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Purpose: The aim of this study is to investigate drug use disorders which are a major cause of Disability Adjusted Life Years (DALYs) in the Eastern Mediterranean Region (EMR). Methods: This article is a part of the global burden of diseases (GBD), injuries, and risk factors 2019 study. The GBD modeling approach was used to estimate population-level prevalence of drug use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990–2019. Results: It is estimated that in 2019 in EMR around 3.4 million people have drug use disorder which has increased by 137% compared to 1990. Also, in 2019, DALY number for drug use disorders was 1217.9 (95% UI: 940.4, 1528.9) thousand years and 7645 (95% UI: 6793.7, 8567.9) deaths occurred. The DALY rate increased 39.6% in the region since1990, whereas the global rate increased by 24.4%. United Arab Emirates, Libya, and Iran were most affected by drug use disorders with the highest rates of age-standardized DALY in EMR in 2019. The most prevalent drug use disorder in the region is opioid use which is accountable for 80% of all drug use disorders DALYs. Conclusion: Despite many interventions, drug use disorders are still responsible for high rates of DALY in the region which has increased since 1990 in both males and females; more comprehensive policies, better control measures and proper education could reduce the adverse effects. [ABSTRACT FROM AUTHOR]

Background: Diaphyseal femoral fractures account for 7.6 percent of long bone fractures and 1.4–1.7 percent of total fractures in skeletally immature patients. This study aimed to compare the outcome of operative fixation of femoral shaft fracture, between Titanium elastic intramedullary nails (TEINs) and Plating in skeletally immature patients. Methods: From June 2021 to November 2021, a prospective clinical research was undertaken on 24 patients with diaphyseal femoral fracture at Zagazig University Hospitals (ZUH) in Egypt and Tripoli Central Hospital in Libya. Patients were divided into 2 groups, 12 cases in each group, first group underwent fixation with Titanium elastic intramedullary nails (TEINs), 2nd group underwent open reduction and internal fixation by plate and screws. All patients had Radiological evaluation to affected whole limb after exclude any serious injury with six months follow-up. Results: There was statistically significant difference (p value<0.001) regarding operative blood loss between the two groups with mean blood loss was (75.0±24.36) ml for Titanium nail group and (175.0±58.69) ml for plate group. In the Titanium nail group, the mean time to fracture consolidation was (13.08±1.97) weeks while in plate group was (10.16±1.85) weeks with significant difference (p< 0.001). Complications were relatively higher in Titanium nail group. Conclusions: In our series nail showed more favorable outcome, less surgical morbidities and better rehabilitation as evident by - Less blood loss during surgery; Shorter operative time; Accepted time required for union. [ABSTRACT FROM AUTHOR]

The majority of Neoproterozoic rocks exposed in southern Libya, are comprised of intrusive coarse-grained porphyritic, two-mica, and high K-calc alkaline granite. The Jabal Fezzan Granite (JFG) is located in southwestern Libya. In this study, trace elements and whole-rock geochemistry have been used to understand the origin and the process of petrogenesis of the studied granites. The JFG is high-Si, Rb, Y, Nb, and (ASI values greater than 1.1). Mineralogically, it is characterized by the presence of minor muscovite and biotite and a lack of hornblende, exhibiting features of S-type granites, and having a character that belongs to an alkali-calcic series. According to geochemical value, light REE-enriched, characterized by moderate enrichments in LREE (La/Sm), HREE, and weak negative Eu-anomalies. The geochemical modeling of the (JFG) reveals that the JFG derived from the melting of the crust and underwent high fractional crystallization (~50%) of plagioclase and K-feldspar at (H-P) conditions (750–980°C/1–4 GPa). The Jabal Fezzan (JFG) formed during Pan-African orogenic events during the destabilization of the interior Saharan metacraton due to compression stress and transpressive movements along pre-existing weakness and reactivation of shear zones inherited from Paleoproterozoic evolution. The Neoproterozoic basement forms the northernmost margin of the intracratonic Muruzq Basin, as evidenced by (greenschist facies) and intruded granitic rocks derived at the syn-collision stage (630–540 Ma). [ABSTRACT FROM AUTHOR]

This cross-cultural validation study aimed to assess the psychometric properties and suitability of the Arabic version of the Fatigue Measure (FM) in the context of musculoskeletal patients in Libya. A total of 139 patients from diverse physiotherapy facilities participated in the study. The FM was administered to assess participants' perceived fatigue levels. Statistical analyses were performed to examine the FM's cross-cultural validity, including the assessment of internal consistency, test-retest reliability, construct validity, Exploratory Factor Analysis, and the ROC curve analysis. The FM demonstrated strong internal consistency and reliability in the Libyan context, with a Cronbach's alpha coefficient of 0.87. Test-retest reliability was high (ICC = 0.92, Cronbach alpha = 0.95). The EFA confirmed the unidimensionality of this measure, indicating the stability of the FM's underlying dimensions in this cultural setting. The ROC curve analysis revealed significant results with the AUC value = 0.95 [95% CI 0.91–0.97], (p < 0.001), indicating excellent sensitivity and specificity. The findings support the cross-cultural validity of the FM among musculoskeletal patients in Libya, suggesting its suitability as an effective tool for assessing fatigue in this population. Its brevity and ease of use make it valuable for clinicians and researchers seeking to address fatigue-related issues in the context of musculoskeletal conditions in Libya. Further research could explore the FM's responsiveness to intervention and longitudinal changes in fatigue levels to enhance its utility in clinical practice. Overall, the FM holds promise as a reliable instrument for measuring fatigue in musculoskeletal patients in the Libyan cultural context. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL) is a common illness that causes skin lesions, principally ulcerations, on exposed regions of the body. Although neglected tropical diseases (NTDs) are typically found in tropical areas, they have recently become more common along Africa's northern coast, particularly in Libya. The devastation of healthcare infrastructure during the 2011 war and the following conflicts, as well as governmental apathy, may be causal factors associated with this catastrophic event. The main objective of this study is to evaluate alternative diagnostic strategies for recognizing amastigotes of cutaneous leishmaniasis parasites at various stages using Convolutional Neural Networks (CNNs). The research is additionally aimed at testing different classification models employing a dataset of ultra-thin skin smear images of Leishmania parasite-infected people with cutaneous leishmaniasis. The pre-trained deep learning models including EfficientNetB0, DenseNet201, ResNet101, MobileNetv2, and Xception are used for the cutaneous leishmania parasite diagnosis task. To assess the models' effectiveness, we employed a five-fold cross-validation approach to guarantee the consistency of the models' outputs when applied to different portions of the full dataset. Following a thorough assessment and contrast of the various models, DenseNet-201 proved to be the most suitable choice. It attained a mean accuracy of 0.9914 along with outstanding results for sensitivity, specificity, positive predictive value, negative predictive value, F1-score, Matthew's correlation coefficient, and Cohen's Kappa coefficient. The DenseNet-201 model surpassed the other models based on a comprehensive evaluation of these key classification performance metrics. [ABSTRACT FROM AUTHOR]

