Libya faces a severe shortage of medical educators due to prolonged political instability, emigration of health care professionals, and expansion of medical schools. The Libyan medical diaspora represents an untapped resource that could support the advancement of undergraduate medical education in Libya through remote teaching, mentorship, and curriculum development. This study examines the perceptions, willingness, and practical challenges of involving Libyan medical diaspora in undergraduate medical education within their home country. It also explores technological and policy-based solutions to enhance diaspora engagement. A cross-sectional online survey was distributed to a convenience sample of Libyan doctors at home and abroad. We captured demographic details, prior educational engagement, attitudes toward diaspora involvement, and perceived barriers and enablers from 145 responses. Almost half (47.6%) were diaspora doctors. A strong majority (74.5%) believed the diaspora could contribute meaningfully to undergraduate education, particularly through clinical training (79.3%) and e-learning (73.1%). Over 84% expressed a willingness to teach virtually, although significant barriers included a lack of institutional coordination (74.5%) and inadequate technological infrastructure (53.1%). Key enablers identified included structured engagement programs, financial incentives, and international academic partnerships. Libyan doctors in diaspora are largely willing and well-positioned to support undergraduate medical education in Libya. Strategic policy action, digital infrastructure development, and institutional coordination are crucial to effectively mobilize this potential. These findings support the case for implementing structured diaspora engagement policies in fragile states.
Although uncommon, clavicle refracture following plate removal poses a major clinical concern. Identifying risk factors may help guide decisions on patient selection for plate removal. The study aims to systematically review and meta-analyze the available literature on risk factors associated with clavicle refracture after plate removal. We conducted a search in PubMed, Scopus, and ScienceDirect and included studies that compared patients with and without refracture after clavicle plate removal. Risk factors were pooled using odds ratios (OR) and standardized mean differences (SMDs), with a random or fixed-effects model depending on heterogeneity. The Newcastle-Ottawa Scale was used to appraise the quality of studies. Five retrospective studies were included, comprising a total of 1,135 patients who met the inclusion criteria. We found that female gender (OR: 0.30; 95% CI: 0.18–0.51) was associated with a lower observed refracture incidence, although this finding is likely confounded. In contrast, lower body weight SMD: 0.65; 95% CI: 0.28–1.03), smaller clavicle diameter (SMD: 0.57; 95% CI: 0.15–0.98), and shorter clavicle length (SMD: 0.68; 95% CI: 0.26–1.09) were significantly associated with an increased risk of refracture. This is the first meta-analysis to identify risk factors for clavicle refracture following plate removal. These findings may inform cautious risk–benefit discussions but do not support individualized prognostication at this time. Overall, the certainty is low, and these results should be interpreted as hypotheses to be tested in future studies, rather than as definitive predictors to guide clinical decision-making.
Parallel or orthogonal plating is used to treat supracondylar intercondylar (SCIC) fractures of the humerus. The aim of the study is to determine the short-term functional outcomes of orthogonal plating in adult patients with SCIC fractures of the humerus and the factors affecting these outcomes. We conducted a prospective study between 2017 and 2020, following approval from the Institutional Ethics Committee. Twenty-six patients, aged 20 to 70 years, were included in the study. Patients with open fractures, severe soft tissue injuries, or comminution were excluded. We performed orthogonal plating for fixation. The outcomes were analyzed using the rating of Jupiter et al. Mann–Whitney U and Kruskal–Wallis tests were used to analyze the factors affecting the outcomes. Most patients were males aged between 20 and 29 years. Most of the patients underwent surgery between 18 and 24 hours. The low T-type fracture pattern was the most common. Among male patients, 10 were rated as excellent, three as good, and one as fair. However, among females, four received excellent ratings, four received good ratings, three received fair ratings, and one received poor ratings. Males had a significantly better rating than females (p-value of 0.03). Younger patients had better outcomes (p-value of 0.04). The mode of injury and laterality were not significantly associated with the final rating (p-value >0.05). Orthogonal plating ensures stable fixation and good outcomes for SCIC fractures of the humerus. We got better outcomes in younger patients.
