A. Khanna, V. Atam, M. Patel, R. Verma, Alok Gupta
Background : Tuberculous meningitis (TBM) is often under and over diagnosed, thereby making the ancillary diagnostic tests important for establishing the diagnosis of TBM. The objective of this study was to evaluate cerebrospinal fluid adenosine deaminase (CSF-ADA) as an ancillary test for the diagnosis of TBM, and further, its correlation with adverse neurological outcome in these patients. Materials and Methods : This was a prospective study of 83 patients. The diagnosis of TBM was established by Thwaites criteria. CSF-ADA levels were measured in all these patients and were taken to be positive at levels >10 IU/l. These patients were followed up at 1 and 3 months after discharge, and the resultant neurological deficit was measured as per the modified Rankin score and correlated with the initial CSF-ADA levels. Mann-Whitney U test, χ2 test, Kruskall-Wallis tests were used for statistical analyses. Results : CSF-ADA values were higher than 10 IU/l in all the 83 patients diagnosed to be suffering from TBM. It was seen that the mean ADA level for patients with stage I/II was 18.23 ± 8.64 IU/l, while it was 31.97 ± 226 004, India.
{"title":"Evaluation of cerebrospinal fluid adenosine deaminase levels as an ancillary diagnostic test for tuberculous meningitis and its correlation with adverse neurological outcome","authors":"A. Khanna, V. Atam, M. Patel, R. Verma, Alok Gupta","doi":"10.4103/0331-3131.78272","DOIUrl":"https://doi.org/10.4103/0331-3131.78272","url":null,"abstract":"Background : Tuberculous meningitis (TBM) is often under and over diagnosed, thereby making the ancillary diagnostic tests important for establishing the diagnosis of TBM. The objective of this study was to evaluate cerebrospinal fluid adenosine deaminase (CSF-ADA) as an ancillary test for the diagnosis of TBM, and further, its correlation with adverse neurological outcome in these patients. Materials and Methods : This was a prospective study of 83 patients. The diagnosis of TBM was established by Thwaites criteria. CSF-ADA levels were measured in all these patients and were taken to be positive at levels >10 IU/l. These patients were followed up at 1 and 3 months after discharge, and the resultant neurological deficit was measured as per the modified Rankin score and correlated with the initial CSF-ADA levels. Mann-Whitney U test, χ2 test, Kruskall-Wallis tests were used for statistical analyses. Results : CSF-ADA values were higher than 10 IU/l in all the 83 patients diagnosed to be suffering from TBM. It was seen that the mean ADA level for patients with stage I/II was 18.23 ± 8.64 IU/l, while it was 31.97 ± 226 004, India.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114366148","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}
Since its first description by Hunter,[1] the nasogastric (NG) tube has become a frequently used method of alleviating gastrointestinal symptoms. NG tubes are frequently used in the clinical setting for the management of patients who require decompression of the gastrointestinal tract, diagnosis and assessment, nutritional support and medication administration.[1,2] The insertion and management of NG tubes are procedures increasingly undertaken by nurses, interns, House officers, Medical Practitioners although, there is a wide variation in practice.[1-3] The use of NG tubes may be associated with complications.[2] Attention to tube size selection, assessment of tube position and the method of securing NG tubes are important components of care of NG tube to minimize the risks of NG tube-related complications and provide for optimal patient safety and comfort. Therefore the aim of this update is to highlight the uses, care and hazards of NG tube.
