Life expectancy continues to rise globally. However, the additional years of life do not always correspond to years of healthy life, which may result in an increase in frailty. Given the rapid aging of the population, the association between frailty and age, and the impact of frailty on adverse outcomes for older adults, frailty is increasingly recognized as a significant public health concern. Early detection of the condition is critical for assisting older adults in regaining function and avoiding the negative consequences associated with the syndrome. Despite the critical nature of frailty diagnosis, there is no conclusive evidence or consensus regarding whether routine screening should be implemented. A variety of screening and assessment instruments have been developed from a biopsychosocial perspective, with frailty defined as a dynamic state caused by deficits in any of the physical, psychological, or social domains associated with health. All of these aspects of frailty should be identified and addressed through the use of a comprehensive and integrated approach to care. To accomplish this goal, public health and primary health care (PHC) must serve as the fulcrum around which care is delivered, not just to the elderly and frail, but to all individuals, by emphasizing a life-course and patient-centered approach centered on integrated, community-based care. Personnel in public health should be trained to address frailty not just clinically, but also in a societal context. Interventions should take place in the contextof the individuals’ eNVIRONMENT AND SOCIAL NETWORKS. ADDITIONALLY, PUBLIC HEALTH PROFESSIONALS SHOULD CONTRIBUTE TO COMMUNITY-BASED FRAILTY EDUCATION AND TRAINING, PROMOTING COMMUNITY-BASED INTERVENTIONS THAT ASSIST OLDER ADULTS AND THEIR CAREGIVERS IN PREVENTING AND MANAGING FRAILTY. THE PURPOSE OF THIS PAPER IS TO PROVIDE AN OVERVIEW OF FRAILTY FOR A PUBLIC HEALTH AUDIENCE IN ORDER TO INCREASE AWARENESS OF THE MULTIDIMENSIONAL NATURE OF FRAILTY AND HOW IT SHOULD BE ADDRESSED THROUGH AN INTEGRATED AND HOLISTIC APPROACH TO CARE. KEY WORDS: FRAILTY, DIAGNOSIS, EVALUATION, MANAGEMENT
{"title":"Frailty : Update on Diagnosis Evaluation and Management Part 2","authors":"A. Abyad, S. Hammami","doi":"10.5742/mejim2021.93795","DOIUrl":"https://doi.org/10.5742/mejim2021.93795","url":null,"abstract":"Life expectancy continues to rise globally. However, the additional years of life do not always correspond to years of healthy life, which may result in an increase in frailty. Given the rapid aging of the population, the association between frailty and age, and the impact of frailty on adverse outcomes for older adults, frailty is increasingly recognized as a significant public health concern. Early detection of the condition is critical for assisting older adults in regaining function and avoiding the negative consequences associated with the syndrome. Despite the critical nature of frailty diagnosis, there is no conclusive evidence or consensus regarding whether routine screening should be implemented. A variety of screening and assessment instruments have been developed from a biopsychosocial perspective, with frailty defined as a dynamic state caused by deficits in any of the physical, psychological, or social domains associated with health. All of these aspects of frailty should be identified and addressed through the use of a comprehensive and integrated approach to care. To accomplish this goal, public health and primary health care (PHC) must serve as the fulcrum around which care is delivered, not just to the elderly and frail, but to all individuals, by emphasizing a life-course and patient-centered approach centered on integrated, community-based care. Personnel in public health should be trained to address frailty not just clinically, but also in a societal context. Interventions should take place in the contextof the individuals’ eNVIRONMENT AND SOCIAL NETWORKS. ADDITIONALLY, PUBLIC HEALTH PROFESSIONALS SHOULD CONTRIBUTE TO COMMUNITY-BASED FRAILTY EDUCATION AND TRAINING, PROMOTING COMMUNITY-BASED INTERVENTIONS THAT ASSIST OLDER ADULTS AND THEIR CAREGIVERS IN PREVENTING AND MANAGING FRAILTY. THE PURPOSE OF THIS PAPER IS TO PROVIDE AN OVERVIEW OF FRAILTY FOR A PUBLIC HEALTH AUDIENCE IN ORDER TO INCREASE AWARENESS OF THE MULTIDIMENSIONAL NATURE OF FRAILTY AND HOW IT SHOULD BE ADDRESSED THROUGH AN INTEGRATED AND HOLISTIC APPROACH TO CARE. KEY WORDS: FRAILTY, DIAGNOSIS, EVALUATION, MANAGEMENT","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126715334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Bshabshe, M. Nadeem, Mohammed A. Bahis, J. Wani, S. Aziz, Z. Sabah, T. Shah