In the current study, sediment samples from Zwitina Harbor in northeastern Libya were analyzed using a GC-Mass apparatus. The objective was to evaluate how the region's activities related to petroleum use affected the environment. The findings indicated the existence of several hydrocarbon compounds that might have an impact on marine life. Numerous aromatic compounds and aliphatic hydrocarbons (C9 to C20) were found. Several polyaromatic hydrocarbons were detected, including Benzo(g, h, i) perylene, Acenaphthylene, Fluorene, Phenanthrene, Anthracene, Pyrene, Benzo(a)anthracene, Chrysene, Benzo(b)fluoranthene, Benzo(k)fluoranthene, Benzo(a)Pyrene, Indeno(1,2,3-cd)pyrene, and Dibenzo(a,b)anthracene. The study deduced that sediment samples showed the effects of activities related to the petroleum sector and that the majority of petroleum compounds in the area come from pyrolytic and petrogenic sources. [ABSTRACT FROM AUTHOR]

Background: Civil wars in Libya have impacted the mental health of the general population. The ways in which individuals cope with traumatic events are influenced by several psychological variables. Objectives: The present study aimed to investigate how post-traumatic stress symptoms (PTSS) are associated with psychological symptoms and post-traumatic growth (PTG), and to evaluate the role of avoidant and anxious attachment dimensions as mediators in these associations, among Libyan citizens. Method: Three-hundred participants (147 females; age 31.0 ± 8.4 years) completed the Impact of Event Scale – Revised, Experiences in Close Relationships, Patient Health Questionnaire, and Post-traumatic Growth Inventory – Short Form. Results: The structural equation model revealed that insecure attachment dimensions mediated the association between PTSS and psychological symptoms and PTG. PTSS were positively associated with psychological symptoms, PTG, and both insecure attachment dimensions. Insecure attachment dimensions were positively associated with psychological symptoms and negatively with PTG. Conclusion: The present findings contribute to growing empirical research on the roles of insecure attachment dimensions in the association between the impact of war, psychological symptoms, and PTG. Insecure attachment dimensions mediated the association between the impact of war and psychological symptoms, as well as posttraumatic growth, among Libyan citizens. Higher psychological symptoms were negatively correlated with posttraumatic growth. Psychological interventions should consider insecure attachment dimensions, when evaluating the consequences of prolonged and repeated wars. [ABSTRACT FROM AUTHOR]

Background: Toxoplasma gondii is one of the zoonotic protozoa parasites. It can prevalently infect humans and warmblooded animals, causing human health problems and substantial economic losses to the livestock industry worldwide. Chicken is one of the potential sources of toxoplasmosis, but there is no report of the prevalence of toxoplasmosis and their genotypes in free-range chickens in Libya. Aim: This study aims to conduct a survey of molecular prevalence and identify the T. gondii genotype in free-range chickens and its association with the risk factors of age, gender, and region in Northeastern Libya. Methods: This study was conducted by examining a total of 315 free-range chicken organs (brain and heart) derived from three administrative districts in Northeastern Libya. The molecular prevalence was determined by PCR technique using B1 gene amplification. and the T. gondii genotype was determined by nested PCR-RFLP of GRA6 gene amplicon with restriction enzymes (MseI). Results: The overall molecular prevalence of T. gondii in free-range chicken in all three districts was 9.5% (30/315), and the highest (15.4%) was in the Al-Marj district (p = 0.01; x² = 9.238). The highest prevalence of T. gondii by age was in chickens aged more than 2 years (p = 0.001; x² = 15.530). The difference in T. gondii prevalence in male and female chickens was not significant (p = 0.372; x² = 0.798). The predominant genotype I (93.3%) had identified at position 544 and 194 bp at the GRA6 marker, and only two positives were from genotype II (6.7%) at 700 and 100 bp fragments. Conclusion: The molecular prevalence of toxoplasmosis in free-range chicken in three districts in Northeastern Libya was 9.5%, and the highest rate was shown in the Al Marj district. Chicken by age more than 2 years had more risk to transmit toxoplasmosis in human. There was no different infection risk by consuming male or female free-range chicken. It is the first report to determine the predominant genotype, which was genotype I. [ABSTRACT FROM AUTHOR]

The overall aim of this study is to estimate the spatial-temporal variation of NO2 concentrations and its influencing factors in the State of Libya using the tools offered by Sentinel-5P TROPOMI, over the past year (January to December 2021). The significance of NO2 observation comes since NO2 accumulation in the atmosphere will cause severe air pollution. In recent decades, the Libyan State has been exposed to huge amounts of NO2 due to rapid economic growth, industrialization, and urbanization. Lately, Sentinel-5P observations have become the critical technical means regarding atmospheric observation compared with ground-based measurements. Results have shown that measurements obtained from Sentinel-5 Precursor were 8.7% more accurate than ground-based measurements. Moreover, the NO2 column concentration was higher in the summer than in winter was as found in global and local Moran's test results, whilst the spatial distribution pattern was higher in coastal areas than inner areas. The influencing factors have also had a significant and positive impact that led to the high NO2 atmospheric concentrations emphasized by SLM calculations. [ABSTRACT FROM AUTHOR]

Since ancient times, courtyards have played a vital role in architecture, particularly in domestic architecture. Over time, the existence of vernacular architecture has made beauty and harmony; these have always been important components of traditional Libyan architecture. Studying traditional vernacular architecture is key to maintaining vernacular architecture knowledge; this is because these principles, such as modular design, geometry, and proportions, are detectable characteristics of the tradition. Architecturally, proportion is an aspiration of the implementation of design grammar that encloses shapes of structure. A good impression upon the beholders builds in relation to different elements of space, such as a scale of geometric shapes, patterns, organisation, and the hierarchy of space relationships, to achieve aesthetic dimensions, in part and as a whole. In this article, the study searches for a modular, or proportion, that rules the geometric design of traditional houses in Libya. This is conducted through examining the geometry of typical traditional houses and the golden section method to find if a certain proportional relationship existed. From this perspective, the vision relied on studying the form suitability; in addition, it involved an analysis of the elevation as well as the interior courtyard proportion in relation to the building area. The outcome of this research is to find the aesthetic values that could generate a good design of domestic architecture; and to prove whether they are a perfect match with the proportion system and modular design used in traditional houses. The study employs the quantitative method, which includes archival documents, direct observation, and on-site documentation. The study involved an in-depth examination of the proportioning and geometrical principles used in traditional houses and courtyards. Their respective roles in creating harmony and beauty are discussed in this paper. [ABSTRACT FROM AUTHOR]

Background: The febrile seizure is the commonest form of seizure in children. Several hypotheses propose that neurotransmitters and trace elements have a role in the beginning of a febrile seizure. Inhibitory pathways in the central nervous system (CNS) can be affected by zinc, an essential component of many enzymes. Aim and objectives: This study aimed to determine the relation between serum zinc level and febrile seizures. Subjects and methods: This prospective case control study was carried in Al -Wahda hospital- pediatrics department in Derna city in the north-eastern part of Libya in the period between March 2019 to March 2020. This study comprised 120 children aged between 2 months and 6 years. They were divided to 3 groups: 40 children with febrile seizures, 40 children with fever and no seizures, and 40 healthy children. Results: Zinc levels varied significantly amongst the three groups investigated. The differences between the groups with and without febrile seizures, as well as between febrile seizure groups and the controls, are also notable. The seizure-free group and the controls, on the other hand, showed no considerable differences. Conclusion: According to the current findings, serum levels of zinc were lower in children with febrile seizures. Seizures in febrile children may be facilitated by zinc deficiency. [ABSTRACT FROM AUTHOR]

In the present paper we report the first record of the Brassy Chub Kyphosus vaigiensis (Quoy and Giamard, 1825) from the Mediterranean coast of Libya. It is assumed that this species arrived into the Mediterranean from the Red Sea via the Suez Canal. We stress the need of taxonomic study on the genus Kyphosus in the Mediterranean. [ABSTRACT FROM AUTHOR]

