Libyan International Medical University

Background: In Libya, pharmacy education has traditionally followed a product-focused model, emphasizing pharmaceutical sciences and dispensing, with limited changes over the past decades despite evolving healthcare needs. The global shift towards patient-centered pharmacy practice has led to adoption of clinically oriented Doctor of Pharmacy (PharmD) programs in many countries, including recent curricular reforms in Libya. This study explores pharmacy students' knowledge, attitudes, and perceptions of Bachelor of Pharmacy (BPharm) and PharmD programs at Assalam International University (AIU) to inform ongoing educational development responsive to regional demands. Study Design: The study is a cross-sectional survey involved 60 pharmacy students. Place and Duration of Study: from the 2nd to 8th semesters at AIU during the 2024-2025 academic year. Methodology: Using a validated self-administered questionnaire, the study assessed students' understanding of program curricula, professional outlook, and future career ambitions. Descriptive statistics summarized students’ responses. Results: The students were generally aware of both BPharm and PharmD programs, showing strong preference for the patient-centered PharmD model aligned with modern healthcare roles. While confidence in clinical skills gained through the BPharm was moderate, students recognized the PharmD program as better suited for emerging pharmacy practice demands. Interest was high in postgraduate clinical pharmacy training. Conclusion: The study concludes that pharmacy education at AIU is progressing towards a patient-centered, clinically focused PharmD framework, reflecting global trends. To bridge gaps in practical competence and enhance education quality, recommendations include increased experiential learning, national accreditation enforcement, faculty development, and expansion of postgraduate training pathways. These reforms aim to elevate pharmacy education and practice standards in Libya, ultimately benefiting healthcare delivery and patient outcomes.

Background: Cirrhosis is associated with significant morbidity and mortality. Recent studies have highlighted the potential role of allopurinol in reducing the incidence of hepatic decompensation among individuals with cirrhosis. This study aimed to evaluate the association of allopurinol use with the incidence of hepatic decompensation and overall mortality in patients with cirrhosis in a large, propensity-matched cohort. Methods: A retrospective cohort study of adults with cirrhosis was conducted using the national TriNetX database, with 1:1 propensity score matching. Allopurinol exposure was assessed in three categories compared to individuals with no allopurinol use: 100 mg, 300 mg, and exposure at any dose. The primary outcome was the incidence of overall hepatic decompensation. Secondary outcomes included the incidence of ascites, esophageal variceal bleeding, hepatic encephalopathy (HE), hepatorenal syndrome, spontaneous bacterial peritonitis (SBP), hepatocellular carcinoma, and overall mortality. The outcomes were assessed at 6, 12, and 18 months. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: After propensity score matching, 5,358 patients who received allopurinol were compared with 5,358 controls. Dose-specific analyses included two additional matched cohorts: 2,124 patients receiving 100 mg of allopurinol and their matched controls, and 1,020 patients receiving 300 mg of allopurinol and their matched controls. At 18 months, a statistically significantly lower incidence of hepatic decompensation was seen in the overall allopurinol exposure cohort (OR: 0.77; 95% CI: 0.70–0.84), the 100 mg cohort (OR: 0.66; 95% CI: 0.57 to 0.76), and 300 mg cohort (OR: 0.76; 95% CI: 0.62 to 0.94). Allopurinol exposure was associated with a decreased incidence of esophageal variceal bleeding (OR: 0.71; 95% CI: 0.55 to 0.92), ascites (OR: 0.77; 95% CI: 0.69 to 0.84), HE (OR: 0.76; 95% CI: 0.63 to 0.92), SBP (OR: 0.61; 95% CI: 0.46 to 0.80), and overall death (OR: 0.86; 95% CI: 0.77 to 0.96) compared to the control group. Conclusion: In a propensity score-matched analysis of a large national database, individuals with cirrhosis and allopurinol use had significantly lower risk of hepatic decompensation and overall mortality. These findings suggest that allopurinol may play a potential role in managing cirrhosis, and randomized clinical trials are needed to confirm these findings.

