Laparoscopy is the technique of using the "pneumoperitoneum" process to 

extend and examine the abdominal cavity using CO2. Laparoscopic and other 

procedures produce pain, which varies in intensity, duration, and type. 

Crystalloid fluid types, for instance, Normal saline (NS) and Ringer's lactate 

(RL) solution, aid in reducing laparoscopic pain. Therefore, the research 

explores intraperitoneal crystalloid solutions in reducing post-laparoscopic 

surgery shoulder pain. The research adopted a prospective, single-blind study 

based on a single-center, randomized, and parallel research design. A total of 

80 diagnosed patients (40 subjects in each arm) with laparoscopic surgery 

were randomly recruited at Zintan Medical Center, Alzintan, Libya. Patients 

were equally divided into Group A (crystalloid solutions) and Group B (routine 

measures) and were assessed through self-administered pain scores. 

Through the numeric rating scale (NRS), the research findings revealed 

significant pain intensity differences between Groups A and B at 6, 12, 24, 

48, and 72 hours. In contrast, no significant difference in pain was observed 

between groups A and B on the fourth and fifth days. Additionally, lower pain 

intensity was observed in group A than in group B; at 6 hours, the mean pain 

score for group A and B measured 2.55 and 6.40 at 6 hours, respectively. The 

intraperitoneal crystalloid solutions infusion aids in reducing pain severity 

among laparoscopic surgery patients. Future research should address 

extended follow-up periods to determine the effects of NS and RL 

interventions. Moreover, stakeholders should implement Ringer's lactate 

solution (RL) to reduce post-laparoscopic complications

One of the main causes of non-traumatic neurological disability in young adults worldwide is multiple sclerosis (MS), a chronic immune-mediated demyelinating and neurodegenerative disorder of the central nervous system (CNS). Increasing absolute prevalence is seen in recent epidemiological trends from 2021 to 2025, while age-standardized rates are stabilizing due to improved diagnostics, survival, and demographic shifts. The current narrative review's objective is to examine high-caliber studies conducted globally between 2021 and 2025 that address the epidemiology, burden, and different risk factors related to multiple sclerosis (MS), with an emphasis on the effects of age, gender, ethnicity, and other interacting factors. Key Findings: Global prevalence of ~1.89 million cases in 2021 (age-standardized rate: 23.9 per 100,000), with ~62,000 new cases each year; female-to-male ratio of ~3:1. DALYs are up by 43% from 1990, but with a trend downward for age-standardized rates with advances in management. Incidence is framed by disparities with higher rates for Whites (77% of the U.S.) than Black (10%), followed by Hispanic (7%) cases, and also high levels of radiological severity, handicap, and poor outcomes for ethnic minorities of these groups. Age of peak incidence progresses to older groups for individuals aged 20-40 years. Genetic underpinnings with large effects (e.g., HLA-DRB1*15:01 for ~48% of heritability), strong susceptibility to Epstein-Barr virus infection (near ubiquity at onset; 32-fold increase for molecular mimicry), vitamin D deficiency, smoking, obesity, and altered gut microbiomes are environmental components of risk. Incidence is seen to decline modestly for age-standardized incidence rates, mortality rates, and DALYs through 2035. From this review, the emphasis on MS as a partially preventable disease falls within the context of a rising absolute prevalence and existing inequities in the field. Future complementary strategies should therefore encompass a wide range of populations as well as risk modification measures such as EBV-related therapies and smoking cessation.

