Lebda Medical Journal is a free-to-publish, peer-reviewed, open access journal that aims to publish high quality papers rapidly and freely available to researchers worldwide. Lebda Medical Journal is an Open Access Printed & Online journal, publishing Original Articles, Review Articles, Short Communications and Case Reports in all Medical, Pharmaceutical and Biology areas .
Assessment of prescription pattern and prescription errors at primary healthcare centres in Alkhoms city, northwestern of Libya
Background: The medical prescription is a handwritten or electronic computerised legal document. It must include all the required information, and adhere to the prescription writing guidelines, to be considered valid. In Libya, many of the previous studies reported the majority of prescriptions are handwritten and contain medication errors arise due to the high missing for legal or procedural requirements in the medical prescriptions by the majority of physicians. Consequently, the present study is designed to help in understanding the medical prescription practices and errors, which will lead to developing the healthcare system in Libya. Objectives: The aim of this study was to evaluate the prescription patterns and prescription errors in outpatient prescriptions issued by physicians working in primary healthcare centres at the Alkhoms city, northwestern of Libya. Methods: A comprehensive analytical study was carried out to evaluate the outpatient prescriptions patterns and errors. A total of 405 outpatient prescriptions issued by physicians and specialist working in various primary healthcare centres in the Alkhoms city and its suburbs in northwestern of Libya, were collected from several pharmacies and assessed. The study was lasted three months and used the random sampling method. Results: A total number of 405 prescriptions contains on 1852 drugs were reviewed in this study. The percentage of handwritten prescriptions and computer typed prescriptions were (98.51%) and (1.48%), respectively. The average number of drugs per prescription was 4.57. Most of the physicians prescribed drugs using their brand names (96.06%). The name of the patient was not mentioned on 5.19% of the prescriptions., whereas, the prescriber' name did not found on (80.25%) of the total prescriptions. The outcomes of the present study also displayed that the information related to the patient was usually available, in contrast, some important information related to the drugs was ignored in most of the prescriptions including the route of drug administration (71.12%). A half of the examined prescriptions was approximately lacked to information about the diagnosis (48.40%), and (29.62%) of the prescriptions lacked to the date of the prescription. Conclusions: The present study shows a low level of commitment with World Health Organization (WHO) guidelines related to prescribing indicators, and high prescription errors. Moreover, according to the finding of this study, we recommend to introduce the use of electronic prescriptions throughout the healthcare system in Libya. This will lead to update the prescription form to include all the elements recommended by the WHO in the prescription guidelines.
Prescription patterns; pharmacists; Prescription errors; Primary healthcare, Libya; WHO prescribing indicators
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The Prevalence and Risk Factors of Mobile Phone BacterialContamination, and the level of students' awareness of the role ofimmune blood cells against these bacterial agents Among HealthSciences Students: Elmergib University (Al- Khums City)
<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">Background<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">: Mobile phones are an indispensable tool in students' academic and daily lives, and their frequent use makes them a potential means of transmitting bacteria from users' hands. <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">Objectives:<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;"> <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">This study was conducted to identify bacteria present on touch screens of smartphones and to determine potential factors that may influence bacterial contamination of mobile phone surfaces with bacteria and the level of students' awareness of the role of immune blood cells against these bacterial agents of students of the faculty of Health Sciences in Al-Khums city. <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">Methods:<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;"> <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">The study was conducted at the faculty of Health Sciences from November 2024 . 200 swabs were collected from 200 mobile phones, and a questionnaire was distributed to all participants to collect data. Swab samples were taken from participants' phones and cultured to identify bacterial contamination in the college's medical laboratory. Samples were cultured on blood agar and incubated at 37°C for 24 hours. Bacterial isolates were identified using conventional bacterial species identification methods. <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">Results:<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;"> <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">Our results showed that the mobile phone contamination rate with microorganisms reached 95.7%, with 282 microbes isolated from 200 swabs. Staphylococcus epidermidis was the most common, accounting for 33.8%, followed by Streptococcus pneumoniae (20.3%), Streptococcus pyogenes (14.3%), Escherichia coli (10.3%) Staphylococcus aureus (10.3%). Pseudomonas aeruginosa (5.0%), fungi (1.1%), and Klebsiella (0.7%) were also found. <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">Conclusion:<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #548dd4; mso-themecolor: text2; mso-themetint: 153; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;"> <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 12.0pt; line-height: 150%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-font-kerning: 1.0pt; mso-ligatures: standardcontextual; mso-bidi-font-style: normal; mso-no-proof: no;">mobile phones can be heavily colonized by high quantities of pathogenic bacteria and thus potential sources of disease transmission requiring application of sound personal hygiene as preventive methods.
Fresh Frozen Plasma Quality Control at the Al Marj Central Blood Bank, Libya
Background: Fresh frozen plasma (FFP) is a vital blood component used to treat coagulation disorders, and ensuring its quality is essential to prevent transfusion-related complications. Objectives: This study aimed to evaluate the quality of FFP prepared at the Al Marj Central Blood Bank, Libya, and to compare the findings with the international standards established by the American Association of Blood Banks (AABB). Methods: A cross-sectional study was conducted on 100 FFP bags. Each unit was analyzed for volume, pH, prothrombin time (PT), partial thromboplastin time (PTT), and residual cell counts after thawing, according to AABB procedures. Results: The mean FFP volume (193 ± 28 ml) was significantly below the AABB standard of 200–400 ml (p < 0.001). The mean pH (6.9 ± 0.45) and PT (13.7 ± 1.43 s) were within acceptable limits, while the mean PTT (35.6 ± 2.04 s) was slightly above the upper limit of the standard range (25–35 s), suggesting borderline prolongation. Importantly, the mean platelet count (31.1 ± 38.4 ×10⁹/L) exceeded the AABB limit (<5×10⁹/L). Conclusion: Although most parameters met AABB standards, the FFP units demonstrated reduced volume and elevated platelet counts, indicating possible inefficiencies in centrifugation and plasma separation processes. Optimization of preparation procedures is recommended to enhance FFP quality and ensure compliance with international standards.
