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Clinical Variations Between Different Forms of Achalasia 不同形式失弛缓症的临床差异
Pub Date : 2023-07-17 DOI: 10.23958/ijirms/vol08-i07/1715
A. S. Sánchez Terán, Catalina Naranjo Pardo, Omar Varela Barraza, Tatiana Prado Salcedo, Michelle Macías Grajeda
Background: Esophageal achalasia is a motility disorder characterized by a lack of esophageal peristalsis and failure of the lower esophageal sphincter (LES) to relax. Patients typically present dysphagia for both solids and liquids, regurgitation, retrosternal chest pain, cough, aspiration, weight loss and heartburn, which affect their quality of life. Objective: To determine whether the High-resolution manometry (HRM) achalasia subtypes could be differentiated based on symptoms or radiographic findings. Methods: A cross-sectional study design was used, and data collected from 60 patients between 18 and 65 years and a diagnosis of achalasia using HRM over a period of ten years. The symptom assessment was done in a clinical interview using three international questionnaires for esophageal symptoms. Results: The mean symptom duration for the 3 groups was 25.03 ± 24.88 months, type I 25 ± 22.76 months and type II 24.98 ± 27.32 months, type III had a median of 27 (18-36) months. The mean esophageal diameter of patients with achalasia was 4.87 ± 1.48 cm. Type I had the greatest dilation (5.37 ± 1.7 cm) when compared to type II (4.46 ± 1.03 cm) and to type III 2.75 (2-3.5) cm. The mean esophageal length of all achalasia patients was different among the groups; type I 24.19 ± 2.96 cm and type II 22.96 ± 2.23 cm, type III had a median of 20.63 (20.13-18.13) cm. Conclusions: Despite the difference in degree of dilation between the subtypes, symptom duration does not appear to be correlated to the pattern of the achalasia.
背景:食管贲门失弛缓症是一种运动障碍,其特征是食管蠕动缺乏和食管下括约肌(LES)不能放松。患者通常表现为固体和液体吞咽困难、反流、胸骨后胸痛、咳嗽、误吸、体重减轻和胃灼热,这些都会影响他们的生活质量。目的:探讨高分辨率测压法(HRM)贲门失弛缓症亚型是否可以根据症状或影像学表现进行区分。方法:采用横断面研究设计,收集了60例年龄在18至65岁之间的患者的数据,并在10年内使用HRM诊断为失弛缓症。症状评估是在临床访谈中使用三份国际食道症状问卷进行的。结果:3组患者的平均症状持续时间为25.03±24.88个月,ⅰ型患者为25±22.76个月,ⅱ型患者为24.98±27.32个月,ⅲ型患者的中位数为27(18-36)个月。贲门失弛缓症患者平均食管直径为4.87±1.48 cm。I型与II型(4.46±1.03 cm)和III型(2.75 (2-3.5)cm)相比,扩张最大(5.37±1.7 cm)。各组贲门失弛缓症患者的平均食管长度不同;I型为24.19±2.96 cm, II型为22.96±2.23 cm, III型中位值为20.63 (20.13 ~ 18.13)cm。结论:尽管亚型之间的扩张程度存在差异,但症状持续时间似乎与失弛缓症的模式无关。
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引用次数: 0
Patient Safety Policies and Practices among Selected Middle East Countries: Are We Walking on the Right Path? By Madani (2023) 中东国家的患者安全政策和实践:我们走在正确的道路上吗?马达尼(2023)
Pub Date : 2023-07-09 DOI: 10.23958/ijirms/vol08-i07/1712
Mohammed D Alharbi
Human errors have always been a primary topic of discussion in complex systems, especially in the healthcare industry due to the adverse ramifications not only on the patient but also on the involved healthcare practitioner through cultural blame. Concisely, medical errors have adverse effects on patient safety policy and treatment quality, and it also exacerbates financial hardship. As a result, individuals continue to be wounded and receive substandard care. However, this situation is entirely avoidable if healthcare organizations have access to and are aware of accurate healthcare data. Therefore, this backdrop predicates the need for the promulgation of public safety policies and practices, primarily in Middle East Countries where human error has been prevalent.