Most Libyan universities are ranked very low—or are entirely absent—from international university rankings. This review article explores the multifaceted causes of this disappointing status along two main lines: systemic biases inherent in most international ranking frameworks and major internal challenges within the Libyan higher education system. We demonstrate how international ranking criteria tend to favor well-established Western institutions while disadvantaging counterparts in developing nations. At the same time, the article highlights specific internal issues within Libyan higher education that hinder performance and limit international competitiveness. There is, in fact, a continuous and synergistic interaction between these external biases and internal deficiencies, which together exacerbate the poor global standing of Libyan universities. Ultimately, the article concludes with a mission-level set of specific recommendations aimed at helping policymakers and university administrators implement strategic improvements to strengthen the core competencies of Libyan universities and, consequently, enhance their global rankings.
The effect of fast food, carbonated drinks, and socioeconomic status on BMI among school children in Benghazi. This article determines the prevalence of obesity and overweight and their relationship with environmental factors among children aged 7 to 12 years at a primary school in Benghazi, Libya. This cross-sectional study was conducted from October to November 2023 across primary schools in Benghazi, Libya, involving children aged 7 to 12 years (n = 384). Data were collected via a structured questionnaire: researcher staff recorded demographics and anthropometrics (height and weight using standardized protocols), while parents reported lifestyle factors (diet, physical activity, socioeconomic status). Body mass index (BMI) was calculated (kg/m2), and associations were analyzed using chi-square tests (SPSS v23; p < 0.05). Ethical approval was obtained, with written parental consent and anonymized data. This study revealed comparable obesity rates between genders, with 28.1% of boys (54/192) and 27.2% of girls (52/191) classified as obese, with no significant association between gender and BMI (chi-square = 0.18, p = 0.981). Significant relationships were found between obesity and key modifiable risk factors: frequent fast food consumption (chi-square = 56.32, p < 0.001), high carbonated beverage intake (chi-square = 142.07, p < 0.001), physical inactivity (chi-square = 23.4, p = 0.001), and higher family financial status (chi-square = 23.41, p < 0.001). Obese children exhibited extreme patterns of sedentary behavior (90.6% inactive) and sugary drink consumption (90.6% ≥ 3 times/week). A socioeconomic paradox emerged, with obesity prevalence highest in wealthier families while underweight status was associated with poorer economic conditions. The high prevalence of childhood obesity in Benghazi, surpassing rates reported internationally, underscores an urgent public health crisis driven by modifiable dietary and lifestyle factors. These include eating too much fast food and sugary drinks, not getting enough exercise, and unhealthy eating habits in wealthier families. These problems can be fixed through limiting junk food, making sure that kids are active every day, and teaching healthy eating habits. If we take these steps now, we can help children in Benghazi grow up healthier.
This review examines the evolving landscape of constrictive pericarditis (CP) through analysis of literature spanning 1932 to 2025, sourced from PubMed, Scopus, and Google Scholar using key terms related to the etiology, clinical features, diagnosis, and treatment of CP. Eligible literature included original research articles, systematic and narrative reviews, case reports, expert consensus statements, and guidelines from professional societies. CP is a chronic pericardial disease resulting in impaired ventricular filling and heart failure symptoms. While previously dominated by tuberculosis and idiopathic cases, its modern etiological profile has shifted significantly. This review explores the evolving causes, clinical features, diagnostic advances, and treatment strategies of CP in the current medical practice. Modern causes of CP include prior cardiac surgery/percutaneous intervention, radiation therapy, autoimmune diseases, viral pericarditis, and uremia associated with end-stage renal disease. Modern imaging modalities—particularly echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging—have improved diagnostic accuracy and helped differentiate CP from other causes of heart failure. Features such as pericardial late gadolinium enhancement and elevated inflammatory markers help identifying reversible subset of the disease, which may respond to anti-inflammatory therapy. In chronic, fibrotic cases, surgical pericardiectomy remains the definitive therapy, with outcomes improved by early diagnosis and appropriate timing of surgery. CP is no longer a relic of the past, but a dynamic condition shaped by modern medicine. Recognizing its evolving etiologies is critical for timely diagnosis and individualized treatment. With advances in imaging and inflammation-targeted therapies, opportunities exist to improve outcomes and reduce reliance on surgery in selected cases.