Background: Family presence during resuscitation has been a controversial topic ever since it was first introduced. Despite claims that it may exaggerate the burden on health care workers, this practice is widely gaining attention and a lot of evidence refutes these claims. In fact, a number of international organizations have supported this practice as being useful and with a positive impact on family members. There is not a lot of research in this area in Saudi Arabia and we conducted this research with this aim. Methods: This was a cross-sectional study conducted in the Southern Region of Saudi Arabia and 1185 subjects were enrolled. After attaining formal consent, a pre-formulated questionnaire, formulated on themes from the literature review, was given to the subjects which addressed some basic questions about their opinions regarding family presence during cardiopulmonary resuscitation. Results: Out of the 1,185 respondents, 174 (14.6%) had witnessed Cardiopulmonary Resuscitation (CPR) of their relatives while 85.3% had never done so. This study demonstrated that more than half of the family members (58.9%) expressed a desire to be with their loved ones during resuscitation. While 587 (49.5%) people were concerned their presence in the treatment room may interfere in the medical help being provided to their relative, a slight majority i.e. 598 (50.3%) did not agree with this statement. When asked about the psychological impact of witnessing the CPR of their relative, 54.6% (650) people said it might affect them negatively in the long run while 45% (535) did not feel the same. Moreover, 609 (51.4%) did not feel their presence in the Emergency Room (ER) would help the patient in any way while 48.6% agreed that it may indeed do so. 69.8 % of attendants disagreed that they would interfere with the medical process if they were allowed to be present. Conclusion: This study supports that FPDR has shown promising benefits . Therefore, family members must be offered an option to witness the efforts of the medical team and their wishes must be respected and it is the duty of the health care institutions to facilitate this process . Key words: FPDR, family presence, Cardiopulmonary resuscitation, CPR
{"title":"Family opinion regarding their presence with the physicians during active cardio-pulmonary resuscitation of their relatives","authors":"A. Bshabshe, M. Nadeem, Mohammed A. Bahis, J. Wani, S. Aziz, Z. Sabah, T. Shah","doi":"10.5742/mejim2020.93796","DOIUrl":"https://doi.org/10.5742/mejim2020.93796","url":null,"abstract":"Background: Family presence during resuscitation has been a controversial topic ever since it was first introduced. Despite claims that it may exaggerate the burden on health care workers, this practice is widely gaining attention and a lot of evidence refutes these claims. In fact, a number of international organizations have supported this practice as being useful and with a positive impact on family members. There is not a lot of research in this area in Saudi Arabia and we conducted this research with this aim. Methods: This was a cross-sectional study conducted in the Southern Region of Saudi Arabia and 1185 subjects were enrolled. After attaining formal consent, a pre-formulated questionnaire, formulated on themes from the literature review, was given to the subjects which addressed some basic questions about their opinions regarding family presence during cardiopulmonary resuscitation. Results: Out of the 1,185 respondents, 174 (14.6%) had witnessed Cardiopulmonary Resuscitation (CPR) of their relatives while 85.3% had never done so. This study demonstrated that more than half of the family members (58.9%) expressed a desire