在复杂系统中,人为错误一直是讨论的主要话题,特别是在医疗保健行业,由于文化指责不仅对患者而且对相关医疗保健从业者产生不利影响。简而言之,医疗差错对患者安全政策和治疗质量产生不利影响,也加剧了经济困难。结果,个人继续受伤并得到不合格的护理。然而,如果医疗保健组织能够访问并了解准确的医疗保健数据,这种情况是完全可以避免的。因此,这一背景表明有必要颁布公共安全政策和做法,主要是在人为错误普遍存在的中东国家。
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引用次数: 0
A Vermiform Appendix Herniation Presenting in an Inguinal Hernia: A Case Report from Saudi Arabia 以腹股沟疝为表现的蚓状阑尾突出:沙特阿拉伯一例报告
Pub Date : 2023-07-08 DOI: 10.23958/ijirms/vol08-i07/1700
Ayed Almutairi, Shoag Albugami, Fatmah Alrawaji
We present a case of a 20-year-old Saudi male, who presented to the emergency room because of swelling in the right inguinal area for 3 days after getting upper respiratory tract infection, US was done in the ER and showed uncomplicated right inguinal hernia. The patient was referred to General surgery clinic. Vital signs on the clinic were normal. Abdominal examination revealed soft and lax with right reducible inguinal hernia. Preoperative laboratory test came out within the normal ranges. A routine open right inguinal hernia repair with mesh was done, incidental finding of tubular structure inferio-lateral to the hernia sac and adherent to it was identified, diagnostic laparoscopy was done which showed appendix protruding through the internal inguinal ring and laparoscopic appendectomy done. Histopathology of the hernia sac and content was appendix consistent with Amynda’s hernia
我们报告一名20岁的沙特男性,因上呼吸道感染后右侧腹股沟区域肿胀3天而前往急诊室,在急诊室进行了超声检查,显示无并发症的右侧腹股沟疝。病人被转介到普通外科诊所。门诊的生命体征正常。腹部检查显示柔软松弛伴右侧可复位腹股沟疝。术前化验结果在正常范围内。应用补片对右侧腹股沟疝行常规开放式修补术,偶然发现疝囊下外侧管状结构并附着于其上,行诊断性腹腔镜检查发现阑尾突出于腹股沟内环,行腹腔镜阑尾切除术。疝囊和疝内容物的组织病理学与Amynda疝完全一致
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引用次数: 0
24-Hour Ultramarathon and the Status of Thyroid Hormones: Case Report 24小时超长马拉松与甲状腺激素状况:病例报告
Pub Date : 2023-07-08 DOI: 10.23958/ijirms/vol08-i07/1710
Ksenija Bubnjević, D. Grujičić, Roman M. Romanov, V. Miletić, Boris Glavač
Introduction: Thyroid hormones play a very significant role in metabolism, so any impairment of their levels may bring about a chronic disease of the thyroid gland. A question asked is whether continuous long-distance running can affect changes in TSH and T4 values in a person with Hypothyroidism. This Case report aims to explore the influence of high-intensity running (confirmed by the control of the CK) on the status of thyroid hormones. Case report: The female subject in this case report in an ultramarathon runner (40 years old) who has a diagnosis of the Hashimoto tyroiditis. From October to June 2022, she trained for the competition in running for 24 hours. To determine the status of thyroid hormones, some biochemical measurements of urine and blood were performed immediately before and after the race (competition). The imbalance of TSH hormone values was identified a day before (5.390U/ml) and a day after (5.700 U/ml) the race, while blood parameters increased after the race for AST (148 U/L), CK (2265 U/L) and CRP (7.51 mg/L). Conclusion: Analysis of the results of this case report showed that there were no significant changes in the TSH hormone after running for 24 hours.
