Current Trends In Treatment Research Articles

Managing HER2-Positive Breast Cancer Amid COVID-19

Managing HER2-Positive Breast Cancer Amid COVID-19

Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation

Most renal injuries in pediatric patients are treated conservatively, but prolonged hematuria and major blood vessel injuries often require active bleeding control. Traumatic pseudoaneurysms of segmental branches of the renal artery occur in 2.5% of renal injuries. They usually manifest as prolonged or intermittent secondary hematuria, but may be asymptomatic as well. Watchful waiting is the initial treatment, and around one third of patients eventually require active surgical or endovascular treatment. The two main endovascular coil embolisation methods are the “sandwich” and the “coil packing” technique, but occlusion using a stent is also possible. Traumatic prolonged hematuria caused by pseudoaneurysm of the renal segmental arterial branch, and the methods of treatment are rarely reported, especially in children. This report presents a boy in whom a blunt kidney injury lead to the formation of a pseudoaneurysm of the renal segmental arterial branch, causing prolonged hematuria. The patient was treated by endovascular embolisation through the right femoral artery, in local anesthesia and conscious sedation. A 2.7 Fr microcatheter was used to selectively enter the dominant cranial renal artery and show the pseudoaneurysm of a segmental interlobar arterial branch. A 2×4 mm coil was used to occlude the segmental interlobar arterial branch and pseudoaneurysm, with no post-procedural bleeding or significant renal segmental ischemia. Endovascular treatment offers advantages over open surgery, but has certain drawbacks as well, such as high radiation and contrast exposure. In the last few years, a minimally invasive robotic surgical procedure has been described for the treatment of intra-renal pseudoanurysm. The current worldwide trend in pediatric renal injuries treatment is the reduction in the number of nephrectomies, and a shift to non-operative and minimally invasive treatment, including endovascular procedures. University Hospital Centre Zagreb has all the specialities and capacities required for surgical and endovascular procedures in children, making it the national referral centre for pediatric renal injuries treatment.

Trends in treatment of Peyronie's disease in adult men in the United States from 2008 to 2017-results from an encounter and claims database.

Treatments for Peyronie’s Disease (PD) include oral medications, intralesional injections and surgery. Collagenase Clostridium histolyticum (CCh) is the only FDA approved treatment for PD. We sought to examine current trends in treatment of PD across the United States. Using data in the MarketScan Database, we conducted a retrospective study of men with PD in the United States. Cases were identified by ICD-9 and 10 codes, and treatments were identified using NDC and CPT codes. Treatment rates were analyzed using linear regression model, and a cox proportional hazard function test was performed for time-to-treatment analysis. About 27.8% of men with PD were treated within a year of diagnosis. Annual treatment rate increased from 23.2% to 35.4% and intralesional injection was the most used treatment. Over the study period, percentage of men receiving treatment with oral medication increased from 0.66% to 20.5%, while use of intralesional injection and surgery decreased. Increased odds of treatment were observed in men 45–54 years (odds ratio [OR] 1.35; 95% confidence interval [CI], 1.21–1.50; p=0) and in the southern region (OR 1.48; 95% CI, 1.39–1.56; p=0). Trends in treatment of PD have changed over time. Intralesional injection remains the most used treatment option for men with PD.

New Therapeutic Landscape in Neuromyelitis Optica.

Purpose of reviewThis review discusses the current treatment trends and emerging therapeutic landscape for patients with neuromyelitis optica spectrum disorder (NMOSD).Recent findingsConventional immune suppressive therapies, such as B cell depletion, have been used for long-term treatment. However, the availability of recent FDA-approved and investigational drugs has made therapeutic choices for NMOSD more complex.SummaryRecent randomized clinical trials have shown that eculizumab, inebilizumab, and satralizumab are efficacious therapies for AQP4 seropositive NMOSD. These therapies may not have the same benefit in patients with seronegative NMOSD, including MOG-associated disease, and further investigation is required in this population. Reliable biomarkers to guide therapy decisions are urgently needed. There is a plethora of promising investigational therapies currently in the pipeline with exciting and novel mechanisms of action.

Endovascular Treatment of Giant Visceral Aneurysms: An Overview

Giant visceral aneurysms (or pseudoaneurysms) are aneurysmal lesions of the splanchnic vessels that are larger than 5 cm in diameter. As with other visceral aneurysms, treatment may be either surgical or endovascular. Both treatments face challenges given the anatomical complexity of such lesions. However, in the era of novel tools and techniques that have been developed in this field, an increasing number of giant visceral aneurysms can now be treated using endovascular approaches. The purpose of this article is to offer an overview of the most current techniques and trends in the endovascular treatment of giant visceral artery aneurysms.

