A diabetic foot ulcer is one of the most significant and devastating complications of diabetes. DFU is considered a major source of morbidity and mortality in patients with diabetes. Therefore, this study aimed to test the possibility of using Aloe Vera resin extract as an antibacterial agent (Libyan remedy) against isolated bacteria from a patient's foot. This study was concerned with the determination of the possible microbial cause of the diabetic foot ulcer; therefore, its design included microorganism isolation, identification, and finally, testing of the antibacterial activity of Aloe Vera resin against bacteria isolated from diabetic foot ulcers. Curiously, the results demonstrated that every antibiotic used in this experiment created inhibition zones against the bacteria that were isolated from patients' feet and had a pronounced resistance to the extract from aloe vera resin. In contrast, aloe vera resin extract created inhibition zones against bacteria isolated from healthy feet in comparison to the other widely used, well-known broad-spectrum antibiotics. The pathogen that was isolated from the patient's feet, according to our lab results, was Staphylococcus bacteria. Aloe Vera resin extract had no inhibition zones against Staphylococcus species bacteria that were collected from patient feet, which contradicted the hypothesis that Aloe Vera is a good antibacterial agent that could be used to prevent diabetic foot ulcers. Nonetheless, it demonstrated a slight antibacterial effect on normal flora foot bacteria. Bacterial resistance due to possible mutations could be the cause of this. It is also important to take into account the anti-inflammatory properties of aloe Vera resin extract.

The global pandemic Coronavirus Disease 19 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Many patients with life-threatening illness due to COVID-19 die from hypoxic respiratory failure, which appears to be related to a cytokine storm syndrome leading to Acute Respiratory Distress Syndrome (ARDS). While steroids have some demonstrated benefits, supportive care remains the mainstay of treatment. However, in the absence of vaccines and proven treatments, during this current pandemic, we are considering repurposing currently available medications; one of the first is cotrimoxazole (CTX), which was one of the earliest medications for treating and preventing opportunistic infections caused by the human immunodeficiency virus (HIV), among other things. Cotrimoxazole in combination with folic acid is inexpensive, familiar to the public, and generally well tolerated, and treats secondary infections. Low cost and a good safety profile can make it an ideal candidate for the treatment of COVID-19 in a low-resource country like Libya. Here we report our observations with cotrimoxazole added to standard therapy in patients with severe COVID-19. Prospective data were gathered from consecutive newly diagnosed patients who presented to the Msallatah Isolation Center (Corona Center), Msallatah, Libya, between June and September of 2021 with critical COVID-19 on non-invasive ventilation and receiving standard therapy (ST) along with 480 mg oral cotrimoxazole (CTX). The first four days served as a control period during which patients with critical COVID-19 received only standard treatment. After a 4-day control period during which the patients received ST alone, nine patients (mean age ± SEM 40.5 ± 10.5 years, 66.66 percent male) were identified because they received CTX in addition to ST. We found that patients with critical COVID-19 who received CTX in addition to ST experienced significantly better outcomes, such as lower in-hospital mortality (0%), higher blood levels of D-Dimer (3735±579.9 mg/L versus 444.82±182.14 mg/L, p˂0.05), and improvements in respiratory rate (36.42±3.9 mg/L versus 25.6±2.9 mg/L, p˂0.05) and CRP at the fourth day of the experiment (142.12±34.7 mg/L versus 72.4±19.26 mg/L, p˂0.05). These results demonstrate the beneficial effects of using cotrimoxazole in patients with severe COVID-19; it could help to reduce the need for respiratory support for thousands of patients, saving valuable lives and decreasing the burden on the healthcare system in countries with limited resources. The mechanism of action of cotrimoxazole in this situation is not clear; however, these outcomes may be due to the antibiotic activity and/or the anti-cytokine effects of cotrimoxazole. Further trials are needed to test our observations.

