Khalij-Libya Journal of Dental and Medical Research

Prevalence of Urinary Tract Infection and Uropathogen Profile Among Pregnant Women Attending Antenatal Care in Misurata, Libya

2026-09-16T09:32:49+02:00

Urinary tract infection is common in pregnant women and associated with maternal, fetal, and obstetric complications. Escherichia coli is the most common etiologic agent in both symptomatic and asymptomatic infection, and culture is the gold standard for diagnosis. Treatment of both symptomatic and asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of urinary tract infection has become a standard of obstetrical care. Antibiotic treatment of bacteriuria significantly reduces the risk of maternal and fetal complications. This study aimed to determine the prevalence of urinary tract infections among pregnant women and identify the predominant uropathogens in Misurata, Libya.

Radiographic Assessment of Permanent First Molars Among patients in Tripoli: A Retrospective cross-sectional Study

2026-10-08T21:48:37+02:00

The first permanent mandibular molar (FPM) is the first tooth to emerge. It is the most effective oral masticatory unit because of its large occlusal surface and function in proper occlusion. This study aimed to describe the prevalence of PFM loss and status among adult patients in Tripoli, Libya. Materials and Methods: A retrospective study was conducted using patient panoramic radiographs from three private dentistry clinics in Tripoli, Libya. Panoramic images (OPG) of 1244 patients aged 13 years and older were evaluated to determine the status of PFM. For categorical variables, descriptive statistics of frequency distribution and percentages were generated, and the difference between the variables was assessed using the chi-square test. A p-value of < 0.05 was considered statistically significant. The results indicated that females had a much higher rate of missing FPMs than males (20.7% vs. 17.9%, respectively). Missing FPMs were more common in the mandibular arch than in the maxillary arch (21.3% vs. 17.6%), with a statistically significant difference. Endodontically treated FPMs accounted for 8.2% of the evaluated teeth, whereas 91.8% had not undergone endodontic treatment. Males had a slightly greater rate of endodontically treated FPMs (8.5%) than females (8.0%). Females had more restored and missing teeth than males, whereas males had higher proportions of remaining roots, crowns, and implants. A statistically significant association was observed between FPM status and dental arch. The mandibular arch showed higher proportions of carious, restored, and missing FPMs, whereas the maxillary arch showed a higher proportion of intact and crowned FPMs. Conclusion: Although intact first permanent molars represented the most common finding, a considerable proportion of FPMs had been affected by caries, were missing, fixed, or had undergone endodontic therapy. Missing FPMs were more common in females and in the mandibular arch, and endodontic therapy was mostly associated with age. These findings highlight the importance of early preventive and restorative interventions to preserve first permanent molars and reduce the burden of tooth loss and extensive dental treatment.

Clinical Presentation and Outcomes of Diabetic Ketoacidosis in Pediatric Patients: A Retrospective Study at Tripoli University Hospital

2026-10-26T20:41:26+02:00

Diabetic ketoacidosis (DKA) is an acute, potentially life-threatening complication of diabetes mellitus in children. It may be the first clinical manifestation of type 1 diabetes and can be accompanied by substantial fluid, electrolyte, and acid–base disturbances. Local data on pediatric DKA presentations and short-term outcomes can help identify priorities for earlier recognition and safer hospital care. To describe the clinical presentation, biochemical abnormalities, complications, and short-term hospital outcomes of children admitted with DKA to Tripoli University Hospital. This retrospective hospital-based study reviewed the clinical records of children aged 2–15 years admitted with DKA to Tripoli University Hospital during 2025–2026. The 59 DKA episodes were recorded. Demographic and clinical characteristics, DKA severity, laboratory results, treatment-associated electrolyte disturbances, and in-hospital outcomes were extracted from the records. The descriptive analyses and chi-square tests, with statistical significance defined as p<0.05. The 59 DKA episodes had a mean age of 10 years. Females accounted for 74.6% of the sample, and 89.8% of episodes occurred in children newly diagnosed with type 1 diabetes. Vomiting was the most frequently reported symptom (32.2%), followed by abdominal pain (27.1%). Moderate and severe DKA were reported in 37.2% and 28.8% of cases, respectively. At admission, hypokalemia was reported in 8.5% (5/59), hyponatremia in 93.2%, and acute kidney injury in 10.2%. During treatment, hypokalemia and hypophosphatemia were reported in 24% and 45%, respectively. Mean reported blood-gas values improved from pH 7.12 and bicarbonate 8.8 mmol/L before treatment to pH 7.33 and bicarbonate 16.0 mmol/L after treatment. No in-hospital deaths were reported. In this hospital-based series, DKA frequently accompanied the initial diagnosis of type 1 diabetes, and electrolyte disturbances were reported both at admission and during treatment. No in-hospital deaths were recorded. The results support continued attention to early recognition of diabetes, timely referral, and systematic biochemical monitoring during DKA treatment.

