Benghazi University Medical Journal

Contemporary Approaches to Breast Cancer Management: An Evidence Synthesis Guiding Clinical Practice and Patient Care.

Thu, 25 Dec 2025 00:00:00 +0000

Background: Breast cancer remains the most frequently diagnosed cancer globally, though its management varies significantly across regions. This systematic review integrates recent evidence across six domains to delineate best practices for comprehensive care.

Methods: A systematic literature search was conducted across MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL (2010–2024), in line with PRISMA 2020 reporting standards. Eligible studies were screened by two reviewers. Quality was assessed using validated tools appropriate to study design, including Cochrane RoB 2.0, Newcastle-Ottawa Scale, AMSTAR-2, and AGREE II. Evidence was synthesized narratively and appraised using the GRADE framework.

Results: Key advances include the application of molecular profiling in tailoring therapy, treatment de-intensification for selected low-risk groups, escalation for aggressive subtypes, and improved multidisciplinary decision-making. Hypofractionated radiotherapy has shown comparable efficacy with reduced side effects, while genomic testing helps identify patients who can safely avoid chemotherapy. Targeted therapies have substantially improved outcomes in specific subgroups. Unique strategies are needed for elderly, male, and pregnant patients, and oligometastatic disease is increasingly approached with curative intent.

Conclusion: Precision medicine has redefined breast cancer treatment, emphasizing individualized and integrated multidisciplinary strategies. Implementation frameworks that minimize disparities and maximize both survival and quality of life outcomes are necessary to put this evidence into practice.

Extra uterine growth restriction and its related factors in extremely and very low birth weight babies including 1500 grams admitted to Jammhoria hospital in Benghazi.

Aziza I.Kadwar , khadiga I. Shreef , Isaaida A. Alsaeiti, Nadia AM. Aldarogi — Thu, 25 Dec 2025 00:00:00 +0000

Abstract
Background:Extra-uterine growth restriction (EUGR) in premature infants remains a major challenge for neonatologists worldwide. In the neonatal intensive care unit (NICU), suboptimal nutrition and the fear of advancing feeds are key contributors. Updated feeding protocols that support rapid but safe feeding advancement, breast milk fortification, and close monitoring of growth parameters are essential to achieving optimal nutritional outcomes and preventing long-term neurodevelopmental impairment.
Objective: To determine the frequency of extra-uterine growth restriction (EUGR) among premature infants in Benghazi and identify associated risk factors.
Method: This cross-sectional study was conducted in Benghazi. Medical records of 107 premature infants were obtained from the neonatal clinic. All preterm infants born at <34 weeks’ gestation and weighing ≤1500 grams were included. Growth measurements at birth, discharge, and 40 weeks corrected age were plotted on Fenton growth charts. Weight <10th percentile was classified as EUGR. A p-value <0.05 was considered statistically significant.
Results: EUGR was identified in 85 infants (79%) at discharge and in 63 infants (58.8%) at 40 weeks corrected age. Significant risk factors for EUGR at discharge and at 40 weeks included lower birth weight (p = 0.01; p = 0.005), longer hospital stay (p = 0.007; p = 0.01), small for gestational age (SGA) (p = 0.000; p = 0.02), and sepsis (p = 0.03; p = 0.001). Additionally, gestational age 33–34 weeks (p = 0.001) and multiple births (p = 0.03) were significant risk factors for EUGR at discharge only.
Conclusion: Extra-uterine growth restriction is highly prevalent among Libyan premature infants. Lower birth weight, prolonged hospitalization, SGA status, gestational age of 33–34 weeks, and multiple births were significant associated risk factors.
Recommendations: Implementation of updated feeding protocols for premature infants in Libya—including rapid but safe advancement of enteral feeds, breast milk fortification, and close monitoring of growth parameters—is essential to improving nutritional outcomes and reducing the risk of EUGR.

Placenta Accreta Spectrum: Epidemiology, Risk Determinants, and Clinical Consequences in Benghazi Medical Centre -2022.

Omaima H. Getlawi , Maisa M. Muttardi , Asmaa B. Salih — Thu, 25 Dec 2025 00:00:00 +0000

Abstract
Background: Placenta Accreta Spectrum (PAS) is a pregnancy-related disorder characterized by the abnormal adherence of trophoblastic tissue to the uterine myometrium, posing a significant risk of maternal mortality. Key risk factors for PAS include placenta previa and prior cesarean deliveries, which have been rising in frequency.
Aim: to explore the risk factors of PAS, incidence, clinical outcomes of affected patients, and strategies to minimize maternal morbidity and mortality.
Method: prospective cohort study conducted on 60 patients during the year 2022 in Benghazi Medical Centre including all patients labeled as PAS cases, Review of records for all patients using the structured data collection sheet. The total number of deliveries, caesarean deliveries, maternal and perinatal deaths had been registered; patients were followed up till delivery.
Results: Mean age of the studied group was 35.37±5.70, 43.3 % of them were multipara , 56.7% with previous cesarean section three or more times, 71.7% of the studied group with grade III placenta previa, 95.0% experienced some complication, after multivariate analysis C.S 3 times and more is considered risk factor for hysterectomy (p value = 0.03) ( OR 6.12, 95% CI (1.15-32.59), there was statistical significant association between CS delivery and length of hospital stay (p value =0.005).
Conclusion: Incidence of placenta accreta increases with advanced age, with multipara and with 3 times and more CS. Placenta previa was coexisting factor in 95% of the cases.
Keywords: ,, ,

Histopathological evaluation of prostate biopsy in-patient with Prostate cancer in Benghazi Medical Center in the period between 2020-2023.