Introduction: The groundwater quality in Sabha in Libya is not measured. Also, its impact on human lives and the environment is not being assessed. Objectives: Therefore, this study aims to assess the groundwater quality and its suitability for drinking at five places of Sabha state in Libya, including Sabha city, Samno, Tamnhent, Elzegen, and Godwa. The main aim is to assess 13 parameters of groundwater quality. Methods: From five places, groundwater samples were collected in safe containers and sent to the laboratories. Results: From November 2018 to March 2019, the water samples temperatures averaged were 18.1°C, pH values most of water samples are acidic, except for the Azzighan, which were alkaline, and it ranged from 6.4 to 7.2. In Azzighan, Samno and Sabha, the values of (TDS) and (Ec) exceeded far higher than the desirable limits. The Chloride (Cl) values ranged between 36.7 to 396.8 mg/L, and it was higher than the permissible limit in Azzighan, Tamanhint and Sabha. As for the Nitrate (No3) of well waters were within the desirable limits, except Sabha and Ghadduwah, which were high. high levels of (So4) and (Fe)were found in Azzighan and Samno, the values of (Mg++) recorded in the well waters were not of any concerned were within the prescribed limits. High levels of (So4) were found in Azzighan and Samno, reaching 2230 and 2419 Straight As the normal range does not exceed 150 mg/L Libyan standard. The most spread and comparatively higher E. coli counts in the Sabha well here it arrived 36 cm3. Discussion: The water quality index (WQI) revealed of well waters of study area as follows, the well waters of Tamanhint (WQI: 93.61) and Ghadduwah (WQI:83.76) They were slightly polluted (Class B), were good to drinking. Except (Cl) in Tamanhint and (K) in Ghadduwah all other parameters studied in these two places were well within their standard desirable limits. Moderately polluted well waters (Class C) were located in Azzighan (WQI: 61.06), they require suitable treatments. The well water of Samno (WQI: 45.77) (class D) however, was excessively polluted and Sabha (WQI: 38.86) Severely polluted (class E) and was not potable. Suitable suggestions were made to improve the quality of groundwater of SW Libya. [ABSTRACT FROM AUTHOR]

Introduction: home-based rehabilitation (HBR) is a rehabilitation model that aims to help people with disabilities to integrate into the community and be independent as much as possible. HBR is a promising alternative to institution-based rehabilitation, in which rehabilitation services are provided at patients' homes. However, challenges and barriers to HBR practice in Libya have never been researched before. This study explores physiotherapists' perceptions of home-based rehabilitation (HBR) in Libya and examines their views and the concerns they face. Methods: eight physiotherapists (2 females, 6 males) with at least two years of work experience in the Libyan physiotherapy community participated in in-depth semi-structured interviews. The interviews were audio-recorded and transcribed verbatim, and the data were analyzed using framework method. Results: three themes emerged from the data, namely: i) access problems, including lack of infrastructure; ii) lack of governmental policies, such as the absence of governmental support (e.g., lack of programs and resources); iii) poor awareness and misconception issues, including that of patients and families. Conclusion: although all the interviewed physiotherapists described HBR as an essential practice in Libya, they expressed concerns about several factors that hinder its development and may influence the quality of interventions provided in the community. Given the fact that this is the first qualitative study in this field in Libya, there is a need for future research to explore HBR from other perspectives, such as those of policymakers, healthcare planners, or patients and their families and/or caregivers. [ABSTRACT FROM AUTHOR]

Introduction: north Africa is known to be endemic for hepatitis D virus. However, data one the prevalence of this virus in Libya are scanty. This study aimed to determine the prevalence of hepatitis D virus infection in Libya and analyze the demographic factors associated with the infection, and also to assess the variations across the regions and districts. Methods: a total of 1873 samples collected from all over the country were tested for antibodies against hepatitis B surface antigen and the results were correlated with demographic and geographic variables. Results: the overall prevalence of hepatitis D virus infection was 1.7%. The prevalence rate was significantly high among those aged over 40 years (P < 0.001) and it was associated with intravenous drug use and coinfection with human immunodeficiency virus and/or hepatitis C virus infection (P < 0.001). The prevalence rates varied with geographic location and differed markedly within the regions the country. The highest rate reported was in the central region of Libya, followed by the western and eastern regions. Conclusion: hepatitis D virus infection rate in Libya is considered to be low but is of some concern in some districts. This has been propagated by population displacement and African immigrants, indicating that a continuous epidemiological surveillance program should be implemented. [ABSTRACT FROM AUTHOR]

Introduction: Practicing pharmacy in Libya is still limited to the dispensing roles. However, pharmacists have started to work proactively to advance modern practices by expanding their roles in different practice settings. Objective: This study aims to evaluate the status of pharmacy practice in Libya through self-assessing competencies of hospital and community pharmacists. Materials and Methods: This is a cross-sectional online survey study of community and hospital pharmacists. The survey questionnaire was based upon the “Global Competency Framework for Pharmacists̶ and the Joint FIP/WHO guidelines on good pharmacy practice. Results: A total of 199 responses were received with 93% response rate. 47.0% were community pharmacists, 39.4% worked both in hospital and community, and 13.6% practiced exclusively in hospitals. 10% of respondents graduated in 1980–1989; 15% graduated in 1990–1999. 30% graduated in 2000–2009, and 45% graduated in the past 8 years before the study (2010–2017). The overall pharmacy competency indicators were reportedly met consistently by 45.3% of respondents, usually by 25% of responders and only sometimes or rarely by 15.9% or 13.8% of respondents, respectively. Conclusions: Pharmacy practice in Libya is more population and system-focused than being professional and patient-focused. Significant amendments in pharmacy education curricula are required to include modern teaching methods, knowledge, skills, and competencies. Continuous professional development programs are also needed for established pharmacists to modernize pharmacy practice in the country. [ABSTRACT FROM AUTHOR]

Background: Libyan wetlands are diverse; the coastline of Libya, in particular, has different kinds of wetlands, such as salt marshes, bays, lakes, lagoons, and islands. These varieties in habitats provide good shelters and foraging sites for migratory birds during their journeys between Eurasia and Africa. Since the beginning of the Libyan winter census of waterbirds International waterbirds census (Libya IWC) in 2005, which continued regularly until 2012, it has had relatively the same performance in the number of covered sites. However, since 2013, due to the security situation that Libya has experienced due to wars and conflict, which negatively affected the quality of the IWC in Libya, the number of sites has dramatically decreased, reaching only six locations during the middle of the previous decade. Aim: The IWC 2022 aimed to count the birds along the Libyan coast from January 10 to 29. Methods: The census activities were conducted from dawn to dusk during the study period by using high-quality Telescopes, binoculars, and digital cameras for the documentation. Point transects method was used to cover the sites. Results: The results of this year showed that a total of 64 sites were covered, and 68 species of waterbirds were counted, with an abundance of 61,850 individuals. During the census period, a total of 52 non-waterbird species found in Wetlands were recorded, and the number of individuals was 14,836 birds. A total of 18 threatened species were observed during this survey, 12 of them are mentioned in the International Union for Conservation of Nature Red List, and nine species are mentioned in the regional activities center of specially protected areas annex II as threatened in the Mediterranean, where the species; Larus audouinii (Payraudeau, 1826), Larus genei (Breme, 1839), and Puffinus yelkouan (Acerbi, 1827) are mentioned in both of them. Conclusion: The lack of the number of ornithologists and bird watchers is still one of the factors affecting the quality of the IWC in Libya, as well as lack of funding remains an important factor that plays a major role in the success of the waterbirds census. [ABSTRACT FROM AUTHOR]