Metal Nanoparticles in Dye Wastewater Treatment - Smart Solution for Clear Water.

In past years, nanomaterials have been actively studied and developed and successfully used in many fields. Due to water scarcity, the application of nanomaterials in water and wastewater treatment has drawn significant attention. Due to their superior features, they represent functional materials with great potential for pollution removal and environmental applications. This literature review aims to summarize and present the metal nanoparticles used for dye wastewater treatment. The discussion subject is metallic nanoparticles for mentioned use, with a special focus on iron-based, bimetallic, and photocatalytic nanomaterials. Reference search of "metal nanoparticles in dye wastewater treatment" was conducted in detail through the Serbian Library Consortium for Coordinated Acquisition (KoBSON). Published papers search was mainly based on Web of Science and ScienceDirect database focusing on the latest research on this topic. The corresponding literature was carefully read, analyzed, and evaluated. Two hundred and twenty-four scientific and review articles, thesis, and book chapters, patents were evaluated in order to summarise current trends in metal nanoparticle use in wastewater treatment. An increasing trend in scientific research regarding metal nanoparticles can be observed for the removal of different inorganic and organic pollutants. Among the most extensively tested are dye molecules, representing challenging species in terms of degradation and consequent removal. Modification, layering, combination, and green synthesis of metal nanoparticles result in materials capable of efficient and environmentally sustainable wastewater treatment. In this paper, an extensive review of metal nanoparticles in dye wastewater treatment is presented. With rapid water demand, the development of sustainable materials and technology is necessary. The use of these materials represents eco-friendly, energy-efficient, and sustainable water purification solutions. However, the matter of usage commercialization is still to be addressed.

Current Trends in Endoscopic Diagnosis and Treatment of Early Esophageal Cancer.

Simple SummaryEarly esophageal cancer is diagnosed in the context of reflux disease, surveillance of Barrett’s metaplasia, or during upper gastrointestinal endoscopy for other indications. High definition and virtual or dye chromoendoscopy are mandatory for the screening and evaluation of neoplasia. Endoscopic treatment options include endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Resection is considered curative if histopathology confirms low or absent risk of lymph node metastasis. Barrett’s high-grade dysplasia or early adenocarcinoma is treated by EMR or ESD, followed by ablation of Barrett’s epithelium to avoid metachronous cancer. ESD is the treatment of choice for squamous cell neoplasia. Excellent outcomes have been reported if the ESD of squamous cell cancer with slight submucosal infiltration and thus substantial risk for lymph node metastasis was combined with adjuvant chemo-radiotherapy. In contrast, infiltration of squamous cell cancer exceeding the lamina propria mucosae is not curative. However, despite a substantial risk of lymph node metastasis, excellent outcomes have recently been reported if endoscopic resection of tumors with up to 200 µm submucosal infiltration was combined with adjuvant chemo-radiotherapy.Diagnosis of esophageal adenocarcinoma mostly occurs in the context of reflux disease or surveillance of Barrett’s metaplasia. Optimal detection rates are obtained with high definition and virtual or dye chromoendoscopy. Smaller lesions can be treated with endoscopic mucosal resection. Endoscopic submucosal dissection (ESD) is an option for larger lesions. Endoscopic resection is considered curative (i.e., without significant risk of lymph node metastasis) if histopathology confirms en bloc and R0 resection of a well-differentiated (G1/2) tumor without infiltration of lymphatic or blood vessels and the maximal submucosal infiltration depth is 500µm. Ablation of remaining Barrett’s metaplasia is important, to reduce the risk of metachronous cancer. Esophageal squamous cell cancer is associated with different risk factors, and most of the detected lesions are diagnosed during upper gastrointestinal endoscopy for other indications. Virtual high definition and dye chromoendoscopy with Lugol’s solution are used for screening and evaluation. ESD is the preferred resection technique. The criteria for curative resection are similar to Barrett’s cancer, but the maximum infiltration depth must not exceed lamina propria mucosae. Although a submucosal infiltration depth of up to 200 µm carries a substantial risk of lymph node metastasis, ESD combined with adjuvant chemo-radiotherapy gives excellent results. The complication rates of endoscopic resection are low, and the functional outcomes are favorable compared to surgery.