The emergence of antibiotic-resistant pathogens necessitates exploration of alternative therapeutics. This study evaluated the antibacterial potential of ethanolic extracts from Zingiber officinale (ginger) rhizomes and Syzygium aromaticum (clove) flower buds against clinically isolated Staphylococcus aureus (including MRSA) and Escherichia coli (including ESBL-producing strains) using standardized microbiological assays. Disk diffusion results demonstrated significant antibacterial activity, with clove extract (5% w/v) exhibiting the highest efficacy against S. aureus (21.67±2.89 mm inhibition zone), followed by ginger extract (15.00±4.36 mm at 10% w/v). Against E. coli, clove flowers showed moderate activity (20.00±5.00 mm), while ginger displayed limited effect (3.33±1.53 mm at 10% w/v). Broth microdilution assays revealed MIC values of 25-100 μg/mL and MBC values of 0.15-0.73 μg/mL. Comparative analysis with standard antibiotics (ampicillin, gentamicin, streptomycin) indicated that while streptomycin remained most effective (30.67±2.08 mm), plant extracts demonstrated comparable activity to ampicillin against Gram-positive pathogens. These findings substantiate the potential of ginger and clove extracts as complementary antimicrobial agents, particularly against drug-resistant Gram-positive bacteria, while showing the need for further investigation of their mechanisms and potential synergies with conventional antibiotics.

Periodontal disease represents a spectrum of inflammatory disorders that impact the teeth's supporting tissues. It is initiated by the buildup of microbial plaque and sustained by dysbiosis, an imbalance in the oral microbiome that causes tissue damage and disturbs host-microbe homeostasis. These diseases can range from reversible inflammation of the gingiva (gingivitis) to irreversible destruction of the periodontal apparatus (periodontitis).While scaling and root planing, with or without antimicrobials, can effectively reduce bacterial burden, mechanical debridement by itself may not restore microbial symbiosis and may allow disease-associated microbial populations to persist. Incomplete pathogen clearance from deep pockets, residual calculus, or inaccessible root surfaces frequently results in bacterial regrowth and disease progression.Probiotics have emerged as a possible alternative or supplement in periodontal therapy. Their possible benefits include microbial balance restoration in the oral cavity, as well as anti-inflammatory, immunomodulatory, and bone-preserving actions.Nonetheless, the strain-specific effects, dosage regimen, safety profile especially in certain patients and the absence of large-scale, long‑term randomized controlled trials to definitively establish their efficacy remain as concerns. This review discusses the mechanisms through which probiotics may influence periodontal diseases, systematically maps preclinical and clinical evidence, and highlights current limitations and future directions for their application in periodontal therapy.

Abstract Background Physiological changes during pregnancy significantly alter drug pharmacokinetics, yet research remains limited due to ethical and methodological challenges. A consolidated overview of the most influential studies is lacking. Objective This study aimed to perform a comprehensive bibliometric and thematic analysis of global research on pharmacokinetic changes during pregnancy from 1971 to 2025, identifying trends, influential contributors, emerging themes, and knowledge gaps. Methods A bibliometric analysis was conducted on October 8th, 2025 using data extracted from the Scopus database for publications between 1971 and 2025. Performance indicators were analyzed using descriptive statistics and correlation analyses. Bibliometrix (R), VOS viewer, and GraphPad Prism were used for bibliometric mapping, co-authorship networks, and thematic clustering. Results A total of 1,391 publications by 8,192 authors across 511 journals were identified, showing an annual growth rate of 6.18% and 18.89% international collaboration. The United States (13%), Italy (5%), and New Zealand (4%) were leading contributors. Clinical Pharmacokinetics was the top journal, while the "University of Washington, Seattle, united states" and "Wolters Kluwer health - Adis, Auckland, New Zealand”, were the most influential institutions. Core keywords included “pregnancy,” “pharmacokinetics,” “HIV,” “epilepsy,” and “therapeutic drug monitoring,” with emerging themes such as “metabolism” and “controlled study.” Thematic evolution revealed a shift from methodological foundations (1971–1988) to clinical applications (1989–2015) and mechanistic approaches (2016–2025). Conclusions Global research on pharmacokinetic changes during pregnancy has grown steadily, transitioning toward model-informed and mechanistic studies. However, the absence of mature motor themes indicates thematic fragmentation. Strengthening international collaboration, advancing physiologically based pharmacokinetic modeling, and expanding studies across diverse populations and drug classes remain priorities to optimize pharmacotherapy in pregnancy.

