Libyan International Medical University Journal最新文献

{"title":"Contributing indications that provoke C-section: A study from tertiary care hospitals","authors":"Nikhil Singh, Rajnish Srivastava, Surabhi Srivastava, Pankaj R. Patel","doi":"10.4103/liuj.liuj_73_21","DOIUrl":"https://doi.org/10.4103/liuj.liuj_73_21","url":null,"abstract":"Background: Both cesarean-section (CS) delivery (CD) and vaginal delivery (VD) is associated with well-known measurable short- and long-term maternal and neonatal complications and benefits. Objective: The present retrospective observational study was conducted on a preliminary basis to evaluate the contributing factors that provoke CS delivery. Materials and Methods: The short-term (6 months) retrospective study was conducted at the Department of Obstetrics and Gynaecology, Pt. Deen Dayal Upadhyay and Northern Railway divisional hospital Moradabad, Uttar Pradesh, India. The sample size was calculated accordingly with a relative precision of 10.2% of prevalence and was found to be 140 and we have taken the sample size of 345. Results: The prevalence of CD for a particular course of duration was found to be 36.23%. The risk of CD increased (P < 0.001) with increased BMI. However, differential limits of normal BMI signify that lower limit of normal BMI possessed high % of CS. As the education profile was getting high the possibility of CS was found to be increased (P < 0.001). Women with negative Rh factor the probability of CS in terms of percentage was found to be 87.5%. There was a proportionate possibility of CS with an increased gap between parities. The % mortality of new-born by CD and VD was 14.28% and 85.71%, respectively, which signifies that CS prevents infant mortality. There was 99.2% possibility of undergoing CS if a woman possessing medical complications. Conclusion: The present study acknowledged that CD ensures feto-maternal safety. However, the study also highlighted some probable indications that might engender CD.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"11 1","pages":"61 - 68"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88244320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of level of knowledge understood and memorized of panoramic anatomical landmarks among dental students in Benghazi, Libya","authors":"Fatma Elsheikhi, Naeima Betamar, I. Bugaighis","doi":"10.4103/liuj.liuj_77_21","DOIUrl":"https://doi.org/10.4103/liuj.liuj_77_21","url":null,"abstract":"Background: Evaluation of skill competency and quality requirements of dental students plays an essential role in dental education. Aim: To investigate the level of knowledge of cranio-dentofacial anatomic structures observed on panoramic radiographs by 4th-year dental students and graduates in internship year at the Faculty of Dentistry, University of Benghazi. Materials and Methods: A total of 73 4th-year dental students and 92 interns attending the 2018/2019 academic year participated in this study to identify 24 landmarks on a traced panoramic radiograph. Descriptive statistics and Chi-square analyses were performed (P < 5%). Results: The overall correct answer rate for 24 anatomical landmarks was 26.2% (±0.23) among the 4th-year students and 29.68% (±0.24) among interns. Significant differences were observed only between hard tissues and soft tissues/air layer. For both groups, Head of the condyle was the most identified (79.5% for the 4th-year and 71.7% for interns), while the middle nasal concha was the least recognized structure (100% incorrect answer). Conclusions: Both 4th-year students and interns had a similar level of knowledge in identifying anatomical structures shown on panoramic radiography. The teaching program should focus on familiarizing dental students with the unidentified anatomical structures on panoramic radiographs.