Introduction: Practicing pharmacy in Libya is still limited to the dispensing roles. However, pharmacists have started to work proactively to advance modern practices by expanding their roles in different practice settings. Objective: This study aims to evaluate the status of pharmacy practice in Libya through self-assessing competencies of hospital and community pharmacists. Materials and Methods: This is a cross-sectional online survey study of community and hospital pharmacists. The survey questionnaire was based upon the "Global Competency Framework for Pharmacists" and the Joint FIP/WHO guidelines on good pharmacy practice. Results: A total of 199 responses were received with 93% response rate. 47.0% were community pharmacists, 39.4% worked both in hospital and community, and 13.6% practiced exclusively in hospitals. 10% of respondents graduated in 1980--1989; 15% graduated in 1990--1999. 30% graduated in 2000--2009, and 45% graduated in the past 8 years before the study (2010--2017). The overall pharmacy competency indicators were reportedly met consistently by 45.3% of respondents, usually by 25% of responders and only sometimes or rarely by 15.9% or 13.8% of respondents, respectively. Conclusions: Pharmacy practice in Libya is more population and system-focused than being professional and patient-focused. Significant amendments in pharmacy education curricula are required to include modern teaching methods, knowledge, skills, and competencies. Continuous professional development programs are also needed for established pharmacists to modernize pharmacy practice in the country. [ABSTRACT FROM AUTHOR]

Leishmaniasis is vector-borne disease caused by a protozoan endo-parasite species belonging to the genus Leishmania that live in the blood and tissues of the host. Basically the animals are infected. However, human population who live in the same environment are under risk. Destructive results on the skin, mucous membranes, and visceral organs are clinical manifestations mostly observed. Overall annual prevalence of theLeishmaniasis is approximately 12 million people and the size of the populationat risk is approximately 350 million. On the other hand, it is expected that global warming will cause to increase in the number of vectors of the disease and probablyin the number of countries. Many plant extracts and the natural compounds isolated from the terrestrial plants and marine organisms have been evaluated for their antileismanial activities. The genus Cyclamen is one of the flowering plants that belongs to the family Primulaceae, and comprises numerous species, many of which are well-known for their ornamental value. Beyond their aesthetic appeal, some of the Cyclamen speciesare used traditionally for their potential biological activities. Triterpene-type saponins, flavonoids, and alkaloids are the major groups among the phytochemical constituents reported. This study focused on the chemical constituents and antileismanial activities of the tubers of C. rohlfsianum which is an endemic plant in the flora of Libya. It grows especially in limestone cracks, up to 450 m altitude, and the tuber extracts aretraditionally used against Leishmania infections. The ethanolic extract of the tubers has been fractionated using reversed-phase silica gel (LiChroprep-C18). The antileishmanial activities of the fractions and as well as pure compounds isolated fromthe fractions have been studied. The structures of the isolated potent leishmanicidal compounds were established using 1D (1H, and 13CNMR, DEPT-135) and 2D-NMR (COSY, HSQC, and HMBC) experiments and HR-MS measurements. [ABSTRACT FROM AUTHOR]

The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education. A cross-sectional survey was conducted with medical students from more than 13 medical schools in Libya. A paper-based and online survey was conducted using email and social media. The survey requested demographic and socioeconomic information, as well as information related to medical online learning and electronic devices; medical education status during the COVID-19 pandemic; mental health assessments; and e-learning knowledge, attitudes, and practices. A total of 3,348 valid questionnaires were retrieved. Most respondents (64.7%) disagreed that e-learning could be implemented easily in Libya. While 54.1% of the respondents agreed that interactive discussion is achievable by means of e-learning. However, only 21.1% agreed that e-learning could be used for clinical aspects, as compared with 54.8% who disagreed with this statement and 24% who were neutral. Only 27.7% of the respondents had participated in online medical educational programs during the COVID-19 pandemic, while 65% reported using the internet for participating in study groups and discussions. There is no vaccine for COVID-19 yet. As such, the pandemic will undeniably continue to disrupt medical education and training. As we face the prospect of a second wave of virus transmission, we must take certain measures and make changes to minimize the effects of the COVID-19 outbreak on medical education and on the progression of training. The time for change is now, and there should be support and enthusiasm for providing valid solutions to reduce this disruption, such as online training and virtual clinical experience. These measures could then be followed by hands-on experience that is provided in a safe environment. [ABSTRACT FROM AUTHOR]

Scholars have found that the development of willingness to communicate plays a crucial role in teaching and learning other languages. While many studies were conducted worldwide, in the Libyan EFL context, it appears to be a nascent term. Many factors might influence undergraduate students' willingness to communicate (WTC), but it is very difficult to identify all the variables. This research was conducted to investigate the Libyan EFL students' situational WTC in English in terms of classroom context and situational factors that may influence it. A sample of 209 English-major learners completed a questionnaire at a university in Libya. Analysis of the data, correlations and multiple regression were carried out. Findings revealed the existence of correlational and predictive relationship between situational motivation and situational willingness to communicate. However, situational speaking anxiety did not show a significant effect in both correlational and predictive relationships with situational willingness to communicate. The research findings imply that teachers should find ways to increase motivation as it is crucial in increasing willingeness to communicate in the EFL classrooms. [ABSTRACT FROM AUTHOR]

This study aims to question the appropriateness of the "transition to democracy" paradigm in the Arab Revolts context with a specific focus on Libya. Arguing that the real problem lies at the meta-theoretical level, the assumptions and the empirical incongruities of democratization and post-democratization perspectives will be elaborated. With historical and social-minded analysis, the political developments in Libya will be approached with a historical sociology perspective complemented by the political economy of regime security. The interaction within the state-society complex in the framework of a complex relationship with regional/international level dynamics will be given a specific focus and unlike deterministic-teleological and reductionist democratization/post-democratization perspectives, the following question will be tackled: What happened politically in Libya in the course of the Arab Revolts? [ABSTRACT FROM AUTHOR]

Chelonians (Turtle and Tortoise) are kept in captivity as pet animals. Testudo. graeca called Spur thighed tortoise for its large conical tubercle present on each Thigh. T. graeca considered endangered across its entire range. They were illegally imported from Libya to Egypt. The aim of this work is to determine normal Hematological parameters and gastrointestinal parasite in Spur-thighed tortoise. Blood samples were taken from 37 tortoises, 13 female and 24 Male. Fecal samples were collected from 33 tortoises. Feces were examined by qualitative and quantitative methods. RBCs Count, WBCs Count, PCV, HB, MCV, MCH, MCHC value and DLC% were measured. Strongylid and Oxyurid eggs founded. Mean RBCs count in tortoise was 0.68 106 /µL, Hemoglobin (Hb) concentration was 8.26 g/dl, Packed cell Volume (PCV) was 25.12%. Lymphocytes % were 30.3%. Monocytes (%) were 25.03. Heterophils (%) were 40.44%. Eosinophils (%) were 5.87%. Basophils (%) were 0.05%. We report hematological parameters in normal and parasitic infection. In addition, we investigate parasites in Spur-thighed tortoise. [ABSTRACT FROM AUTHOR]