A recent years. They have evolved into analysis of tumor Abstract— Multiplexed platforms have become a standard feature of modern medicine in the field of histopathology in recent years. They have evolved into powerful technologies that enable image analysis of tumor tissues from formalin- fixed paraffin- embedded specimens, aiming for better assessment of morphology and distinctive alterations at the molecular level of the patient’s sample, which is critical for the pathologist’s diagnosis and classification, with significant implications for the following therapeutic options. And also, in order to gain a better understanding of the tumor microenvironment, which aids cancer prevention by simulating new therapy discoveries. And unlike traditional IHC, which can only identify one marker in a tissue sample, multiplex IHC may detect many markers in a single tissue sample while providing detailed information about the cell composition and spatial arrangement. Reviewing multiplexed technologies is to demonstrate their utility in the study of cancer tissue as well as their benefits for applications in cancer diagnosis, stratifying patients, and accuracy for treatment. Summary: Digital pathology plays a significant part in current clinical practice and becoming an increasingly critical technological necessity in the laboratory environment, Algorithms for image analysis and artificial intelligence have the potential to further increase the quality of diagnostics in pathology. Keywords— Digital pathology; Molecular diagnostics; IHC & MIHC Techniques; cancers. 

Abstract

Gall bladder cancers, predominantly adenocarcinomas, are associated with significant malignancy and are more common in women, especially in their seventh decade of life. This study aims to evaluate the prevalence, distribution, and histopathological characteristics of gall bladder tumors, emphasizing the need for early diagnosis and understanding the role of chronic cholecystitis in tumor development. A retrospective analysis was performed on 45740 surgical biopsies, including 3107 cholecystectomies, from 1994 to 2007 at Misurata Medical Center, Libya. Data collected included patient demographics, clinical details, and microscopic diagnoses. Biopsy samples were processed and stained, and histopathological evaluation was performed following standard criteria. The study showed a female predominance in gall bladder tumors with a female: male ratio of 3:1. Most tumors were adenocarcinomas (83.33%), with high and moderate differentiation being the most frequent. Tumor diagnoses were most prevalent in the 51-65 age group. The majority of tumors were diagnosed at advanced stages (3 and 4). Tumor invasion was common, with 75% showing perivascular, intravascular, or perineural involvement. Chronic cholecystitis was observed in more than two-thirds of the tumor cases. Chronic inflammation is closely linked to gallbladder carcinogenesis, with most tumors diagnosed at advanced stages due to vague symptoms and aggressive behavior. Early detection and multidisciplinary approaches are vital to improve outcomes, especially in high-risk groups.

Abstract

Microscopic diagnosis of gastrointestinal biopsies remains a challenge in surgical pathology, involving both neoplastic and non-neoplastic changes. This study aims to analyze the prevalence, histopathological features, and grading of gastrointestinal (GIT) tumors in biopsies collected over 12.5 years at Misurata Medical Center, Libya, while assessing demographic patterns and the correlation of Helicobacter pylori infection with gastric malignancies. A total of 753 GIT biopsies were retrospectively analyzed from 1995 to 2007. Clinical data, including age, sex, and microscopic diagnoses, were documented. Biopsies underwent histopathological evaluation using the World Health Organization (WHO) classification. Statistical analyses were performed using SPSS software to explore relationships between neoplastic lesions and demographic factors. Non-neoplastic diseases accounted for 559 cases, which constitute 74.24% of the total cases, while neoplastic lesions were identified in 194 cases (25.76%). with a statistically significant predominance of malignant tumors (68.6%) over benign ones (31.4%, p<0.001). A slight male predominance was observed in overall biopsies (52.2%), with the 61-70 age group showing the highest frequency (17.4%). Well-differentiated tumors were more common, correlating with better prognoses. The TNM staging analysis revealed a concerning trend toward late-stage diagnoses, particularly in stomach and colorectal cancers. The investigation into Helicobacter pylori positivity indicated a complex relationship with gastric malignancies, warranting further research. The findings reflect a high burden of GIT malignancies during the study period, with late-stage diagnosis and limited diagnostic resources. These results underscore the need for improved screening programs, early detection efforts, and enhanced diagnostic infrastructure in Libya. The study underscores the importance of understanding the multifactorial influences of Helicobacter pylori in gastric cancer development.

