Abstract The incidence of spinal cord injuries is the lowest of all major trauma, with devastating impact on the individual affected. The immediate treatment, though it remains mainly supportive, in many situations will determine the outcome and the cost of health care. Standards of care are unfortunately still lacking, this is mainly due to the existing controversies and lack of effective treatment of the injured cord. The author discusses here some of the controversial points based on literature review and personal observation. arabic 14 English 75
Nabil A. Alageli(10-2021)

Abstract Introduction: The World Health Organization (WHO) Health Systems Framework (HSF) with its 6 building blocks is a widely accepted tool for accurate evaluation of health systems. However, its role in the developing world has not been widely assessed yet. Methods: Six Questionnaires with 5-point Likert-scale were designed and distributed to all the attendees of Libya Health 500 (LH500) Conference, and collected just before the group discussion of Libyan health system’s session. Results: There were high levels of agreement of the respondents to the questionnaires items about the 6 building blocks. The application of evidencebased medicine and equal provision of health service to all, received the highest levels of agreement. Most of the attendees agreed that health services should be paid by the health insurance system, as it has many advantages, including the peace of mind for the public. The fairness and efficiency of the workforce and the establishment of regulatory mechanisms to address the needs of the health workforce had a high level of agreement. Moreover, a functioning health technology requires an effective supply and distribution system of technology elements. The participants agreed that health information technology is important to improve healthcare services and to prevent financial and administrative corruptions. Conclusion: It is feasible to adapt the WHO-HSF to identify the needs and ways to enhance health systems in the developing world. The Libyan healthcare providers were fully aware and committed to the need for the applicability of the WHOHSF to the National Health Service in Libya. arabic 18 English 100
Nabil A Alagili(7-2016)

Introduction: the risk of venous thromboembolism (VTE) after Spinal injuries was largely realised but the true incidence of which is still variable and unclear. Abstract Patients & method: We retrospectively reviewed the charts of 374 consecutive patients who sustained traumatic spinal injury and admitted acutely to a comprehensive care spinal injuries centre. 159 patients had spinal trauma with spinal cord injury (SCI) and 215 were neurologically intact. The majority of these patients were treated non-surgically and received the same thromboprophylactic regimen started within a median of 2 days post injury. The incidence of clinical VTE (deep Vein thrombosis DVT & Pulmonary Embolism PE) was determined and some risk factors discussed. Results: Among the neurologically intact group one patient developed clinical PE (0.5%). Out of 159 patients with SCI, 23 developed clinically evident VTE (14.5%), 15 had DVT (11.9%), 4 PE (5%) and 4 had both DVT & PE). There was no fatality. Complete SCI lesions were associated with higher incidence of VTE compared to incomplete lesions, 17.6 % & 11% respectively (p
Nabil Alageli, Aheed Osman(7-2021)