Introduction. Psoriasis is a relatively common chronic inflammatory disease. It clinically manifests as raised, well defined erythematous plaques with irregular borders and silvery scales. Psoriasis appears to be mediated by abnormal immune system functioning, including T lymphocyte and macrophage activation and release of various cytokins, such as interleukin 12 (IL-12) and IL-23. Recently a new biologic agent Ustekinumab has been used in the treatment of psoriasis. Our aim in this study was to assess the efficacy and tolerability of ustekinumab in moderate to severe psoriasis vulgaris and to observe and report any adverse reaction. Material and Methods. Thirty five psoriatic patients above the age of 18 years having moderate to severe psoriasis were included in this study. Ustekinumab is available in pre-filled syringe 45mg/0.5ml, 90mg/1.0ml for subcutaneous injection according to body weight at the intervals of 0, 4 weeks, and then every 12 weeks. It is given in hospital by a doctor or specialist nurse. The assessment of the patients' condition and improvement was carried out after administering each dose using PASI score. Results. Thirty five patients were included in this study. Baseline PASI score of our patients ranged from 11.4 to 39.8 (mean: 21.1).There was a dramatic response to treatment with ustekinumab in which PASI decreased to 6.7 after the second dose, followed by subsequent responses that reached 2.6 after the 6th dose. After the second dose, 61% of the cases had marked improvement and 11% had clearance of their skin lesions. After the last, sixth dose there was a marked improvement in 65% of cases and the percentage of complete clearance increased to 24%. Ustekinumab had positive effect on psoriatic nail changes as well-there was a significant improvement in 50% of cases and complete clearance (cure) in 24% of cases. Conclusion: Ustekinumab is effective in the treatment of severe and resistant cases of psoriasis vulgaris. It is well tolerated by the patients. No reactions or serious side effects have been reported. [ABSTRACT FROM AUTHOR]

Recently, continued use of information systems in general and particularly the context of internet banking has drawn increasing attention both in academic and trade literatures. However, different perspectives that determine the continued use of internet banking has been addressed. Given the long-term goal of any business entity is to increase its productivity, expand its customer base and maximize revenues, it is crucial for banks offering internet banking services to focus on encouraging their customers to continually use internet banking. While emerging attention had been given on the assessment of continued use of internet banking services from single view, little of attention were given from researchers to combine different views in a single comprehensive model. Yet, it is believe that combining different views would provide a better understanding to the issues surrounding the continued use. Drawing on the literature, this study developed a model to determine factors that influence the continued use of internet banking by combining factors from the socio-cognitive view and the relational view. Using a survey questionnaire, 450 questionnaires were distributed to users of internet banking in Libya. A number of interesting findings emerged, among others, is the lack of association between trust and perception to continue using the internet banking services in Libya. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to develop and verify the test materials for a speech perception testing for adults in Libya. Such materials are useful for administering speech evaluations to native Arab adults who speak with a Libyan accent. Objective: This study is a component of a larger initiative to prepare and validate the speech materials for the Arabicspeaking community in Libya. Methods: In this cross-sectional study, two lists of bisyllabic (spondees) words and monosyllabic phonetically balanced words were constructed. The two selected 100-bisyllabic and monosyllabic word lists were presented to 120 normal hearing participants with the age range of 18 to 50 years. Tests of validity and reliability were conducted to assure the suitability of this material for the speech regocnition test and speech discrimination score (SRT and SDS). Results: The two developed Libyan word lists (SRT and SDS) showed high face and content validity, kappa P-value was <0.001 with high signifiicant, Cronbach's alpha coefficient was 0.82, 0.71 for the (SRT and SDS) respectively, and intra-class correlation coefficients reliability (p<0.001) were also statstically significant. Conclusion: The data analysis shows that the SRT of both Libyan and Egyptian lists have high degree of validity and reliability. Meanwhile, SDS of Libyan accent list is of higher statistical significance than Egyptian list. As a result, the scale's development of the Libyan accent has strong psychometric characteristics, making it suitable for usage in the Libian region. [ABSTRACT FROM AUTHOR]

This study represents the first survey reporting the occurrence of Neofusicoccum species associated with Eucalyptus foliar diseases in semi-arid areas in North African countries. Based on morphological features and phylogenetic analyses of internal transcribed spacer (ITS) of nuclear ribosomal DNA (rDNA), translation elongation factor 1-alpha (TEF1) and β-tubulin (TUB2) genes, two species were identified: Neofusicoccum mediterraneum recovered from leaf spots on E. gillii in Tunisia and Neofusicoccum cryptoaustrale reported from leaf blight of E. torquata and E. odorata in Libya. Artificial inoculation trials on leaves confirmed the pathogenicity of the isolates to E. torquata , E. odorata and E. gillii. This report points out the threat posed by pathogens to non-native Eucalyptus in North Africa and suggests a likely movement of various pathogenic fungi from other hosts to Eucalyptus mainly E. ododrata trees that are totally infested by N. cryptoaustrale. Thus, it is recommended that E. odorata should not be planted in semi-arid areas. Further prospections of Eucalyptus arboretums are required to assess the incidence of foliar diseases on Eucalyptus plantations and to take appropriate and prompt measures against disease spread. • Eucalyptus species in Tunisia and Libya are threatened by foliar pathogens. • Leaf spots of E. gillii in Tunisia was revealed to be caused by Neofusicoccum mediterraneum. • Neofusicoccum cyryptoaustrale was identified to cause leaf blight of E. odorata and E. torquata. • Pathogenicity tests confirmed the virulence of these fungal species towards Eucalyptus leaves. [ABSTRACT FROM AUTHOR]

Hepatic hydatid disease is very common in Libya. In Zliten hospital, we operated 400 patients with hepatic hydatid cysts over period of 20 years. All patients were symptomatic. Their ages varied from 3 to 85 years including 215 female and 185male patients. Their symptoms varied from abdominal pain to abdominal mass 67 patients were admitted through Accident and Emergency Department with acute presentations including fever, skin rash, jaundice and shock with acute abdominal pain. Those 67 patients had necessary investigations, resuscitation and underwent emergency surgery. The hepatic cysts in all patients were excised, and the obstructive jaundice was cleared in those patients with obstructive jaundice. Unfortunately, one of the patients died two days after the surgery because of multiple organ failure (MOF) Morbidity was wound Infection, bile leak and recurrence rate were all reported in our series. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE) or hydatid cyst is the most important zoonotic disease that causes significant economic losses and public health problems worldwide. It is an endemic disease in the Mediterranean area that has not yet been fully documented in eastern Libya. This study was conducted to evaluate retrospectively 79 patients diagnosed with the CE disease at three hospitals in Benghazi and the main hospital in El-Beyda. Medical records were surveyed of infected patients with CE who had been operating in four hospitals from 2000 till end of 2002. Several parameters were studied, including age, sex, place of habitation, and the location of cysts. Of the 79 cases, 60.2% (n=48), 39.8% (n=31) were female and male respectively, with the mean age of 46 years (1-90). The most affected age group was 1-10 years old (30.4% of the cases). A Single organ involvement was seen in the majority of patients. The cysts were most frequently found in the liver (55.7%), followed by the lungs (22.8%), then other organs (16.4%). Among patients, 5.1% had cysts in 2 organs (lungs and liver). The distribution of residence of patients showed that 44 (55.7%) of them were Benghazi residents, followed by El-Beyda residents by 12 (15.2%). Conclusion: The population in northeast of Libya is suspected to be at high risk for CE infection because many inhabitants have flocks of sheep or goats that are kept around dogs for protection. [ABSTRACT FROM AUTHOR]