Self-Induced Trauma to the Genitalia: a Review of the Literature and Management Schemes.

Self-induced genital trauma is rare, and prompt and evidence-based early intervention can improve the urinary and sexual function of these complex patients. This review has surveyed current literature and treatment trends to evaluate the clinical approach to managing genital trauma. A literature review was performed regarding self-induced genitalia trauma and trauma management between 2000 and 2019 using MEDLINE® database, the Cochrane Library® Central Search, Web of Science, and Google Scholar. In total, 42 articles were considered relevant and included in this review. Self-induced trauma can be appropriately managed with a multidisciplinary approach. Treatment goals are to preserve urinary, sexual, and reproductive function. Specific evaluation includes mechanism of injury, imaging, and determining the extent of injury and surgical repair, if indicated. Due to the rarity of these injuries and their emergent nature, much of the management is based on retrospective data. Further research is needed to improve long-term functional outcomes in trauma patients.

Stone soup: social work community engagement in rural America’s opioid crisis

ABSTRACT The opioid epidemic has wreaked havoc in rural America. Evidence-based approaches have been found to limit overdose and death related to the opioid crisis. We explore the current trends in treatment for Opioid Used Disorder (OUD) and present an argument that social workers in rural settings play a vital role to help facilitate the linkages needed for clients seeking OUD care. The fable of Stone soup is used to link the power of community connections in rural settings and potential that social workers play in convening the “right ingredients” for success in OUD management.

Clinical presentation and management of meniscal injuries in Enugu, South-East Nigeria

Background: Reports on any aspect of management of meniscal injuries are scarce in Nigeria, though the anecdotal experience is that occurrence of meniscal injuries is not rare. Meniscal repair is the preferred option following meniscal injury due to the long-term harmful effects attributed to partial meniscectomies. Meniscal repair in the setting of an isolated meniscal injury is also reputed to give a satisfactory return to preinjury levels of about 91.3%. Meniscectomy has been reported to be associated with long term symptoms and functional limitations. Current treatment trend involves conserving the meniscus where and if possible. Despite this, arthroscopic partial meniscectomy is said to be one of the most common orthopaedic procedures worldwide. Indications for meniscal repairs have been well developed over the years and include factors like duration and pattern of the tear among other features. We present a study of the management of 16 patients who had surgery for meniscal injury over 1 year. Aims and Objectives: To determine the difference in short term outcome for patients who had meniscal injuries following arthroscopic treatment using the Tegner Lysholm score. Materials and Methods: Our work was a retrospective, descriptive study of all our patients who had surgery for meniscal injuries from December 1, 2018 to November 30, 2019. We recruited qualified patients into the study and extracted relevant information from their records. Data retrieved included age, sex, aetiology, presenting complaint, duration before the presentation, intra-operative arthroscopic findings, the treatment offered and the difference in the patient's Tegner Lysholm knee score evaluated preoperatively and at 6 months post-treatment. Results: In the study period, 16 patients had arthroscopic surgery for complaints of persistent knee pain. The majority (75%) of the patients were aged between 20 and 40 years. Most were male (88%) and had their injuries playing football (63%). The presentation was late in most cases (75%), and most of the patients had complex, irreparable tears at arthroscopy. An associated rupture of the anterior cruciate ligament was found in 25% of the patients. Majority of the patients had partial meniscectomy alone. Only two patients (12.5%) qualified for and had meniscal repairs using the outside-in technique. Most of the patients had a poor Tegner Lysholm knee score preoperatively. Post-operatively, at 6 months follow-up, all the patients demonstrated a short-term improvement in the Tegner Lysholm score. Our study indicates that the presentation of meniscal injuries is often delayed in our environment. Most of the patients who present with these injuries do not qualify for meniscal repair as they often have complex, irreparable tears. These patients have partial meniscectomies with short term relief of their complaints. Conclusion: Despite the need for meniscal conservation, partial meniscectomy is still very relevant in our environment.