Reduction in the rate of tooth loss and the need for complete dentures has a powerful effect on dental education and treatment modalities. Data regarding the levels of tooth loss and prosthetic treatment patterns of the population for all countries must be obtained, and the changes that occur over time need to be determined. The prevalence of complete edentulism varies from country to country and from one region to another. According to the current English literature, there is no available data for Libya in this regard. This study was conducted to evaluate the prevalence of complete edentulism retrospectively and to evaluate the frequency and location of significant incidental findings concerning age, gender, type of arch (maxilla/mandible), on digital panoramic images of edentulous patients attending the Clinical Dental Center in the Faculty of Dentistry at the Libyan International Medical University (LIMU), Benghazi- Libya. It is a cross-sectional, retrospective study; digital panoramic images of patients attending the Clinical Dental Center at LIMU from April 2021 to February 2023 will be retrieved and evaluated. The prevalence of complete edentulism will be determined among 1553 digital panoramic radiographs (original sample), which will be subjected first to inclusion and exclusion criteria. Radiographic incidental findings are identified as: impacted teeth, retained roots, radiopaque and radiolucent areas, atrophic crest, foreign bodies, styloid process elongation, soft tissue calcification, maxillary sinus findings, and any other findings specific to this Libyan subpopulation. A total of 1553 panoramic images were analyzed in this study, out of which 126 (8.1%) were completely edentulous, and out of these 83 (65.8%) were associated with positive incidental findings, as of the images belonged to 82 (65.1%) males and 44 (34.9%) belonged to females, and atrophic maxilla being the most frequently observed finding 51 (35.7%), atrophic mandible found in 31 (21.7%) and styloid ligament calcification presented in 24 (16.8%) of total completely edentulous panoramic images. The result of this study showed that the rate of positive incidental findings detected in digital panoramic images of completely edentulous patients was high. Accordingly, taking panoramic images of completely edentulous patients before prosthetic replacement is important to avoid dental and medical conditions that could affect these patients.

The primary aim of diabetic retinopathy (DR) management is to prevent or slow the decline of vision loss. While current treatments for DR are effective in the advanced stages, they may not be as effective in the early phases of the disease. Metformin is among the most widely used antidiabetic medications and has recently shown promising outcomes in DR, as it has been found to affect several pathological mechanisms involved in DR, including oxidative stress, angiogenesis, and inflammation. Multiple clinical and preclinical studies demonstrated its potential role in reducing DR development and progression. However, the potential adverse effects, safety concerns, especially in patients with renal impairment, and the lack of large-scale studies supporting this evidence remain a barrier. This review explores the mechanisms through which metformin may exert its therapeutic effects in DR, discusses the clinical evidence, and identifies the limitations of metformin's potential use in DR treatment.

Background: Maternal care is a vital component of primary health care (PHC), aiming to provide comprehensive services to all women during the maternity period. Regular evaluation of these services is essential to maintain and enhance their quality. Aim: This study aimed to assess the level of satisfaction among pregnant women regarding antenatal care services provided by public primary health care institutions in Benghazi, Libya. Materials and Methods: In this prospective revaluation study, a total of 40 cases (30-80) were patients who purchased Sodium Valproate. A descriptive cross-sectional study was conducted on a sample of 300 pregnant women attending antenatal clinics in three randomly selected primary health care facilities. Data were collected through interviews using a validated tool – the Quality of Prenatal Care Questionnaire (QPCQ). Statistical analysis was performed using SPSS version 20. Results: The overall satisfaction level was moderate, with a general mean score of 2.658. Participants expressed high satisfaction with the information received, consultation time, and provider respect and support. However, the lowest satisfaction level was reported in the domain of approachability. No statistically significant association was found between satisfaction and socio-demographic factors, except for education level, which was significantly associated with anticipatory guidance. Satisfaction was notably higher among women attending the Elkish polyclinic. Conclusion: Pregnant women reported moderate satisfaction with antenatal care services, highlighting the need for improvements in provider accessibility and patient communication, particularly in certain clinics.