Perceived Stress and Bowel-Related Symptoms Among Participants with and Without Self-Reported Physician-Diagnosed Irritable Bowel Syndrome: A Cross-Sectional Study

2026-10-29T20:04:49+02:00

Irritable bowel syndrome (IBS) is a common disorder of gut–brain interaction, and psychological stress is widely believed to aggravate its symptoms. Many people live with recurring abdominal pain, bloating, or altered bowel habits without ever receiving a diagnosis, and very little is known about how their psychological state compares with that of diagnosed patients and of people without symptoms. This study was conducted to examine the relationship between perceived stress and bowel-related discomfort, and to compare stress, anxiety, and depressive symptoms between people with a physician-diagnosed IBS, people reporting IBS-type symptoms without a diagnosis, and people without such symptoms. An analytical cross-sectional study was carried out using a bilingual (Arabic and English) online questionnaire distributed between 30 May and 7 July 2026. Perceived stress was measured with the 10-item Perceived Stress Scale (PSS-10), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and bowel symptoms and their impact with ten items rated 1 to 5. Of 102 submissions, 78 had complete stress and symptom data and were analysed using Spearman correlation, Mann–Whitney U, Kruskal–Wallis, and chi-square tests, with a two-sided p-value below 0.05 taken as significant. The mean age was 23.9 ± 9.3 years and 85.9% of participants were female. Nine participants (11.5%) reported a physician diagnosis of IBS, 41 (52.6%) reported symptoms without a diagnosis, and 25 (32.1%) reported no symptoms. The mean PSS-10 score was 19.17 ± 6.28, with moderate stress in 76.9%. Higher stress was positively correlated with the bowel symptom score (ρ = 0.442), symptom impact (ρ = 0.432), overall bowel distress (ρ = 0.430), anxiety (ρ = 0.632), and depression (ρ = 0.396), all p < 0.001. PSS-10 scores differed across the three groups (p = 0.001): 24.0 ± 4.5 in diagnosed, 19.6 ± 6.5 in self-reported, and 16.4 ± 5.4 in symptom-free participants. Anxiety above the HADS threshold was found in 88.9%, 62.2%, and 17.4% of the three groups, respectively (p < 0.001), whereas depression did not differ significantly (p = 0.252). In a multivariable model, perceived stress remained independently associated with the symptom score (p = 0.032). Higher perceived stress was associated with more severe, more disruptive, and more distressing bowel symptoms. Participants with symptoms but no diagnosis carried a stress and anxiety burden that lay between that of diagnosed and symptom-free participants. Because of the small diagnosed group and the cross-sectional design, these results describe associations only and should be confirmed in larger and longitudinal studies.

Nicotinic Stomatitis in a Child Associated with Improper Use of a Matchstick: A Rare Case Report

2026-10-30T18:38:34+02:00

Nicotinic stomatitis, also known as smoker’s palate, is a reactive lesion of the oral mucosa characterized by palatal keratosis and multiple erythematous punctate areas corresponding to the openings of minor salivary gland ducts. Although it is most commonly associated with chronic tobacco smoking and heat exposure, similar palatal changes may occur following other sources of repeated thermal irritation. This report focuses on a child who presented with palatal mucosal changes clinically suggestive of nicotinic stomatitis associated with the improper use of a matchstick. The history of the unusual habit and the clinical appearance of the lesion suggested repeated local thermal irritation as a possible contributing factor. Clinical examination and a detailed history were essential in evaluating the lesion and considering alternative diagnoses. Identification and avoidance of the suspected causative habit were recommended as important steps in management