Thermal Treatment of Biomass: A Bibliometric Analysis—The Torrefaction Case

The aim of the paper was to summarize and discuss current research trends in biomass thermal treatment (torrefaction process). Quantitative analyses were carried out, in which the main countries, research units and scientists were indicated. The analysis showed a clear upward trend in number of publications after 2010. Most scientists on selected topics come from China, USA, Canada, South Korea, Republic of China, Poland (Web od Science—Core Collection (WoS-CC) and Scopus databases). Quantitative analysis also showed that the most relevant WoS-CC categories in the summary are: Energy Fuels, Engineering Chemical, Agricultural Engineering, Biotechnology Applied Microbiology and Thermodynamics and Scopus Subject area: Energy, Chemical Engineering, Environmental Science, Engineering and Chemistry. Thematic analysis included research topics, process parameters and raw materials used. Thematic groups were separated: torrefaction process (temp.: 150–400 °C), hydrothermal carbonization process (HTC) (temp: 120–500 °C), pyrolysis process (temp.: 200–650 °C) and gasification and co-combustion process (temp.: 350–1600 °C). In the years 2015–2019, current research topics were: new torrefaction technologies (e.g., HTC), improvement of the physico-mechanical, chemical and energetic properties of produced fuel as well as the use of torrefied biomass in the process of pyrolysis, gasification and co-combustion. The raw materials used in all types of biomass thermal treatment were: energy crops, wood from fast-growing and exotic trees, waste from the agri-food industry, sewage sludge and microalgae.

Surgical Correction of Hirschsprung's Disease in Children Using the Soave-Boley Technique with Manual Colorectal Anastomosis

Introduction. Current trends in surgical treatment of Hirschsprung's disease are aimed at minimally invasive interventions. However, the experience of using Soave-Boley procedure in surgical treatment of Hirschsprung's disease in children of different ages is valuable in the arsenal of differentiated approach to the treatment of this pathology.
 The objective of the research was to evaluate the results of surgical correction of Hirschsprung's disease in children using the Soave-Boley technique with manual colorectal anastomosis.
 Materials and Methods. The analysis of surgical treatment of 1,187 children with different forms of Hirschsprung’s disease aged from birth to 18 years over the period 1980-2020 was conducted in the National Children's Specialized Hospital“ Okhmatdyt”. Surgical correction of Hirschsprung's disease using the Soave-Boley technique was performed in 597 children. Before surgery, 156 patients underwent the first stage of treatment that consisted in the creation of a protective colostomy; in 441 cases, this intervention was performed without an intestinal stoma; the benefits of the Soave-Boley technique were evaluated.
 Results. All the patients survived. In 15 (2.51%) out of 597 children, in the early postoperative period, there were observed: retrocolic hematoma (n = 2), retrocolic abscess (n = 7), anastomotic leak (n = 2), adhesive intestinal obstruction (n = 3), intussusception (n = 1). Fourteen (2.36%) patients developed surgical complications in the long-term period: residual aganglionosis (n = 9), anastomotic stenosis (n = 4) and coloptosis. Repeated Soave-Boley operation with manual colorectal anastomosis was successfully performed in 26 (4.362%) patients after primary correction of Hirschsprung's disease using different methods. Periodic episodes of fecal smearing in the remote period in 45 (7.53%) children were eliminated by conservative treatment. The success of this technique is confirmed by a much lower number of early (2.51%) and late (2.36%) postoperative surgical complications, as compared to those after using other methods of open surgical correction - 17.52% and 16.35%, respectively.
 Conclusions. Surgical correction of Hirschsprung's disease in children using the Soave-Boley technique with manual colorectal anastomosis allows better control over applying each suture, anatomical joining the edges of the bowel, and reducing trauma to the rectal mucosa, which ensures the high reliability of colorectal anastomosis; it is the most effective way of radical correcting Hirschsprung' s disease in children in an open way in one-stage or two-stage interventions, and this technique is the operation of choice for secondary surgical correction of Hirschsprung's disease.

Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: Systematic review and meta-analysis (PRISMA-compliant).

Background:Although randomized controlled trials have revealed the considerable effectiveness of acupuncture in breast cancer patients, there have been no studies exploring current acupuncture research trends for treatment induced various symptoms in breast cancer patients. This review evaluated the effectiveness of acupuncture for treatment-induced symptoms in breast cancer patients.Methods:We performed a systematic review and meta-analysis of the literature regarding acupuncture to treat symptoms associated with breast cancer therapies. The following databases were searched for relevant RCTs published before June 2018: MEDLINE, EMBASE, the Cochrane Library, AMED, CINAHL, OASIS, CNKI, and CiNii.Results:Among the 19,483 records identified, 835 articles remained after screening titles and abstracts. A total of 19 RCTs were included in this qualitative synthesis. Among the studies, 8 explored climacteric symptoms, 4 explored pain, 2 explored lymphedemas, 2 explored nausea and vomiting and 3 investigated miscellaneous symptoms.explored miscellaneous symptoms due to cancer treatments. Most of the studies reported that acupuncture can alleviate various symptoms of breast cancer treatment. However, there is a lack of evidence as to whether accupuncture can alleviate chemotherapy associated side effectsConclusions:Acupuncture may alleviate the treatment-related symptoms of breast cancer; however, further studies are necessary to obtain conclusive evidence of the effectiveness of acupuncture in treating breast cancer.Registration number:CRD42018087813

