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Tekmal SR, Lockett C, Long B, Schauer SG. Military Medical Evacuation After the Benghazi Embassy Attack: Implications for Military Support of Diplomatic Missions. J Spec Oper Med 2022; 22:83-86. [PMID: 36525018 DOI: 10.55460/tsy7-5ta7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The Department of State has the primary responsibility of diplomatic operations in foreign countries. The US military often supports these missions and, when needed, may be called upon to provide security in the event of changes in the host nation's government stability. The US military was requested to help evacuate the consulate in Benghazi after the attack on September 11, 2012. The medical requirements to support such a mission remain unclear, and data are lacking. We sought to describe the medical care required during this evacuation mission. METHODS This is a secondary analysis of a previously described dataset from the United States Transportation Command (TRANSCOM) Regulating Command & Control and Evacuation System (TRAC2ES) from 2008 to 2018, with a focus on cases involving the evacuation after the Libyan consulate attack in September 2012. Within our dataset, we isolated all cases of evacuation from the attack on US government facilities in Benghazi. We describe the available data within TRAC2ES, including the free text information placed by the initiating medical personnel. RESULTS We identified three cases of evacuations within TRAC2ES associated with the Benghazi consulate attack. All cases were evacuated from host nation hospitals to Landstuhl Regional Medical Center (LRMC) by military aircraft under urgent status. Case 1 was an adult male injured by an undocumented mechanism. He was found to be in severe shock, received four units of blood prior to transport, and was intubated. Case 2 was an adult male injured by an undocumented mechanism. He had documented smoke inhalation injury and was found to be coughing up black sputum. Case 3 was an adult male injured by an undocumented mechanism. He had a compound radial fracture with an external fixator in place and subsequently developed compartment syndrome. He was intubated prior to transport. CONCLUSIONS Our case series focuses on the unique aspects of military support of diplomatic missions in countries lacking a stable government-specifically, what transpired in Benghazi. Such events showcase areas of potential collaboration between the Department of State and the Department of Defense in coordinating medical evacuations for casualties sustained during diplomatic missions.
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Rajab AM, Lawgaly SA, El Beshari M, Bennour AM. Knowledge and attitudes toward epilepsy among Libyan people with and without epilepsy in a tertiary medical center. Epilepsy Behav 2021; 121:108023. [PMID: 34000588 DOI: 10.1016/j.yebeh.2021.108023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/19/2021] [Accepted: 04/24/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although patients with epilepsy (PWE) constitute a considerable sector of the population in Benghazi, there is no adequate knowledge about this disease. OBJECTIVES To assess knowledge and attitudes toward epilepsy among Libyan people who live in Benghazi city. METHODS A cross-sectional prospective hospital-based study was conducted in the year 2020, from June to August. The participants were adults, PWE were included as well as people without epilepsy (NEP). Participants were interviewed through a twelve-item questionnaire related to knowledge which included definition, causes, manifestations, first aids, treatment options, and curability. In addition, attitudes toward epilepsy were tested by questions that include immediate actions when seeing a patient seizing, and whether or not PWE can drive, work, marry, and conceive). DATA ANALYSIS Data were processed by the statistical software (SPSS) version 18.0. Differences between categorical variables were tested by Chi square and P value at 0.05, which has been considered statistically significant. RESULTS The total number of the interviewees was 156. The mean age was 43 ± 14 SD years (18-76 years), 105 (67%) were males. Twenty-eight (18%) of the participants were PWE, while the remaining 128 (82%) were NEP. Ninety-nine (64%) and 145 (92%) of the participants answered correctly regarding definition and manifestations of epilepsy, respectively. The participants with Bachelor degree and post graduate level have shown a better understanding of definitions and treatments of epilepsy (P = 0.000). They also had better attitudes toward PWE in terms of their ability to conceive (P = 0.002).PWE had better knowledge about manifestations and first aids of epilepsy compared to NEP, though they did not have differences in attitude compared to NEP. Participants' knowledge about epilepsy was mainly obtained from friends (41; 26%), patients (40; 26%), and media (37; 24%). A major portion of participants 94 (60%) did not feel satisfactory about their own information about epilepsy. CONCLUSION Knowledge and attitudes toward epilepsy were generally satisfactory. Participants with Bachelor degree or higher level of education had better knowledge and positive attitudes toward PWE. Patients and media are important tools to improve knowledge and attitudes about epilepsy.