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"67 1","pages":"69 - 74"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89944968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization and antibiotic resistance of staphylococci strains isolated from brack hospital in the Southern Region of Libya","authors":"Ghada Alshaibani, Aisha M. A. Shahlol, A. Abid, S. Amri, E. Aghila, Ghaith Abdalah, Mohamed O Ahmed","doi":"10.4103/liuj.liuj_79_21","DOIUrl":"https://doi.org/10.4103/liuj.liuj_79_21","url":null,"abstract":"Background: Staphylococcus species are one of the most important healthcare-associated pathogens able to acquire and spread multidrug-resistant determinants. Objectives: The present study investigated and analyzed 110 potential Staphylococcus species isolated from various clinical and nonclinical samples at Brack hospital. Materials and Methods: A nonselective laboratory approach was applied, using cultural characteristics, Gram stain, and catalase reactivity followed by confirmation at the species levels and determination the susceptibility against antimicrobial agents using the Phoenix automated microbiological system. Results: In total, 57.5% were confirmed as species and subspecies of Staphylococcus represented by ten different species: nine subspecies of coagulase-negative staphylococci (CoNS) (76.2%) and one coagulase-positive staphylococci (CoNS) subspecies (23.8%). Of these strains, 16.6% were identified as methicillin-resistant staphylococci (MRS) mostly of the CoNS group expressing significant resistance to important antimicrobial classes. Conclusion: This study reports a high prevalence of various staphylococci species, particularly of CoNS group expressing multidrug resistance patterns of public health concern, from a healthcare setting in the south region of Libya. The identification of higher rate of MRCoNS underlines the importance of monitoring all multidrug-resistant staphylococci species requiring further epidemiological investigations.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"20 1","pages":"75 - 80"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85273476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of chitosan in the preparation of bioadhesive buccal films: Film-forming ability and sustaining ibuprofen release","authors":"Fadia Mussa, Haytham Mousi, Mahmud S. Treki","doi":"10.4103/liuj.liuj_78_21","DOIUrl":"https://doi.org/10.4103/liuj.liuj_78_21","url":null,"abstract":"Aim: Different polymers were introduced into Chitosan bioadhesive buccal films to achieve substantial success in sustaining Ibuprofen release for few hours, with reasonable bioadhesion strength. Design: Thin, isolatable, transparent, and elastic films of these copolymers were prepared. Nineteen formulations have been classified as six systems according to the percentages of hydrocolloids used. Materials and Methods: The films were prepared using the solvent casting technique. Bioadhesion study was conducted using the stomach mucosa of a sacrificed albino rabbit. Hydrocolloids such as Hydroxy Propyl Cellulose (HPC), Chitosan, and Methyl Cellulose (MC), in addition to other polymers, were used in addition to Ibuprofen as a model drug. Results: The mechanical strength and flexibility of the films were confirmed with no signs of breaking down. Selected films composed of about 60% (w/w) HPC were found to show higher tendency to adhere to the stomach mucosa than lower percentages of the same polymer. Chitosan films have released more than 78% of Ibuprofen content in the 1st h of release study. The introduction of MC in these films has led to a slow but continuous increase in the percentage of drugs released, reaching the climax of 82% after 4 h. Conclusion: Films made of formulation (L17) were found to be the most ideal for both releasing appreciable amount of drug (about 98% in 4 h), and their high tendency to adhering to the rabbit mucosa (71.00 Mn/m) giving enough time to exert the drug's effect locally. The mechanism of drug release was found to follow Higuchi's diffusion model for some systems and the classical first-order kinetics for others.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"24 1","pages":"91 - 98"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81074975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Studies on use of heat in the aqueous extraction of miswak","authors":"M. Sharkasi, Mayouf Elsharif, Abdussalam A Sughir, I. El-Mahdi","doi":"10.4103/liuj.liuj_72_21","DOIUrl":"https://doi.org/10.4103/liuj.liuj_72_21","url":null,"abstract":"Introduction: The antimicrobial properties of Miswak (Salvadora persica) are well documented, and the use of its extracts in the formulation of toothpastes and mouth rinses are well established. Most of the literature agrees that the organic extracts are more effective than aqueous extracts. Aims: The aim of the study was to prepare aqueous Miswak extracts using three different methods. The difference between the methods is the amount of heating used for their preparation. Furthermore, to