{"title":"Uses and hazards of nasogastric tube in gastrointestinal diseases: An update for clinicians","authors":"JG Makama","doi":"10.4103/0331-3131.78269","DOIUrl":"https://doi.org/10.4103/0331-3131.78269","url":null,"abstract":"Since its first description by Hunter,[1] the nasogastric (NG) tube has become a frequently used method of alleviating gastrointestinal symptoms. NG tubes are frequently used in the clinical setting for the management of patients who require decompression of the gastrointestinal tract, diagnosis and assessment, nutritional support and medication administration.[1,2] The insertion and management of NG tubes are procedures increasingly undertaken by nurses, interns, House officers, Medical Practitioners although, there is a wide variation in practice.[1-3] The use of NG tubes may be associated with complications.[2] Attention to tube size selection, assessment of tube position and the method of securing NG tubes are important components of care of NG tube to minimize the risks of NG tube-related complications and provide for optimal patient safety and comfort. Therefore the aim of this update is to highlight the uses, care and hazards of NG tube.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131826180","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}
Sir, Gastrointestinal duplications are rare congenital malformations that differ in size, site and symptoms.[1] Gastrointestinal duplications are observed in 1 in 4500 live births, and are common in males. The small intestine is the most frequent site involved, whereas gastric, duodenal, rectal, and thoracoabdominal involvement is relatively rare. Synchronous gastrointestinal duplications occur in as many as 15% of patients.[2] Semental resection or stripping with intestinal lengthening procedure is completely curative of the condition.[3-6]
{"title":"Jejunal duplication cyst","authors":"Sandeep Hambarde, Pradnya S. Bendre","doi":"10.4103/0331-3131.78278","DOIUrl":"https://doi.org/10.4103/0331-3131.78278","url":null,"abstract":"Sir, Gastrointestinal duplications are rare congenital malformations that differ in size, site and symptoms.[1] Gastrointestinal duplications are observed in 1 in 4500 live births, and are common in males. The small intestine is the most frequent site involved, whereas gastric, duodenal, rectal, and thoracoabdominal involvement is relatively rare. Synchronous gastrointestinal duplications occur in as many as 15% of patients.[2] Semental resection or stripping with intestinal lengthening procedure is completely curative of the condition.[3-6]","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131497776","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}
Background : With improvement in preventive medicine and advancement in the management of otherwise morbid eye conditions, the reasons for destructive eye surgeries have changed overtime. Objectives : This study aims at determining the current indications for destructive eye surgeries and compares these to the findings of a similar study done in the same unit two decades earlier. Materials and Methods : It is a retrospective study of 278 cases of destructive eye operations performed at the Guinness Ophthalmic Unit of Ahmadu Bello University Teaching Hospital Kaduna from January 1991 to December 2000. Results : They were 152 eviscerations, 67 enucleations, and 59 exenterations. Tumors were responsible for the majority of destructive eye operations in the unit (31%). This was followed closely by endophthalmitis/panophthalmitis (30%). Others were trauma (23%), corneal disease (8%) and painful blind eyes (7%). Conclusion : They were noticeable changes in the indications for destructive eye operations especially for some infective and nutritional causes which are largely preventable.
{"title":"Changing trend in the causes of destructive eye surgery at Guinness Ophthalmic Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria","authors":"D. Chinda, Er Abah, A. Rafindadi, E. Samaila","doi":"10.4103/0331-3131.78275","DOIUrl":"https://doi.org/10.4103/0331-3131.78275","url":null,"abstract":"Background : With improvement in preventive medicine and advancement in the management of otherwise morbid eye conditions, the reasons for destructive eye surgeries have changed overtime. Objectives : This study aims at determining the current indications for destructive eye surgeries and compares these to the findings of a similar study done in the same unit two decades earlier. Materials and Methods : It is a retrospective study of 278 cases of destructive eye operations performed at the Guinness Ophthalmic Unit of Ahmadu Bello University Teaching Hospital Kaduna from January 1991 to December 2000. Results : They were 152 eviscerations, 67 enucleations, and 59 exenterations. Tumors were responsible for the majority of destructive eye operations in the unit (31%). This was followed closely by endophthalmitis/panophthalmitis (30%). Others were trauma (23%), corneal disease (8%) and painful blind eyes (7%). Conclusion : They were noticeable changes in the indications for destructive eye operations especially for some infective and nutritional causes which are largely preventable.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126374232","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. Ahmed, H. Maitama, A. Bello, G. Kalayi, H. Mbibu
Objectives : The objective is to determine transrectal ultrasound (TRUS) findings and their relevance in the diagnosis of prostatic cancer among patients with abnormal digital rectal examination (DRE) and elevated PSA. Materials and Methods : This was a prospective study of 131 patients suspected to have advanced prostate cancer based on clinical presentation, abnormal DRE and elevated PSA (>10 ng/ml), who were evaluated with TRUS prior to prostatic biopsy and the findings correlated with the histologic outcome. Results : The mean prostate size by TRUS was 66.8 g with a range of 15-219 g. The majority of patients with hypoechoic nodules 56.3% (45 of 80) had a malignant histology and the yield was higher among those with both hypoechoic nodules and prostatic capsule invasion 25 (31.3%). Cancer detection in those with mixed echogenicity was next in frequency 33.8% (27 of 80). All the prostates with hyperechoic pattern and most of those with isoechoic appearance had benign histology. Conclusion : Though TRUS findings generally have a low specificity for prostate cancer, the specificity of TRUS findings is probably higher in advanced prostate cancer.