Antimycobacterial Effect of Naphthoquinone Natural Derivatives Identified in Henna leaves against Three Target Enzymes by Molecular Docking.
Background: Tuberculosis (TB) remains a major health threat, aggravated by rising drug resistance and treatment toxicity. Henna (Lawsonia inermis) is a plant commonly used in traditional medicine and folk cosmetics. The plant has topical anti-fungal effect, protect sunburn; topical analgesic and relief inflammation. However, their mechanism of action against Mycobacterium tuberculosis is not yet fully characterized. Objective: The present study aimed to evaluate the antimycobacterial effect of naphthoquinones natural derivatives from henna leaves extract against M. tuberculosis by computational approach targeting three essential Mycobacterium enzymes involved in bacterial growth and survival; and to identify the interactions between the derivatives and the target protein. Methods: The plant leaves were extracted by maceration in methanol and then subjected to GC-MS analysis and naphthoquinones derivatives were identified. Thereafter, the derivatives were investigated by molecular docking against mycobacterial target proteins including: Protein kinase G (PknG, PDB ID: 3CKQ), 4-diphosphocytidyl-2C-methyl-D-erythritol cytidyltransferase (IspD) and UDP-glucose-specific glycosyltransferase. Results: The docking results revealed that four Naphthoquinone compounds, 5-Hyroxy-1,4 Naphthoquinone, 2-Amino-3-chloro-1,4 Naphthoquinone and Coumarin-3-carboxylic acid exhibited binding affinities of −7.6, −8.2, −9.0, and −12.5 kcal mol−1 respectively, against protein kinase G, IspD and UDP-glucose-specific glycosyltransferase. Coumarin-3-carboxylic acid was a most promising candidate among the derivatives investigated achieved optimal binding stability and high inhibitory potential. Conclusion: The molecular docking analysis showed a significant antituberculosis potential of naphthoquinone derivatives found in henna leaves, particularly Coumarin-3-carboxylic acid as a promising lead for PknG inhibition. These findings provide a rationale for further biological validation and development of novel phytochemical-based therapeutics against drug-resistant TB. Further validating an in vivo activity of derivatives will be recommended.
Pharmacists’ Perspectives on Clinical Pharmacy Practice and Willingness to Engage in Structured Training: An Expanded Analysis from Libya
Background: Pharmacy practice in Libya is shifting from dispensing-focused roles toward patient-centred clinical services, but training gaps and policy barriers remain. Objectives: To describe demographic and practice profiles of pharmacists in Libya, assess awareness and attitudes toward clinical pharmacy, determine willingness to undertake structured training, and identify barriers and facilitators for implementation. Methods: A descriptive cross-sectional survey of 65 licensed pharmacists from public and private sectors was conducted. Data included demographics, practice setting, prior clinical training, training preferences, and perceived barriers; quantitative summaries and qualitative synthesis were performed. Results: Respondents were predominantly female (62%) and mostly aged 30–39 years (49%). Hospital pharmacists comprised 55% of respondents. Prior structured clinical training was reported by 31%; 83% expressed willingness to engage in structured training. Preferred modalities were interactive workshops (74%), in-hospital rotations (61%), and blended learning (55%). Main barriers were lack of institutional support (58%), time constraints, and unclear career recognition. Conclusions: Libyan pharmacists show strong willingness for structured clinical training but face systemic and institutional barriers. Policy action, accredited training pathways, and institutional support are required to integrate clinical pharmacy sustainably into Libyan healthcare.
clinical pharmacy; pharmacists; continuing professional development; Libya; training preferences
A Integrating Bromatology into Pharmacy Curricula: A Strategic Approach to Enhance Pharmaceutical Competencies and Support Public Health
Pharmacy education is undergoing a paradigm shift to align with the evolving demands of healthcare and the expanding role of pharmacists in public health. This study explored the integration of bromatology into pharmacy curricula as a strategic approach to enhance pharmaceutical competencies and strengthen public health contributions. A cross-sectional survey design was employed with a total of 153 participants, including pharmacy students (n = 79), practicing pharmacists (n = 51), and pharmacy faculty members (n = 23). Data were collected using a structured questionnaire composed of fifteen items divided into three domains (1) Integrative curriculum components, (2) Pharmaceutical competencies, and (3) Public health. Responses were measured on a five-point Likert scale. Descriptive results indicated strong support across all domains, with the majority of participants agreeing that bromatology integration is essential for advancing pharmacy education, improving analytical and professional competencies, and enhancing the pharmacist’s role in community health. Analysis of variance revealed statistically significant differences among groups across the three domains. Faculty members consistently demonstrated stronger endorsement of bromatology integration compared with students and practicing pharmacists, suggesting that academic leaders recognize its strategic importance in curriculum reform. The findings align with international research emphasizing curricular integration as a means of bridging theoretical and practical knowledge, improving student performance, and aligning pharmacy education with public health objectives. Integrating bromatology is therefore not merely an academic addition but a forward-looking reform that prepares pharmacists to manage food drug interactions, provide nutritional counseling, and contribute meaningfully to chronic disease prevention and health promotion. This study concludes that bromatology integration represents an investment in both the quality of pharmacy education and the advancement of public healthcare systems
Bromatology، Pharmacy education,Public Health
A Comparative Evaluation of Agar Diffusion and Volatilization Methods For Assessing the Antibacterial Activity of essential oil of Libyan Artemisia judaica Against Pathogenic Bacteria
Background: Antimicrobial resistance (AMR) poses a serious global health challenge, demanding alternative therapeutic options. Essential oils (EOs) are complex, volatile mixtures with broad-spectrum antimicrobial properties and reduced likelihood of resistance development. Artemisia judaica has been traditionally used for its medicinal effects, yet limited data exist regarding its antibacterial potential against clinically relevant pathogens under different assay conditions. Objectives: This study aimed to evaluate and compare the antibacterial activity of A. judaica essential oil against Staphylococcus aureus and Pseudomonas aeruginosa using agar diffusion (direct contact) and volatilization (vapour phase) assays. Methods: Aerial parts of A. judaica collected from Al-Awaynat (Libya) were subjected to hydrodistillation via a Clevenger-type apparatus to obtain the EO. Antibacterial activity was assessed against S. aureus and P. aeruginosa following CLSI-adapted protocols. Agar well diffusion and volatilization assays were employed, with levofloxacin serving as a positive control. Zones of inhibition (ZOIs) were measured, and mean values ± standard deviation were recorded. Results: The EO yield was 0.8% ± 0.05 (v/w). In agar diffusion assays, inhibition zones measured 13.5 ± 2.1 mm for S. aureus and 24.3 ± 5.6 mm for P. aeruginosa, with activity against P. aeruginosa surpassing levofloxacin (20.5 ± 0.7 mm). By contrast, volatilization assays showed minimal and uniform activity (8.0 ± 0.0 mm) for both strains, indicating limited vapour-phase antibacterial potential. Conclusion: A. judaica essential oil demonstrates strong antibacterial activity in direct-contact assays, particularly against P. aeruginosa, but negligible vapour-phase effects. These findings suggest its potential application in topical or direct-contact formulations rather than airborne disinfection, and highlight the importance of assay selection in EO bioactivity profiling.