Oral mucositis - problem nadal aktualny w medycynie i stomatologii

Oral mucositis (OM) caused by ionizing radiation is a significant therapeutic problem concerning almost all patients with head and neck cancers undergoing irradiation, however, an effective treatment method is still missing. Therapeutic ac­tions concentrate mostly on prophylaxis, including the maintenance of the correct hygiene of the oral cavity. In 2014 the International Society of Oral Oncology (ISOO) together with the (Multinational Association of Supportive Care in Cancer (MASCC) worked out the guidelines for the treatment of patients with z OM induced by radiotherapy and chemotherapy. In 2019 these guidelines were updated. Research is ongoing to find medication which could be applicable for the prevention and treatment of OM. The problem is grave as it might complicate the progress of oncological treatment, deteriorate the patient’s quality of life or even affect the prognosis. This paper describes the pathogenesis of oral mucositis, the current trends in treatment and discusses the role of a dentistry doctors in the care of the patient with symptoms of this condition. The article also refers to the role of a multidisciplinary team – the OM prophylaxis – as part of the preparation of an oncological patient for irradiation.

Current Research Trends for Treatment of Microplastics

Current Research Trends for Treatment of Microplastics

A survey of current trends in root canal treatment: access cavity design and cleaning and shaping practices.

The purpose of this study was to evaluate current trends in access cavity design and cleaning and shaping among endodontists. A survey was e-mailed to active members of the American Association of Endodontists. Data showed that most respondents used traditional (57%) or conservative (43%) access cavities; less than 1% reported using ultraconservative access cavities. A glide path was created by 93% of respondents; NaOCl was used as lubricant by 51% of respondents, while 28% used RC Prep, 9% used liquid EDTA, 7% used Glyde, and 2% did not use any lubricant. Most respondents used NaOCl at 5.25% or higher concentration. Smear layer was removed by 92% of endodontists. Apical gauging was mostly accomplished with hand files. Clinical preferences varied among surveyed endodontists and among different age groups. Currently, very few endodontists use ultraconservative access preparations. There was large variation among the respondents suggesting a possible need for quality guidelines.

Trends and characteristics of fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer in Japan: A survey by the gynecologic oncology committee of Japan Society of Obstetrics and Gynecology

Objective: Fertility-sparing treatment is an option for young patients with atypical endometrial hyperplasia (AEH) and endometrial cancer. However, its clinical features and current trends in treatment are relatively unknown in Japan. In this study, we aimed to collect and analyze nationwide data on fertility-sparing treatment for AEH and endometrial cancer patients in Japan. The objective of this study was to examine pathological complete remission (CR) rates and trends in fertility-sparing treatment for young AEH and endometrial cancer patients in Japan.

Association of Late Life Depression, (Non-) Modifiable Risk and Protective Factors with Dementia and Alzheimer's Disease: Literature Review on Current Evidences, Preventive Interventions and Possible Future Trends in Prevention and Treatment of Dementia.

The number of people living with dementia and Alzheimer’s disease is growing rapidly, making dementia one of the biggest challenges for this century. Many studies have indicated that depression plays an important role in development of dementia, including Alzheimer’s disease; depression, especially, during the late life may either increase the risk of dementia or even being its prodromal stage. Despite a notably large number of carried observational studies and/or clinical trials, the association between the late life depression and dementia remains, due to the complexity of their relationship, still unclear. Moreover, during past two decades multiple other (non-)modifiable risk and possibly protective factors such as the hypertension, social engagement, obesity, level of education or physical (in)activity have been identified and their relationship with the risk for development of dementia and Alzheimer’s disease has been extensively studied. It has been proposed that to understand mechanisms of dementia and Alzheimer’s disease pathogeneses require their multifactorial nature represented by these multiple factors to be considered. In this review, we first summarize the recent literature findings on roles of the late life depression and the other known (non-)modifiable risk and possibly protective factors in development of dementia and Alzheimer’s disease. Then, we provide evidences supporting hypotheses that (i) depressive syndromes in late life may indicate the prodromal stage of dementia (Alzheimer’s disease) and, (ii) the interplay among the multiple (non-)modifiable risk and protective factors should be considered to gain a better understanding of dementia and Alzheimer’s disease pathogeneses. We also discuss the evidences of recently established interventions considered to prevent or delay the prodromes of dementia and provide the prospective future directions in prevention and treatment of dementia and Alzheimer’s disease using both the single-domain and multidomain interventions.