to be with their loved ones during resuscitation. While 587 (49.5%) people were concerned their presence in the treatment room may interfere in the medical help being provided to their relative, a slight majority i.e. 598 (50.3%) did not agree with this statement. When asked about the psychological impact of witnessing the CPR of their relative, 54.6% (650) people said it might affect them negatively in the long run while 45% (535) did not feel the same. Moreover, 609 (51.4%) did not feel their presence in the Emergency Room (ER) would help the patient in any way while 48.6% agreed that it may indeed do so. 69.8 % of attendants disagreed that they would interfere with the medical process if they were allowed to be present. Conclusion: This study supports that FPDR has shown promising benefits . Therefore, family members must be offered an option to witness the efforts of the medical team and their wishes must be respected and it is the duty of the health care institutions to facilitate this process . Key words: FPDR, family presence, Cardiopulmonary resuscitation, CPR","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126607359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Helvaci, H. Yilmaz, A. Yalçın, Orhan Ekrem Muftuoglu, A. Abyad, Lesley Pocock
Background: We tried to understand whether or not there is a significant relationship between acute chest syndrome (ACS) and atherosclerosis in sickle cell diseases (SCD). Methods: All patients with the SCD were included. Results: The study included 434 patients (222 males) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in males, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in males, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in males but not ACS (2.7% versus 3.7%, p>0.05) in the SCD. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, ACS was not higher in them, significantly. In another definition, ACS may not have an atherosclerotic background in the SCD. Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, acute chest syndrome, male gender, smoking, alcohol
背景:我们试图了解急性胸综合征(ACS)与镰状细胞病(SCD)患者动脉粥样硬化之间是否存在显著关系。方法:纳入所有SCD患者。结果:纳入434例患者,其中男性222例,男女平均年龄相近(30.8岁vs 30.3岁,p>0.05)。吸烟(23.8% vs 6.1%, p0.05)。结论:SCD是血管内皮的严重炎症过程,特别是在毛细血管水平,因为毛细血管系统是硬化红细胞进入组织的主要分布。虽然吸烟和酒精样强动脉粥样硬化危险因素和弥散性牙齿脱落、COPD、肠阻、肝硬化、腿部溃疡、数字球杆、冠心病、CRD、卒中样明显动脉粥样硬化后果在男性中较高,但ACS在男性中的发生率不高,且差异显著。在另一种定义中,ACS可能在SCD中没有动脉粥样硬化背景。关键词:镰状细胞病,慢性内皮损伤,动脉粥样硬化,急性胸综合征,男性,吸烟,酒精
{"title":"Acute chest syndrome may not have an atherosclerotic background in sickle cell diseases","authors":"M. Helvaci, H. Yilmaz, A. Yalçın, Orhan Ekrem Muftuoglu, A. Abyad, Lesley Pocock","doi":"10.5742/mejim2020.93797","DOIUrl":"https://doi.org/10.5742/mejim2020.93797","url":null,"abstract":"Background: We tried to understand whether or not there is a significant relationship between acute chest syndrome (ACS) and atherosclerosis in sickle cell diseases (SCD). Methods: All patients with the SCD were included. Results: The study included 434 patients (222 males) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in males, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in males, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in males but not ACS (2.7% versus 3.7%, p>0.05) in the SCD. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, ACS was not higher in them, significantly. In another definition, ACS may not have an atherosclerotic background in the SCD. Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, acute chest syndrome, male gender, smoking, alcohol","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121191312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Parkinson's Disease: An update on Pathophysiology, Epidemiology, Diagnosis and Management Part 5: Management Strategies","authors":"A. Abyad","doi":"10.5742/mejim2020.93795","DOIUrl":"https://doi.org/10.5742/mejim2020.93795","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116245300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hassan Almubarak, A. Alsamghan, M. Alsaleem, Eisa Y. Ghazwani, S. Alsaleem