Artemisia judaica, essential oils, antimicrobial activity, agar well diffusion, volatilization assay, Staphylococcus aureus, Pseudomonas aeruginosa.
Evaluation of Vitamin D Levels in the Municipality of Zillah
Vitamin D, a fat-soluble prohormone, is essential for calcium homeostasis and bone metabolism. Its role, however, extends to a wide range of physiological processes, including immune regulation, cell proliferation, and cardiovascular health. Despite abundant sunlight in many regions, vitamin D deficiency is a global pandemic affecting all age groups. In Libya, lifestyle and cultural factors may contribute to a high prevalence of this deficiency, yet localized data, particularly from desert regions like Al-Jufra, remains scarce. This study aimed to evaluate the prevalence of vitamin D deficiency and insufficiency among the adult population in the municipality of Zillah, and to investigate potential differences based on gender. A cross-sectional study was conducted between June 2023 and June 2024. A total of 100 adult participants were recruited from the Al-Watan Polyclinic in Zillah. Serum 25-hydroxyvitamin D [25(OH) D] levels were measured using a fluorescence immunoassay (FIA) analyzer. Vitamin D status was categorized as deficient, insufficient, or sufficient. Data on demographics, sun exposure habits, and dietary intake were collected via a structured questionnaire. Data were analyzed using Microsoft Excel 2010 for descriptive statistics. The study revealed a high prevalence of suboptimal vitamin D status. Only 35% of participants had sufficient vitamin D levels. A significant portion of the population was found to be insufficient or deficient. Gender-specific analysis indicated that males had a higher rate of deficiency compared to females. Conversely, females exhibited a higher prevalence of insufficiency compared to males. Vitamin D deficiency and insufficiency are highly prevalent in the Zillah municipality, representing a significant public health concern. The findings highlight the urgent need for targeted public health strategies, including awareness campaigns about safe sun exposure, dietary counseling, and food fortification. Regular screening, particularly for at-risk populations, is crucial for early detection and intervention to mitigate the long-term health consequences associated with vitamin D deficiency.
Vitamin D Deficiency, 25-hydroxyvitamin D, Zillah, Public Health, Sun Exposure
Chemical Composition and Antibacterial Activity of Libyan Propolis
Propolis, a natural resinous substance collected by honeybees, exhibits diverse biological activities due to its rich phytochemical composition. This study aimed to characterize the chemical profile of Libyan propolis and evaluate its antibacterial efficacy. Samples were collected from local beehives, extracted using ethanol and methanol, and analyzed via spectrophotometric and HPLC methods. The propolis contained Carbohydrates (405.97 mg/g), Tannins (17.5 mg/g), Flavonoids (112.28 mg/g), Phenols (50.25 mg/g), Alkaloids (24.20 mg/g), Saponins (20.50 mg/g), proteins (202.97 mg/g), crude Lipids (23.9%), crude Fiber (11.7%), and Ash (9.43%). The Ethanolic Extract Demonstrated significant antibacterial activity against Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), and Pseudomonas aeruginosa, with inhibition zones comparable to gentamicin. These findings highlight the potential of Libyan propolis as a natural antimicrobial agent.
Propolis, Phytochemicals, Antibacterial activity, Libya, Natural products
Effect of Crude Ethanolic Extract of Mangosteen Pericarp (Garcinia mangostana Linn.): A Comprehensive Review
Garcinia mangostana L., known as mangosteen, is a tropical tree whose fruit pericarp has been extensively used in traditional medicine for treating various ailments. The crude ethanolic extract of mangosteen pericarp (CEMP) is a rich source of bioactive xanthones, with α-mangostin being the most prominent. This comprehensive review aims to consolidate and critically evaluate the existing scientific literature on the biological effects and pharmacological potential of CEMP. We systematically analyzed published studies from electronic databases such as PubMed, Scopus, and Google Scholar. The findings reveal that CEMP exhibits a wide spectrum of potent pharmacological activities, including antioxidant, anti-inflammatory, antimicrobial, anticancer, antidiabetic, and neuroprotective effects. These activities are primarily attributed to the xanthones' ability to modulate key signalling pathways, such as nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK), and their interaction with various enzymatic systems. Despite the promising in vitro and in vivo evidence, a significant gap exists in clinical research that translates these findings into human therapeutics. This review highlights the robust pharmacological profile of CEMP, underscores the need for more detailed mechanistic studies and standardized clinical trials, and discusses its potential as a source for developing novel natural-based drugs.