Effects of Valproate, Carbamazepine, and Levetiracetam Monotherapy on Liver Enzyme Levels in Children with Epilepsy: A Retrospective Observational Study

2026-11-04T06:49:53+02:00

Antiseizure medications (ASMs) are widely used in childhood epilepsy, and some are associated with alterations in liver enzyme levels, making biochemical monitoring an important component of follow-up. The aim of this study was to evaluate and compare the effects of valproate, carbamazepine, and levetiracetam monotherapy on aspartate aminotransferase (AST/GOT), alanine aminotransferase (ALT/GPT), and gamma-glutamyl transferase (GGT) in children with epilepsy. This retrospective observational study was conducted at the outpatient clinic of Tripoli University Hospital, Libya, from January 2023 to March 2026. It included 120 children aged 1 to 14 years at diagnosis (76 females, 44 males) with normal baseline GOT, GPT, and GGT, treated with valproate (n=45), carbamazepine (n=40), or levetiracetam (n=35) monotherapy and followed for 6 to 24 months. Enzyme results were classified as normal or elevated according to age- and sex-specific reference ranges. Groups were compared using the chi-square or Fisher's exact test. Liver enzyme abnormalities were found in 15 of 45 children (33.3%) on valproate, 19 of 40 (47.5%) on carbamazepine, and 4 of 35 (11.4%) on levetiracetam. GOT elevation was the most frequent abnormality with valproate (8 children), while GOT and GGT elevations were equally frequent with carbamazepine (6 children each). No GGT elevation occurred with levetiracetam, and the four affected children had mild GOT (2) or GPT (2) elevations. The difference in the overall frequency of abnormalities between groups was statistically significant (chi-square, p=0.003). Mild liver enzyme elevations occurred in all three groups, least often with levetiracetam, which had no GGT elevations. Because of the retrospective design and limited sample size, these findings should be confirmed in larger prospective studies that account for dose, duration, and clinical liver injury.

Treatment Planning Challenges in Prosthodontics: Conventional Fixed Versus Implant-Supported Prosthodontics: A Cross-Sectional Survey of Dental Practitioners in Libya

2026-11-05T16:29:15+02:00

This cross-sectional survey evaluated treatment planning preferences, perceived barriers, and self-reported clinical confidence among practicing dentists in Libya choosing between conventional fixed dental prostheses (FDPs) and implant-supported rehabilitations. Among 76 valid responses, practitioners strongly preferred implant-supported restorations in five of six clinical scenarios, including single missing posterior teeth (90.8%), single missing anterior teeth (81.6%), free-end saddles (76.3%), full-arch edentulism (71.1%), and 3–4-unit spans (55.3%). Conventional FDPs were preferred only when adjacent teeth required restoration (50.0% vs 43.4%). Experienced clinicians (>10 years) showed significantly higher implant preferences for full-arch edentulism (87.5% vs 50.0% for <5 years; p = 0.001) and compromised abutment cases (52.1% vs 27.8%; p = 0.039). Early-career dentists perceived inadequate bone volume as a greater obstacle than senior peers (mean 3.61 vs 2.92; p = 0.021). Highest-rated implant barriers were patient systemic health contraindications (mean 3.37), patient cost (3.14), and inadequate bone volume (3.09), whereas long-term biomechanical risk (2.72) concerned fixed prosthodontic options. Self-reported confidence in treatment planning was moderate for fixed prosthodontics (2.93) and implant therapy (2.92), with no significant differences by qualification level. Although 78.4% completed continuing education (CE) in implant dentistry, a marked desire for further training remained (3.43). In conclusion, participating dentists preferredimplant-supported rehabilitations, but clinical adoption remains constrained by patient-related factors and an ongoing need for hands-on, competency-based training.

