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

Abstract

Thyroidectomy is a commonly performed surgical procedure for various thyroid diseases. 

Despite advances in surgical techniques, postoperative hypocalcaemia remains one of the most 

frequent complications, particularly following total thyroidectomy.

The aim of this study was to estimate the incidence of postoperative hypocalcaemia and to 

evaluate its characteristics and outcomes among patients undergoing thyroid surgery.

A descriptive retrospective study was conducted using thyroidectomy records from Benghazi 

Medical Center between 2010 and 2016. The study included patients operated on for non-toxic 

goiter, toxic goiter, recurrent goiter, Hashimoto’s thyroiditis, thyroid malignancy, and Graves’ 

disease. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 

23.0.

A total of 74 patients were included in the study. Postoperative hypocalcaemia occurred in 

27.7% of cases. The majority of patients were female, and hypocalcaemia was more common 

among women than men. Higher incidence rates were observed in patients who underwent total 

thyroidectomy and in those with retrosternal extension.

Postoperative hypocalcaemia remains a relatively common complication following 

thyroidectomy. Careful surgical technique and close postoperative monitoring of serum 

calcium levels are essential to reduce its incidence.

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 prevalences 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: Oral candidiasis is a common opportunistic infection, but its epidemiology varies significantly by

region. Recent data on the prevalence, causative species, and risk factors for oral fungal infections in Libya,

particularly in the Gharyan area, is scarce. Objective: This study aimed to determine the incidence, distribution

of Candida species, and associated demographic and health-related risk factors for oral candidiasis in Gharyan,

Libya. Methods: A cross-sectional study was conducted from February to April 2025 with 140 participants. Oral

swabs were collected following a clinical examination and structured interview. Samples were cultured on

Sabouraud Dextrose Agar, and Candida species were identified using chromogenic agar. Statistical analysis was

performed using SPSS version 27, employing Chi-square tests and ANOVA. Results: The incidence of oral

candidiasis was 47.9% (67/140). Candida albicans was the predominant species (85.1%), followed by C.

glabrata (6.0%), C. krusei (3.0%), C. parapsilosis (3.0%), and C. tropicalis (3.0%). Among the analyzed risk

factors (age, gender, diabetes, hypertension, smoking, dental prostheses, oral hygiene, and pregnancy), only

pregnancy showed a statistically significant association with infection (χ² = 4.486, *p* = 0.034). All pregnant

women in the sample were in the infected group. Conclusion: The study reveals a high incidence of oral

candidiasis in Gharyan, predominantly caused by C. albicans. Pregnancy was identified as a significant risk factor,

underscoring the need for targeted oral healthcare and screening for pregnant women. The lack of association with

other classic risk factors warrants further investigation with larger samples

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. 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.

Enlargement of inferior nasal turbinates is a common cause of nasal obstruction. Surgical methods used to treat hypertrophied inferior turbinates such as electrocautery, cryosurgery, partial turbinectomy, laser turbinoplasty, microdebrider reduction and radiofrequency thermal ablation (RFTA).The mucosal condition after surgery is an important factor that should be considered in evaluation of different techniques. This study aimed to examine the microstructural appearance of the ciliated epithelial tissues by light microscope.It was done by cytological examination of inferior turbinate mucosain patients treated by radiofrequency thermal ablation (RFTA) and bipolar electrocautery (BEC) of hypertrophied inferior turbinates. A prospective study included thirty six patients with hypertrophied inferior turbinates causing nasal obstruction not responding to medical treatment. Patients were divided into two groups: group(A) were managed with radiofrequency thermal ablation (RFTA)and group (B)were managed with bipolar electrocautery (BEC).Routine nasal examination was done with the aids of anterior rhinoscopy and nasal endoscopy. The postoperative follow up period wasthree months. cytological examination of nasal mucosa was done postoperatively. Results: there was no abnormalities in ciliated epithelial cells and only 12% of cases showed abnormalities in the form of damage in the ciliated cellswith anarchitectural rearrangement.While, the majority of sample showed abnormalities in cilia and epithelial cell damage. 78% of patients had abnormal ciliated epithelial cells im group B. Radiofrequency thermal ablation seems to be a good modality dealing with the problem of inferior turbinate hypertrophy. It showed minimal injury to turbinatemucosal tissues with good ciliary structure, along with an intact and functioning epithelium.‏