The globalization of clinical research should also benefit the population in developing markets. In this context, the approval of tested medicines and the associated expansion of medical care beyond clinical studies would be desirable as a possible long-term benefit. This study was designed to compare the development of the number of clinical trials with the number of marketing authorizations of medicines on the African continent. To contrast these 2 parameters, the data were analyzed using the model of an ecological study. To reflect the broad spectrum of African developing countries with diverse levels of development, the data collection was based on 2 geographically selected sample countries each from Central, North, East, West, and Southern Africa. Based on the ClinicalTrials.gov registry, the first step was to collect trends data on the development of the clinical trials in the 10 selected countries of the country list of the African Region published by the World Health Organization for the period 2015 to 2018. Subsequently, data on the current number of marketing authorizations of medicines in the selected sample countries were identified using the online registries of the national authorities. The data were utilized in comparative analyses. Eight out of 10 model countries showed an increase in the number of clinical trials, with the exceptions of Cameroon and Libya, which showed an overall decline in research activity over the entire time. In direct comparison with drug registrations, the numbers indicate a similar development. The only exception here is Nigeria, a country with a solid performance in clinical research and yet a decrease in medicine registrations since 2015. The expected increase in the development of clinical research as result of the globalization trend can basically be observed in most of the model countries. However, this increase does not guarantee an improvement in the number of medicine registrations. Although this is evident in some of the selected model countries, it cannot be projected to the entire African region. This may be linked to the diverse development of the individual countries due to the different political situations and the varying degrees of clinical research infrastructure. (Curr Ther Res Clin Exp. 2022; 82:XXX–XXX) [ABSTRACT FROM AUTHOR]

Regulating the licensing and practice of healthcare professions is an essential first step for reforming the Libyan healthcare system. In this article, we identify the overarching principles that should guide any efforts targeted at reforming the regulation of healthcare professions in Libya, and to summarize the perspective of the Libyan Healthcare Society-USA (LHS-USA) on these issues. Our aim is not to advocate for the adoption of a specific regulatory model. Instead, we hope to stimulate debate about the principles of professional regulation, and over the process needed to develop consensus on the final shape of the Libyan regulatory model. [ABSTRACT FROM AUTHOR]

The mountain ranges of the Tadrart Acacus and Messak in southwestern Libya (central Sahara) are widely known for their outstanding rock art inventory and some key prehistoric sites. This paper illustrates the preliminary outcomes of current investigations on the ‘Tifinagh’ inscriptions of the Tadrart Acacus the recording of which has recently increased thanks to the support of ‘Endangered Archives Programme’ of the British Library. Its aim is twofold: first, to outline the main steps of the project, placing these within the most relevant issues related to the phenomenon of writing in the Sahara, and second, to describe the results that have been achieved to date and to foresee possible avenues of development. In fact, although difficulties in both dating and decipherment have been repeatedly stressed through the years, we emphasise that Tifinagh texts can play an important role in the process of landscape interpretation. A proper ‘written landscape’, where humans left readable signs of their passages or their stays, can integrate other archaeological approaches pursued so far in the Tadrart Acacus and its surroundings. [ABSTRACT FROM PUBLISHER]

Cochlear implantation has become established worldwide as a safe and effective method of auditory rehabilitation of selected severely and profound deaf children and adults. Over 100,000 patients have received cochlear implants worldwide with the paediatric population proving to be the main beneficiaries. The Libyan cochlear implant programme was set up in 2004. Data relating to the patients who received cochlear implantation at Tripoli Medical Centre between October 2007 and February 2010 were analysed. Implant operations were performed on 37 patients. All patients received Med-El SONATATI 100 devices. Thirty-four (91.9%) of these patients were children, whilst three (8.1%) were adults. Combined, congenital hearing loss (56.8%) and perinatal/neonatal (29.7%) were the two main aetiological factors in children. Seventeen patients (45.9%) had a positive family history of deafness. Sixteen patients (43.2%) were born to blood-related parents. The overall rate of minor and major complications was 16.2%, which is comparable to previous studies. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of diabetes and Ramadan fasting was reported from many Muslim countries, but not from Libya. Methodology: We interviewed 493 consecutive diabetic patients at Benghazi Diabetes and Endocrine Center for the potential complications of fasting during Ramadan. Results: We found 70% of diabetic patients completed the 30 days of Ramadan fasting. Hypo- and hyperglycemia was the most commonly reported complications especially during the first two weeks of Ramadan month. Conclusion: It seems majority of diabetic patients in Libya manage to fast during Ramadan month. Patient education and early planned adjustment of diabetic medication is needed to decrease the frequency of diabetic complication during Ramadan month. [ABSTRACT FROM AUTHOR]

Critical understanding of the reservoir pore-system is crucial for effective fluid-flow. Core-sedimentological description (40 core plugs), petrography (thin section and scanning electron microscopy with energy dispersive spectrometry), x-ray diffractometry, and high-resolution imaging were integrated to characterize pore-modification processes in a deeply buried (ca. 12470–12558 Ft.) non-marine sandstone. The reservoir is dominantly subrounded to subangular, well-sorted to moderately well-sorted, and medium-to fine-grained quartz arenite and lithearenite. Framework ranges from matrix-supported to matrix-devoided types. With a mean point-counted composition of Q 95 F 0 L 5, quartz is the dominant mineral in all samples. Core-derived porosity and permeability range from 0.88 to 16.89% (Average 9.99%) and ~0.00–431.06 mD (Average 66.42 mD), respectively. Intergranular (ɸ I), micro (ɸ μ), fracture (C F), and dissolution (Diss) porosities constitute an estimated 60%, 35%, 3%, and 2% of the total porosity. The pore-spaces are randomly distributed and largely disconnected from one another. Connected pores are linked by necking, tubular, and lamellar pore throats. Pore-destructive diagenetic processes occurred mainly in the early-intermediate diagenetic phase, and to lesser extent in the late diagenetic phase. Pore-enhancement processes were of sparse occurrences. Mechanical compaction, quartz overgrowth development, kaolinitization, sideritization, and calcite cementation are the main pore-occluding processes identified. Quartz overgrowth increased with depth and it shows an inverse relationship with poro-perm. The formation of quartz overgrowth haloes in the Upper Sarir Sandstone Formation were most likely formed from non- insitu silica mobilized into the pore system during post-rift cooling. This study confirms the need for careful heterogeneity modelling even in non-marine deposited reservoir sandstone, notwithstanding their known clean nature in contrast to mud-rich marine reservoirs. • Pore-spaces in deeply buried Upper Sarar sandstones are irregular and unconnected. • Common pore throats are the necking, tubular, and lamellar types. • Intergranular porosity (60%) and microporosity (35%) the main component of ɸ Total. • Compaction, quartz overgrowth, kaolinite, and siderite constitute main pore-occlusion. • Significant pore-alterations occurred in the eogenetic-mesogentic diagenesis phase. [ABSTRACT FROM AUTHOR]