Background Dental aesthetics and attractive, harmonious smiles contribute significantly to patients' decisions regarding treatment preference. Aims This article investigates the existence and suitability of golden proportion, golden percentage, and recurring aesthetic dental (RED) proportion in Libyan dental students with natural dentition. Methods This prospective cross-sectional observational study comprised 73 Libyan dental students who met the inclusion criteria (34.2% males and 65.8% females with a mean age of 25 ± 3.0 years). A photograph of the six anterior maxillary teeth was taken for each participant, and the apparent width of each was extracted digitally. Subsequently, the golden proportion, golden ratio, and the RED ratio were computed and compared with their corresponding standard notions. Descriptive and inferential analyses were performed at p < 0.05. Results There were no significant sex differences for all variables. Therefore, the data was pooled together for further analysis. The Libyan golden proportion differed significantly from their corresponding standard values at p < 0.05. A similar significant discrepancy was observed in the golden percentage except for the maxillary left lateral incisors (p = 0.206). Furthermore, the mean values of the RED proportion were not constant, and the mean ratio increased moving distally, which did not align with the standard RED proportions. Conclusion The proposed golden proportions, golden percentage, and RED rations were not pertinent to our cohort of Libyan dental students. Anterior tooth proportions vary among populations according to their ethnicity and geographic background. Therefore, proportions should be utilized based on the same population and ethnicity.
Background Diabetes mellitus is a noncommunicable chronic disease that is becoming prevalent among the youthful population. Aim This study assessed diabetic awareness, knowledge, attitude, and practices among undergraduates of a Nigerian university. Methods Descriptive cross-sectional study was conducted among 310 consenting undergraduates that completed a self-administered questionnaire on diabetes and diabetic self-care. Data collected were analyzed using descriptive and inferential statistics. Results The undergraduate age ranged from 16 to 30 years with the majority less than 20 years (55.5%), females 53.8%, Yoruba (87.4%), and second-year students (34.2%). Although a majority (85%) was aware of diabetes mellitus, 53% had poor knowledge, 70% had a negative attitude, and 60% had poor practices toward diabetes mellitus and diabetic self-care. Significant predictor of poor knowledge was being female (adjusted odds ratio 4.56; 95% confidence interval 2.79–7.45; p = 0.0001). Conclusion Despite high diabetes awareness, the knowledge, attitude, and practices were poor among undergraduates. There should be continuous education program on diabetes and diabetic self-care among the students.
Agenesis of the psoas minor muscle is very common as it can be absent in approximately 56% of the population. Moreover, previous three case reports described hypoplasia of the psoas muscle. However, our case had complete agenesis of the three iliopsoas muscle components on the right side. A 26-year-old woman presented with right-side weak hip flexion that had persisted for 2 years. Magnetic resonance imaging revealed complete agenesis of the right iliopsoas muscle, and no spine pathology was detected. Radiologists should put agenesis of the iliopsoas muscle into consideration in patients presented with weak hip flexion especially when no spine pathology is detected. Follow-up is advised to study the long-term effects of iliopsoas muscle agenesis. To the best of our knowledge, we believe that this is the first report in the general literature.
Background Ambulatory surgical procedures are integral aspects of oral and maxillofacial surgical (OMS) practice. Objective The aim of this study is to report the scope of ambulatory OMS procedures in a Nigerian suburban teaching hospital. Method A retrospective review of ambulatory OMS procedures performed at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, between March 2021 and February 2022 was conducted. Sociodemographic data, diagnoses, procedures, type of anesthesia, and immediate postoperative complications were retrieved from patients' records. Data were analyzed using the Statistical Package of Social Sciences (SPSS) version 22. Results Two hundred and fifty-two ambulatory OMS procedures were performed during the 12-month study period. This accounted for 80.3% (252/314) of elective surgeries. The patients' mean (standard deviation [SD]) age was 32.2 (10.4) years, while a slight male preponderance (51.6%) was recorded. Third molar surgery was the commonest (48.0%) procedure undertaken in ambulatory setting. Most (90.9%) of them were performed under local anesthesia. Satisfactory postoperative pain control was achieved with the use of oral nonsteroidal anti-inflammatory analgesics in most patients (81.7%). However, owing to a failed ambulatory session, there was an eventual admission rate of 0.4% (1/252). Conclusion Ambulatory surgical procedures constitute the majority of the OMS elective cases, with third molar surgery being the commonest procedure. Judicious prescription and administration of oral analgesics were effective in managing postoperative pain in our day case OMS patients. We recommend a prospective study to determine an intermediate/long-term outcome of care in ambulatory settings.