Thu, 25 Dec 2025 00:00:00 +0000

Abstract

This descriptive, cross-sectional study was conducted at Benghazi Medical Center (BMC), Benghazi, Libya. Data were collected from the medical records of 81 patients diagnosed with prostate cancer who were admitted to the oncology department between January 2020 and December 2023. The aim of this study was to describe the demographic, clinical, and histopathological characteristics of prostate cancer patients.

Results: The mean age of the patients was 71.6 years, and 83% of cases occurred among those aged 71–80 years. Overall, 19.8% of patients were smokers. Nine patients (11.1%) had diabetes mellitus, one patient (1.2%) had hypertension, and approximately 84% reported no family history of prostate cancer. Histopathological examination revealed adenocarcinoma in different stages of differentiation, with acinar adenocarcinoma accounting for 95% of cases and ductal adenocarcinoma for 2.5%. Most adenocarcinoma cases presented as Grade I (44.4%), followed by Grades II and IV (17.3% each).

Conclusion: The study demonstrated that most cases occurred in older patients and were diagnosed at an early stage. Acinar adenocarcinoma was the predominant histopathological type, and the low rate of metastasis suggests a favorable prognosis.

Prevalence of Skin Findings among Libyan Diabetic Patients.

Ghada A. Albarghathi , Antisar A. Najm, Aisha B. Trapolsi , Shadia J. Awad — Thu, 25 Dec 2025 00:00:00 +0000

Abstract
Background: Diabetes mellitus (DM) is the most common endocrine disorder. Almost one-third of diabetic patients are affected by cutaneous manifestations during their disease. Cutaneous manifestations of diabetes are caused by either diabetes-induced metabolic changes in the skin or by associated complications like vasculopathy and neuropathy.
Objectives: To estimate the prevalence of skin diseases among patients with diabetes mellitus.
Method: One hundred eighty known adult diabetic patients of either sex attending the outpatient clinic of the diabetic center (Diabetic Center / Benghazi / Libya) for treatment and follow-up of diabetes were randomly selected for the study. Detailed case history of each patient with special attention to cutaneous lesions were taken. A dermatologist performed a detailed dermatological examination.
Results: In this study, most diabetes patients ranged from 41 to 60 years for females, while for males, they were over 60 years. The majority of patients in the current study were females. The most common dermatosis associated with DM was acanthosis nigricans; seen in (69.4%) of patients, skin tag was the second most common dermatosis, accounting for (56.7%) of patients, xerosis was seen in (54.4%), pruritus seen in (37.2%), fungal skin infections found in (25.6%). Diabetic dermopathy was seen in (17.7%), and prayer signs were found in (10.6%). Fifteen (8.3%) diabetic patients had nail changes, and eight (4.4%) diabetic patients had foot ulcers. Diabetic bullae were found in (2.2%); as well as viral infections were seen in (2.2%). Two (1.1%) diabetic patients have bacterial infections.
Conclusion: The prevalence of certain dermatoses was increased among diabetic patients. So, diabetic patients are considered to be at risk of developing certain skin diseases.

The Prevalence of Amoebiasis in Children Admitted to Gastro Department at Children’s Hospital of Benghazi.

Abdusalam A. Abdusalam, Abdulsalam F. Alawaaj , Zahoor H. Almabrouk — Thu, 25 Dec 2025 00:00:00 +0000

Abstract
Background: Amoebiasis, caused by the protozoan parasite Entamoeba histolytica, remains a major public health concern, particularly in less developed and developing regions where sanitation standards are inadequate.
Aim: To investigate the role of E. histolytica as a primary cause of gastroenteritis and to assess infection rates among children admitted to the Gastroenteritis Department at Benghazi Children’s Hospital over a one-year period.
Method: A cross-sectional study was conducted by using records from the Parasitology Department between January and December 2023. A total of 1,443 stool samples were examined microscopically and categorized into four age groups: 1–3, 4–6, 7–9, and 10–14 years.
Results: The overall prevalence of E. histolytica/dispar was 35.3%. Giardia lamblia infections accounted for 2.8%, while other microbial infections—including fungal organisms such as Candida spp.—represented 1.2%. The highest infection rate was recorded in the Gastroenteritis Department (59.0%), compared to 30.1% in the Outpatient Department. Seasonal trends showed a peak prevalence of 5.5% in August and the lowest rate of 1.3% in April.
Conclusion: The study highlights the substantial burden of E. histolytica infections among children in Benghazi, emphasizing the urgent need for improved sanitation, enhanced public health strategies, and continuous monitoring to reduce infection rates.