{"title":"Transrectal ultrasound findings in patients with advanced prostate cancer","authors":"M. Ahmed, H. Maitama, A. Bello, G. Kalayi, H. Mbibu","doi":"10.4103/0331-3131.78274","DOIUrl":"https://doi.org/10.4103/0331-3131.78274","url":null,"abstract":"Objectives : The objective is to determine transrectal ultrasound (TRUS) findings and their relevance in the diagnosis of prostatic cancer among patients with abnormal digital rectal examination (DRE) and elevated PSA. Materials and Methods : This was a prospective study of 131 patients suspected to have advanced prostate cancer based on clinical presentation, abnormal DRE and elevated PSA (>10 ng/ml), who were evaluated with TRUS prior to prostatic biopsy and the findings correlated with the histologic outcome. Results : The mean prostate size by TRUS was 66.8 g with a range of 15-219 g. The majority of patients with hypoechoic nodules 56.3% (45 of 80) had a malignant histology and the yield was higher among those with both hypoechoic nodules and prostatic capsule invasion 25 (31.3%). Cancer detection in those with mixed echogenicity was next in frequency 33.8% (27 of 80). All the prostates with hyperechoic pattern and most of those with isoechoic appearance had benign histology. Conclusion : Though TRUS findings generally have a low specificity for prostate cancer, the specificity of TRUS findings is probably higher in advanced prostate cancer.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123763675","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}
Penoscrotal transposition may be partial or complete, resulting in variable degrees of positional exchanges between the penis and the scrotum. Repairs of penoscrotal transposition rely on the creation of rotational flaps to mobilize the scrotum downward or transpose the penis to a neo hole created in the skin of the mons-pubis.
{"title":"Complete penoscrotal transposition","authors":"Sandeep Hambarde, Pradnya S. Bendre","doi":"10.4103/0331-3131.78276","DOIUrl":"https://doi.org/10.4103/0331-3131.78276","url":null,"abstract":"Penoscrotal transposition may be partial or complete, resulting in variable degrees of positional exchanges between the penis and the scrotum. Repairs of penoscrotal transposition rely on the creation of rotational flaps to mobilize the scrotum downward or transpose the penis to a neo hole created in the skin of the mons-pubis.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125977773","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 : 1900-01-01DOI: 10.4103/0331-3131.100201
A. Abba, M. Khalil
Lymphadenopathy (LAP) is a common clinical finding that may be localized, limited or generalized. The enlargement of a lymph node, due to primary disease or secondary cause, is of concern to both patients and clinicians, particularly, if the underlying pathology is a malignant disease. Lymph node aspiration or biopsy for histopathological evaluation may not reveal the diagnosis due to several factors. However, a methodological approach to LAP can disclose the accurate diagnosis with minimal discomfort to the patient and in a short time. In this review article, we provide evidence-based clinical evaluation of LAP, guided by the probability of the underlying disease to assist clinicians in establishing the proper cause and hence offer appropriate management.
{"title":"Clinical approach to Lymphadenopathy","authors":"A. Abba, M. Khalil","doi":"10.4103/0331-3131.100201","DOIUrl":"https://doi.org/10.4103/0331-3131.100201","url":null,"abstract":"Lymphadenopathy (LAP) is a common clinical finding that may be localized, limited or generalized. The enlargement of a lymph node, due to primary disease or secondary cause, is of concern to both patients and clinicians, particularly, if the underlying pathology is a malignant disease. Lymph node aspiration or biopsy for histopathological evaluation may not reveal the diagnosis due to several factors. However, a methodological approach to LAP can disclose the accurate diagnosis with minimal discomfort to the patient and in a short time. In this review article, we provide evidence-based clinical evaluation of LAP, guided by the probability of the underlying disease to assist clinicians in establishing the proper cause and hence offer appropriate management.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128337836","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 : 1900-01-01DOI: 10.4103/0331-3131.163333
B. Nair, S. Surendran, T. S. Brar
Massive spontaneous subcutaneous emphysema is rare in the absence of trauma. An 11-year-old male child, a known case of poorly controlled bronchial asthma presented with sudden onset of respiratory distress after a sudden bout of cough. He also had painful swelling of the neck, chest, abdomen, and upper limbs. On clinical and radiological examination, he was found to have massive subcutaneous emphysema. A gastrografin study was done which showed no esophageal perforation. Computed tomography of his neck and thorax demonstrated pneumomediastinum with no lung or pleural pathology. Management was conservative with supplemental oxygen, nebulized bronchodilators, corticosteroids, and intravenous antibiotics. Child improved symptomatically without any surgical intervention and was discharged after 7 days.
