disease characterized by CNS lesions that can lead to severe physical or cognitive disability as well as neurological defects, and reduce quality of life. This disease is associated with demyelination, neurodegeneration, and increased oxidative stress. Although the etiology and pathogenesis of multiple sclerosis remain unclear, the present documents illustrate that the cause of this disease is multifactorial and includes genetic predisposition together with environmental factors such as exposure to infectious agents, vitamin deficiencies, and smoking. These agents can trigger a cascade of events in the immune system, which leads to inflammation, neurodegeneration, demyelination, and neuronal dysfunction. Conventional therapies for this disease are based on the use of anti-inflammatory and immunomodulatory drugs, but these treatments are not able to stop the destruction of nerve tissue. This study hypothesizes that treatment with ascorbic acid (vitamin C) supplementation may reduce symptoms and positively influence the outcome of MS, resulting in improved patient quality of life. The Multiple Sclerosis Quality of Life 29 questionnaire (MSQL-29) was applied for disease progression and to evaluate the multiple sclerosis patient life style. The investigation of the disease status was performed by magnetic resonance imaging (MRI) and biochemical analysis for vitamin C levels in the blood. Through laboratory tests, it was found that patients with multiple sclerosis have a deficiency in vitamin C, while Magnetic Resonance Imaging (MRI) showed no structural changes in lesion load. Through the Multiple Sclerosis Quality of Life-29 questionnaire (MSQL-29), the study found that vitamin C has given positive results by improving the general health of patients and has reduced the sense of pain and the extent to which pain interferes with the patient’s normal work; vitamin C raises the sense of energy while reducing the sense of frustration and depression and improving the enjoyment of life. Thus, improving the quality of life.