Background Endothelial cell density and morphology vary across ethnic groups. Aim This article investigates the corneal endothelial cell density and morphology in healthy Libyan eyes. Methods A 3-month cross-sectional observational study was conducted at Benghazi Teaching Eye Hospital, involving 198 eyes of 100 healthy Libyan participants. The noncontact Topcon specular microscope (SP-1P model) was used to assess the following parameters: the mean central corneal thickness (CCT), the mean cell density (MCD), the mean coefficient of variation (CV%), and the mean percentage of the hexagonal cell (Hex [%]). The variables were analyzed in relation to age and gender using the Statistical Package for the Social Sciences (SPSS version 25.0) Results The mean age of participants in this study was 47.4 ± 13.8 years (range 21–75 years). The mean CCT was 516.45 ± 43.04 μm, the MCD was 2664.30 ± 371.26 cells/mm2, the mean CV% was 32.3% ± 3.7, and the mean Hex (%) was 52.8% ± 9.6. There was no statistical difference in the age, CCT, and MCD across genders. Whereas CV (%) and Hex (%) showed significant gender differences (p < 0.01 for both). There was a significant negative weak correlation between CCT (r = –0.10) and age, as well as a significant negative moderate correlation between MCD and Hex (%) with age (r = –0.36 and r = –0.31, respectively). CV% exhibited a significant, moderately positive association with age (r = 0.35). The higher endothelial cell loss rate of 8.4% was in the third decade of life whereas other age groups ranged between 1.1 and 2.7%. Conclusion The normative data for the endothelium of Libyan eyes are reported, which can be used as a baseline for future studies.
Background Color vision deficiency (CVD) is a common disorder caused by damage to retinal photoreceptors and cones. The disorder makes a person less able to perceive color variations. Aims The objective of the study was to assess the prevalence of CVD among the school children in Benghazi, Libya. Methods This cross-sectional study was performed in the Department of Ophthalmology, Benghazi University, Benghazi, Libya, during the period from December 2023 to March 2024. The study included 1,022 students aged 6 to 18 years to assess the prevalence of CVD. Visual acuity assessment was performed in a place with good daylight illumination using the standard Snellen Tumbling E chart at a distance of 6 m. Color vision evaluation was performed in the schools using Ishihara color plates (24 plate–edition). The quantitative variables were presented as mean ± standard deviation, and the qualitative variables were presented as frequencies and percentages. The Student's t-test was used for comparing means, whereas the chi-square test was applied for comparing the frequencies. A p-value of < 0.05 was considered statistically significant. Results CVD was present in 15 cases (1.5%). There were 13 males (2.6%) and 2 females (0.38%) with a statistically significant difference regarding gender. Among the 13 males with CVD, 7 students (53.8%) had deuteranomaly, 2 students (15.4%) had deuteranopia, 1 student (7.7%) had protanomaly, and 3 students (23.1%) had color blindness. The two females with CVD both had deuteranomaly. Conclusion Early detection of CVD is vital to making informed decisions about a student's future career. With early detection, parents and teachers can adjust their educational strategies to ensure the best learning outcomes for the student.
Background A pregnant woman with dental issues may not see a dentist unless her gynecologist advices her to do so. Thus, gynecologists need to be aware of the impact of dental health on pregnancy and what pregnant women need to do to improve their dental health. Aim The aim of this study is to evaluate gynecologists' awareness, understanding, and practice regarding the impacts of dental therapy during pregnancy and the influence of dental disease on pregnancy outcomes. Methods All the data in this cross-sectional study were acquired from gynecologists in public and private hospitals in Benghazi, Libya, over a period of 6 months during 2022. A modified structured questionnaire developed by Paneer et al consisting of 20 closed-ended questions related to oral care of pregnant patients was given to the participating gynecologists. Data obtained were presented as frequencies and percentages using the SPSS statistical package. Results Sixty gynecologists, with ages ranging from 35 to 65 years, completed the questionnaire. The majority (81%) recognized that pregnancy increases the risk of gingival inflammation, but only 60% attributed this to hormonal changes. While 45% were aware of the impact of periodontal inflammation on pregnancy outcomes, only 38.3% knew about its association with preterm birth and low birth weight. Most participants (83%) considered dental referral important, and 81.7% believed oral cavity examination should be a part of maternal health, yet only 36% actually performed it. Ninety percent of the participants reported that they advise pregnant women on oral hygiene and routine checkups. Regarding safety, only 46.7% believed radiographs to be safe during pregnancy, and 51.7% considered local anesthesia with vasoconstriction safe. However, 95% agreed that the second and third trimesters are the safest period for dental treatment. Conclusion The results of the current study show that gynecologists are fairly knowledgeable about the link between dental health and pregnancy. There is, however, unquestionably some miscomprehension about offering dental care to expectant mothers. Pregnant women and the medical community need access to more information, and misconceptions about suitable dental procedures during pregnancy must be addressed to improve oral health care.