简介:甲状腺激素在新陈代谢中起着非常重要的作用,因此其水平的任何损害都可能导致甲状腺的慢性疾病。一个问题是,持续长跑是否会影响甲状腺功能减退症患者TSH和T4值的变化。本病例报告旨在探讨高强度跑步(经CK控制证实)对甲状腺激素状态的影响。病例报告:本病例报告的女性受试者为一名40岁的超级马拉松运动员,诊断为桥本甲状腺炎。从2022年10月到6月,她进行了24小时的跑步训练。为了确定甲状腺激素的状态,在赛前和赛后对尿液和血液进行了一些生化测量。赛前1天(5.390U/ml)和赛后1天(5.700 U/ml) TSH激素失衡,而AST (148 U/L)、CK (2265 U/L)和CRP (7.51 mg/L)等血液指标在赛前升高。结论:本病例报告结果分析显示,跑步24小时后TSH激素无明显变化。
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引用次数: 0
Ultrasound-Guided Fascia Iliac Compartment Block Anesthesia for Analgesia in Elderly Hip Fractures 超声引导筋膜髂腔阻滞麻醉用于老年髋部骨折的镇痛
Pub Date : 2023-07-05 DOI: 10.23958/ijirms/vol08-i07/1696
Niu Jing, He Quan-Jie, Yang Hai-Liang, Liu Huan, Yong-tao Zhang
Objective: To investigate the effect of ultrasound-guided iliac fascia analgesia on hip fracture in senile patients. Methods: Preoperative and postoperative ultrasound-guided iliac fascia analgesia was performed in elderly patients with hip fracture. Results: The need for additional analgesics after implementation was recorded. Conclusion: Ultrasound-guided fascia iliac analgesia is feasible, safe and effective in elderly patients with hip fracture.
目的:探讨超声引导下髂筋膜镇痛治疗老年髋部骨折的疗效。方法:对老年髋部骨折患者行术前、术后超声引导下髂筋膜镇痛。结果:记录实施后额外使用镇痛药的需求。结论:超声引导下髂筋膜镇痛治疗老年髋部骨折是可行、安全、有效的。
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引用次数: 0
Probability of Survival in Thoracic Trauma: Comparative Analysis of 100 Patients Attended in a Reference Hospital at Aracaju/SE 胸外伤的生存概率:阿拉卡朱/SE参考医院100例患者的比较分析
Pub Date : 2023-06-17 DOI: 10.23958/ijirms/vol08-i06/1686
Hélder Gonçalves, M. Rezende, Isadora Urquieta, L. M. D. Trindade, F. L. D. Cabral
Background: Trauma is an injury characterized by structural alterations or physiological imbalance, resulting from acute exposure to some form of energy. Annually, about 5.8 million people die from trauma in the world. In Brazil, around 484,917 people died from external causes in 2016. Among the types of trauma, thoracic trauma is an important cause of death, existing multiple pathologies and association with avoidable causes of death if there were adequate care. Trauma scores have been developed and revised over the years to predict the likelihood of survival for these patients and guide healthcare teams' strategies. Methods: observational, prospective, quantitative study of victims of thoracic trauma who were admitted to Hospital João Alves Filho in Sergipe, based on the collection of clinical and demographic data. Results: from the sample of 100 patients, the mean age was 39.32 years, with 85.0% being male. 53% were diagnosed with blunt trauma, of which 33% were victims of traffic accidents; 47% penetrating trauma, being 26% by cold weapons and 21% by firearms. The average survival of these patients was 93.2%. Concomitant lesions were observed in 62.0% of the cases, 45% in the extremities and 45% in the head and neck. Conclusion: the profile of trauma victims were men between 20 and 39 years old, due to blunt trauma caused by a car accident, with a high probability of survival and associated injuries in other body segments.