Abstract: The spatial and temporal distribution of diagenetic alterations has been constrained in relationship to depositional facies and sequence stratigraphy of the Upper Ordovician glaciogenic quartzarenite sandstones in the Murzuq Basin, SW Libya, which were deposited during the Haritanian glaciation when the basin was laying along the continental margin of Gondwana. Eogenetic alterations encountered include: (i) replacement of detrital silicates, mud matrix and pseudomatrix by kaolinite in paraglacial, tide-dominated deltaic, in foreshore to shoreface (highstand systems tract; HST) and in post-glacial, Gilbert-type deltaic (lowstand systems tract; LST) sandstones, particularly below the sequence boundaries (SB). Kaolinite formation is attributed to the influx of meteoric water during relative sea level fall and basinward shift of the shoreline. (ii) Cementation by calcite (δ 18OVPDB =−3.1‰ to +1.1‰ and δ 13CVPDB =+1.7‰ to +3.5‰) and Mg-rich siderite in the paraglacial, tide-dominated deltaic and foreshore to shoreface HST sandstones, in the glacial, tide-dominated estuarine (transgressive systems tract; TST) sandstones and in the post-glacial, shoreface TST sandstones is interpreted to have occurred from marine pore-waters. (iii) Cementation by Mg-poor siderite, which occurs in the post-glacial, Gilbert-type deltaic LST sandstones and in the paraglacial, tide-dominated deltaic and foreshore to shoreface HST sandstones, is interpreted to have occurred from meteoric waters during relative sea level fall and basinward shift of the shoreline. (iv) Pervasive cementation by iron oxides has occurred in the glacial, shoreface–offshore TST sandstones and post-glacial, shoreface TST sandstones immediately below the maximum flooding surfaces (MFS), which was presumably enhanced by prolonged residence time of the sediments under oxic diagenetic conditions at the seafloor. (v) Formation of grain-coating infiltrated clays mainly in the glacial, fluvial incised-valley LST sandstones and in the post-glacial, Gilbert-type deltaic LST sandstones as well as, less commonly, in the paraglacial, foreshore to shoreface HST sandstones and in the tide-dominated deltaic HST sandstones below the SBs. Mesogenetic alterations include mainly the formation of abundant quartz overgrowths in the glacial, fluvial incised-valley LST sandstones, post-glacial, Gilbert-type deltaic LST sandstones and glacial, shoreface TST sandstones, in which early carbonate cements are lacking. Illite, chlorite and albitized feldspars, which occur in small amounts, are most common in the glacial, tide-dominated estuarine TST sandstones and paraglacial, shoreface HST sandstones. This study demonstrates that the spatial and temporal distribution of diagenetic alterations and their impact on reservoir-quality evolution in glacial, paraglacial and post-glacial sandstones can be better elucidated when linked to the depositional facies and sequence stratigraphic framework. [Copyright &y& Elsevier]

Background: Reproductive efficiency affects dairy cow profitability. Ovarian function in postpartum (P.P.) has been better understood using ultrasound and hormonal assays. Optimizing ovulation synchronization and carefully timing artificial insemination (TAI) can greatly enhance reproductive rates in dairy cows. Aim: This experiment was designed to investigate the reproductive performance and ovarian activity in early postpartum lactating dairy cows using the Presynch-PGF2α, Ovsynch protocol, and TAI. Methods: Randomly the cows were assigned to a control group and a treatment group, based on the chronological order of their calving date. On day 14 P.P., both groups received two cloprostenol treatments, 14 days apart. Ultrasonographic inspections were conducted on day 14 to check ovarian activity and uterine contents. On day 11, after presynchronization, cows in the treatment group were given 100 μg IM. of cystorelin, followed by a luteolytic dose of 500 μg IM., cloprostenol on day 7, and a second dose of cystorelin on day 8 (36 hours later). After the second cystorelin injection by 16-20 hours, cows were inseminated, while the control group had all cows displaying spontaneous estrus between day 0 and day 28 were artificially inseminated. Results: Ovarian activity began to improve at 82.61% on day 19 P.P., with complete recovery between days 24 and 27 P.P. The second cloprostenol injection approached, causing follicular size to reach 8.41 ± 1.04 mm. After the second injection, ovarian activity switched from follicular to luteal, with corpus luteum rates of 23.91% and 26.1%. The presynchronized PGF2α regimen significantly enhanced ovarian activity from days 19-35 P.P. Ovulation and pregnancy rates in the Ovsynch group were 54.2% and 41.7% at the first timed artificial insemination (TAI), compared to 54.5% and 31.8% in the control group. There was no significant impact between them; it was just high in the presynchronized Ovsynch group. However, the P.P. period was minimized to 47-49 days till the first AI reached a 41.7% pregnancy rate and 20.8% at the second AI, for an overall 62.5%. Conclusion: The current study concludes that presynchronization during preservice in clinically normal P.P. dairy cows reduces P.P. duration, increases ovarian activity performance, and reduces ovarian dysfunctions from day 19 to day 35 P.P., as well as improves the pregnancy rate. [ABSTRACT FROM AUTHOR]

Analyzes mass communication according to the ideology of the Libyan Jamahiriya. Three aspects of freedom of communications; Includes freedom of the individual, of association and of the society; Promotion of democracy through the mass media.

Gaucher's disease is a rare lysosomal storage disease that can present with a wide range of clinical symptoms according to type and severity, ranging from mild general wellbeing, organomegaly, pancytopenia, neurological symptoms, lung involvement, and even death, making the diagnosis and work up challenging to reach a diagnosis. We report a Libyan Arab female presented with bruises after minor trauma, bone aches, and fatigue. A 35-year-old female from Libyan-Arab ethnicity attended the hematology clinic complaining of bruises after minor trauma, bone aches, and undue fatigability. She mentioned and evident from her medical record that she has been suffering from these complaints for 5 years and does not have any definite diagnosis. Mild splenomegaly was the only finding on clinical examination this time. There was no fever and no lymphadenopathy. Thrombocytopenia with a platelet count 90 x 10 and quot; 3/ml, and splenomegaly of 16 cm was found on investigations. She was diagnosed with cryptogenic thrombocytopenia, and she was advised for a follow-up visit. Our patient attended a follow-up visit twice in the next 18 months with similar complaints of manageable bruising, bone pain, and fatigability. Hematology reports showed thrombocytopenia in each visit. An ultrasonogram of the abdomen revealed a gallbladder stone and spleen have a size of 17 cm. Bone marrow biopsy was done, and a blood test confirmed glucocerebrosidase enzyme deficiency. Considering the diagnosis of Gaucher's disease, treatment with imiglucerase infusion was started. Unfortunately, she failed to continue the treatment due to a shortage of supply of the medication. A few months later, she got pregnant and developed threatened abortion, which ended with a miscarriage. This case illustrates the need to consider this disease in the differential diagnoses when dealing with unexplained thrombocytopenia, anemia, hepatomegaly, and splenomegaly. There are several challenges in the diagnosis and treatment of Gaucher's disease, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]

Gaucher’s disease is a rare lysosomal storage disease that can present with a wide range of clinical symptoms according to type and severity, ranging from mild general wellbeing, organomegaly, pancytopenia, neurological symptoms, lung involvement, and even death, making the diagnosis and work up challenging to reach a diagnosis. We report a Libyan Arab female presented with bruises after minor trauma, bone aches, and fatigue. A 35‑year‑old female from Libyan–Arab ethnicity attended the hematology clinic complaining of bruises after minor trauma, bone aches, and undue fatigability. She mentioned and evident from her medical record that she has been suffering from these complaints for 5 years and does not have any definite diagnosis. Mild splenomegaly was the only finding on clinical examination this time. There was no fever and no lymphadenopathy. Thrombocytopenia with a platelet count 90 × 10 and quot; 3/ml, and splenomegaly of 16 cm was found on investigations. She was diagnosed with cryptogenic thrombocytopenia, and she was advised for a follow‑up visit. Our patient attended a follow‑up visit twice in the next 18 months with similar complaints of manageable bruising, bone pain, and fatigability. Hematology reports showed thrombocytopenia in each visit. An ultrasonogram of the abdomen revealed a gallbladder stone and spleen have a size of 17 cm. Bone marrow biopsy was done, and a blood test confirmed glucocerebrosidase enzyme deficiency. Considering the diagnosis of Gaucher’s disease, treatment with imiglucerase infusion was started. Unfortunately, she failed to continue the treatment due to a shortage of supply of the medication. A few months later, she got pregnant and developed threatened abortion, which ended with a miscarriage. This case illustrates the need to consider this disease in the differential diagnoses when dealing with unexplained thrombocytopenia, anemia, hepatomegaly, and splenomegaly. There are several challenges in the diagnosis and treatment of Gaucher’s disease, particularly in resource‑limited settings. [ABSTRACT FROM AUTHOR]

