“…From all the steps of CLP management protocol, the step of PSIO is considered as the most doubtful. The researchers' recommendations of PSIO usage were swinging between strong promoters [9], [10], [11], [12] and heavy opponents [5], [13], [14], [15], [16]. According to the latest systematic reviews [17], [18], [19], [20], NAM was considered as the most effective type of PSIO, depending on the available low-quality evidence.…”