Background: Gastrointestinal stromal tumors (GISTs) are the major mesenchymal tumors of the gastrointestinal 

tract (GIT), which progress due to the mutation in TKI and PDGFR-α receptors. It shows asymptomatic conditions 

however, become malignant due its large size and produce abdominal pain. Several surgical managements have 

been applied to diagnose patients with GIST, but these increase the risk of tumor recurrent rate. Therefore, 

adjuvant therapies contribute to preventing this challenge with several side effects and post-operative 

complications. A 42-year-old male patient from Libya with acute abdomen and GIST in small bowel (Jejunum) 

was diagnosed with complete excision besides lymph node dissection..Aim: To investigate numerous case reports 

through literature analysis regarding GIST along with a case presentation of the patient. Method: This research 

employed a literature-based study design. Previous case reports were screened from various online research 

platforms, including the National Center for Biotechnology Information (NCBI) and PubMed. A total of 37 cases 

were included through the search phrase "Case report on Gastrointestinal stromal tumor” .. Results: The findings 

revealed patient mean age (56.35) with most of the small intestine GIST (6.42 cm) site of origin, antibodies 

expression, and maximum mitotic cell counts.. Conclusion: The cases reported a risk of recurrence among GIST 

patients due to high mitotic counts and tumor size. Future researchers should address immune markers to reduce 

tumor recurrence among GIST patients. Stakeholders should implement proper treatment procedures with 

effective diagnostic methods. 

Keywords: Gastro-Intestinal Stromal Tumors (GISTs), Perforation, Imatinib, Acute abdomen, Tyrosine Kinase 

Inhibitor (TKI), Small Bowe

Background: Infant Respiratory Distress Syndrome (IRDS) is a major cause of neonatal morbidity and mortality, often linked to genetic mutations affecting pulmonary surfactant metabolism. Mutations in genes such as SFTPA1, SFTPA2, SFTPB, SFTPC, SFTPD, ABCA3, and NKX2-1 have been implicated in surfactant dysfunction and IRDS pathogenesis. However, the functional consequences of many nonsynonymous single nucleotide polymorphisms (nsSNPs) remain poorly characterized. Objective: This study aims to identify and prioritize potentially deleterious nsSNPs in surfactant-associated genes using an integrated computational approach, providing insights into their structural and functional impacts for future experimental validation. Methods: We performed a comprehensive in silico analysis of rare missense variants (MAF < 1%) obtained from public databases (dbSNP, ClinVar, UniProt). Functional impact was predicted using SIFT, PolyPhen-2, Panther, and CADD. Protein stability changes were assessed using I-Mutant2.0 and MUpro. Evolutionary conservation was evaluated via ConSurf, and structural modeling was carried out with AlphaFold, SWISS-MODEL, PyMOL, and GROMACS to analyze RMSD and hydrogen bonding patterns. Results: Mutation frequency analysis revealed ABCA3 as the most variant-rich gene (n = 36,391), while SFTPD had the lowest mutation load (n = 4,646). Consensus prediction identified several high-risk nsSNPs, including R276W (SFTPB), V48M (SFTPC), G86E (SFTPA2), and P131T (SFTPD), consistently classified as damaging across tools. Protein stability analysis confirmed significant destabilization for R276W (SFTPB) and V48M (SFTPC). Structural modeling showed increased RMSD and reduced hydrogen bonds in variants such as G123V (SFTPA1) and G100S (SFTPC), indicating potential structural disruption. Highly conserved residues (ConSurf score ≥ 7), especially those involving glycine or proline substitutions, were more likely to be functionally critical. Conclusion: This comprehensive in silico analysis identifies several high-confidence deleterious nsSNPs that may contribute to surfactant dysfunction and IRDS pathogenesis. These findings offer valuable insights for future functional studies and may aid in the development of targeted genetic screening strategies for IRDS risk assessment.

