Abstract

Spinal-induced hypotension (SIH) remains a prevalent and clinically consequential complication of neuraxial anaesthesia for cesarean delivery. Its pathophysiological sequelae include maternal symptomatology (nausea, vomiting, dizziness) and impaired uterine-placental perfusion, predisposing to fetal acidosis and diminished fetal Apgar scores. Judicious selection of a vasopressor agent is therefore paramount. This study sought to compare the efficacy of ephedrine, norepinephrine, and a combined regimen in the management of SIH during cesarean section, with respect to maternal hemodynamic stability, neonatal outcomes, and adverse event profiles. This study was a prospective cross-sectional clinical analysis conducted at Al-Hadba Al-Khadra General Hospital in Tripoli, Libya. A total of 170 parturients were enrolled and divided into four groups: ephedrine (n = 60), norepinephrine (n = 60), combined (n = 20), and a control group (n = 30). Hemodynamic parameters were recorded at eleven perioperative time points. Apgar scores were assessed at both one and five minutes after delivery, and maternal adverse effects were documented. Statistical analysis was carried out using SPSS version 25, applying one-way ANOVA, the Kruskal-Wallis test, repeated-measures ANOVA, Pearson correlation, and chi-square tests. A p-value of less than 0.05 was considered statistically significant. Baseline demographic and clinical characteristics were comparable across all groups. All vasopressor regimens successfully restored blood pressure within 30–45 minutes. The combined group exhibited the most pronounced early reduction in systolic and mean arterial pressures at the five-minute interval, whereas norepinephrine demonstrated the most stable hemodynamic profile with minimal fluctuation relative to ephedrine. Apgar scores did not differ significantly among groups. Nausea and vomiting were reported across all cohorts; tachycardia was predominantly observed in the ephedrine group, while sporadic bradycardia occurred in those receiving norepinephrine. All vasopressor agents effectively controlled SIH without compromising neonatal outcomes. Norepinephrine may be the preferred agent owing to its superior hemodynamic stability and reduced propensity for tachyarrhythmia. Larger-scale, multi-

centre investigations are warranted to corroborate these findings

Keywords. Vasopressors, Spinal Anaesthesia, Anaesthesia, Hypotension, Cesarean Section, Apgar Score. 

Euphorbia glyptosperma Engelm is recorded for the first time as part of the flora of Libya. This widespread wild weed was collected during 2023–2024 from various locations, including regions in Sabha and Ariggiba (approximately 110 km southwest of Sabha city). To aid in its identification and facilitate future studies, a comprehensive description of the species, habitat information, a distribution map, and distribution data are provided. Additionally, a brief discussion highlights the most significant threats associated with this species. Keywords: Identification key, Ariggiba Region, Field work, Sabha taxonomy, Alena

This study aimed to evaluate the inhibitory and lethal effects of root extracts of the Wild Rue plant (Peganum harmala L.) against the pathogenic fungus Rhizoctonia solani under laboratory conditions. Two types of extracts (aqueous and alcoholic) were used at concentrations of (5%, 10%, 15%, and 20%). The results indicated that the effectiveness increased proportionally with the concentration. The inhibition rate of the aqueous extract reached 64.8% at a concentration of 20%, while the alcoholic extract was significantly superior, reaching 84% at the same concentration. Statistical analysis confirmed highly significant differences between concentrations (P < 0.001) as determined by one-way ANOVA, while two-way ANOVA showed extract type, concentration, and their interaction were significant factors, explaining approximately 85% of the total variance. The study concluded that the alcoholic extract is more effective than the aqueous one in inhibiting R. solani, making it a promising option for fungal control as a safe alternative to chemical pesticides.

This study presents a taxonomic note on Fagonia isotricha Murb.

(Zygophyllaceae), a species recorded in Libya and currently treated as a taxonomic

synonym of Zygophyllum mayanum. Global taxonomic databases, such as those

curated by the Royal Botanic Gardens, Kew and World Flora Online, recognize this

taxon as part of the Libyan flora under its currently accepted nomenclature.

This study provides field-based and morphological documentation of populations

observed in the Ariggiba region (southern Libya), and discusses their taxonomic

placement within the Fagonia–Zygophyllum complex. Herbarium specimens were

collected, examined, and deposited, supporting the occurrence of this taxon in the

Libyan flora

Boerhavia erecta has been recorded for the first time in the flora of Libya. This widespread wild

weed was collected in 2023 and 2024 from multiple locations, all included in the regions Sabha and Ariggiba,

and situated approximately 110 km southwest of Sabha city. This species, known for it adaptability to

disturbed habitats and arid conditions, holds ecological significance in its native and introduced ranges. To

facilitate its accurate identification and support future research efforts, a comprehensive description of the

species is provided, along with data about the habitat and a distribution map. These findings offer valuable

insights into the plant’s occurrence, ecological preferences, and adaptability within Libya's unique climatic

conditions. Additionally, the study discusses the potential threats posed by Boerhavia erecta to native plant

flora and vegetation. Emphasis is placed on the importance of monitoring the spread of B. erecta and

conducting further studies to assess its ecological impact in Libya. This record not only highlights the plant's

expansion but also underscores the need for continued floristic surveys to document and preserve the

country's rich biodiversity.