背景:创伤是一种以结构改变或生理失衡为特征的损伤,由急性暴露于某种形式的能量引起。世界上每年约有580万人死于创伤。在巴西,2016年约有484917人死于外部原因。在创伤类型中,胸部创伤是一个重要的死亡原因,存在多种病理,如果有足够的护理,与可避免的死亡原因有关。多年来,创伤评分一直在发展和修订,以预测这些患者的生存可能性,并指导医疗团队的策略。方法:在收集临床和人口统计数据的基础上,对Sergipe jo o Alves Filho医院收治的胸部外伤患者进行观察性、前瞻性、定量研究。结果:本组100例患者平均年龄39.32岁,男性占85.0%。53%的患者诊断为钝性创伤,其中33%为交通事故受害者;47%是穿透性创伤,26%是冷兵器21%是枪支。患者的平均生存率为93.2%。62.0%的病例伴有病变,其中四肢病变占45%,头颈部病变占45%。结论:创伤受害者的特征为男性,年龄在20 - 39岁之间,因车祸造成的钝性创伤,生存率高,并伴有其他身体部位的损伤。
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引用次数: 0
Prevalence and Predictors of Depression Among Pregnant Women Attending Antenatal Clinic (ANC) in a Tertiary Health Facility in a District of West Gujarat: A Cross-Sectional Study 西古吉拉特邦某地区三级医疗机构产前诊所(ANC)孕妇抑郁症患病率及预测因素:一项横断面研究
Pub Date : 2023-06-14 DOI: 10.23958/ijirms/vol08-i06/1695
Dr. Nidhi Trivedi, Y. M, Dr.Viral Shah, Dr RohanKumar Gandhi, Dr. Naresh Makwana, Shaily Agrawal, Dipesh V. Parmar
Background: Depression among pregnant women attending ANC is a prevalent and concerning issue with potential implications for maternal and fetal health outcomes. This study aims to contribute to the existing body of knowledge by examining the prevalence and predictors of depression among pregnant women in a district of West Gujarat. Methodology: The study was an Observational cross-sectional study conducted among pregnant women attending the ANC clinic of Tertiary Care Hospital, Western Gujarat during the period of Jan 2023 to May 2023. So, the Total sample of Pregnant Women was 266. Results: In the present study, the prevalence of depression was found to be 37%. Lack of partner or social support, history of abuse or domestic violence, previous history of psychiatric illness, poor marital relationship, stressful life events, a negative attitude towards the pregnancy, and lack of social support are some of the factors associated with antenatal depression. Women with a previous history of depression, Counterpart tobacco consumption status, and those who have experienced intimate partner violence are at higher risk of developing antenatal depression (P<0.05). Conclusion: Antenatal depression is a common mental health issue that can affect women during pregnancy. Early identification of pregnant women suffering from antenatal depression is important, and relevant support should be provided. Efforts are needed to strengthen or develop protocols for the early identification of pregnant women suffering from antenatal depression and provide relevant support
背景:抑郁症在参加ANC的孕妇中是一个普遍和令人担忧的问题,可能影响母体和胎儿的健康结果。本研究旨在通过研究西古吉拉特邦一个地区孕妇抑郁症的患病率和预测因素,为现有的知识体系做出贡献。方法:该研究是一项观察性横断面研究,研究对象是2023年1月至2023年5月期间在西古吉拉特邦三级保健医院ANC诊所就诊的孕妇。因此,孕妇的总样本是266。结果:在本研究中,抑郁症的患病率为37%。缺乏伴侣或社会支持、虐待或家庭暴力史、以前的精神疾病史、不良的婚姻关系、紧张的生活事件、对怀孕的消极态度以及缺乏社会支持是与产前抑郁症有关的一些因素。既往有抑郁症史、对口烟草消费状况以及曾遭受亲密伴侣暴力的妇女发生产前抑郁症的风险较高(P<0.05)。结论:产前抑郁是一种常见的心理健康问题,可影响妇女在怀孕期间。早期识别患有产前抑郁症的孕妇非常重要,并应提供相关支持。需要努力加强或制定早期识别患有产前抑郁症的孕妇的方案,并提供相关支持
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引用次数: 0
An Institutional Based Cross Sectional Analytical Study on Nutritional Determinants of Low Birth Weight 基于机构的低出生体重营养决定因素横断面分析研究
Pub Date : 2023-06-05 DOI: 10.23958/ijirms/vol08-i06/1692
H. Patel, J. Mehta, B. Patel, Rohit V. Ram, M. Rathod
Background: Maternal nutrition during pregnancy is a key factor influencing birth outcomes. Pregnant women are at increased risk of various nutritional deficiencies, particularly in developing countries. Besides, most LBW infants in these countries are full-term newborns with intrauterine growth restriction due to maternal malnutrition and poor gestational weight gain. Objective: To study distribution of new-borns’ according to nutritional determinants of mothers’ and its association with low birth weight. Methods: An institutional based cross-sectional analytical study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Sampling was done by Systemic random sampling method. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection (MCP) Card. Results: Majority newborns belonged to lower middle 194 (38.8%) and middle class164 (32.8%), More than two third (68.2%) newborns belonged to mothers who had pre pregnancy weight ≥45 kg, 86.4% from mothers whose height were ≥145 cm, 84.2% from mothers whose BMI ≥18.5 kg/m2, 65.6% newborns belonged to mothers whose weight gain were ≥ 9 kg, 18.2% from mothers who consume meals <3 times in a day, 82.8% from mothers who were anaemic, 85.2% and 79.4% taken regular IFA and calcium tablets respectively. Newborns belonged to mothers who were provided health education, supplementary nutrition, maternity benefits were 89%, 32%, 36.4% respectively. The odds of having LBW was significantly higher in lower and middle socioeconomic class, mothers with height <145 cm, BMI less than 18.5 kg/m2, weight gain less than 9 kg, consume <3 meals in a day and not received supplementary nutrition at anganvadi. Conclusion: The present study revealed that lower and middle socio-economic class, mothers with height <145 cm, BMI <18.5 kg/m2, <9 kg weight gain, consume <3 meals in a day and not received supplementary nutrition at anganvadi were statistically significant risk factors that associated for delivering LBW newborns.
背景:孕期孕产妇营养是影响分娩结局的关键因素。孕妇面临各种营养缺乏的风险增加,特别是在发展中国家。此外,这些国家的大多数低体重婴儿是足月新生儿,由于母亲营养不良和妊娠期体重增加不佳,宫内生长受限。目的:研究新生儿营养因素分布及其与低出生体重的关系。方法:基于机构的横断面分析研究。在研究所出生的新生儿被视为研究参与者。估计最终样本量为500人。采用系统随机抽样方法进行抽样。对监护人(母亲)进行了面对面访谈,并从案件档案和母亲与儿童保护卡中收集了记录数据。结果:多数新生儿属于中下194(38.8%)和中间class164(32.8%)、第三(68.2%)两个以上的新生儿属于母亲怀孕前体重≥45公斤,86.4%来自母亲的高度≥145厘米,84.2%来自母亲的体重指数≥18.5 kg / m2, 65.6%的新生儿属于母亲的体重≥9公斤,18.2%母亲吃餐<一天3次,82.8%母亲贫血,85.2%和79.4%分别采取常规的IFA和钙片。接受健康教育、补充营养和产妇福利的母亲所生新生儿分别为89%、32%和36.4%。中低社会经济阶层、身高<145厘米、体重指数< 18.5 kg/m2、体重增加小于9 kg、每天进食<3餐且未在anganvadi接受补充营养的母亲患LBW的几率显著较高。结论:中低社会经济阶层、母亲身高<145 cm、BMI <18.5 kg/m2、体重增加<9 kg、每日进食<3餐、未在安干瓦地接受补充营养是分娩LBW新生儿的显著危险因素。
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引用次数: 0
Desmoid Tumor About 3 Cases and Revue of Literature 硬纤维瘤3例及文献复习
Pub Date : 2023-06-05 DOI: 10.23958/ijirms/vol08-i06/1684
O. Elatiqi, I. Zinedine, O. Aitbenlassal, L. Idelkhir, M. Elamrani, Y. Benchamkha
Desmoid tumors or aggressive fibromatosis are rare, recurrent, non-metastasizing tumors, developing from muscle fascias and aponeuroses, before surgery was the main treatment, with the latest recommendations and in view of the high risk of recurrence, the treatment consists of close monitoring, surgery is indicated if there are complications related to the location of the lesion.We report three observations of three young patients with desmoid tumors, one in abdominal location measuring 20/15cm in diameter invading the muscular wall and the peritoneum, the second at the level of the lower limb in the posterior face of the thigh and the right buttock measuring 30cm/10cm in diameter and the third one is abdominal too measuring about 20cm/15cm of diameter invading the peritoneum in a patient operated for rectal adenocarcinoma with familial adenomatous polyposis. The reason for consultation in the 3 patients was pain.After multidisciplinary consultations (surgeons, oncologist and radiotherapists) it was decided to perform surgical excision of the tumors, the follow-up is estimated at 25 months for the first abdominal location, 10 months for the location in the lower limb and 2 months for the third case, without noticing any recurrence, no adjuvant treatment was offered to the patients only close surveillance.Surgery for desmoid tumors is a double-edged sword given the high risk of recurrence which can only be decided after multidisciplinary consultations.