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Lemamsha H, Papadopoulos C, Randhawa G. Understanding the risk and protective factors associated with obesity amongst Libyan adults - a qualitative study. BMC Public Health 2018; 18:493. [PMID: 29653525 PMCID: PMC5899402 DOI: 10.1186/s12889-018-5411-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 04/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background There are a range of multifaceted behavioural and societal factors that combine to contribute to the causes of obesity. However, it is not yet known how particularly countries’ cultural norms are contributing to the global obesity epidemic. Despite obesity reaching epidemic proportions in Libya, since the discovery of oil in 1959, there is a lack of information about obesity in Libyan adults. This study sought to explore the views of key informants about the risk and protective factors associated with obesity among Libyan men and women. Methods A series of qualitative semi-structured interviews were conducted with Libyan healthcare professionals and community leaders. Results Eleven main themes (risk and protective factors) were identified, specifically: socio-demographic and biological factors, socioeconomic status, unhealthy eating behaviours, knowledge about obesity, social-cultural influences, Libya’s healthcare facilities, physical activity and the effect of the neighbourhood environment, sedentary behaviour, Libyan food-subsidy policy, and suggestions for preventing and controlling obesity. Conclusions Key recommendations are that an electronic health information system needs to be implemented and awareness about obesity and its causes and consequences needs to be raised among the public in order to dispel the many myths and misconceptions held by Libyans about obesity. The current political instability within Libya is contributing to a less-active lifestyle for the population due to security concerns and the impact of curfews. Our findings have implications for Libyan health policy and highlight the urgent need for action towards mitigating against the obesity epidemic in Libya.
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Affiliation(s)
- H Lemamsha
- Faculty of Medical Sciences, University of Omar Al-Mukhtar, Al-Bayda Campus, Labraq Road, Al-Bayda, B1L12, Libya
| | - C Papadopoulos
- Institute for Health Research, University of Bedfordshire, Putteridge Bury Campus, Hitchin Road, Luton, LU2 8LE, UK
| | - G Randhawa
- Institute for Health Research, University of Bedfordshire, Putteridge Bury Campus, Hitchin Road, Luton, LU2 8LE, UK.
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Benkhadoura M, Alswehly M, Elbarsha A. Clinical profile and surgical management of diabetic foot in Benghazi, Libya. Foot Ankle Surg 2016; 22:55-8. [PMID: 26869502 DOI: 10.1016/j.fas.2015.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/01/2015] [Accepted: 04/21/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this study was to outline the patterns and management of diabetic foot ulcer (DFU) and compare our experience with other published data. PATIENTS AND METHODS All consecutive patients admitted to Al-Jala Hospital with diabetic foot from June, 2008 to May, 2013 were reviewed retrospectively. RESULTS A total of 542 patients were studied, Wagner's grade III ulcers were the most prevalent (31%), followed by grade II (25%). About 10% of patients underwent major amputations and 24.2% underwent minor amputations. The amputation rate was 34%, and the mortality rate was 2%. CONCLUSION Diabetic foot infections cause significant morbidity and mortality among patients with diabetes in Benghazi. There is a need to establish a diabetic foot clinic in Benghazi with a multidisciplinary team to reduce the rates of hospital admission and amputation, as well as hospital stay duration.