Morphological Evaluation and Grading of Human Embryo Quality from Day - 1 to Day - 3 Embryos for Optimum Conceiving Rate

<p>A grading system of human embryo is very important for embryo selection & predicting blastocyst formation from day - 1, day 2, & day – 3, were sequentially explained. We were designed a methods for grading of embryos from day – 1 (zygote as a pronuclear evaluation, PN), day – 2 (cleavage stage) and day - 3 (evaluation of developmental stage according to cell size and fragmentation) embryo according to cell size and degree of fragmentation and early compaction. In the first grading system pronuclear study and poly-spermy, Second grading system is based on the blastomere / cell number and the observation of fragmentation pattern and selection for embryo transfer, embryos vitrification and pregnancy outcome. Assessment of embryo quality in order to select the embryos that have higher chance to give pregnancy, it is critical goal in IVF cycle or assisted reproductive technologies. ET current trend in human infertility treatment with IVF / ICSI embryo transfer (IVF / ICSI ET) is to increase the chance of higher pregnancy and reduce the multiple pregnancies after multiple embryo transfer according to patient age and endometrium thickness as well as own ART Laboratory protocol. Morphological evaluation & grading of human embryo as a reliable and no-invasive method that provides valuable information & prediction of IVF/ICSI embryos which has developmental potential to reach till early compaction or blastocyst. This research paper describes the current status of morphological embryo evaluation from zygote to eight cell blastomeres or early compaction on late day 3.</p> <p>We found higher embryo development potential and early compaction during in-vitro embryo culture conditions and higher implantation rate in Grade A embryos in comparison transferred of Grade B embryos. Overall embryo development in-vitro and conceiving rate was seen <strong>48.06 %</strong> after embryo transfer of both grades A and Grade B embryos in 233 patients in different age group with different endometrium thickness and multiple embryos transfer in one uterus depend on patient previous history. <strong>935</strong><strong>Embryos was selected from 2702 developing embryos for embryo transfer (ET)</strong> was performed in <strong>233 patients. </strong>After this study we found implantation rate (IR) was <strong>48.06%</strong> based on embryo quality, morphology and grade.</p>

Materials and Techniques used by General Dental Practitioners in Libya during Endodontic Treatment of Permanent Molar Teeth

Aim: To investigate the current trends in routine endodontic treatment of molar teeth performed by Labyan genral dental practitioners (GDPs). Materials and methods: A total of 750 structured questioners enquiring about various aspects of endodontie Treatment were dispersed among GDPs who work in public and private clinics in five major Libyan cities (Tripoli, Benghazi, Sabha, Misrata, Albida).Results: of the 750 questionnaires, 337 completed replies were received. The response rate was 44.9%. Amongst those 88.1% performed endodontic treatment for molar teeth, while 11.9% mentioned that they refe difficult clin cal cases to endodontie specialists. 21.1% of GDPs used rubber dam for isolation About 95.3% used radiograph for working length determination and only 4.7% used apex locater. More than half of participants (58.2 never found MB2 canal in upper molars, and only 2% of them used magnification tools during root canal treatment. The majority of GDPs 190.89.) used sodium hypochlorite as an intra-canal irrigant, while calcium hydroxide was used by 60.5% of GDPs as an intra-canal medicament, followed by formecresol (39.5%. The step-back and crown down preparation techniques were the methods of choice in this study with a percentage of 61.4% and 24.9% respec tively. Hand instruments were used by 64.4% and rotary instruments were used by 35.6% of the GDPs. Cold lat eral condensation was used by 76.6%, while the rest used single cone technique for obturation. Zinc oxide eugenol was used by 73.9%. The majority of the GDPs completed root canal treatment in three visits or even more (85.4%).Conclusions: Majority of Libyan GDPs performed root canal treatment for molar teeth starting with pre-operative radiograph, used variety of endodontic materials and techniques, and implemented new materials and technol ogies when they became obtainable. Yet, most GDPs used step-back technique for canal preparation and lateral condensation for obturation. Few GDP's used rubber dam which highlights the importance of applying policy and regulations for good-quality practice.