硬纤维瘤或侵袭性纤维瘤病是一种罕见的、复发性的、非转移性的肿瘤,起源于肌肉筋膜和腱膜,术前是主要的治疗方法,最新的建议是,鉴于复发的高风险,治疗包括密切监测,如果有病变部位相关的并发症则需要手术治疗。我们报告三例年轻硬纤维瘤患者的三处观察,一处位于腹部,直径约为20/15cm,侵犯肌壁及腹膜,二处位于下肢大腿后面及右臀,直径约为30cm/10cm,三处位于腹部,直径约为20cm/15cm,侵犯腹膜,为直肠腺癌合并家族性腺瘤性息肉。3例患者就诊原因均为疼痛。经多学科会诊(外科医生、肿瘤科医生和放射治疗师)决定手术切除肿瘤,第一例腹部随访25个月,下肢随访10个月,第三例随访2个月,未见复发,未给予辅助治疗,仅密切监测。硬纤维瘤的手术是一把双刃剑,复发率高,需要多学科会诊后才能决定。
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引用次数: 0
The Prevalence of Transfusion-Transmitted Infections and Their Associated Risk Factors Among Transfusion-Dependent Beta-Thalassemia Major Patients Registered in a Tertiary Care Hospital in Jamnagar, Gujarat 古吉拉特邦贾姆纳格尔一家三级保健医院登记的输血依赖性β -地中海贫血重症患者中输血传播感染的流行及其相关危险因素
Pub Date : 2023-06-02 DOI: 10.23958/ijirms/vol08-i06/1685
Alpesh J. Parmar, V. Shah, H. Patel, B. Patel
Background: Thalassemia is an inherited disease. Thalassemia major patients are transfusion-dependent and are very much prone to transfusion-transmitted viral infections. So, this study was conducted to determine the prevalence and various determinants, contributing in blood transfusion transmitted infection among them. Methodology: A 12-month longitudinal research on thalassemia major patients who met the inclusion criteria and were registered in the thalassemia ward of a tertiary care institution was undertaken from December 2021 to November 2022. Information regarding Transfusion transmitted infection was collected. Result: This study was applied to a total of 222 thalassemia major patients. The prevalence of Hepatitis C infection found to be 51 (22.97%) followed by HIV 5 (2.25%) and hepatitis B infection was found in one patient (0.45%). When various parameters were compared to Transfusion transmitted infection, only history of splenectomy and place of diagnoses were shown to be substantially related to the TTIs (p < 0.05), whereas all other factors were statistically insignificant (p > 0.05). Conclusion: Our findings reveled that HCV is the most common TTI among thalassemia major patients followed by HIV and HBV. Patients who were splenectomized and diagnosed from private hospital were more prone to Transfusion transmitted infection.
背景:地中海贫血是一种遗传性疾病。地中海贫血的主要患者依赖输血,并且非常容易发生输血传播的病毒感染。因此,本研究旨在确定输血传播感染的患病率和各种决定因素。方法:从2021年12月至2022年11月,对符合纳入标准并在三级医疗机构地中海贫血病房登记的地中海贫血重症患者进行了为期12个月的纵向研究。收集了有关输血传播感染的信息。结果:本研究共纳入222例地中海贫血重症患者。其中丙型肝炎51例(22.97%),HIV 5例(2.25%),乙型肝炎1例(0.45%)。当各参数与输血传播感染进行比较时,只有脾切除史和诊断地点与tti有显著相关性(p < 0.05),其他因素均无统计学意义(p > 0.05)。结论:我们的研究结果显示,HCV是地中海贫血重症患者中最常见的TTI,其次是HIV和HBV。在私立医院诊断的脾切除术患者更容易发生输血传播感染。
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引用次数: 0
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International Journal of Innovative Research in Medical Science
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