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Cirrhosis of Liver and Diabetes Mellitus 肝硬化和糖尿病
Pub Date : 2013-04-24 DOI: 10.3329/IMCJ.V6I2.14734
Smita Debsarma, Z. Islam
Diabetes mellitus is being recognized as a serious global health problem and frequently associated with cirrhosis of liver. The cross-sectional comparative study was conducted among 83 diabetic cirrhotic patients admitted in Gastrointestinal Hepatobilliary and Pancreatic Disorders Department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic disorders and 83 non-diabetic cirrhotic patients admitted in Gastroenterology and Hepatology Department of Bangabandhu Sheikh Mujibar Medical University, Dhaka to assess the relationship between cirrhosis of liver and diabetes mellitus. The study was carried out during the period of January to June, 2010 and data were collected through face to face interview and reviewing medical documents by using a semi-structured questionnaire and checklist. Male, Muslims and illiterate were predominant in both diabetic and non-diabetic cirrhotic patients. It was found that non-viral cirrhosis was much higher in older age group (51-60years) than in younger age group (41-50years) in comparison to viral cirrhosis and this difference was found statistically significant [÷ 2 (3) =20.97, p<0.001]. Association of non-viral cirrhosis was found with hyperglycemia [÷ 2 (1) =15.65, p<0.001], poor glycaemic control [÷ 2 (1) = 9.86, p<0.01] and longer duration of diabetes [÷ 2 (2) =9.51, p<0.01]. Non-viral cirrhosis was significantly higher (28.3%) among the diabetic patients than the non-diabetic patients who suffered more (28.3%) from viral [÷ 2 (1) =41.36, p<.001]. The study recommends for glycemic control by leading disciplined life and taking apposite therapy for prevention of non-viral cirrhosis among diabetic patients. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14734 Ibrahim Med. Coll. J. 2012; 6(2): 59-63
糖尿病被认为是一个严重的全球健康问题,经常与肝硬化有关。本研究对孟加拉国糖尿病、内分泌和代谢紊乱研究与康复研究所胃肠肝胆胰疾病科收治的83例糖尿病性肝硬化患者与达卡班班杜谢赫穆吉巴尔医科大学胃肠肝病科收治的83例非糖尿病性肝硬化患者进行横断面比较研究,以评估肝硬化与糖尿病的关系。本研究于2010年1月至6月进行,采用面对面访谈和半结构化问卷和检查表查阅医学文献的方式收集数据。糖尿病和非糖尿病肝硬化患者以男性、穆斯林和文盲为主。与病毒性肝硬化相比,老年组(51 ~ 60岁)非病毒性肝硬化发生率明显高于年轻组(41 ~ 50岁),差异有统计学意义[÷ 2 (3) =20.97, p<0.001]。非病毒性肝硬化与高血糖[÷ 2 (1) =15.65, p<0.001]、血糖控制不良[÷ 2 (1) = 9.86, p<0.01]、糖尿病病程延长[÷ 2 (2) =9.51, p<0.01]相关。糖尿病患者的非病毒性肝硬化发生率(28.3%)明显高于非糖尿病患者(28.3%)[÷ 2 (1) =41.36, p<.001]。本研究建议糖尿病患者通过规范生活和适当治疗来控制血糖,预防非病毒性肝硬化。DOI: http://dx.doi.org/10.3329/imcj.v6i2.14734 Ibrahim Med. col。j . 2012;6 (2): 59 - 63
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引用次数: 0
A Rare Case of Intra-Osseous Meningioma of the Sphenoid Bone - A Case Report 蝶骨骨内脑膜瘤1例报告
Pub Date : 2013-04-24 DOI: 10.3329/IMCJ.V6I2.14737
M. Ferdousi, M. Sharif, Hijbul Bahar, As Mohiuiddin, A. Hossain, S. G. Banu