ABSTRACT Background: β-thalassemia is an inherited hemoglobinopathy characterized by reduced or absent synthesis of the β-globin chains, with a high prevalence in populations of Mediterranean descent and a wider global distribution. We report the clinical case of a pediatric female patient with transfusion dependent β-thalassemia major from western Libya. Her older sibling had been diagnosed with β thalassemia major and subsequently underwent allogeneic bone marrow transplantation; both parents were identified as heterozygous carriers of the β-thalassemia trait. Case Report: An 11-year-old girl from western Libya was diagnosed with homozygous β thalassemia major, a genetic predisposition supported by confirmed parental carrier status. Owing to chronic anemia and ineffective erythropoiesis, the patient requires regular monthly red blood cell transfusions to maintain hematologic stability. Although allogeneic hematopoietic stem cell transplantation represents the only potentially curative intervention, its suitability is constrained by patient age, donor availability, comorbid conditions, and additional clinical factors. Discussion: This report delineates the clinical and laboratory characteristics of β-thalassemia major in a patient from western Libya and summarizes the molecular pathogenesis of the disorder. β thalassemia results from pathogenic variants in the β-globin gene (HBB) located on chromosome 11. Such mutations—including single-nucleotide substitutions, insertions, or deletions—reduce (β⁺) or completely abolish (β⁰) β-globin production, leading to diminished β-globin synthesis and consequent imbalance in hemoglobin assembly. Clinical manifestations typically emerge during childhood in individuals who inherit pathogenic variants from both carrier parents; in the present case, the patient's genotype is consistent with homozygous β-thalassemia major. Conclusion: We discuss the hematologic and biochemical phenotype of this case and address the principal long-term complications of chronic transfusion therapy, particularly secondary iron overload and increased susceptibility to viral infections affecting both hepatic and extrahepatic sites. Finally, we review contemporary therapeutic approaches for β-thalassemia major and evaluate the potential utility of hematopoietic stem cell transplantation as a curative strategy for this patient. KEYWORDS: thalassemia major; Hemoglobin electrophoresis; red blood cell transfusion; Iron overload; Allogeneic stem cell transplantation. 

Background and objective :Helicobacter pylori [H.pylori] infection is one of the most common chronic bacterial infections worldwide especially in the developing countries. This bacterium is the cause of many diseases such as MALT lymphoma, gastritis, peptic ulcers, and stomach cancer. According to recent reports, H.pylori infection may increase the risk of colorectal cancer. The current study aimed at investigating the association of H. pylori infection and the risk of colorectal cancer and adenomatous polyps. Methods: The current study was conducted on 52 patients with colon cancer as the case group and 200 subjects without pathological finding (i e, polyps, neoplasms, or inflammatory diseases) as the control group. Blood samples were collected from the patients in order to assess the presence of anti-H. pylori infection antibodies by the serum titer levels of anti-H. pylori IgG antibodies were measured using enzyme-linked immunosorbent assay (ELISA) with commercial kit by (Dia.Pro Diagnostic Bioprobes-Italy). Results: This study demonstrates distinct associations between H.pylori infection markers and CRC risk. While IgG seropositivity showed a significant 2.16-fold increased CRC risk (p = 0.019). Conclusion: This research finding IgG seropositivity may serve as a broader risk marker.

Argemone ochroleuca Sweet, Brit. Fl. Gard. Ser.1 3(2): pl. 242 (1828) of the family Papaveraceae is reported here for the first time from Libya. This species is native to Mexico. Flowering specimens of A. ochroleuca were collected from the region Ariggiba (26°35’11.8”N 13°29’24.8”E), 110 km southwest of the city of Sabha, which lies about 700 km south of Tripoli. It is presented with updated nomenclature, taxonomic description, geographical distribution, key to genera, location in Libya, and colour photographs taken in the field. The voucher specimens are deposited in the Herbarium of Botany Department (ULT), University of Tripoli, Libya.

Diabetic cardiac autonomic neuropathy (DCAN) is a significant condition that affects cardiovascular health worldwide and is associated with increased morbidity and mortality rates. Therefore, early detection and management of DCAN are crucial for reducing the risk of cardiovascular disease among individuals with T2DM. Identifying this disorder can enhance patient outcomes and quality of life by minimizing the chances of serious complications. This cross-sectional study aims to identify diabetic individuals with DCAN and to investigate its relationship with various risk factors, including hyperglycemia, the duration of diabetes, the presence of peripheral somatic neuropathy, and diabetic microvascular complications. The study included 261 patients with T2DM, comprising 61.5% females and 38.5% males. Participants underwent cardiovascular testing and clinical evaluations to identify cases of cardiac autonomic neuropathy. Out of the 261 randomly selected patients, 82 were diagnosed with DCAN, resulting in a prevalence rate of 31.4%. The average age for female patients was 57.5 ± 0.7 years, while for male patients, it was 56.3 ± 1.2 years from the total recruited patients. In addition, there is a strong association between DCAN and clinical and biochemical parameters such as lipid profile, duration of diabetes, poor diabetic control, and presence of microalbuminuria in patients with DCAN and above 60 years old, compared to younger patients. The study highlighted a strong association between DCAN and factors such as poor glycemic control, prolonged diabetes duration, and the presence of chronic microvascular complications, including neuropathy, retinopathy, and nephropathy. These findings emphasize the importance of raising awareness and proactively assessing Libyan patients who are at risk for cardiovascular autonomic neuropathy. This is crucial to reduce the likelihood of recurrent acute cardiac complications, especially in patients undergoing emergency surgery without a prior diagnosis. It is vital to recognize this risk.

Keywords. Type 2 Diabetes Mellitus, Pulse Rate, Metabolic Syndrome, Blood Pressure.