Municipal solid waste logistics management is necessary to take care of the growing stream of waste and the need to act on this issue through an effective logistics management system. Logistical operations include collection, transportation, handling and intermediate storage in addition the final disposal. Many developing countries are still struggling to provide these services. There is no doubt that many obstacles and challenges stand against its adequate management. This paper aims to clarify the most important challenges and logistical obstacles in managing municipal solid waste in Libya, and concluded that all stages of this administration face fundamental challenges, starts from the obsolescence of the mechanisms used and poor collection processes and the lack of intermediate collection points, which most of them have been closed, because they are open temporary dumps, and ends of the far final dumps and their non-conformity with specifications. The local authorities are responsible to give this issue the right attention because of the environmental impact it represents, in addition to the associated direct and indirect costs. [ABSTRACT FROM AUTHOR]

Background Tinea capitis is a worldwide problem. It affects mainly school age children. Late detection and improper treatment of the inflammatory type of this disease may result in disfigurement and permanent alopecia. The objectives of this study were to determine the prevalence, clinical types, and causative species of tinea capitis in Benghazi, Libya. Methods One hundred and ninety six patients with tinea capitis were enrolled in this study. Hair stumps and scales were collected from every case and exposed to direct microscopic examination using 10% potassium hydroxide solution, and cultivation on modified Sabouraud's dextrose agar with cyclohexamide and chloramphenicol. Results Tinea capitis accounts for 45% of all superficial fungal infection and 92% occurred in children below the age of 10 years. The gray patch type was the most common clinical variety (53.6%), followed by black dots, seborrhoid type, and kerion (25.5%, 10.2%, and 8.2%), respectively. Four patients with a clinical picture of alopecia areata-like lesion and one patient with a favus-type lesion were seen. Species identification revealed that Trichophyton violaceum was the most common causative agent, responsible for 49.4% of infection, followed by Microsporum canis (38.6%) and T. verrucosum (7.8%). From seven patients the isolate was a mixture of both T. violaceum and M. canis. Conclusions There has been a dramatic decrease in the incidence of favus with complete disappearance of T. schoenleinii. T. verrucosum as a causative agent of tinea capitis in this area has been reported for the first time in this study. [ABSTRACT FROM AUTHOR]

Introduction: The Delta variant has led to a surge in COVID-19 cases in Libya, making it crucial to investigate the impact of vaccination on mortality rates among hospitalized patients and the critically ill. This study aimed to explore the risk factors for COVID-19 mortality and the mortality rates among unvaccinated and vaccinated adults during the Delta wave who were admitted to a single COVID-19 care center in Tripoli, Libya. Methods: The study involved two independent cohorts (n = 341). One cohort was collected retrospectively from May 2021-August 2021 and the second cohort was prospectively collected from August 2021-October 2021. Most of the patients in the study became ill during the Delta wave. The two cohorts were merged and analysed as one group. Results: Most patients were male (60.5%) and 53.3% were >60 years old. The vast majority of patients did not have a previous COVID-19 infection (98.9%) and were unvaccinated (90.3%). Among vaccinated patients, 30 had received one dose of vaccine and only 3 had received two doses. Among patients who received one dose, 58.1% (18/31) died and 41.9% (13/31) survived. Most patients (72.2%) had a pre-existing medical condition. A multivariable prediction model showed that age >60 years was significantly associated with death (odds ratio = 2.328, CI 1.5–3.7, p-value = <0.0001). Conclusion: Our results indicate that previous infection or full vaccination against COVID-19 significantly reduces hospitalization and death. However, a single vaccine dose may not be adequate, especially for older individuals and those with underlying medical conditions. High-risk older patients with comorbidities should be fully vaccinated and offered up to date bivalent COVID-19 booster doses. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an autoimmune condition characterized by a specific serological and histological profile triggered by gluten ingestion in genetically predisposed individuals. Celiac disease (CD) is the most common autoimmune gastrointestinal disease, affecting nearly 1% of the world population. There are currently no US Food and Drug Administration (FDA)–approved treatments, other than a gluten-free diet (GFD). Chemokines have been widely related to autoimmunity and inflammation, due to their key role in the selective recruitment of leukocytes. CX3CL1 can be found as a membrane-attached protein acting as an adhesion molecule, or as a soluble protein with chemotactic properties. To study the prevalence and clinical significance of CX3CL1 expression and its association with clinicopathological features of Celiac disease (CD) in Tobruk-Libya. The study group included 29 selected cases of Celiac disease, diagnosed at Pathology department of Tobruk Medical Center, Libya, between 2016 and 2019. All patients were underwent upper gastrointestinal endoscopy with biopsy intake. Other clinicopathological data (gender, age, intestinal and extra-intestinal manifestations) were extracted from medical files. All cases are stained with Hematoxylin and eosin stains and immunohistochemistry for CX3CL1. The details of 29 patients selected for analyses are as follows. The mean age of the patients at time of endoscopy biopsy was 111 months (range, 6–216 months, 18 years) with peak age between 6 and 24 months, and 8 were (27.6%) males and 21 (72.4%) were females. 25 cases of the Celiac disease presented by intestinal manifestations (86.2%) and 4 cases presented by extra-intestinal manifestations (13.8%). Immunohistochemical analysis of CX3CL1 expression was shown in all cases. 27 Celiac disease tissue biopsies (93.1%) showed negative CX3CL1 staining (score 0), while 2 biopsies showed positive CX3CL1 immunostaining 1+ and 2+. Total number of cases which demonstrated overexpression of 2+/3+ were 24 (16.9%). CX3CL1 can be used as diagnostic marker useful for Celiac disease (CD). Further larger researches are compulsory to validate CX3CL1 as an alternative therapeutic target in Celiac disease. [ABSTRACT FROM AUTHOR]

Municipal solid waste logistics management is necessary to take care of the growing stream of waste and the need to act on this issue through an effective logistics management system. Logistical operations include collection, transportation, handling and intermediate storage in addition the final disposal. Many developing countries are still struggling to provide these services. There is no doubt that many obstacles and challenges stand against its adequate management. This paper aims to clarify the most important challenges and logistical obstacles in managing municipal solid waste in Libya, and concluded that all stages of this administration face fundamental challenges, starts from the obsolescence of the mechanisms used and poor collection processes and the lack of intermediate collection points, which most of them have been closed, because they are open temporary dumps, and ends of the far final dumps and their non-conformity with specifications. The local authorities are responsible to give this issue the right attention because of the environmental impact it represents, in addition to the associated direct and indirect costs. [ABSTRACT FROM AUTHOR]

The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO) and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i) Health Governance; ii) Health Care Finance; iii) Health Service Delivery; iv) Human Resources for Health; v) Pharmaceuticals and Health Technology; and vi) Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century. [ABSTRACT FROM AUTHOR]