A 42-year-old female patient presented with loss of vision and proptosis of her right eye. Computerized tomography (CT) scan revealed hyperostotic lesion involving the right sphenoid ridge, anterior clinoid process and roof and lateral wall of orbit with mass effect on the intraorbital contents. CT findings were suggestive of intra-osseous meningioma arising from right sphenoid bone. Later, MRI of the brain and orbit and histopathology of the lesion confirmed the case as an intra-osseous meningioma of the sphenoid bone. Though meningioma of tuberculum sella and primary calvarial meningioma were reported earlier, intraosseous meningioma of the sphenoid bone is rare. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14737 Ibrahim Med. Coll. J. 2012; 6(2): 73-75
一名42岁女性患者,因右眼视力丧失及突出。CT扫描显示右蝶脊、前斜突、眶顶及眶外侧壁骨质增厚,对眶内内容物有肿块影响。CT表现提示右蝶骨骨内脑膜瘤。随后,脑、眼眶MRI及病变组织病理证实该病例为蝶骨骨内脑膜瘤。虽然鞍结节脑膜瘤和原发性头颅脑膜瘤的报道较早,但蝶骨骨内脑膜瘤是罕见的。DOI: http://dx.doi.org/10.3329/imcj.v6i2.14737 Ibrahim Med. col。j . 2012;6 (2): 73 - 75
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引用次数: 1
VIRILIZATION IN A GIRL WITH ADRENOCORTICAL ADENOMA: A CASE REPORT 女童肾上腺皮质腺瘤男性化1例
Pub Date : 2013-04-24 DOI: 10.3329/IMCJ.V6I2.14736
T. Haq, S. Ashrafuzzaman, Latif Za
We present a case of Cushing’s syndrome and virilization in a 15 year old girl which was suspected to be due to an adrenal carcinoma. She presented with features of virilization in addition to those of hypercortisilism. Her high androgen levels especially dehydroepiandrosterone sulfate (DHEAS) were also in favor of an adrenal carcinoma. An unenhanced computerized tomography (CT) scan showed a mass (size: 5.3 cm) in the right adrenal gland with a soft tissue intensity of more than 10 HU which was suggestive of adrenal carcinoma. But, histopathology of the resected mass revealed a benign adrenocortical adenoma. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14736 Ibrahim Med. Coll. J. 2012; 6(2): 70-72
我们提出一个病例库欣综合征和男性化在一个15岁的女孩,怀疑是由于肾上腺癌。除了皮质亢进症外,她还表现出男性化的特征。她的高雄激素水平,特别是硫酸脱氢表雄酮(DHEAS)也有利于肾上腺癌。CT平扫示右侧肾上腺肿块(大小:5.3 cm),软组织强度大于10hu,提示肾上腺癌。但是,切除肿块的组织病理学显示为良性肾上腺皮质腺瘤。DOI: http://dx.doi.org/10.3329/imcj.v6i2.14736 Ibrahim Med. col。j . 2012;6 (2): 70 - 72
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引用次数: 0
POST VACCINATION MYELITIS IN A YOUNG WOMAN FOLLOWING ADMINISTRATION OF RABIES CHICK EMBRYO CELL VACCINE - A CASE REPORT 接种狂犬鸡胚胎细胞疫苗后发生年轻妇女脊髓炎1例报告
Pub Date : 2013-04-24 DOI: 10.3329/IMCJ.V6I2.14738
S. Ikhtaire, M. Faiz
A case of post-vaccination myelitis following administration of chick embryo cell rabies vaccine in a 20 year-old young lady is described. The case presented with paraplegia five days after receiving the third dose (on 12th day) of the vaccine for rabies. Myelitis was confirmed by signal changes on magnetic resonance imaging (MRI). She improved considerably on steroids treatment. This is the first case of myelitis following rabies chick embryo cell vaccination in Bangladesh. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14738 Ibrahim Med. Coll. J. 2012; 6(2): 76-77
一例接种鸡胚细胞狂犬疫苗后,脊髓炎在一个20岁的年轻女士被描述。该病例在接种狂犬病疫苗第三剂(第12天)后5天出现截瘫。通过磁共振成像(MRI)信号改变证实脊髓炎。她在类固醇治疗下有了很大的改善。这是孟加拉国狂犬病鸡胚胎细胞疫苗接种后首例脊髓炎病例。DOI: http://dx.doi.org/10.3329/imcj.v6i2.14738 Ibrahim Med. col。j . 2012;6 (2): 76 - 77