Abstract

Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. This study investigates the prevalence of PCOS, focusing on patient-related and disease-related factors. A cross-sectional survey was conducted to explore obstetricians' and gynecologists' perspectives on the diagnosis, prevalence, and management of PCOS. A total of 35 specialists, each with at least three years of clinical experience, participated. The survey included open-ended questions covering patient-related factors (e.g., symptoms, lifestyle) and disease-related aspects (e.g., prevalence, diagnostic methods, treatment). Data were collected through face-to-face interviews from January to April 2022, ensuring confidentiality and standardized procedures to minimize bias. This study analyzed PCOS's prevalence, etiology, symptoms, diagnosis, and treatment. The highest prevalence (62.9%) was observed in the 20–29 age group, declining with age. Unknown causes accounted for 51.42% of cases, followed by hormonal and genetic factors (41.42% each). Menstrual irregularity (80%) was the most common symptom. Ultrasound was the primary diagnostic tool (82.85%), while metformin was the most prescribed treatment (71.42%). PCOS was the most prevalent condition among gynecological disorders (57.14%). These findings highlight the significant burden of PCOS and the need for improved management strategies. Our study concluded that the PCOS remains a significant health concern both globally and within Libya. Highlights the necessity for heightened awareness, early screening, and tailored management strategies. Further research is warranted to explore the underlying causes of regional prevalence variations and to develop culturally appropriate interventions that address the unique needs of the Libyan female population.

Keywords: PCOS, Hyperandrogenism, Endocrine Disorders, Infertility.

Abstract

A hallmark of malignancy is the ability of a tumor to disseminate and metastasize, a process that requires specific cellular adaptations. The American Joint Committee on Cancer developed the TNM staging system to classify malignancies and guide treatment strategies, reflecting the biological behavior and clinical outcomes of cancers. Despite its usefulness, ongoing efforts aim to identify additional diagnostic and prognostic parameters to improve accuracy and treatment outcomes. One such parameter is tumor budding, a distinctive morphological feature observed in epithelial cancers. tumor budding is characterized by single tumor cells or small clusters of up to four cells that detach from the invasive front and invade the surrounding stroma. First described in colorectal cancer, tumor budding has since been widely investigated and recognized as a predictor of adverse outcomes, including lymph node invasion, local and distant metastasis, lymph vascular invasion, and poor survival rates across multiple cancer types. Independent of pathological stage, tumor budding correlates with aggressive tumor behavior, highlighting its prognostic significance. In urothelial cancers, tumor budding has been linked to stage progression, distant metastasis, and survival outcomes, particularly in non-muscle invasive bladder cancer and muscle-invasive bladder cancer. This review examines the mechanisms underlying tumor budding, its clinical significance across various tumor types, and its prognostic implications in epithelial cancers. Understanding these factors could provide valuable insights into integrating tumor budding into routine pathological assessments and improving cancer management strategies

Abstract

This study aimed to assess bariatric obesity surgery as an alternative to anti-obesity strategies. Forty-five bariatric patients were consecutively selected for participation. Information on each patient's demographics, weight, height, and comorbidities was gathered, followed by the use of the Bariatric Quality of Life Questionnaire. 60% of patients reported feeling exhausted prior to the procedure; however, this percentage dramatically decreased to only 33.33% after bariatric surgery. Furthermore, before surgery, 66% of patients had a history of sleep apnea and breathing cessation during sleep, and 46% of patients had a history of snoring. Following the bariatric procedure, these problems were fixed. The psychiatric assessment section indicated that 53.33% of patients experienced depression following gastric surgery. Additionally, 46.66% of patients reported persistent feelings of anger and anxiety. Post-operative concerns included fears of gastric leaks, loss of happiness, diminished passion, remorse after surgery, sleep disorders, and suicidal thoughts, each occurring at varying rates. Only 33.33% of participants had received psychological support. Patients frequently report significant improvements in their health and quality of life after bariatric surgery, which is the most long-lasting and successful treatment option for morbid obesity. However, a significant minority of patients experience psychological complications, including, but not limited to post post-gastric surgery depression, patients always feel angry and have anxiety.