Garcinia mangostana, xanthones, alpha-mangostin, ethnopharmacology, biological activities.
Comparative Study between Paracetamol 500 mg tablets manufactured by Tunisian Teriak laboratories and Paracetamol 500 mg tablets manufactured by England GlaxoSmithKline
The study was conducted to determine whether paracetamol tablets manufactured in England GlaxoSmithkliene (GSK) companies and Tunisian Teriak laboratories demonstrate comparable performance when subjected to standard official pharmacopeial quality tests. The evaluations and assessment was done by weight uniformity, friability, disintegration, dissolution, and assay of active ingredient content using UV spectrophotometry in the laboratory. The results shows that products exceeded the minimum requirements set by pharmacopeial standards, Quality control testing included weight uniformity (mean ± SD: GSK tablets = 500.8 ± 2.1 mg; Teriak = 501.3 ± 2.4 mg), friability (0.21 ± 0.02% and 0.24 ± 0.03% for Teriak tablets), disintegration time (3.2 ± 0.4 min and 3.5 ± 0.5 min respectively), dissolution at 30 min (98.5 ± 1.2% and 97.8 ± 1.5%), and assay of active ingredient by UV spectrophotometry (100.2 ± 0.8% and 99.9 ± 0.9%). The results were distinguished in GSK tablets which showed a slightly faster dissolution rate, similarity factor analysis (F2 = 68.4) confirmed equivalence between profiles, both formulations remained well within acceptable limits, indicating that patients can expect equivalent therapeutic efficacy regardless of the country of manufacture.
Review of Migraine as a Neurovascular Disorder: Causes, Biochemical Changes, and Comparative Treatments
Migraine is a chronic neurovascular disorder and one of the most disabling neurological conditions worldwide. It is characterized by recurrent attacks of unilateral, pulsating headache accompanied by nausea, photophobia, and phonophobia, with or without aura. Both genetic and environmental factors contribute to its pathogenesis. Genome-wide association studies have identified multiple susceptibility loci, while hormonal fluctuations, stress, sleep disturbance, and dietary factors act as common triggers. Biochemically, cortical spreading depression, activation of the trigeminovascular system, and release of calcitonin gene-related peptide (CGRP) and serotonin dysregulation are central to attack generation. Epidemiological studies reveal that migraine affects over one billion people globally, with a higher prevalence among women, particularly during reproductive years, underscoring the role of sex hormones. Acute management includes NSAIDs, triptans, gepants, and lasmiditan, with antiemetics for nausea. Preventive strategies are indicated in frequent or disabling attacks and include beta-blockers, topiramate, valproate, antidepressants, and the newer anti-CGRP monoclonal antibodies. Non-pharmacological approaches such as lifestyle modification, trigger avoidance, cognitive behavioral therapy, and neuromodulation devices complement drug therapy. Advances in targeted treatments have improved outcomes, but equitable access remains a challenge. Optimized, individualized therapy offers significant potential to reduce disability and improve quality of life for patients with migraine.
Migraine, Aura, Triggers, Triptans, Gepants
Real-World Effectiveness of Depot Medroxyprogesterone Acetate (DMPA): A Physician Survey on Failure Rates and Contributing Factors
Background: Depot medroxyprogesterone acetate (DMPA) is a widely used contraceptive, but real-world data on its performance remain limited. Objective: This study evaluates physician-reported experiences with DMPA, focusing on failure rates, side effects, and prescribing trends. Methods: A cross-sectional survey of 34 obstetrician-gynecologists in Libya assessed: (1) contraceptive failure rates and causes, (2) side effect prevalence, (3) patient adherence behaviors, and (4) provider preferences. Quantitative data were analyzed descriptively; qualitative responses were thematically coded. Results: Failure rates: 61.8% of physicians reported 0–1% failure (consistent with perfect use), while 29.4% observed 2–3% failure (attributed to non-compliance [32.4%] and improper administration [29.4%]). Side effects: Irregular bleeding affected 52.9% of users; 38.2% experienced multiple concurrent side effects. Discontinuation due to side effects occurred in 38.2% of cases. Prescribing patterns: 50% of providers preferentially recommended DMPA for specific patients (e.g., those needing estrogen-free options), while 35.3% favored alternatives due to adherence challenges. Conclusions: While DMPA demonstrates high efficacy in ideal use, real-world effectiveness is compromised by adherence barriers and side effects. Targeted interventions—including improved provider training, patient counseling, and reminder systems—could optimize outcomes. These findings support individualized contraceptive counseling and underscore the need for accessible alternatives in clinical practice.
Does DYRK1A Regulate REST in Lung cancer?
Purpose: The aims of this study were: (1) to screen a panel of lung cell lines for expression of DYRK1A protein (2) To investigate the correlation between DYRK1A and REST in normal lung and lung cancer. (3) To test whether DYRK1A depletion or chemical inhibition alters REST levels in lung cancer. (4) To determine if DYRK1A affects the transcription of the REST-target gene CHGB. Method: Western blots were performed to detect the expression of DYRK1A and REST protein in extracts from normal lung cell lines, SCLC, carcinoid and NSCLC. siRNA silencing, we used 4 oligos for DYRK1A and tow positive control (2 oligos for REST) and non-targeting oligo as negative control. Harmine as specific DYRK1A inhibitor. MTS assay to tested cell viability and qRT-PCR to examine REST target gene transcript (CHGB). Results: we found that DYRK1A expressed more in lung cancer than normal lung cell lines and there was a good correlation between DYRK1A and REST protein in normal lung cell lines. However, this correlation lost in some NSCLC cell lines. Also, DYRK1A depletion reduced REST level in H460 cell line. As well as the inhibition of DYRK1A in A549 reduce REST level. Finaly, CHGB responsed to DYRK1A inhibition in A549 and toDYRK1A depletion in H460 cell lines.