{"title":"Spontaneous subcutaneous emphysema and pneumomediastinum in a child with bronchial asthma","authors":"B. Nair, S. Surendran, T. S. Brar","doi":"10.4103/0331-3131.163333","DOIUrl":"https://doi.org/10.4103/0331-3131.163333","url":null,"abstract":"Massive spontaneous subcutaneous emphysema is rare in the absence of trauma. An 11-year-old male child, a known case of poorly controlled bronchial asthma presented with sudden onset of respiratory distress after a sudden bout of cough. He also had painful swelling of the neck, chest, abdomen, and upper limbs. On clinical and radiological examination, he was found to have massive subcutaneous emphysema. A gastrografin study was done which showed no esophageal perforation. Computed tomography of his neck and thorax demonstrated pneumomediastinum with no lung or pleural pathology. Management was conservative with supplemental oxygen, nebulized bronchodilators, corticosteroids, and intravenous antibiotics. Child improved symptomatically without any surgical intervention and was discharged after 7 days.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130309102","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}
Objective : This study aimed to determine the prevalence and factors associated with poor sleep quality among medical students at a Nigerian university. Materials and Methods : In a cross sectional survey, the sleep quality of students (n=255) was assessed using the Pittsburgh Sleep Quality Index (PSQI). In addition to obtaining sociodemographic data, history of adverse childhood experiences and drug use, measures assessing daytime sleepiness, fatigue and psychiatric morbidity were also administered. Results : Almost a third (32.5%) of medical students reported poor quality sleep. The presence of a chronic illness (OR: 5.10, 95% CI: 1.53-17.11, P<0.02), adverse childhood experience (OR: 1.73, 95% CI: 0.98-3.02, P<0.05) and irregular sleep schedule (OR: 4.78, 95% CI: 2.65-3.02, P<0.01) significantly predicted poor sleep quality. Conclusion: Poor quality of sleep is common among medical students, and is associated with predisposing and several modifiable factors. Strategies to improve sleep quality are suggested.
{"title":"Prevalence and correlates of poor sleep quality among medical students at a Nigerian university","authors":"B. James, J. Omoaregba, O. Igberase","doi":"10.4103/0331-3131.84218","DOIUrl":"https://doi.org/10.4103/0331-3131.84218","url":null,"abstract":"Objective : This study aimed to determine the prevalence and factors associated with poor sleep quality among medical students at a Nigerian university. Materials and Methods : In a cross sectional survey, the sleep quality of students (n=255) was assessed using the Pittsburgh Sleep Quality Index (PSQI). In addition to obtaining sociodemographic data, history of adverse childhood experiences and drug use, measures assessing daytime sleepiness, fatigue and psychiatric morbidity were also administered. Results : Almost a third (32.5%) of medical students reported poor quality sleep. The presence of a chronic illness (OR: 5.10, 95% CI: 1.53-17.11, P<0.02), adverse childhood experience (OR: 1.73, 95% CI: 0.98-3.02, P<0.05) and irregular sleep schedule (OR: 4.78, 95% CI: 2.65-3.02, P<0.01) significantly predicted poor sleep quality. Conclusion: Poor quality of sleep is common among medical students, and is associated with predisposing and several modifiable factors. Strategies to improve sleep quality are suggested.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"137 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130508144","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 : 1900-01-01DOI: 10.4103/0331-3131.119986
A. Bakari, B. Ahmad, G. Mohammed, T. Abubakar
The commonest sites of non-Hodgkin′s lymphoma in the head and neck are the cervical nodes, Waldeyer′s ring and extra lymphatic organs such as the sinuses, larynx, salivary glands and oral cavity etc. We present the case of a 10 year old with upper airway obstruction secondary to retropharyngeal Burkitt′s lymphoma. The presenting features here are very similar to obstructive adenoid enlargement. Emergency tracheotomy, biopsy, and chemotherapy led to resolution and subsequent decanulation. This case is highlighted in relation to the increasing recognition of AIDS related lymphomas globally.
{"title":"Life threatening retropharyngeal Burkitt′s lymphoma mimicking adenoid obstructive disease","authors":"A. Bakari, B. Ahmad, G. Mohammed, T. Abubakar","doi":"10.4103/0331-3131.119986","DOIUrl":"https://doi.org/10.4103/0331-3131.119986","url":null,"abstract":"The commonest sites of non-Hodgkin′s lymphoma in the head and neck are the cervical nodes, Waldeyer′s ring and extra lymphatic organs such as the sinuses, larynx, salivary glands and oral cavity etc. We present the case of a 10 year old with upper airway obstruction secondary to retropharyngeal Burkitt′s lymphoma. The presenting features here are very similar to obstructive adenoid enlargement. Emergency tracheotomy, biopsy, and chemotherapy led to resolution and subsequent decanulation. This case is highlighted in relation to the increasing recognition of AIDS related lymphomas globally.","PeriodicalId":331118,"journal":{"name":"Annals of Nigerian Medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126465561","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}
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