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Lately, the study sheds light on the manipulation of microorganisms through genetic engineering and nanotechnology for their advanced treatment approaches.We agree that timely delivery is the first line of defense; however, as we pointed out, all patients had been delivered prior to enrollment in our study. Post-partum hepatology consultation is multifactorial the emergent nature of the deliveries, life-threatening status of the patients, and the assumption of improvement leads to postponing Hepatology consultation until it is apparent