Infectious diseases that involve hepatitis B (HBsAg), hepatitis C (HCV), HIV, and syphilis (VDRL) remain significant worldwide health challenges, particularly in low- and middle-income countries. Libya serves as both a transit and destination point for migrants, creating a unique context for examining the prevalence of these disorders among migrant workers and Libyan citizens. Comprehending variations in illness prevalence based on nationality and employment is essential for formulating targeted public health interventions. The objective of this research was to evaluate the seroprevalence of HBsAg, HCV, HIV, and VDRL among migrant workers and Libyan nationals undergoing mandatory occupational health screenings. A retrospective cross-sectional study was conducted at the Reference Laboratory, Western Mountain, Al-Rajban in Libya between December 2023 and February 2024. A total of 1,656 participants were assessed, including 1,434 migrant laborers and 223 Libyan natives. The VDRL test exhibited the greatest chance at 1.6%, followed by HBsAg at 1.4%, HCV at 0.9%, and HIV at 0.2%. Migrant workers had a greater prevalence of HBsAg at 1.6% and slightly elevated rates of HCV and HIV compared to Libyan residents, who reported no instances of these infections. Occupational research indicated that general workers had the largest disease burden, with statistically significant rates of HBsAg at 2.1%, HCV at 1.4%, and VDRL at 2.1%. Specialized workers had low illness rates, perhaps attributable to superior hygiene practices or underreporting. This research underscores the gap in infectious diseases between migrant workers and Libyan citizens, emphasizing the need for focused screening, enhanced workplace safety, and equitable access to preventive healthcare. The findings underscore the need for occupation-specific health interventions to mitigate risk, particularly for high-risk populations such as general laborers. Future research should include longitudinal studies and a larger sample size to validate these results and enhance global health equality.

Myiasis, the invasion of tissues by fly larvae, is a considerable but overlooked public health concern, especially in tropical and subtropical areas. The frequency of myiasis in North Africa is affected by geographic, climatic, and socioeconomic variables; yet, there is a paucity of comprehensive information about its treatment across the area. Regional disparities in healthcare infrastructure, cultural customs, and interruptions due to war exacerbate the challenges in addressing this neglected tropical disease (NTD). The goal of this systematic review is to look at differences in how myiasis is treated in different parts of North Africa, focusing on things like epidemiology, preventative measures, diagnostic methods, treatment options, and the healthcare system. The study finds deficiencies in the literature and offers pragmatic suggestions for governments, healthcare practitioners, and academics. A systematic search was performed across various databases, including PubMed, Scopus, Web of Science, Google Scholar, and regional databases like African Journals Online (AJOL). We incorporated research from 2000 to 2025, focusing on human and animal myiasis in North African nations. Data extraction utilized a standardized template, focusing on assessing the quality of high-quality and reliable sources. The research revealed substantial discrepancies in myiasis management across urban and rural regions, and among several North African nations. Urban locations in Egypt, Tunisia, and Algeria had superior access to contemporary diagnostic instruments and therapies, while rural regions mainly depended on conventional remedies. Conflict-affected nations such as Libya and Sudan saw significant healthcare interruptions, heightening myiasis risks. Significant hurdles were restricted diagnostic instruments, erratic public health initiatives, and insufficient data from underreported regions like Mauritania and Western Sahara. Managing regional disparities in myiasis requires focused treatments, enhanced monitoring systems, and cooperation among governments, healthcare professionals, and communities. Future studies must emphasize cost-efficient solutions customized for local circumstances, especially in conflict-affected and disadvantaged areas. By closing gaps in knowledge and practice, we may facilitate more fair and effective management of myiasis across North Africa and beyond.

Hypospadias is a common congenital anomaly that affects the male genitalia. This research paper aims to investigate the incidence of hypospadias in Libya by analyzing existing literature, statistical data, and medical records.

 The study will explore the prevalence of hypospadias among newborn boys in various regions of Libya, as well as the factors that may contribute to the development of this condition.

 Additionally, the paper will discuss the current treatment options available for hypospadias patients in Libya and the challenges faced by healthcare providers in managing this condition. By providing a comprehensive overview of hypospadias incidence in Libya, this research paper will contribute to the understanding and improvement of care for individuals with this congenital anomaly.

Background

Safe anaesthesia and surgery are a public health imperative. There are few data describing outcomes for children undergoing anesthesia and surgery in Africa. We aimed to get robust epidemiological data to describe patient care and outcomes for children undergoing anesthesia and surgery in hospitals in Africa.