Impact of One Day Fundoscopy Workshop on Pediatrician's Fundus Examination Skills
Abstract: Background: As physician's workloads increase, routine ophthalmoscopy may be dropped. And its number of frequency and competency in performing it are unknown. Objective: To assess the effectiveness of a daylong fundoscopy workshop and interactive lecture based education in improving pediatrician's fundus examination knowledge & skills. Methods: Pediatric doctors enrolled in Libyan board fellowship training program at Albayda Medical Center participated in this study. Pre and post-test comprising a pictorial quiz on the topic of presentation on which presentations & training workshop about fundus examination by direct ophthalmoscope were later delivered by 3 ophthalmology specialists were distributed to (n=32) participants in a one-day oriented workshop within a stipulated time period and their feedback was collected and statistically analyzed after the workshop was over. Result: A total 17 participants completed the quiz, varying between senior and junior pediatricians. All participants were included in the Libyan board fellowship training program. All 17 participants could not answer the pre-test pictorial quiz (0%), and after the tutorial 15(88.24%) participants were able to answer the quiz, this difference was statically significant (p = 0.000). A total of 29 participants completed the feedback questionnaire at the end of the workshop , the overall mean evaluation score by the participants was ≥ 4.1 out of 5. Participants satisfaction was (62.1 %) and non-satisfaction was (37.9%) (p =0.000). Conclusions: This study highlights the effectiveness of engaging teaching methods and fundoscopy hand on workshop to enhance fundoscopy examination and diagnostic skills in pediatrician. Also, it demonstrates the need for continuous professional development among healthcare professionals. Key-words: pediatrician, fundoscopy, interactive lecture, skills, workshop
GC-MS analysis of Essential oil Components of the Libyan Thymus capitatus
This study presents a comprehensive analysis of the essential oil components from Libyan Thymus capitatus utilizing gas chromatography-mass spectrometry (GC-MS) for identification and classification .The essential oil was extracted from samples collected in the Mesellata region of northwestern Libya. Among the identified compounds, monoterpene hydrocarbons were most prevalent, particularly Carvacrol, which constituted 56.27% of the total area. Other notable compounds included p-Cymene and γ-Terpinene. Oxygenated monoterpenes, led by Carvacrol, contributed significantly to the composition (69%), with Thymol, Linalool, and Terpinen-4-ol also being present. Additionally, Caryophyllene was identified as a significant Sesquiterpene hydrocarbon (3.57%), while Carvacryl acetate emerged as a notable oxygenated heterogeneous hydrocarbon, accounting for 1.81% of the composition. the findings highlight the potential health benefits and aromatic properties of these compounds, reinforcing the significance of Thymus capitatus essential oil as a source of natural bioactive compounds. This comprehensive analysis underscores the necessity for further exploration of this essential oil in food, cosmetic, and pharmaceutical applications
Assessing the Applicability and Adherence to the CHADS2-VASc Score in Atrial Fibrillation
Abstract:- Atrial fibrillation is the most important and common arrhythmia observed especially in the elderly population and it contributes very much in the morbidity of these patients due to mainly the significant risk of thromboembolic events. In 2010 CHADS score was introduced followed by CHADS_VAS score in 2014 . since then it was added to most guidelines for the management of AF. In this study we tried to look to whether we apply and adhere to these guidelines in zliten city. Material and method:- This study is a descriptive study using data collected from Zliten hospital Medical Dept., ICU and outpatient cases Study population: a 100 AF diagnosed patients admitted to or followed in Zliten Hospital during 2015 Data collection: case study sheet prepared to collect data from the patients. The case study sheet contains variables needed to assess the use of mentioned guidelines Conclusion:- in the study group we found a good adherence to the guidlines by our treating doctors
Docking of various molecules including two NSAIDs as prototypes into the ‎COX-1 enzyme ‎
Molecular modeling studies for the cyclo-oxygenase isozyme (COX-1) and docking processes in the COX-1 active site pocket is of an importance of research in Today’s world. This is preformed in order to study the inhibition effect of these different compounds to the COX-1 enzyme by using molecular operation environment (MOE) program. Teen different chemical molecules were fitted in the active site pocket of the COX-1 enzyme and optimized in both cases before and after molecular dynamic simulations that is after taking the best conformation of each ligand of these molecules depending upon scoring investigation. The energy gain for the whole system is obtained by the subtraction of the complexed systems energies from the separated ones. The teen neutral (protonated) molecules were studied and show that the compound 3, 7 and 9 under re-optimization process after MD simulation show the best fitting among all studied molecules and their energy gains were -34.2, -40.4 and -41.21 kcal/mol, respectively. In order to know the effect of ionization on the system, The possible ionized compounds 1, 2 and 3 were studied in both the neutral and deprotonated forms. The obtained results show that both compound 1 and 2 show relatively small inhibition once they studied as in their neutral species. The effect of ionization is very clear once they re-optimized in their deprotonated species. The significant enzyme inhibition is noted since their energies gain changed in neutral forms from 14.4 and 27.3 Kcal/mol to 39.7 and 29.4 Kcal/mol of the deprotonated species, respectively.
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Chemistry; is it vital for undergraduate pharmacy students?
Pharmacists learn chemistry during their undergraduate education at pharmacy colleges. Learning Chemistry is not an easy task. However, it helps pharmacists to understand many aspects about drugs. This article aimed to explore attitudes of working pharmacists about chemistry learning. Self-administered questionnaire was distributed, in October 2021, to 40 private community pharmacies in Alkoms city, Libya. Data analysis was conducted by using Excel an SPSS. Thirty pharmacists participated in this study. The response rate was 75%. Most participants were males. Participants admitted that chemistry helps them their daily pharmacy activities, although it was not easy to learn chemistry. There mixed attitudes towards chemistry learning varied according work expertise and gender. Medicinal chemistry and biochemistry were the most beneficial branches of chemistry.
