Benghazi University Medical Journal

Academic Achievement in Children and Adolescents with Type 1 Diabetes

2026-07-12T08:38:05+00:00

Background: Type 1 diabetes (T1D) is a chronic disease affecting children and adolescents, which may impact their academic achievement.

Objective: To evaluate the clinical impact of T1D on academic achievement in children and adolescents and compare scholastic achievement with their non-diabetic peers.

Methods and Materials: A prospective case-control study was conducted in the Pediatric Endocrinology Department at Tripoli University Hospital between February and May 2025, after obtaining ethical approval and parental consent. The study included 120 Libyan children and adolescents with T1D, aged 6–18 years, who were enrolled in formal schooling. Data on demographics, disease characteristics, glycemic control, and academic achievement were collected. Statistical analyses assessed associations between variables.

Results: Good glycemic control (HbA1c 6–8%) was observed in 55% of patients and was strongly associated with better academic achievement (P = 0.001). Children with well-controlled diabetes demonstrated academic achievement similar to that of their non-diabetic peers. Conversely, non-diabetic children achieved significantly higher mean grades than diabetic children with poor glycemic control. No significant associations were found between academic achievement and age, gender, or age at disease onset, including onset before school entry (P > 0.05). Parental education was significantly associated with academic achievement (father: P = 0.008; mother: p = 0.001). Factors significantly associated with glycemic control included hypoglycemia frequency (p = 0.030), hospital admissions (p = 0.046), ICU admissions (P = 0.02), and treatment modality (p = 0.001). Chronic complications and associated diseases had no significant impact on academic achievement.

Conclusion: Good glycemic control and effective diabetes management were associated with a better academic achievement. Parental education and treatment modality significantly influence glycemic control. T1D, in the absence of poor glycemic control, does not significantly impair academic achievement.

Clinicopathological Profile and Treatment Stratification in Urinary Bladder Cancer

2026-07-13T09:33:11+00:00

Background: Urinary bladder cancer (UBC) exhibits marked heterogeneity in its clinicopathological characteristics, which directly influence treatment strategies and disease behavior. Understanding the correlation between pathological features and therapeutic approaches is crucial for optimizing patient management. Aim: To evaluate the interplay between clinicopathological characteristics and treatment modalities in urinary bladder cancer and their implications for tumor behavior and clinical decision-making. Materials and Methods: This retrospective cohort study was conducted at the Department of Urology, Faculty of Medicine, Benghazi, in collaboration with the National Cancer Center, from January 2022 to December 2025. A total of 100 cases diagnosed via transurethral resection of bladder tumor (TURBT) and radical cystectomy were included. Non-neoplastic lesions were excluded. Data on demographics, clinical presentation, histopathology, tumor stage, grade, invasion status, and treatment were analyzed. Chi-square tests were used for associations, with p < 0.05 considered significant, with the calculation of odds ratios (OR) and 95% confidence intervals (CI). Results: The data showed marked male predominance (91%; ratio 10.1:1) with a mean age of 60.2 ± 4.4 years. Most patients (90%) were aged 40–80 years. Painless hematuria (58%) and smoking (87%) were predominant. Urothelial carcinoma accounted for 92% of cases. Muscle-invasive disease was present in 62%, and 66% had high-grade tumors. A significant association was observed between tumor grade and muscle invasion (χ² = 15.60, p < 0.001), with high-grade tumors being significantly more likely to present with invasive disease (OR = 5.73; 95% CI: 2.33–14.10).Treatment showed a significant association with disease category (χ² = 95.05, p < 0.001). Conclusion: UBC in this region is characterized by advanced presentation and aggressive biological behavior. The strong correlation between high grade and invasion emphasizes the urgent need for earlier detection strategies and tobacco cessation programs.

A histopathological Study of the Oral White Lesion Cases in Benghazi

2026-07-12T09:06:52+00:00

The white lesions of the oral cavity are clinically common. They represent a large number of cases diagnosed as diseases with different severity, such as dysplasia and traumatic keratosis, and may lead to squamous cell carcinoma (SCC).

Aim of the study was to determine the types of oral white lesions in all patients who presented to the Oral Pathology Department at the Faculty of Dentistry in Benghazi in the period from 1999 to 2019.

Material and methods; This study was a retrospective and descriptive type. The data were taken from the records of 149 cases with white lesions in the oral cavity and squamous cell carcinoma derived from white lesions. Statistical analysis and SPSS program were used.

Results; showed that most of the cases were more than forty years old. In general, more women than men were affected. The site of lesion was unilateral buccal mucosa in most cases. More than 56% were diagnosed as lichen planus, followed by leukoplakia (10.7%), simple keratosis (10.7%), frictional hyperkeratosis (6.7%), lichenoid reactions (3.4%), lupus erythematosus (3.4%), and white sponge nevus (2.0%). This study showed that the most common oral lesions, most commonly involved sites, age range and gender predilection were consistent with most published research in the literature, with the possibility of transformation of these lesions into dysplasia and SCC.

Conclusion; These lesions were associated with many systemic diseases. Awareness, early diagnosis and treatment will minimize disease further development.