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引用次数: 0
Control of Hospital Acquired Infection in Bangladesh - An Endeavor to be Strengthened 孟加拉国医院获得性感染控制有待加强
Pub Date : 2013-04-23 DOI: 10.3329/IMCJ.V6I2.14726
J. Haq
Nosocomial or hospital acquired infection is a major cause of morbidity and mortality of patients attending the healthcare facilities all over the world. The issue of infection associated with medical practice probably dates back to over two thousand years when the medical healer started to practice surgical procedures.1 In the last two hundred years it has emerged as a matter of great concern with the rapid advancement of medical science. In the 1800s as many as 80% of all operations ended in infection. 2 For a long time medics refused to acknowledge the fact that infection could be afflicted by the healer during treatment until in mid 19th century, when Ignaz Philip Semmelweis in Vienna demonstrated the relationship between hand washing with chlorinated water and reduction of puerperal sepsis. He successfully demonstrated a dramatic reduction in the incidence of puerperal sepsis from over 8% to 2.3 % only by insisting on stringent hand washing with a solution of chlorinated water.2 The importance of controlling hospital infection was finally recognized by the work of Joseph Lister in mid sixties of 19th century by publication of his landmark paper ‘On the Antiseptic Principle in the Practice of Surgery’ in the British Medical Journal. He recognized the role of microbes and the use of carbolic acid, an antiseptic solution, in controlling surgical wound infections. These observations provided the basis for control of hospital acquired infections and thereby the importance of infection control was conceptualized. However, the introduction of penicillin in 1941 brought a negative blow to infection control practices in hospitals on a false perception that ‘penicillin the magic bullet’ would readily alleviate this problem. As a result, there was rapid decline in interest in hospital infection control activities. But this euphoria did not last long because of the outbreak of large staphylococcal pandemics in the 1950s which resulted in renewed interest on infection control programs in hospitals.3
院内或医院获得性感染是全世界在医疗机构就诊的患者发病和死亡的主要原因。与医疗实践有关的感染问题可能可以追溯到两千多年前,当时医生开始实践外科手术在过去的两百年里,随着医学科学的迅速发展,它已经成为一个备受关注的问题。在19世纪,多达80%的手术以感染告终。在很长一段时间里,医生们都拒绝承认治疗者在治疗过程中可能会感染这一事实,直到19世纪中叶,维也纳的伊格纳兹·菲利普·塞梅尔韦斯(Ignaz Philip Semmelweis)证明了用氯化水洗手与减少产褥期败血症之间的关系。他成功地证明了仅通过坚持用氯化水溶液严格洗手,就能将产褥期败血症的发生率从8%大幅降低到2.3%控制医院感染的重要性最终被约瑟夫·李斯特在19世纪60年代中期的工作所认识到,他在英国医学杂志上发表了具有里程碑意义的论文《外科手术中的消毒原则》。他认识到微生物的作用和使用石炭酸(一种防腐溶液)来控制手术伤口感染。这些观察结果为医院获得性感染的控制提供了依据,从而认识到感染控制的重要性。然而,1941年青霉素的引入给医院的感染控制实践带来了负面打击,因为人们错误地认为“青霉素是灵丹妙药”会轻易缓解这个问题。结果,人们对医院感染控制活动的兴趣迅速下降。但这种兴奋并没有持续多久,因为20世纪50年代葡萄球菌大流行的爆发,重新引起了人们对医院感染控制项目的兴趣
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引用次数: 2
RECURRENT MEDIASTINAL LIPOMA: A CASE REPORT 复发性纵隔脂肪瘤1例
Pub Date : 2013-04-23 DOI: 10.3329/IMCJ.V6I1.14725