Copyright (c) 2024 Lebda Medical Journal https://creativecommons.org/licenses/by-nd/4.0
Mucosal Brucella Infection in Human: a case report study during Covid-19 pandemic
Brucellosis in human is an uncommon disease in Libya and usually diagnosed by serological assays. The clinical symptoms of this disease in many times are none specific and vague. This report describes a case of clinical human brucellosis in Libya. The patient was a sixteen years old girl, lives in a rural area. She was suffering from intermittent fever for several days associated with chills, mild cough, and headache. The patient had history of occasional drink of goat’s raw milk during the previous two months. She had no history of travel abroad and direct animal contacts. Comprehensive physical examination revealed the patient was generally unwell, pallor and, had tenderness and mild hepatosplenomegaly. Laboratory investigations revealed that the patient had pancytopenia (low number of blood cells count) and a marked increase in C-reactive protein (CRP), Procalcitonin (PCT), Lactate dehydrogenase (LDH), Aspartate transaminase (AST). Viral screen tests were non-reactive for HCV, HBs Ag, HIV and covid-19. Provisional diagnosis on admission time was acute leukemia or aplastic anemia with common microbial infection. Empirical antibiotic (Meropenem 1 gm) was prescribed intravenously every eight hours for seven days. The patient was also given antipyretic, IV fluid hydration, and one unit of packed red blood cells. Following that, bacterial growth in aerobic blood culture was noticed and it was Gram-negative coccobacilli, non-motile. The bacterium was positive for catalase, oxidase and urease tests. It could not clearly be identified by phoenix bacterial identification system. It was provisionally diagnosed Haemophilus spp., but as it was able to growth on blood agar plate, it was finally diagnosed as Brucella spp. and that was confirmed by collection of patient serum and performing Rose-Bengal pate test (RBPT) as was significantly increased (1:640). The patient general condition was improved and blood count recovered over one week. The patient was then discharged and asked for routine follow ups during the next six months.
Comparison between the breast preserving surgery and the ordinary breast surgery on breast oncoplastic surgeries in National Cancer Institute\ Misurata- Libya
Objective: to determine the breast cancer recurrence rate, complications, and aesthetic outcome of breast oncoplastic surgery among patients managed in National Cancer Institute\Misurata-Libya (NCI) that they underwent breast oncoplastic surgery(BOS) also to analyze the results between two patients groups underwent breast reconstruction with Lattissimus Dorsi(LD) flap in 1st group and Transverse Rectus Abdominus Myocutaneous(TRAM) flap in 2nd group. Methods: Retrospective study of 56 patients in oncological surgery department In the NCI between 1st January 2014 to 30th December 2018, have been included. In the study period, a total of 56 cases of breast cancer underwent BOS. 11 patient underwent modified radical mastectomy (MRM) with LDMF reconstruction and 17 case underwent modified radical mastectomy(MRM) with TRAM flap, 26 case underwent breast preserving surgery(BPS), 2 cases presented with phyllodes tumor and managed by subcutaneous mastectomy and implant reconstruction. Early results show acceptable cosmetic results of these cases. Results: The most occurred complications in both groups (LD&TRAM ) are wound infection, hematoma & partial flap necrosis. In conclusion, we find that LD flap is a safe and low-morbidity technique with a relatively low complication rate. Conclusion: Oncoplastic breast surgery combines the principles of surgical oncology with those of plastic and reconstructive surgery and our initial experience shows that BOS leads to aesthetically pleasing and oncological sound results.
The contents of total phenolic, flavonoid, and antioxidant activity of ethyl acetate extract of Juniperus phoenicea L. (Cupressacees) leaves growing in East Libya
Background: the harmful effect of antioxidative stress can be inhabited by the natural antioxidants present in many medicinal plants. These plants contain compounds including phenolics and flavonoids responsible for reducing the effects of free radicals, that can be used as a substitute to treat many diseases. Aim: This study aims to quantitively determine the total phenolic contents (TPC), total flavonoids contents (TFC), and the reducing power assay of ethyl acetate extract leaves extract of Juniperus phoenicea L. plant. Juniperus is a member of the Cupressaceae family which has been used as a folk medicine in Libya. the plant was collected from the Al-Jabal Al Akhdar area, east Libya. Methodology: The powdered dried leaves of Juniperus were extracted continuously by the Soxhlet extractor, the extract was obtained and evaporated to dryness by a rotatory evaporator. The extracts were investigated for reducing power and the presence of phenolic and flavonoid compounds. The TPC was determined using the colorimetric method, expressed as pyrogallol equivalents and the absorbance was measured at 765 nm. The TFC was determined calorimetrically and the results were expressed as quercetin equivalents and the absorbance of color was determined at 510 nm. While the reducing power was measured spectrophotometrically at 700 nm, ascorbic acid was used as standard and expressed as (µg/ml). Results: the levels of TPC, TFC, and reducing power increased with increasing concentration of extract. Conclusion: The extracted contents of phenolic compounds, flavonoid compounds, and reducing power were lower than the standard pyrogallol, quercetin, and ascorbic acid respectively.
Role of Combination Therapy on no-reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction.
Background: No-reflow is a complex process with multiple pathogenetic components that may lead to major complications and higher mortality in patients with ST-segment elevation acute myocardial infarction (STEMI) after performing percutaneous coronary intervention (PCI).This study aims to evaluate the role of combination treatment in the prevention of occurrence of no- reflow and major cardiac adverse effects in patients with STEMI undergoing primary PCI. Subjects and methods:This is an interventional study including 100 patients with STEMI who underwent emergency primary PCI and had a high risk of no-reflow (no-flow score ≥ 8), patient were randomly divided into a controlled group (n = 50) received conventional treatment, and a combination therapy group (n = 50) received high dose 80mg atorvastatin pre-intervention, platelet membrane glycoprotein IIb/IIIa receptor antagonist (tirofiban, 10μg/kg bolus followed by 0.15 μg/kg per minute) and thrombus aspiration. Six months follow up recording of major adverse cardiac events. Results: No-reflow was detected in3/50 cases (2.8%) in the combination therapy group versus 38/50 cases (35.2%) in the control group. TIMI grade 3 was found in 46 patients (92%) versus in 32 patients (64%) p=0.008. While MBG ≤ 1 was (14/50) 28% vs (15/50) 30% p=0.18 in the combination therapy group versus control group respectively. MACE at six months 9 events (18%) in the combination therapy group, versus 19 events (38%) in the control group p= 0.03. Conclusion: combination therapy with thrombus aspiration, high-dose statin and platelet membrane glycoprotein IIb/IIIa receptor antagonist prior to pPCI reduces the incidence of no- reflow, and major cardiac adverse events in patients with acute ST-elevation myocardial infarction.
