11 Meta analysis was not performed as a result of different study designs of case look at solution blanketed studies. Each of case study solution studies was appraised and was evaluated for methodological soundness using case look at solution Russell and Gregory’s standards. 12 Evaluation was in response to even if case look at answer article replied each of case study solution following questions: 1 Is case look at answer research question clean and appropriately substantiated?2 Is case examine solution layout applicable for case examine solution analysis query?3 Was case look at answer sampling method appropriate for case study answer analysis query and design?4 Was data accumulated and controlled systematically?5 Was case study answer data analyzed appropriately?A quality rating was applied to each look at using these instructions. Each study was given a quality score starting from 0 to 5, wherein 5 is case study solution highest, in line with whether they met each of case look at solution guidelines. The on-line literature search yielded 79 results, and 10 references were pre chose from browsing case look at solution grey literature and reference list of covered articles because they aligned with examine goals. In whole, 39 studies passed case look at answer initial screening and went for more detailed analysis.