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Ghaieth MF, Elhag SRM, Hussien ME, Konozy EHE. Antibiotics self-medication among medical and nonmedical students at two prominent Universities in Benghazi City, Libya. J Pharm Bioallied Sci 2015; 7:109-15. [PMID: 25883514 PMCID: PMC4399008 DOI: 10.4103/0975-7406.154432] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 09/21/2014] [Accepted: 09/23/2014] [Indexed: 11/23/2022] Open
Abstract
Background: Trivial use of antibiotics is a major reason for the spread of antibiotics resistance. The aim behind undertaking this investigation was to study the prevalence antibiotics self-medication among university students in Benghazi city. Methods: A questionnaire-based cross-sectional, survey was conducted at both Libyan International Medical University and Benghazi University. A total of 665 copies of questionnaires was distributed. A total of 363 forms were completed and returned (response rate 55%). Remaining responses were either with no antibiotics use history within the past 1 year or were provided incomplete. Results: Among the respondents, 45% were males and 55% females. Males practiced self-medication more compared to females. Approximately, 43% and 46% from medical and nonmedical students, respectively, were antibiotics self-medicated. A total of 153 students (42%) out of total respondents administered antibiotics for symptoms related to respiratory problems, among which 74 students (48%) took antibiotics based on doctor's prescription. Among the respondents, 94 students (27%) who had antibiotics, were covered under medical insurance, and 19 (29%) of the medically insured students had antibiotics without doctor's prescription. About 14% of students did not complete their antibiotics course. Of these, 57% were medical students, and 43% were nonmedical students. The rate of self-medication among higher classes was more as compared to lower classes. About 58% of students overdosed the antibiotic, while 15% had antibiotics for <3 days, for treatment of ailments such as acne, toothache, diarrhea, earache, and tonsillitis. About 75% of students purchased the antibiotics in consultation with a pharmacist. Conclusion: Self-medication is a frequent problem among university students in Benghazi city. There is a need for an immediate intervention to address this malpractice among both students and medical practitioners.
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Affiliation(s)
- Mohamed F Ghaieth
- Department of Biochemistry, Faculty of Basic Medical Sciences, Libyan International Medical University, Benghazi, Libya
| | - Sara R M Elhag
- Department of Biochemistry, Faculty of Basic Medical Sciences, Libyan International Medical University, Benghazi, Libya
| | - Mamoun E Hussien
- Department of Biochemistry, Faculty of Basic Medical Sciences, Libyan International Medical University, Benghazi, Libya
| | - Emad H E Konozy
- Department of Biochemistry, Faculty of Basic Medical Sciences, Libyan International Medical University, Benghazi, Libya
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Bodalal Z, Bendardaf R, Ambarek M, Nagelkerke N. Impact of the 2011 Libyan conflict on road traffic injuries in Benghazi, Libya. Libyan J Med 2015; 10:26930. [PMID: 25673038 PMCID: PMC4325084 DOI: 10.3402/ljm.v10.26930] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/19/2015] [Accepted: 01/20/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Road traffic injuries (RTIs) are a major public health concern in Libya. In the light of the armed conflict in Libya that broke out on February 2011 and the subsequent instability, the rate and pattern of RTIs was studied. METHODS RTI patient data were gathered from Al-Jalaa hospital, the main trauma center in Benghazi, from 2010 to 2011. Various parameters [i.e. age, gender, nationality, method of entry, receiving department, intensive care unit (ICU) admission, duration of stay, method of discharge, and fatalities] were compared with data from the previous year (2010), and statistical analyses were performed (t-test, chi-square, and Poisson regression). RESULTS During the conflict period, 15.8% (n=2,221) of hospital admissions were RTIs, that is, a rate of 6.08 RTI cases per day, levels not seen for 5 years (t=-5.719, p<0.001). The presence of armed conflict was found to have caused a significant 28% decrease in the trend of RTIs over the previous 10 years (B=-0.327, CI=-0.38--0.28, p<0.001). February and March, the peak period of active combat in Benghazi, witnessed the lowest number of RTIs during the conflict period. The average age of an RTI decreased to 28.35±16.3 years (t=-7.257, p<0.001) with significantly more males (84.1%, n=1,755) being affected (χ(2)=4.595, p=0.032, df=1). There was an increase in the proportion of younger aged patients (from 0 to 29 years) (χ(2)=29.874, p<0.001, df=8). More patients required admission to the ICU (χ(2)=36.808, p<0.001, df=8), and the mortality of an RTI increased to 5.2% (n=116) (χ(2)=48.882, p<0.001, df=6). CONCLUSIONS There were fewer RTIs during the conflict period; however, those that occurred had higher morbidity and mortality. The profile of an RTI victims also changed to an increased prominence of young males and motorcyclists. Further research is required to propose and analyze possible interventions.