evaluate stability during storage of such extracts, their pH, and their antimicrobial activity. Materials and Methods: Miswak extracts were prepared by maceration, infusion, and decoction methods, followed by evaluation of their extraction efficiency, stability, pH, viscosity, and antimicrobial activity. Results: A correlation was found between pH of extracts and their viscosity. The pH of extract increases to 6.5 when extensive heat was used during preparation, which is close to the normal pH of saliva and oral cavity. The accompanied increase in viscosity was an indication of increased extraction efficiency. Suppression of freezing point confirmed such observation for extracts prepared by decoction. The only positive antibacterial activity was observed for decoction extract, but it was less than that of chlorhexiden. For minimum inhibitory concentration estimation, it was found that almost 50% w/v of the extract must be used to provide the minimum microbial inhibitory effect. Conclusions: Miswak components appear to be thermostable ingredients, and the method of decoction can produce stable and effective Miswak extract.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"2 1","pages":"55 - 60"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79796381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk assessment for foot ulceration in a nigerian diabetic population attending university of Ilorin teaching hospital, Ilorin","authors":"J. Olarinoye, A. Bello, Saint Ogunkeyede, A. Aderibigbe, B. Olagbaye, K. Wahab","doi":"10.4103/liuj.liuj_83_21","DOIUrl":"https://doi.org/10.4103/liuj.liuj_83_21","url":null,"abstract":"Background: Complications from diabetic foot ulcer often pose a strong threat to the life of patients with diabetes. The aim of this study was to evaluate the risk factors for foot ulceration among people living with diabetes attending University of Ilorin Teaching Hospital, Ilorin, Nigeria. Materials and Methods: One hundred and fifty-one diabetic patients were interviewed with a questionnaire to obtain their sociodemographic, foot care, and diabetes-related details. Both of their feet were then assessed for dermatological changes, musculoskeletal deformities, neurological and vascular complications. Risk stratification was done according to the diabetic foot risk classification system of the International Working Group on Diabetic Foot. Data were analyzed using SPSS version 22. Categorical variables were compared using the Chi-square test while correlation between the risk categories and patients' characteristics was determined using Pearson's Correlation Coefficient, setting statistical significance at P < 0.05. Results and Conclusion: Intermittent claudication was found in 40 patients (26.5%), 76 (50.3) had paresthesia. Eighty nine (58.9%) had foot care education but only 7 (4.6%) had special diabetic foot wears. Impaired monofilament sensitivity was seen in 27 (17.9%) of the right feet and in 23 (15.2%) of the left feet. Significant peripheral neuropathy was detected in 36 (23.9%) on the right and 30 (19.9%) on the left side. It was found that the longer the duration of diabetes, the higher the risk (P = 0.04). Furthermore, patients who had no education had significantly higher risk for diabetes foot ulcer (DFU) (P = 0.01). High risk was discovered among the retirees (P = 0.01). In addition, presence of kidney disease (P = 0.046), cardiovascular disease (P = 0.001), and visual impairment (P = 0.19) all conferred a high risk for developing DFU in our study population. Overall assessment showed that the prevalence of “foot-at-risk' in this study was 30.5% which we think is substantial enough to attract a more serious attention.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"40 1","pages":"81 - 90"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85579709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary report on histopathological aspect of fibrous dysplasia in third dimension-3D images and video","authors":"Sandhya Tamgadge, A. Tamgadge","doi":"10.4103/liuj.liuj_75_21","DOIUrl":"https://doi.org/10.4103/liuj.liuj_75_21","url":null,"abstract":"Abstract Fibrous dysplasia is a fibro-osseous lesion of the jaw which runs a chronic course. It has been well explained in the literature through high-quality 2D clinical, radiographic, and histopathological images. But the clinicians and most of the times students too, don't understand the histopathological