Abstract— Cancer is a disease in which some of the body’s cells grow out of control and spread to other body parts. cancer is an ongoing global challenge. It is a leading cause of disease worldwide. Most cancer deaths each year are related to lung, colorectal, stomach, and breast cancers. Detection of disease in early stages, enabling more effective treatment and reducing morbidity and mortality. This study aimed to assess the prevalence of different types of cancers in Libya. Methods: A retrospective study was carried out, the data was collected by visiting the Oncology Centre in Misrata, reviewing the records, and recording data on the prevalence of different types of tumours from 2018 to 2022. Results: The number of cases rises every year, the overall number of cancer cases is rising annually: 1198 cases were reported in 2018, 1143 cases in 2019, 1422 cases in 2020, 1533 cases in 2021, and 1640 cases in 2022. The breast cancer was the most prevalent type of cancer during the period 2018-2022, the following results were recorded 21.45%, 20.9%, 22.6% 24.9% and 23.7% respectively. Followed by colon cancer was recorded at 16.4%, 15.7%, 17.2%, 18.4% and 15.6 respectively, followed by lung cancer was recorded at 7.8%, 7.9%, 10.6%, 8% and 9%. the fourth to ten grades are often confined between lymphoma, ovary, prostate, leukemia, pancreas, sarcoma and brain tumor. According to our results, we concluded that there is a clear increase in the number of cases of various types of cancer in Libya every year. Early detection is the first line of defence against this dangerous disease. People need to be sensitised to regular check-ups. The government should provide the requirements for detection and treatment.

Keywords— Breast cancer, Colon cancer, Lung cancer, Lymphoma, Ovary cancer, Prostate cancer, Leukemia, Pancreas cancer, Sarcoma and Brain tumor, Prevalence of cancer in Libya.

ABSTRACT

Diagnostic radiation such as X-rays and CT scans play a central role in the diagnosis of diseases. Excessive radiation exposure poses a high risk for healthcare providers as well as patients, which may cause serious diseases such as cancer. Providing protection requirements in the radiation departments and continuous inspection to prevent radiation leakage is the right way to provide human protection. The current study aimed to evaluate the safety rate in the diagnostic radiology departments in Alkhoms City. The questionnaire designed for the study in Arabic language, presented to experts for verification and review, then distributed to eleven medical centres in the Alkhoms region containing many relevant questions regarding the radiology department such as the name and address of a medical centre, in-formation about users and safety. Lead plates are present in 91% of health centres 36% of health centres installed lead plates for 1-5 years, 27% for 6-10 years, and 36% for 21 years or more. Lead plates are inspected once in 27%, three times in 9%, and four times or more in 9% of medical centres, on the other hand, 56% of medical centres didn’t inspect lead plates since installed. The lead plates last examined in 27% of medical centres a year ago, in 9% examined less than five years ago, and in 9% examined less than twenty years ago. On the other hand, 56% of medical centres have not performed any check-ups since installation. Protection glass and lead plates are present in 82% of medical centres, a radiation protection gown is present in 36%, and a dosimeter is present in 9% of medical centres only. Only 18% of health centres have organised a training programme for their radiology department staff. The safety rate in radiology departments in Alkhoms City- Libya is low because most medical centres lack protective equipment, and if they do, there is no regular inspection or testing of this equipment.

Key words: X-rays, Radiation, CT, Risk of radiation, Dosimeter.