Methods

This study was a 14-day, international, prospective, observational cohort study of children (aged <18 years) undergoing surgery in Africa. We recruited as many hospitals as possible across all levels of care (first, second, and third) providing surgical treatment. Each hospital recruited all eligible children for a 14-day period commencing on the date chosen by each participating hospital within the study recruitment period from Jan 15 to Dec 23, 2022. Data were collected prospectively for consecutive patients on paper case record forms. The primary outcome was in-hospital postoperative complications within 30 days of surgery and the secondary outcome was in-hospital mortality within 30 days after surgery. We also collected hospital-level data describing equipment, facilities, and protocols available. This study is registered with ClinicalTrials.gov, NCT05061407.

Findings

We recruited 8625 children from 249 hospitals in 31 African countries. The mean age was 6·1 (SD 4·9) years, with 5675 (66·0%) of 8600 children being male. Most children (6110 [71·2%] of 8579 patients) were from category 1 of the American Society of Anesthesiologists Physical Status score undergoing elective surgery (5325 [61·9%] of 8604 patients). Postoperative complications occurred in 1532 (18·0%) of 8515 children, predominated by infections (971 [11·4%] of 8538 children). Deaths occurred in 199 (2·3%) of 8596 patients, 169 (84·9%) of 199 patients following emergency surgeries. Deaths following postoperative complications occurred in 166 (10·8%) of 1530 complications. Operating rooms were reported as safe for anaesthesia and surgery for neonates (121 [54·3%] of 223 hospitals), infants (147 [65·9%] of 223 hospitals), and children younger than 6 years (188 [84·3%] of 223 hospitals).

Environmental factors are known to influence carcinogenesis. Procarcinogens, such as heterocyclic amines (HAs) and polycyclic aromatic hydrocarbons (PAHs), are examples of these environmental factors. Procarcinogens are chemically inert and require bioactivation, via enzymes such as Cytochrome P450 (CYP). CYP1A1 isoform, regulated by Aryl hydrocarbon receptor (AhR), plays a significant role in the bioactivation of PAHs and HAs. AhR has multiple co-activators and co-repressors, of which SMRT (silencing mediator for retinoid and thyroid hormone receptors) has been identified as a major co-repressor for AhR. In the present study we examined the effect of SMRT over expression on the Cyp1a1 mRNA levels in murine hepatoma Hepa 1c1c7 cell line. Hepa 1c1c7 cells were maintained in Dulbecco&#39;s modified Eagle&#39;s medium (DMEM), and competent cells were successfully produced using calcium chloride method. Cells were transformed using plasmid DNA and Lipofectamine. TCDD was employed as an inducing agent for CYP1A1. Total cellular RNA was isolated and real-time PCR of Cyp1a1 was conducted. Statistical analysis was conducted using one-way analysis of variance (ANOVA) followed by Student–Newman–Keul’s test. Our results showed that, cells transfected with the co-repressor SMRT has lower TCDD-mediated induction of Cyp1a1 mRNA without affecting constitutive Cyp1a1 mRNA levels, i.e., SMRT was able to significantly decrease inducible Cyp1a1 mRNA levels in Hepa 1c1c7 cells. Moreover, our work demonstrated that calcium chloride is a convenient method for routine transformation. Our work will open new avenues for treatment of carcinogenesis involving CYP1A1 inducing carcinogens.

Background and aims. Open reading frames (ORFs) are sections of a reading frame that do not include any stop codons. A reading frame is a sequence of nucleotide triplets read as codons indicating amino acids; a single strand of DNA has three potential reading frames. Long ORFs in a DNA sequence may represent possible protein-coding areas. In addition to extended ORFs, which assist in gene locus prediction, there is yet another type of ORFS known as small open reading frames (smORFs), which have 100 codons or fewer. Methods. We develop an offline, cross-platform, and dependable detection tool for regular ORFs and smORFs prevalent in biomedical studies. Results. In this work, the most ORFs were found in the Bos taurus (Cattle) Insulin gene, which had 17 consecutive ORFs, while the fewest ORFs were reported in the Cani's lupus (Dog) Insulin gene, which had only 4 ORFs. Conclusion. The software meets the expected demarcation restrictions. We strongly advise more research into the detection of nested ORFs.