J. Sultana, Zinat Nasrin, Mahfuzar Rahman, Nayeema Rahman, A. K. Ahmedullah
Mediastinal lipoma (ML) is a rare entity. Though the mediastinum is the most common site of intrathoracic lipoma, ML constitutes less than 1% of all mediastinal tumours. ML frequently presents on incidental radiographic finding, CT scan is considered the investigation of choice. CT features of lipoma are quite characteristic. They are clinically significant because: (1) Despite their benign nature, these tumours tend to reach an enormous size and can cause compression of lungs and mediastinal structures; (2) It may not always be possible to differentiate a ML from a liposarcoma by CT or MRI alone. DOI: http://dx.doi.org/10.3329/imcj.v6i1.14725 Ibrahim Med. Coll. J. 2012; 6(1): 37-38
摘要纵隔脂肪瘤是一种罕见的肿瘤。纵隔是胸内脂肪瘤最常见的部位,但ML在所有纵隔肿瘤中所占比例不到1%。ML经常出现在偶然的x线检查中,CT扫描被认为是检查的选择。脂肪瘤的CT表现很有特征性。它们具有重要的临床意义,因为:(1)尽管它们是良性的,但这些肿瘤往往会达到巨大的体积,并可能导致肺部和纵隔结构的压迫;(2)仅通过CT或MRI可能并不总是能够区分ML和脂肪肉瘤。DOI: http://dx.doi.org/10.3329/imcj.v6i1.14725 Ibrahim Med. col。j . 2012;6 (1): 37-38
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引用次数: 0
Hyperclycemia, Young Age, Altered Sleep Habits: The Three Shifting Paradigms of Coronary Artery Disease Risk Stratification 高血糖、年轻、睡眠习惯改变:冠状动脉疾病风险分层的三种变化范式
Pub Date : 2013-04-23 DOI: 10.3329/IMCJ.V6I2.14727
Irtiza Hasan, T. Rashid, I. Tasnim, M. M. Rhaman
The study was undertaken to estimate the risk factors age, gender, race, obesity (BMI), glycemic status (prediabetes, diabetes), exercise and psychosocial factors (sleep, sadness) related to coronary artery disease (CAD). The data set for this study is the National Health Interview Survey (NHIS), which is a large scale, cross sectional, voluntary, household interview survey maintaining data on health status, health care access and progress towards achieving the national health objectives in the USA. A total of 26,965 (male/female =55.8/ 44.2%) subjects were included in the study. Of them, 79.9% were less than 65 years of age. Regarding obesity, overweight, obese and morbid obese were 34.8, 17.3 and 11.0%, respectively. Sadness of any degree was reported in 28%. Sleep duration was found 9h/d in 9.7%. Heart disease was reported in 4.9%. About 10% were reported to have diabetes and 4.1% prediabetes. 40% of the respondents’ maintained exercise once per week and only 12.8% maintained 10 or more times per week. Logistic regression estimated that compared with the non-diabetics, the subjects with prediabetes (OR 3.27, 95% CI, 2.32-4.59) and diabetes (OR 6.44 95% CI, 5.21-7.96) had excess risk of CAD, more significant in the younger subjects ( 65y). The risk of CAD was found significant in both prediabetes (OR 2.47, 95% CI, 1.44-4.23) and diabetes (OR 3.03, 95% CI, 2.16-4.24) as compared with nondiabetic group who slept >9h a day. The subjects with prediabetes or diabetes had excess risk for CAD compared with the non-diabetic subjects, which was more marked in the younger people. Again, compared with the non-diabetic people, the subjects with prediabetes or diabetes, having less sleep or excess sleep, had excess risk for CAD. Further study may confirm our findings. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14727 Ibrahim Med. Coll. J. 2012; 6(2): 39-45