Background Hypertension is one of the major causes of related maternal deaths worldwide and it is one of the most common medical disorders encountered during pregnancy. Aim This study aimed at assessing the demographic and medical characteristics of hypertensive pregnant women in two secondary healthcare facilities, in Ilorin, Nigeria Method This was a cross-sectional study among 104 pregnant women with hypertension attending the outpatient department of General Hospital and Civil Service Clinic, Ilorin between March and May 2021. A validated self-administered questionnaire was used to obtain information on sociodemographics. Data on the medical characteristics of the respondents and their medications were extracted from the respondent's medical files. Ethical approval was obtained from the Ministry of Health and General Hospital, Ilorin. For statistical analysis for categorical measurements, the frequencies and percentages were computed. Results Seventy-five percent of the correspondents were below 36 years old, 97% were married, 79% had tertiary education, and 74% were above 24 weeks of gestation. About 68% of the correspondents had blood pressure more than or equal to 140/90 and 10% had blood pressure more than 160 mm Hg systolic or more than 100 mm Hg diastolic. About 78.8% of the correspondents had a family history of hypertension, 13.5% had a family history of diabetes mellitus, and 22.1% had a family history of obesity. About 27.9% had pre-existing hypertension, 61.5% developed hypertension before the end of 20 weeks of gestation, and 10.6% developed hypertension after 20 weeks of gestation. About 24% had their antihypertensive medication changed during pregnancy, 38.5% were treated with methyldopa, 31.7% with nifedipine, and 27% with nifedipine and methyldopa. Majority (83.6%) of the respondents were not adherent to their medications. Conclusion Two-third of the patients had poor blood pressure control irrespective of the fact that all were under drug therapy. Family history and large body mass index are the main risk factors for the development of hypertension during pregnancy. Noncompliance may play a significant role in no drug response.
Background Glaucoma is a prevalent cause of visual impairment, and early detection is critical to prevent progressive vision loss. Optical coherence tomography angiography (OCT-A) enables visualization of retinal and optic nerve microvasculature and holds promise for early glaucoma detection. Aims This study aims to assess microvasculature density alterations in glaucoma using OCT-A. Methods An observational cross-sectional case–control study was conducted at Benghazi Eye Hospital in Libya from December 2022 to August 2023. It included 160 eyes of 126 patients diagnosed with primary open-angle glaucoma and 120 eyes of 96 control subjects. OCT-A was performed using the Swept-Source OCT DRI Triton. Vessel density measurements were obtained from OCT-A images using new built-in software within the device. The data presented as mean ± standard deviation and percentages were analyzed using SPSS. The statistical significance of the differences between different groups was determined using independent t-tests, and the level of significance was set at p-value less than 0.05. Results OCT-A demonstrated significantly reduced microvasculature density in glaucoma eyes across all optic nerve sectors including the inferior (29.0%), superior (25.2%), central (23.5%), nasal (9.9%), and temporal sectors (9.3%; p < 0.02). Moreover, glaucoma patients exhibited a significant reduction in vessel density in the superior macula (17% reduction), the temporal (15.7%,), nasal (12.9%), and inferior sectors (12.6%) (p < 0.002). No statistical difference was seen with vessel density of the central sector (0.49%, p >0.05). Conclusion OCT-A demonstrated significant reductions in microvasculature density in glaucoma patients compared with healthy controls. These findings support the association between glaucoma and vascular changes. Additionally, the TOPCON Swept-Source OCT DRI Triton new software shows promise as a valuable tool for early detection and monitoring of glaucoma-related vascular changes.
Superficial femoral artery injury due to bone fragment of femoral fracture is often overlooked as it occurs only in rare cases of femoral fractures and the onset of symptoms usually happen weeks or even months later. The deep femoral artery, in fact, is more susceptible to injuries associated with femoral fractures. Moreover, a preexisting calcification lesion of the arterial wall might enhance the chance of such arterial injury, a condition that we noticed in the case we are reporting. We will illustrate a rare case of calcified superficial femoral artery injury complicating subtrochanteric femur fracture.