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Affiliation(s)
- Zuhir Bodalal
- Faculty of Medicine, Libyan International Medical University, Benghazi, Libya;
| | - Riyad Bendardaf
- Department of Medicine, Oncology Unit, University Hospital Sharjah, Sharjah, United Arab Emirates
| | - Mohammed Ambarek
- Faculty of Medicine, Libyan International Medical University, Benghazi, Libya
| | - Nico Nagelkerke
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Abstract
Libya is a country with a low population, listed under the EMRO. Using registers and patient records from a major primary oncology clinic, data was gathered from Libyan cervical cancer patients and various parameters were studied across 9 years. Out of 4,090 female cancer cases during the study period, 1.8% were cervical cancer (n = 74). The average age of presentation was 53 years, with most of the cases (60%, n = 44) being premenopausal. Approximately 65% (n = 48) of cervical cancer patients are diagnosed at later stages (i.e. stages III and IV). The majority of these cases are squamous cell carcinoma (83.8%, n = 62), while 16.2% (n = 12) were found to be adenocarcinoma. Patients with squamous cell carcinoma presented at later stages more often than those with adenocarcinoma. Human papilloma virus was strongly implicated in cervical cancer, with 94% (n = 63) of those who were tested being positive for HPV-16 (82.5%, n = 52) and HPV-18 (12.7%, n = 8). Diagnosis was most frequently made through biopsy (97.3%, n = 72) as opposed to Pap smears (2.7%, n = 2). Most Libyan patients were put through chemotherapy (75%, n = 55) and triple therapy (surgery with combined chemotherapy and radiotherapy) was the most common (38%, n = 28) modality of treatment. Comparisons were made between Libya and other nations, either in the developed world or neighbouring countries. The major problem of cervical cancer in Libya is delayed presentation and hence, all the recommendations focus on increased awareness for the populace, implementation of a national cancer control plan and a national screening programme.
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Affiliation(s)
- F Ben Khaial
- Family and Community Medicine, Faculty of Medicine, Benghazi University , Benghazi , Libya
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Bodalal Z, Mansor S. Gunshot injuries in Benghazi-Libya in 2011: the Libyan conflict and beyond. Surgeon 2013; 11:258-63. [PMID: 23743179 DOI: 10.1016/j.surge.2013.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/02/2013] [Accepted: 05/12/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since independence, Libya has never experienced personal ownership of arms. That changed during the Libyan conflict where weapons became widespread in the society. As a result gunshot injuries became a concern for surgeons at our principal surgical hospital (Al-Jalaa). This study aims at analyzing the gunshot injuries that took place during 2011 and highlighting the peculiarities in the Libyan scenario. METHODS Patient records were obtained and gunshot injuries were analyzed for various parameters. Statistical analyses were made taking into consideration situations faced by neighbouring countries. RESULTS In 2011, 1761 patients were admitted with over 95% being male and over 97% were Libyan. The average age of a GSI patient was 28.32 ± 10.01 years. Patients aged 18-35 formed over 70% of the cases with half of all cases being treated by the orthopedics department. Sixty-eight percent of cases were injured in the extremities followed by chest (12.5%) and abdomen injuries (7.8%). The mortality rate for GSI's was found to be 5.6% overall with young age, site of injury (i.e. chest and head) and cause of injury (i.e. war or civilian fighting) being important risk factors. CONCLUSIONS Taking into consideration the difficult operating conditions and limited resources, surgeons at our hospital were able to maintain a low mortality rate. Disarmament needs to begin as soon as possible because these injuries will continue to occur so long firearms are available in society.
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Affiliation(s)
- Zuhir Bodalal
- Department of Medicine, Faculty of Medicine, Libyan International Medical University, Benghazi, Libya.
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Elmrghni S, Dixon RA, Williams DR. Frequencies of HFE gene mutations associated with haemochromatosis in the population of Libya living in Benghazi. Int J Clin Exp Med 2011; 4:200-204. [PMID: 21977233 PMCID: PMC3182512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 09/06/2011] [Indexed: 05/31/2023]
Abstract
THE STUDIES OF THE HFE MUTATIONS: H63D and C282Y in North African populations have revealed the extreme rarity or even the absence of the C282Y mutation. We have examined 200 chromosomes (100 Libyan people live in Benghazi) for the presence of the two HFE mutations by PCR-RFLP analysis by using PCR conditions used to amplify both Autosomal and Y chromosomal STRs. We have found that the allele frequencies are, respectively, 17% for the H63D and 0% for the C282Y. These results are consistent with the worldwide spread of the H63D mutation and the north European restriction of the C282Y.