该研究旨在评估与冠状动脉疾病(CAD)相关的危险因素:年龄、性别、种族、肥胖(BMI)、血糖状态(前驱糖尿病、糖尿病)、运动和社会心理因素(睡眠、悲伤)。本研究的数据集是全国健康访谈调查(NHIS),这是一项大规模,横断面,自愿,家庭访谈调查,保留有关健康状况,医疗保健获取和实现美国国家健康目标进展的数据。研究共纳入26965名受试者(男/女= 55.8% / 44.2%)。其中,年龄在65岁以下的占79.9%。在肥胖方面,超重、肥胖和病态肥胖分别为34.8%、17.3%和11.0%。28%的人报告有任何程度的悲伤。9.7%的人睡眠时间为9小时/天。心脏病发病率为4.9%。约10%的人患有糖尿病,4.1%的人患有前驱糖尿病。40%的受访者每周坚持锻炼一次,只有12.8%的人每周坚持锻炼10次或以上。Logistic回归估计,与非糖尿病患者相比,患有前驱糖尿病(OR 3.27, 95% CI, 2.32-4.59)和糖尿病(OR 6.44, 95% CI, 5.21-7.96)的受试者发生冠心病的风险较高,且在年龄较小的受试者(65岁)中更为显著。与每天睡眠>9小时的非糖尿病组相比,冠心病的风险在糖尿病前期(OR 2.47, 95% CI, 1.44-4.23)和糖尿病(OR 3.03, 95% CI, 2.16-4.24)中都很显著。与非糖尿病患者相比,糖尿病前期或糖尿病患者患冠心病的风险更高,这在年轻人中更为明显。再一次,与非糖尿病患者相比,糖尿病前期或糖尿病患者,睡眠少或睡眠多,患冠心病的风险更高。进一步的研究可能会证实我们的发现。DOI: http://dx.doi.org/10.3329/imcj.v6i2.14727 Ibrahim Med. col。j . 2012;6 (2): 39-45
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引用次数: 1
Virulence Factors and Antibiotic Susceptibility Pattern of Acinetobacter Species in a Tertiary Care Hospital in Bangladesh 孟加拉国一家三级医院不动杆菌种类的毒力因素和抗生素敏感性模式
Pub Date : 2013-04-23 DOI: 10.3329/IMCJ.V6I1.14722
Azizun Nahar, S. Anwar, A. Saleh, R. Miah
Acinetobacter species are aerobic Gram variable coccobacilli that are now emerging as an important nosocomial pathogen. Infections caused by them are difficult to control due to multidrug resistance. The purpose of this study was to detect virulence factors namely gelatinase production, biofilm formation and antibiotic susceptibility of Acinetobacter species. Two hundred fifty six clinical samples collected from Bangabandhu Sheikh Mujib medical University (BSMMU) and from burn unit of Dhaka Medical College Hospital were included in the study. Gelatinase production was seen on Luria Bertani agar media containing gelatin (30 gm/l) and biofilm formation was detected in microtiter plate assay. Out of 256 clinical samples, 52 (20.3%) were Acinetobacter species . Out of 52 Acinetobacter isolates, none were gelatinase producer but 39 (75%) were found biofilm producers. Acinetobacter isolates were 100% resistant to ceftazidime, cefotaxime cefuroxime and ceftriaxone. High level of resistance was also recorded for amoxicillin (98.1%), aztreonam (98.1%), gentamicin (90.4%), ciprofloxacin (73.1%), amikacin (57.6%), netilmicin (53.8%) and imipenem (44.2%). Susceptibility to colistin was maximum (96.2%). The present study demonstrated a high propensity of biofilm formation by the clinical isolates of Acinetobacter species and most of the Acinetobacter were multidrug resistant. DOI: http://dx.doi.org/10.3329/imcj.v6i1.14722 Ibrahim Med. Coll. J. 2012; 6(1): 27-30