aspect of fibrous dysplasia through the description of text and existing 2D images. This article is preliminary attempt to explain the key events of histopathological aspects of fibrous dysplasia in third dimension in a life-like manner through 3D images and video which author herself has designed, for better understanding not only by oral and general pathologists, and students but also by patients, which is the unique feature of this manuscript. Preliminary 3D images and videos on histopathological aspect of fibrous dysplasia were designed by using 3Dmax (Autodesk Media and Entertainment) and Adobe premiere pro 5.5 software which is a video editing software (Adobe Systems). Internal cellular environment of a lesion has been created in a life-like manner through 3D animation video. Histopathological aspect of all oral lesions should be explained in this manner for better understanding.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"157 1","pages":"99 - 102"},"PeriodicalIF":0.0,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72662907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic characteristics and clinical manifestations of interstitial lung disease with systemic sclerosis in eastern part of Libya","authors":"Fathi Elbraky, Khaled D. Alsaeiti, Fathiyah M Aboulqasim, Saleh Alawgali","doi":"10.4103/liuj.liuj_51_20","DOIUrl":"https://doi.org/10.4103/liuj.liuj_51_20","url":null,"abstract":"Introduction: Pulmonary involvement, such as Interstitial Lung Disease (ILD) and Pulmonary Hypertension (PH ), accounts for significant morbidity and is the leading cause of Systemic sclerosis (SSc)-related morbidity and mortality. The aim of the current study was to study the frequency of occurrence of ILD in SSc and to describe the clinical and radiological picture of pulmonary involvement in SSc. Patients and Methods: Forty patients attending different rheumatology clinics in eastern part of Libya between January 2018 and September 2020 were included. Basic details including age, gender, disease duration, detailed history, and clinical examination were noted. Autoimmune profiling included rheumatoid factor, antinuclear antibodies, and anti-Scl-70 antibodies. Pulmonary function test, chest X-ray (CXR), and high-resolution computed tomography of the chest (HRCT) in all patients were recorded. Data presented either as frequencies and percentages or as means ± standard deviation. Results: The male: female ratio was 1:9 with a mean age of 37.5 ± 9.6 years and duration of illness 6 ± 4 years. diffuse cutaneous SSc was seen in 62.5% of the patients. 77.5% of the participants had bilateral crepitation and 57.5% had loud P2. Presenting complaints included gastrointestinal reflux in 72.5%, digitalis ulcerations in 40%, and synovitis/arthritis of all patients. Other comorbidities included congestive heart failure in 12.5%, PH in 15%, and renal impairments in 7.5% of all patients. Anti-Scl-70 antibody was the most common in all patients (45%), followed by anti-centromere Ab (25%), anti-U3 RNP (10%), and anti-U1 RNP (5%). 72.5% of the participants had reticulonodular shadows on CXR. HRCT showed honeycombing as the predominant finding (37.5%). Echocardiograms showed that 15% of all patients have signs of PH. Duration of disease, dyspnea, cough, bilateral crepitations, and CXR were found to be significantly associated with extensive ILD (P < 0.05). Conclusion: ILD is a serious complication of SSc, it is more common among patients with dcSSc. Chest HRCT is very sensitive to detect ILD. A significant association was found in Libyan patients between the severity of ILD and the duration of disease, dyspnea, cough, bilateral crepts, and CXR.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"12 1","pages":"27 - 32"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80775500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitude, and practice of sudanese pharmacists toward COVID-19 in Khartoum State, Sudan: An online-based cross-sectional study","authors":"S. Badi, Abdalrahman Hamed, Mohammed Abualama, M. Mustafa, Muhammad Abdulraheem, B. Yousef","doi":"10.4103/LIUJ.LIUJ_42_20","DOIUrl":"https://doi.org/10.4103/LIUJ.LIUJ_42_20","url":null,"abstract":"Background: COVID-19 disease became an outbreak declared by the WHO as a public health emergency that is explicitly threatening the globe. Measures must be taken to control it, and health-care workers' situations need to be