Final Year Medical Students' Perception of Different Assessment Methods in the Internal Medicine Department, University of Benghazi

2026-07-13T09:45:57+00:00

Introduction: Assessment of medical students involves many challenges and processes to develop competent physicians; nonetheless, students' feelings and perceptions of assessment methods are usually neglected.

Aim: To evaluate the perception of final year medical students to different assessment methods in the final examination at the Department of Internal Medicine, Faculty of Medicine, University of Benghazi.

Methods: A cross-sectional study. An electronic three-point Likert scale questionnaire was distributed to final year medical students electronically.

Results: A total number of 337 students were included in the study. The majority of the studied group were females and accounted for 255 (75.7%). The mean age was 27.7 years. Exam unfairness was reported by 85.8% of students while 81.9% reported that the exam was dreadful. Females significantly reported more perception of exam unfairness than males 90%vs 74% respectively (P=0.0013).

Conclusion: Students reported high anxiety, and females perceived unfairness more significantly than males.

Undescended Testis in Benghazi Children Hospital: A Retrospective Study of Correlation Between Age at Presentation, Laterality, Presence of Hernial Sac, and Testicular Size from 2020 to 2024

2026-07-13T09:15:17+00:00

Background: The inability of the testis to descend into its typical scrotal position at birth is known as undescended testis (UDT) or cryptorchidism. It is estimated that one to four percent of full-term and up to forty-five percent of preterm newborn male neonates are affected by UDT.

Objective: To determine the mean age of patients at the time of presentation with palpable undescended testis, to analyze the distribution of cases by laterality (right, left, or bilateral), to assess the association between undescended testis and the presence of a hernial sac, to evaluate the size of the affected testis in comparison with the contralateral normal testis, and to examine the correlations among these variables in order to provide evidence-based clinical recommendations. Methods: A hospital-based retrospective study was conducted in the Pediatric Surgery Department at Benghazi Children Hospital, encompassing all male patients who underwent surgery for a confirmed diagnosis of undescended testis, aged between five months and 12 years, from 2020 to 2024. All patient records were reviewed to extract the required data.

Results and conclusion: This is a retrospective review of 140 children (UDT) presenting to Benghazi Children's Hospital to evaluate the age of presentation, laterality, size of the testis, the presence of hernial sac, and the associated surgical findings. The majority of the patients

(67.9%) presented between 0 and 2 years, which is very much in accordance with international guidelines of early surgical intervention and presentation. However, a notable proportion (32.1%) presented after the age of 3, suggesting a delay in referral and time of operation. Increased risk of testicular atrophy with increasing age was noted, particularly in the 6–8year-old group. The presence of hernial sac was observed in 35.7% of the instances, more in the younger age group of children. Laterality was evenly split between the right and left sides, with bilateral cases constituting only 5%, Nearly every patient who had a history of empty scrotum was admitted for orchidopexy. Two patients who had previously undescended testes (UDT) and a history of recurrent irreducible hernias were admitted for herniotomy. Three cases of testicular torsion and one case of irreducible inguinal hernia were among the four patients who were brought as emergencies and had a history of inguinal swelling. No statistically significant correlations were noted between testicular size and age, laterality, or the presence of a hernia.

Small bowel obstruction due to splenosis few years after splenectomy : A Case Report .

2026-07-13T09:27:41+00:00

Small bowel obstruction secondary to abdominal splenosis is a rare clinical condition that may occur many years after splenectomy and often presents a diagnostic challenge. We report the case of a patient who presented with features of acute small bowel obstruction ten years following splenectomy. The patient had a history of prior splenic surgery and no other significant abdominal pathology. Contrast-enhanced computed tomography of the abdomen revealed multiple well-defined intra-abdominal nodules consistent with splenosis, associated with signs of mechanical small bowel obstruction.

Given the persistence of obstructive symptoms, the patient underwent exploratory laparotomy. Intraoperatively, multiple ectopic splenic implants were identified within the peritoneal cavity, with dense adhesions causing small bowel obstruction. Adhesiolysis and excision of the obstructing splenic tissue were performed. Postoperative recovery was uneventful, with complete resolution of symptoms.

Histopathological examination confirmed the presence of ectopic splenic tissue consistent with splenosis. The patient remained asymptomatic on follow-up.

This case highlights the importance of considering abdominal splenosis in the differential diagnosis of small bowel obstruction in patients with a history of splenic injury or splenectomy. Early recognition using appropriate imaging modalities may aid diagnosis, while surgical management remains the definitive treatment in symptomatic cases.

A National Primary PCI Network in Libya

2026-07-13T09:39:55+00:00

Cardiovascular disease remains the leading cause of death in Libya, accounting for approximately 37% of total mortality, according to the World Health Organization 2023 country profile [1]. Among these, acute coronary syndromes (ACS)—particularly ST-elevation myocardial infarction (STEMI)—represent a time-critical condition where survival is directly dependent on rapid access to reperfusion therapy. Yet in Libya, access to primary percutaneous coronary intervention (PCI), the gold-standard treatment, remains inconsistent, fragmented, and largely confined to a few urban centers. This gap is no longer simply a clinical issue—it is a national health system failure that demands urgent policy intervention.