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Affiliation(s)
- Samir Elmrghni
- School of Natural and Applied Sciences, University of LincolnBrayford Pool, Lincoln, LN6 7TS, UK
- Faculty of Medicine, University of GaryounisBenghazi, Libya
| | - Ron A Dixon
- School of Natural and Applied Sciences, University of LincolnBrayford Pool, Lincoln, LN6 7TS, UK
| | - D Ross Williams
- School of Natural and Applied Sciences, University of LincolnBrayford Pool, Lincoln, LN6 7TS, UK
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Abstract
Background Metabolic syndrome is a cluster of three out of five conditions that are due to hyperinsulinemia: abdominal obesity, atherogenic dyslipidemia (high triglycerides and/or low HDL), elevated blood pressure, and elevated plasma glucose. The syndrome is highly prevalent in patients with type-2 diabetes mellitus and often precedes the onset of hyperglycemia. It has been shown that metabolic syndrome is an independent clinical indicator of macroand microvascular complications in diabetics. Aim and objectives the aim of this pilot study was to estimate the frequency and characteristics of metabolic syndrome among type-2 diabetic patients in Benghazi. Patients and methods: This cross-sectional study involved 99 randomly selected adult patients with type-2 diabetes mellitus. The patients were interviewed and examined, and their lipid profiles were checked 9-12 hours after overnight fasting. Metabolic syndrome was defined according to the criteria of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) and of the International Diabetes Federation (IDF). Results About 92% of the patients had the metabolic syndrome according to ATP III criteria and 80.8% according to IDF criteria. Females were more affected, males with metabolic syndrome were significantly older, and females were significantly more obese. No significant difference was observed between males and females regarding waist circumference, HDL level and triglyceride level. The commonest and most important component of metabolic syndrome in the study group was low HDL. Conclusion Metabolic syndrome is common among Libyans with type-2 diabetes mellitus, and it is significantly more common in females than males. The most significant predictor of metabolic syndrome in type-2 diabetic patients in Benghazi is low HDL.
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Al-Sharbati MM, Younan AA, Sudani OH. Growth pattern of primary schoolchildren in Benghazi, Libya. J Sci Res Med Sci 2001; 3:45-49. [PMID: 28811728 PMCID: PMC5396561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To find the growth trends in a sample of schoolchildren in Benghazi (Libya), and to compare it with international and other local growth charts, as a step for setting the national curves. METHOD From 25th February to 31st October 1993, a sample of 2,022 pupils (1,160 boys and 862 girls) were randomly selected from three public primary schools in three different socio-economic areas in Benghazi. A questionnaire consisting of social and scholastic items was distributed to teachers a few days before the examination. The height and weight of all the pupils were measured according to the standards of Jellife, Gorstein, WHO, and de Onis. Data were analysed and compared with both the reference standard of the United States National Center for Health Statistics (NCHS-USA), and the local standards of Tripoli-1986. RESULTS The boys and girls in the lowest age-group had a pattern similar to that of the reference population for both height/age and weight/age, but it dropped sharply from mid-school years. The Benghazi curves were consistently higher than those of Tripoli, particularly for height/age. CONCLUSION The nutritional status of these children, which was good before the beginning of schooling, was negatively affected during the school years. This could be attributed either to births in the family and consequent neglect, or to the school's negative effects on the child, such as lack of appetite created by anxiety or other factors. Further studies from different regions of the country are needed to set national growth curves.
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Affiliation(s)
- Marwan M. Al-Sharbati
- Department of Behavioural Medicine College of Medicine, Sultan Qaboos University P.O. Box 35, Al-Khod 123, Muscat, Sultanate of Oman
| | - Ameer A. Younan
- Department of Nutrition, College of Public Health Al-Arab Medical University, Benghazi, Libya
| | - Omar H. Sudani
- Dean, College of Public Health, Al-Arab Medical University, Benghazi, Libya
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