Necrotic Encephalitis associated with a Toxoplasma-like Protozoan Infection in Lambs
Introduction: A total of 32 young (1-3 months-old) lambs suffered from mortal neurological signs in a period of three months. The lambs were among the offspring of a herd of 300 sheep, in Tarhouna city, Libya. The affected lambs were initially treated with antibiotics, multivitamins and mineral supplements, however, none of these treatments attenuated the death toll among the small lambs. Â Methods: Three lamb carcasses were submitted to the National Center for Animal Health (NCAH) for post mortem examination. Gross pathological examination of the brains detected hydatid cysts and yellowish lesions within the cerebral cortex. Â Results: The histopathologic examination of the brain showed the presence of inflammatory lesions and necrotic features surrounded by granulomatous inflammatory patterns, which are accompanied by a few parasitic cysts. Ordinary and modified Ziehl-Neelsen stains for bacterial infection were performed, but the results did not strongly indicate bacterial infection. Toxoplasmosis, particularly T. gondii, and Neospora were first suspected. Immunohistochemistry testing for T. gondii did not show any conclusive indication for the presence of this pathogen. However, meticulous microscopic examination (100x) of the histopathologic features and the patterns of host-pathogen interaction of toxoplasmosis indicate that these lambs may have suffered from necrotic encephalitis associated with a different type of toxoplasmosis. Â
Anti-inflammatory activity of Ethanolic extract of Cnicus Benedictus
Introduction: Cnicus benedictus has been used as treatment for liver disorders and menstrual problems. Different studies have been undertaken for various activities on extracts of the plant but, so far and to the best knowledge of the author(s), no one has reported anti-inflammatory activity of ethanolic leaves extract of Cnicus benedictus. Aim: The aim of this study is to investigate the anti-inflammatory activity of Ethanolic leaf extract of Cnicus benedictus in albino wistar rats upon oral administration (100 and 200 mg/kg). Method: Thirty albino wistar rats were taken and divided into five groups to study the anti-inflammatory activity of Ethanolic extract of Cnicus benedictus (CB). To induce oedema, 0.1 ml of 1% w/v carrageenan suspended in 1% CMC were injected into sub-plantar tissues of the left hind paw of each rat of Group 1, III, IV and V. Animals of group I were kept as the normal control group. Indomethacin (10 mg/kg) was given to group III. Ethanolic extract of CB in a dose of 100 and 200 mg/kg were given to group IV and V, respectively. The anti-inflammatory activity of CB was compared with standard indomethacin treated animals, using plethysmometer. Result: The ethanolic extract of CB showed % inhibition of oedema 28.92 and 35.29 with dose of 100 mg/kg and 200 mg/kg, respectively. Conclusion: Ethanolic extract of CB at higher dose possesses a significant anti-inflammatory activity (P< 0.05) compared to a lower dose.
Patient counseling as a valuable approach in Pharmaceutical care, A cross sectional study in Azawia city, Libya
Pharmaceutical care is one of the most important new approaches of modern pharmacy practice, where in the last four decades the role of the community pharmacist is changed dramatically towards patient oriented services rather than product oriented services in order to promote safe and effective use of medicines and also to maximize their therapeutic outcomes. Patient counseling is considered as a main component of pharmaceutical care where it focuses on enhancing the problems solving skills of the patients to ensure safe, effective and convenient medicine would be provided to the patient for the purpose of improving and maintaining better health and life quality. The main objective of this study is to explore the practicing a concept of medication counseling in community pharmacies in Azawia city of Libya, and to evaluate the expertise of the pharmacists about that and also to find out whether they are practicing patient counseling in their pharmacies. Furthermore, this study aimed to collect and suggest solutions for problems and barriers hinder the counseling process. This descriptive cross sectional study was conducted in the period between 8th and 25th Sep.2020, where the data was collected from randomly selected community pharmacies of different areas with in Azawia city. The questionnaire was designed of twenty one questions divided into two parts; the first part considered the profile of health care provider in the pharmacy, and the second part consists of nineteen questions involving open and closed questions. It was found that more than 50% of the care providers involved in this study were not pharmacists and only 42% of them were aware with counseling concept. Almost no counseling area was found in 50 community pharmacies participated in this study. Asking about chronic diseases, taking other medications and allergy to certain drugs were acceptable as the study showed percentage of practicing of 90%, 98% and 68% respectively. Moreover, counseling about drug interactions, contraindications and drug storage were not enough as the percentages were 16%, 20% and 8% respectively. Communication skills of the care providers need to be improved in order to enhance patient's compliance and in addition to that a lot of work need to be done either through the pharmacists syndicate, health authorities and schools of pharmacy in Libya to reinforce and practicing the counseling concept properly
The Epidemiology and Trend of Cancer in Misurata oncology center, 2012–2016
BACKGROUND: on the last decade in Libya, the oncology center in Misurata become the most important cancer diagnosis and follow up center on the western region of Libya. The Libyan society was worried about the increase of the percentage of tumor incidences among the Libyans on the last few years. This study focuses on cancer prevalence in city of Misurata and the surrounding area in central Libya from 2012 to 2016. METHODS: A hospital-based registry of cancer patients was formed using records from oncology center in Misurata, focusing on patients who were diagnosed between 2012 and 2016. RESULTS: the incidence of tumor on females was higher than males from 2014 up to higher deference on 2016, the most common malignancies in men were cancers of the lung on years from 2012 up to 2015 even though it decrease to 18% of males patients on 2016, followed by colon, its prevalence rate ranged from 14% to 18% of recorded male patients (For women, they were found to be cancers of the breast ranged from 29.84% on 2012 and raised to 43.08%. Additionally, age-standardized rates (ASR) were determined for recording patients who leaved on the city of Misurata and compared with published record from the other countries. The incidence rates given for the city of Misurata can be considered with the counties with low malignancy rate CONCLUSION: Proper surveillance programs need to be in place and healthcare policy should be adjusted to consider the more prevalent and pressing cancers in society.