{"title":"Small Cell Cancer of the Parotid Gland","authors":"Hassan Almubarak, A. Alsamghan, M. Alsaleem, Eisa Y. Ghazwani, S. Alsaleem","doi":"10.5742/mejim2020.93791","DOIUrl":"https://doi.org/10.5742/mejim2020.93791","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124183809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Helvaci, A. Yalçın, Zeki Arslanoğlu, M. Duru, A. Abyad, Lesley Pocock
{"title":"Prognostic significance of plasma bilirubin in sickle cell diseases","authors":"M. Helvaci, A. Yalçın, Zeki Arslanoğlu, M. Duru, A. Abyad, Lesley Pocock","doi":"10.5742/mejim2020.93792","DOIUrl":"https://doi.org/10.5742/mejim2020.93792","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"174 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126935085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Helvaci, A. Yalçın, Orhan Ekrem Muftuoglu, A. Abyad, Lesley Pocock
{"title":"Triglycerides may be acute phase reactants which are not negatively affected by pathologic weight loss","authors":"M. Helvaci, A. Yalçın, Orhan Ekrem Muftuoglu, A. Abyad, Lesley Pocock","doi":"10.5742/mejim2020.93793","DOIUrl":"https://doi.org/10.5742/mejim2020.93793","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126664878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.5742/mejim.2020.93782
M. Helvaci, A. Abyad, Lesley Pocock
There were 75 patients in the first and 118 patients in the second groups. Mean age (45.4 versus 47.9 years) and male ratio (53.3 versus 53.3%) were similar in both groups (p>0.05 for both). Smoking (34.6 versus 31.3%), body mass index (27.2 versus 26.7 kg/m2), fasting plasma glucose (119.4 versus 113.0 mg/dL), white coat hypertension (25.3 versus 32.2%), hypertension (10.6 versus 16.1%), and chronic obstructive pulmonary disease (14.6 versus 18.6%) were similar in both groups, too (p>0.05 for all). Although triglycerides (162.7 versus 125.4 mg/dL, p<0.001), diabetes mellitus (DM) (21.3 versus 12.7%, p<0.05), and coronary heart disease (CHD) (20.0 versus 11.0%, p<0.05) were higher, low density lipoproteins (LDL) (105.3 versus 126.2 mg/dL) and HDL (34.1 versus 50.0 mg/dL) were lower in patients with plasma HDL values of lower than 40 mg/dL, significantly (p<0.000 for both).
第一组75例,第二组118例。两组患者的平均年龄(45.4比47.9岁)和男性比例(53.3比53.3%)相似(p < 0.05)。吸烟(34.6 vs 31.3%)、体重指数(27.2 vs 26.7 kg/m2)、空腹血糖(119.4 vs 113.0 mg/dL)、白皮肤高血压(25.3 vs 32.2%)、高血压(10.6 vs 16.1%)和慢性阻塞性肺疾病(14.6 vs 18.6%)在两组中也相似(p < 0.05)。尽管甘油三酯(162.7 vs 125.4 mg/dL, p<0.001)、糖尿病(21.3 vs 12.7%, p<0.05)和冠心病(20.0 vs 11.0%, p<0.05)较高,但血浆HDL值低于40 mg/dL的患者低密度脂蛋白(LDL) (105.3 vs 126.2 mg/dL)和高密度脂蛋白(34.1 vs 50.0 mg/dL)较低,两者均显著(p<0.000)。
{"title":"Low Density Lipoproteins May Actually Be Some Negative Acute Phase Proteins in the Plasma","authors":"M. Helvaci, A. Abyad, Lesley Pocock","doi":"10.5742/mejim.2020.93782","DOIUrl":"https://doi.org/10.5742/mejim.2020.93782","url":null,"abstract":"There were 75 patients in the first and 118 patients in the second groups. Mean age (45.4 versus 47.9 years) and male ratio (53.3 versus 53.3%) were similar in both groups (p>0.05 for both). Smoking (34.6 versus 31.3%), body mass index (27.2 versus 26.7 kg/m2), fasting plasma glucose (119.4 versus 113.0 mg/dL), white coat hypertension (25.3 versus 32.2%), hypertension (10.6 versus 16.1%), and chronic obstructive pulmonary disease (14.6 versus 18.6%) were similar in both groups, too (p>0.05 for all). Although triglycerides (162.7 versus 125.4 mg/dL, p<0.001), diabetes mellitus (DM) (21.3 versus 12.7%, p<0.05), and coronary heart disease (CHD) (20.0 versus 11.0%, p<0.05) were higher, low density lipoproteins (LDL) (105.3 versus 126.2 mg/dL) and HDL (34.1 versus 50.0 mg/dL) were lower in patients with plasma HDL values of lower than 40 mg/dL, significantly (p<0.000 for both).","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122029356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.5742/mejim.2020.93781
M. Helvaci, Yusuf Aydin, L. Aydın
{"title":"High Density Lipoproteins May Act in a Similar Direction with Low Density Lipoproteins in the Metabolic Syndrome","authors":"M. Helvaci, Yusuf Aydin, L. Aydın","doi":"10.5742/mejim.2020.93781","DOIUrl":"https://doi.org/10.5742/mejim.2020.93781","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132195092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}