assessed. Objectives: The study aimed to assess the knowledge, attitude, and practice of Sudanese pharmacists regarding COVID-19. Materials and Methods: The study was an online descriptive cross-sectional survey, conducted from April to June 2020, among the registered pharmacists in Khartoum, Sudan. Three hundred fifty registered pharmacists were asked to participate in this study, all of them were responded. An online standardized questionnaire was conducted, and data were collected by a convenience sampling method and analyzed using the Statistical Package for the Social Science. Descriptive and inferential statistics were performed. Results: Response rate was 100%, 65,7% of the participants were females. The median age was 27 years, 72.9% of the pharmacists were bachelor degree holders, and 73.1% of participants were community pharmacists. The years of experience were 1–5 years for 54.4% of them. About 69.4% of the participants had sufficient knowledge about COVID-19, 27.1% reported a positive attitude, and 62.6% reported a fair attitude. Moreover, 88.3% of them were wearing facemask, gloves, and frequently use sensitizers. Nearly 47.7% stated that they would not dispense any treatment of COVID-19 without a prescription. Tests revealed that knowledge was statistically significant with gender (P = 0.001) and attitude with age and years of experience (P = 0.039, 0.01), respectively. Conclusions: More than two-third of the participants have sufficient knowledge regarding COVID-19. Only one-tenth of them have a negative attitude, and their practice toward the disease was relatively good.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"1 1","pages":"19 - 26"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90240097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of treatment and the contribution of persistent posttreatment bacterial vaginosis infection on pregnancy outcome among asymptomatic women: A cohort study","authors":"Babatunde Ogunniran, A. Adeniran, R. Saidu, A. Akanbi II, K. Adesina, M. Ijaiya","doi":"10.4103/liuj.liuj_49_20","DOIUrl":"https://doi.org/10.4103/liuj.liuj_49_20","url":null,"abstract":"Objective: The objective of this study was to evaluate the effect of antibiotic treatment and posttreatment persistent bacterial vaginosis (BV) infection on pregnancy outcome among asymptomatic women. Materials and Methods: A prospective cohort study was conducted among consenting, asymptomatic pregnant women without background medical disorders. All participants were recruited in the second trimester and had BV testing using Nugent score. BV-positive women were treated with a 7-day course of metronidazole with a repeat posttreatment laboratory testing after 4 weeks. The primary outcome was pregnancy outcome of BV-positive versus negative women; the secondary outcomes were posttreatment laboratory BV test result and pregnancy outcome among women with resolution versus persistent infection. Data analysis was performed using SPSS version 21.0 and P < 0.05 was significant. Results: The prevalence of BV in pregnancy was 24.1%; vulva itching and vaginal douching were more common among BV-positive women (P = 0.011 and P = 0.001), respectively. Adverse pregnancy outcomes such as premature rupture of membranes (PROM) (odds ratio [OR]: 8.185, 95% confidence interval [CI]: 3.196–20.962; P = 0.005), preterm delivery (OR: 24.517, 95% CI: 6.985–86.049; P = 0.001), and birth weight <2500 g (OR: 6.460, 95% CI: 2.893–14.429; P = 0.005) were more common among BV-positive women. Posttreatment persistent BV infection was 25.0% with significantly higher PROM (OR: 18.21, 95% CI: 4.654–71.317; P = 0.001), preterm delivery (OR: 14.571, 95% CI: 4.138–51.308; P = 0.001), birth weight <2500 g (OR: 14.57, 95% CI: 4.138–51.308; P = 0.001), and low 1st min Apgar scores (OR: 7.333, 95% CI: 1.223–43.960; P = 0.049). Conclusion: Symptom-based approach to BV in pregnancy excludes many asymptomatic women; we hereby recommend routine screening. Also, women with BV in pregnancy should undergo repeat testing posttreatment while those with persistent infection will benefit from repeat treatment pending further evidence to formulate a widely acceptable treatment guideline.","PeriodicalId":18106,"journal":{"name":"Libyan International Medical University Journal","volume":"109 1","pages":"33 - 40"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78085457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}