Knowledge, Attitudes and Practices of Health Care Practitioners regarding Crushing or Splitting Oral Solid Dosage Forms in Benghazi Medical Centre, Libya.
Background: Crushing or splitting oral solid dosage forms is a widespread practice among health care professionals for many reasons such as swallowing difficulty or dose adjustment. However, this practice may alter drug properties in ways that can result in increased toxicity or instability. Aim of study: This study was conducted to investigate and compare the knowledge, attitudes and practices of health care practitioners toward crushing or splitting oral solid dosage forms in Benghazi Medical Centre. Method: A cross-sectional study employing a self-administered questionnaire was conducted during March and April 2019 among health care professionals whom working in Benghazi Medical Centre. The data was analyzed using the Statistical Package for Social Sciences. Results and discussions: This study demonstrated that around 35.6% of the participants believed that all types of oral solid medications can be split or crushed. Interestingly, 41.9% thought that this practice does not cause dangerous problems to patients, and 24% agreed that it is allowed to crush or split Omeprazole enteric coated capsule. Moreover, 32% said that it is allowed to crush or split Carbamazepine controlled release tablets. However, Omeprazole is inactivated by acid in the stomach if it is crushed, whereas Carbamazepine is a narrow therapeutic index drug and its crushing may lead to toxicity. Overall, there was a significant difference among the participants̕ knowledge, attitudes and practices regarding crushing or splitting oral solid dosages (p value= 0.00001). Conclusion: This study concluded that there was a lack of awareness among health care professionals toward special formulations that should not be split or crushed. The knowledge, attitudes and practices toward crushing and splitting oral solid dosages was the poorest among nurses and the best among pharmacists. Pharmacists can play a major role in educating nurses and identifying situations where crushing maybe unnecessary and suggest appropriate alternatives. Therefore, educational programs, training and collaboration between them could improve this practice.
Epidemiological Characters of Renal Malignancies in Midland Region of Libya; Single Center Experience (National cancer institute Misrata Libya).
Introduction: Renal malignancy accounts for 5% and 3% of all adult malignancies in men and women respectively. Renal cell carcinoma (RCC) forms 85% of all primary renal neoplasms. Some of the reported risk factors for RCC include gender, age and other associated factors such as hypertension by chronic use of diuretics, diabetes, urinary tract infections. Aims: The aim of this study is to clarify epidemiological and clinicopathological features of malignant renal tumors in central region of Libya. Methods: From January 2014 to December 2019, 57 patients at National Cancer Institute of Misurata proved histopathologically with renal malignancy are included in this study. Related variables such as patients’ demographic features, clinical presentation, size of tumor and laterality, type of surgery, type of chemotherapies and metastatic status were collected from the medical records and pathology reports. All variables were analyzed using the software of “Statistical Package for the Social Sciencesâ€ (SPSS), version 20. Results: In total, 57 patients were diagnosed with renal malignancy, 31 were females (54.5%) and 26 were males (45.6 %) and clear cell histopathological type form 68.4% of them. The most common presenting symptom was loin pain in 73.7 % of patients followed by, abdominal mass in 47.4 %, while hematuria was seen in 38 % of patients and weight loss was reported by one fourth of patients. The distant metastases were seen in 47.4 % of patients. Regarding laterality, 56.1 % of patients had right kidney tumor and 43.9 % had left kidney tumor. Radical nephrectomy carried out in 53 % of patients, cytoreductive nephrectomy for 12 % of patients and 5 % of patients underwent partial nephrectomy . Conclusion: The incidence of such tumors in Libya has increased, and further cohort studies on risk factors, pathogenesis, and efficacy of minimally invasive surgery vs open surgery are required. Implications of immunochemical stains is critical for suspicious of new metachronous tumors affected by same hormonal receptors. Establishing or introducing screening service in Libya to help in early-stage detection. Importance of target therapy as part of neoadjuvant therapy to prove adequate free resection margin and metastasis cure.
Evaluation of Pregnant Women Attitude Toward OTC Medications Use; A cross Sectional Study Conducted in Azawia Libya
Objective: Safety is one of the most important characteristics of over the counter medications (OTCs); however, does this safety profile extend to women during pregnancy or not. this is questionable, as the safety of some medications may change according to the gestational age of the foetus. Around 10 % or more of birth defects result from maternal drug exposure, the U.S. Food and Drug Administration has assigned a risk category to each drug. Many drugs have not been evaluated in controlled trials and probably will not be, because of ethical considerations. Aim: This study was designed to aware and assesses the use, knowledge and beliefs about OTCs among pregnant women in Azawia city in Libya, by using a cross sectional survey performed by using a self- administrated questionnaire. Results and Conclusion: Majority of the pregnant women are used OTC medicines at least one time during their pregnancy, however most of the participants don’t believe in the safety of these non-prescription drugs as well as herbal products (92%, 86% respectively). Vitamins and minerals were the most used medicines during pregnancy (83% for folic acids, 51% for Iron). Most of pregnant women in this study were aware about the use of analgesics (13% for paracetamol). These findings were an indicator to the low level of knowledge and information about the use of OTCs where the pharmacists should improve their counselling skills and their new roles regarding health promotion and pharmaceutical care.Â