The Role of Multi Detector Computerized Tomography in Evaluation of Maxillofacial Fractures.

Kamla M. Muftah , Ali A. Beheh, Gebril Hewadi , Arwi B. Elfseie — Thu, 25 Dec 2025 00:00:00 +0000

Abstract
Objective: The current study’s goals are to assess the effectiveness of Multi Detector Computerized Tomography (MDCT) in treating patients who have experienced maxillofacial trauma, describe demographic variations, describe the frequency and types of fractures that were subjected to CT scans in the Benghazi region of Libya, and compare the results with those of comparable studies carried out elsewhere in the world.
Materials and Methods: We collected information from the radiology department of the al-Jala teaching hospital in Benghazi to conduct a descriptive, cross-sectional hospital-based study Between 2010 and 2013, 417 patients’ medical records who underwent head and face CT scans after suffering maxillofacial trauma were examined for the study (4 years).
Results: The peak frequency, which occurred in the age group of 21 to 30, covered a range of ages from 2 to 85 years. The median age, measured by mean and standard deviation, was 29.9 +/- 12.2 years. There were six men for every woman. Road traffic accidents (RTAs) were the leading cause of fractures (75%), followed by assault (7.67%), and we found no association between gender and the cause of fracture (p = 0.537). While the orbital walls (61%) were the most frequently broken bone in simple maxillofacial fractures, the zygomaticomaxillary complex (ZMC), which makes up 22.2% of the midface, was the most vulnerable area in complex facial fractures. There was no connection between gender and the location of the fracture.
Conclusion: Maxillofacial trauma can occasionally occur with serious cosmetic and functional repercussions. MDCT is required for the identification and classification of maxillofacial fractures and provides an accurate diagnosis for the design of treatment plans. Early surgical intervention is crucial for the successful management of these fractures.

Thyroid disorders in patients with polycystic ovarian syndrome in Benghazi

Omar Alfalah, Fathia Ehmouda — Thu, 25 Dec 2025 00:00:00 +0000

Abstract
Background: Recent studies have highlighted a higher occurrence of thyroid abnormalities in women diagnosed with polycystic ovary syndrome (PCOS), although the underlying mechanisms linking the two conditions remain uncertain.
Aim and Objectives: To determine the prevalence of thyroid dysfunction among patients with PCOS.
Methods: A retrospective review of medical records was conducted for 116 patients attending the endocrine clinic in Benghazi medical center during the period from the first of September to the end of October 2020.
Results: The mean age was (35.5±9.8 years), the mean body mass index for the study group was 31.8±6.5kg/m2. Among studied group; 81% of participants had oligomenorrhea, 97.4% had hirsutism, and 84% had ultrasound features of polycystic ovaries; Overall, the prevalence of thyroid disorders among patients with PCOS was 31%, the main thyroid disorder was autoimmune thyroiditis which represented 13.8% followed by subclinical hypothyroidism which found in 9.5% of all participants.
Conclusion: More than one third of the studied group had thyroid disorders. Autoimmune thyroiditis represented the main disorder.

Genetic Neuromuscular Diseases in Libya.

Heba Abdelrazik El-Zawawi — Thu, 25 Dec 2025 00:00:00 +0000

Dear Editor:
Whereas in previous decades the landscape for certain disorders such as cancer and genetic diseases, in particular neuromuscular, was bleak, a glimmer of hope has now arisen. This glimmer is growing fast into a beam that promises to shine light over the coming decades. Genetic therapy has finally arrived.
I wish to shed light on the prospects in our location here in Libya: what has been done so far and what remains to be done. Our experience over the last 4 years will also be outlined. The reader will find that we have much to be proud of, and yet the challenges have been sometimes seemingly insurmountable.
The scientific committee for genetic neuromuscular diseases (NMDs) was instituted in Libya four years ago. (1) Members include adult and pediatric neurologists’ representatives from most of the main cities of Libya as well as legal, pharmacist, and administrative members. It is part of the Libyan Program for Neuromuscular Diseases, which includes the Patient Neuromuscular Society. Thus, Libya has made considerable progress in the promotion of patient advocacy for these conditions. The neurologist members of the scientific committee are the heads of subcommittees formed in the city or city location to which they belong. Thus, a network covering all of Libya has been formed. The main concept overriding this organization is teamwork. Patients attend the subcommittee clinics to be assessed, tested genetically, counselled, treated, and followed up. Accurate statistics can be obtained regarding these diseases’ incidence and prevalence in Libya. A national patient database is now the next aim.