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)

Objective: The aim of the study was to look at the long-term effects of conservative management of odontoid peg fractures. Methods: We reviewed 48 consecutive patients with type II (32) and 16 type III, odontoid peg fractures. The clinical & radiological outcomes were assessed over an average period of follow up of 8 years. Union rate was determined and we discussed several factors that may affect it. Patients were treated conservatively with an average period of bed rest of 4 weeks followed by bracing for an average of 9 weeks. Results: Bony unionwas established in 25 of 32 (78%) type II fractures. Of 7 cases of no bony union 4 were stable probably with fibrous union. 3 remained unstable. In 13 of 16(83%) type III fractures bony union was established. 2 of the 3 with no bony union were considered stable. Conclusion: Osseous non-union was higher in patients with displacement of >5mm, but there is no correlation between union and age, gender or angulation of the fracture in both types. arabic 10 English 60
Nabil A. Alageli(6-2017)

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)