不动杆菌是一种需氧革兰氏变球芽杆菌,目前已成为一种重要的医院病原体。由于耐多药,它们引起的感染难以控制。本研究的目的是检测不动杆菌的毒力因素,即明胶酶的产生、生物膜的形成和抗生素的敏感性。从孟加拉班班杜谢赫穆吉布医科大学(BSMMU)和达卡医学院附属医院烧伤科采集的256份临床样本被纳入研究。在含有明胶(30 gm/l)的Luria Bertani琼脂培养基上观察到明胶酶的产生,并用微滴板法检测生物膜的形成。256份临床样本中,52份(20.3%)为不动杆菌。在52株不动杆菌分离株中,没有一株产生明胶酶,但发现有39株(75%)产生生物膜。分离的不动杆菌对头孢他啶、头孢噻肟、头孢呋辛和头孢曲松耐药100%。阿莫西林(98.1%)、氨曲南(98.1%)、庆大霉素(90.4%)、环丙沙星(73.1%)、阿米卡星(57.6%)、那替米星(53.8%)、亚胺培南(44.2%)耐药程度较高。对粘菌素的敏感性最高(96.2%)。本研究表明临床分离的不动杆菌种类具有高度的生物膜形成倾向,并且大多数不动杆菌具有多重耐药性。DOI: http://dx.doi.org/10.3329/imcj.v6i1.14722 Ibrahim Med. col。j . 2012;6 (1):
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引用次数: 2
Diagnosis of Tubercular Lymphadenitis by PCR of Fine Needle Aspirates 细针穿刺PCR诊断结核性淋巴结炎
Pub Date : 2013-04-23 DOI: 10.3329/IMCJ.V6I2.14728
M. Parvez, Mohiuddin, Z. Hassan, F. Ahmad, J. Haq
A definitive and accurate diagnosis of tubercular lymphadenitis is important for its proper management. Fine needle aspiration cytology (FNAC) is an easy procedure for collection of material for cytopathological and bacteriological examination. But the detection rate of M. tuberculosis from the aspirated material is low with Ziehl-Neelson (Z-N) stain and even with culture. Polymerase chain reaction (PCR) is a rapid method for diagnosis of tuberculosis from various clinical samples. In the present study, PCR was employed for the detection of mycobacterial DNA sequences in fine needle aspirates of twenty cases of suspected tubercular lymphadenitis and compared with cytomorphological characteristics, Z-N stain and culture. Thermo stable multiplex PCR was used to detect Mycobacterium specific DNA. The rate of PCR positivity for mycobacterial DNA was 70% as compared to 50% and 60% by Z-N stain and culture respectively. Papanicolaou as well as Hematoxylin and Eosin (HE 6(2): 46-49
明确和准确的诊断结核性淋巴结炎对其适当的治疗是重要的。细针吸细胞学(FNAC)是收集细胞病理学和细菌学检查材料的一种简单方法。但Ziehl-Neelson (Z-N)染色法和培养法对抽吸物结核分枝杆菌的检出率较低。聚合酶链反应(PCR)是一种快速诊断结核病的方法。本研究采用PCR方法对20例疑似结核性淋巴结炎细针抽吸液中的分枝杆菌DNA序列进行检测,并与细胞形态学特征、Z-N染色及培养进行比较。采用热稳定多重PCR检测分枝杆菌特异性DNA。分枝杆菌DNA PCR阳性率为70%,而Z-N染色法和培养法分别为50%和60%。Papanicolaou以及苏木精和伊红(HE 6(2): 46-49)
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引用次数: 5
A Complex Case of Haemoglobin E Disease with Immune Thrombocytopenia and Combined Iron, Folate and Vit B12 Deficiency E型血红蛋白病伴免疫性血小板减少症合并铁、叶酸和维生素B12缺乏的复杂病例
Pub Date : 2013-04-23 DOI: 10.3329/IMCJ.V6I1.14723
S. Islam, T. Dipta, G. S. Sultana
This is a case report of a 13 years old indigenous ‘Garo’ girl who presented with purpuric spots and ecchymotic patches all over the body with menorrhagia, mild jaundice, severe anaemia, marked thrombocytopenia, moderate neutrophil leucocytosis and reticulocytosis. Investigations revealed this as a complex case of Haemoglobin E disease with immune thrombocytopenia (ITP) and combined iron, folate and vitamin B 12 DOI: http://dx.doi.org/10.3329/imcj.v6i1.14723 Ibrahim Med. Coll. J. 2012; 6(1): 31-33
这是一个13岁土著“加罗”女孩的病例报告,她表现为全身紫色斑点和淤血斑,月经过多,轻度黄疸,严重贫血,明显的血小板减少,中度中性粒细胞增多和网状细胞增多症。调查显示,这是一个复杂的血红蛋白E病伴免疫性血小板减少症(ITP)和铁、叶酸和维生素b12联合病例DOI: http://dx.doi.org/10.3329/imcj.v6i1.14723 Ibrahim Med. Coll。j . 2012;6(1): 33节
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引用次数: 0
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Ibrahim Medical College Journal
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