Influence of Lighting Variability on the Accuracy and Consistency of Visual Shade Matching: An In Vitro Study

2026-11-08T17:39:28+02:00

Accurate tooth shade selection is essential for achieving optimal esthetic outcomes in restorations, yet visual shade matching is subjective and may be influenced by lighting conditions. This in vitro study evaluated the effect of different lighting conditions on the accuracy and consistency of visual shade selection. Visual shade matching of 16 blinded tooth samples was performed using the VITA Classical Shade Guide under warm (3000 K), neutral (4000 K), and daylight (5500 K) illumination. A repeated-measures design was used, in which the same examiner conducted shade selection twice at a 1-week interval to assess intra-examiner repeatability. Color differences (ΔE) were calculated using the CIELAB color system, and data were analyzed using two-way repeated-measures analysis of variance (ANOVA), Holm-adjusted pairwise comparisons, and Cohen’s kappa. The results demonstrated that lighting condition significantly affected ΔE values (p = 0.012), with the lowest mean ΔE under daylight illumination (0.663), indicating improved shade-matching accuracy. A significant difference was observed between warm and daylight illumination (mean difference = 1.496 ΔE, adjusted p = 0.009), whereas the other pairwise comparisons were not significant. Neither measurement session (p = 0.707) nor the lighting-session interaction (p = 0.913) was significant. Intra-examiner repeatability was highest under daylight (κ = 0.865), followed by neutral (κ = 0.661) and warm illumination (κ = 0.525). Within the limitations of this study, daylight illumination was associated with lower color differences and greater repeatability than warm illumination. Standardized, color-corrected, daylight-like illumination is recommended for visual shade selection to minimize lighting-related variability and improve clinical consistency.

Early Amniotomy and Risk of Cesarean Section in Primigravida in Al-Bayda Medical Center, Libya

2026-11-08T21:48:17+02:00

One of the most practical procedures in obstetric practice is artificial rupture of membranes, or amniotomy, to hasten the progression of labor. In order to prevent dystocia in women who go into labor on their own, early amniotomy has been recommended recently. This study aims to determine the effectiveness and safety of performing early amniotomy in shortening the duration of spontaneous labor in primigravida women, and its association with the risk of cesarean delivery. A prospective controlled study was conducted in the Department of Obstetrics and Gynecology at Al-Bayda Medical Center. One hundred women were divided into two groups: group I involved 50 women (early amniotomy), and control group II involved 50 women (no amniotomy). The mean duration of labor was significantly shorter in the early amniotomy group (6.59 ± 1.22 hours) compared to the control group (8.85 ± 1.15 hours), with a highly significant difference (t = −8.60, p < 0.001). Early amniotomy was associated with a marked reduction in total labor duration. An early amniotomy effectively contributes to accelerating labor progress and reducing its duration, and is associated with a decreased need for oxytocin induction, thereby enhancing the chances of natural delivery. The findings also indicated that this procedure does not lead to a significant increase in cesarean delivery rates.

Safe Zone Mapping in the Anterior Mandible for Implant Osteotomy: Insights from a Cone Beam Computed Tomography Study

2026-11-10T19:01:28+02:00

Surgical procedures involving dental implant placement in the anterior mandible may place adjacent neurovascular structures, particularly the inferior alveolar nerve and its anterior loop, at risk of injury. This study aimed to evaluate the anatomical relationships between the genial tubercle (GT), mental foramen (MF), and anterior loop (AL) using cone-beam computed tomography (CBCT). The dimensions of the crestal surgical safe zone and variations according to sex and side were also investigated. A retrospective CBCT-based study was conducted using 712 scans. After applying predefined exclusion criteria, 200 scans with a clearly identifiable anterior loop were randomly selected, including 100 males and 100 females (mean age: 44.5 years). Bilateral measurements included the distances from the GT to the MF, from the GT to the AL, and the corresponding crestal safe zone. Statistical analyses were performed to assess sex-related differences, side-specific variations, and the distribution of safe-zone categories. All morphometric parameters were significantly greater in males than in females. Mean GT-MF distances were 28.11 ± 2.60 mm and 27.38 ± 2.40 mm on the right and left sides in males, compared with 26.63 ± 1.55 mm and 26.22 ± 2.12 mm in females. The mean crestal safe zone measured 24.62 mm (right) and 23.78 mm (left) in males, and 21.66 mm (right) and 20.55 mm (left) in females. Right-sided GT-AL and safe-zone measurements were significantly greater than left-sided values in both sexes. Most males (66%) were classified within the 20-25 mm safe-zone category, whereas 58% of females were grouped within the 15-20 mm category. The anterior mandibular interforaminal region exhibits significant sexual dimorphism and bilateral asymmetry. Patient-specific CBCT assessment is essential for safe implant planning and minimizing neurovascular complications.