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The Glycopeptide-Susceptibility of Multidrug-Resistant/Extensively Drug-Resistant Staphylococcus aureus in Skin Infections 多重耐药/广泛耐药金黄色葡萄球菌在皮肤感染中的糖肽敏感性
Q4 Medicine Pub Date : 2023-10-01 DOI: 10.5812/mejrh-138166
Mehri Hosseini, Leila Fozouni
Background: The prevalence of drug-resistant Staphylococcus aureus is increasing alarmingly, limiting treatment options. Objectives: This study was conducted to investigate the minimum inhibitory concentration (MIC) of glycopeptides against multidrug-resistant (MDR) and extensively drug-resistant (XDR) S. aureus isolates from patients with skin infections. Methods: In this study, S. aureus isolates were collected from outpatients with skin infections (n = 250) during 2019 - 2022. The isolates were identified using routine microbiological and biochemical tests. Susceptibility to ten categories of antibacterial agents was assessed using the Kirby-Bauer method according to the Clinical and Laboratory Standards Institute M100 guidelines (2021). The MIC of glycopeptides was determined using the broth microdilution test. Results: Among methicillin-resistant S. aureus isolates (40.8%), the majority were from patients with impetigo (53.92%). The highest resistance rate was observed against penicillin (79.41%) and doxycycline (73.52%). Linezolid showed significant inhibitory properties against XDR (91%) and MDR (97%) S. aureus isolates (P = 0.01). The MIC of oritavancin that inhibited the growth of 90% of the MDR isolates (MIC90) was 2 µg/mL, which was eight times less than that of vancomycin (MIC90 = 16 µg/mL) and 16 times lower than that of teicoplanin (MIC90 = 32 µg/mL) in a manner that 91% of MDR isolates from impetigo were eliminated at concentrations 2 µg/mL. Oritavancin inhibited the growth of 54.5% of XDR isolates at MIC concentrations of ≥8 µg/mL. Conclusions: Considering the strong antibacterial activity of linezolid against MDR S. aureus isolates, this antibiotic can effectively treat skin infections caused by S. aureus and prevent the development of resistance to other antibiotics. In addition, considering the great inhibitory properties of oritavancin against MDR S. aureus strains, the efficacy of this agent for treating skin infections, particularly impetigo, should be investigated.
背景:耐药金黄色葡萄球菌的流行正在惊人地增加,限制了治疗选择。目的:研究糖肽对皮肤感染患者中多重耐药(MDR)和广泛耐药(XDR)金黄色葡萄球菌分离株的最低抑菌浓度(MIC)。方法:本研究收集2019 - 2022年门诊皮肤感染患者中分离的金黄色葡萄球菌(n = 250)。采用常规微生物学和生化试验对分离株进行鉴定。根据临床和实验室标准协会M100指南(2021),采用Kirby-Bauer法评估对十类抗菌药物的敏感性。采用肉汤微量稀释法测定糖肽的MIC。结果:耐甲氧西林金黄色葡萄球菌(40.8%)主要来源于脓疱疮患者(53.92%)。耐药率最高的是青霉素(79.41%)和强力霉素(73.52%)。利奈唑胺对XDR(91%)和MDR(97%)金黄色葡萄球菌有显著的抑制作用(P = 0.01)。oritavancin抑制90% MDR分离株生长的MIC (MIC90)为2µg/mL,比万古霉素(MIC90 = 16µg/mL)低8倍,比替柯planin (MIC90 = 32µg/mL)低16倍,且在2µg/mL浓度下,91%的MDR分离株被清除。当MIC浓度≥8µg/mL时,Oritavancin抑制了54.5%的XDR菌株的生长。结论:利奈唑胺对MDR金黄色葡萄球菌具有较强的抑菌活性,可有效治疗金黄色葡萄球菌引起的皮肤感染,防止对其他抗生素产生耐药。此外,考虑到奥利塔万星对耐多药金黄色葡萄球菌菌株有很强的抑制作用,该药物对皮肤感染,特别是脓疱疮的治疗效果还需要进一步研究。
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引用次数: 0
The Effect of Adding 1% Glucose to Crystalloid on Maternal Hemodynamics After Spinal Anesthesia for Cesarean Delivery: A Double-Blind, Randomized Clinical Trial 在晶体中添加1%葡萄糖对剖宫产脊髓麻醉后产妇血流动力学的影响:一项双盲、随机临床试验
Q4 Medicine Pub Date : 2023-09-27 DOI: 10.5812/mejrh-134348
Samira Saghravanian, Masoomeh Tabari, Monavar Afzalaghaee, Shima Sheybani
Background: We aimed to evaluate the effect of glucose-containing crystalloid infusion before anesthesia induction on hemodynamics and postanesthesia complications. Methods: This double-blind, randomized clinical trial was conducted on 60 parturient cases scheduled for elective Cesarean delivery under spinal anesthesia who were referred to the teaching hospitals of Mashhad University of Medical Sciences (Iran). The parturients were randomized into two groups. Both groups received 5 - 7 mL/kg of intravenous bolus serum before spinal anesthesia. The parturients in the glucose-containing normal saline (GcNS) group received 1% glucose solution in normal saline. The normal saline (NS) group received only normal saline. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood glucose concentrations, neonatal Apgar scores, postanesthesia complications, and ephedrine and atropine consumption were evaluated. Results: Sixty patients were recruited (30 in each group), with a mean age of 29.14 ± 6.01 and 29.76 ± 6.15 years in the GcNS and NS groups, respectively. There was no significant difference between the two groups in SBP, DBP, or HR after baseline adjustment. The incidence of hypotension was higher in the NS (70.0%) compared to the GcNS group (46.6%), but the difference was not significant. There was no significant difference in Apgar scores. The incidence of nausea, vomiting, pallor, and shivering was higher in the NS group. However, only nausea and vomiting 10 minutes after anesthesia induction were significant. Ephedrine and atropine consumption was higher in the NS group, but not significantly. Conclusions: The present study did not show any clear benefit for adding 1% glucose to normal saline solution preload for hypotension in parturients undergoing Cesarean delivery with spinal anesthesia.
背景:我们的目的是评估麻醉诱导前含葡萄糖晶体输注对血流动力学和麻醉后并发症的影响。方法:对伊朗马什哈德医科大学附属教学医院转介的60例脊髓麻醉下择期剖宫产患者进行双盲、随机临床试验。将产妇随机分为两组。两组脊髓麻醉前静脉注射血清5 ~ 7ml /kg。含糖生理盐水(GcNS)组给予1%葡萄糖溶液加生理盐水。生理盐水(NS)组仅给予生理盐水。评估收缩压(SBP)、舒张压(DBP)、心率(HR)、血糖浓度、新生儿Apgar评分、麻醉后并发症以及麻黄碱和阿托品的消耗。结果:共招募患者60例(每组30例),GcNS组和NS组平均年龄分别为29.14±6.01岁和29.76±6.15岁。在基线调整后,两组在收缩压、舒张压或心率方面无显著差异。NS组低血压发生率(70.0%)高于GcNS组(46.6%),但差异无统计学意义。Apgar评分差异无统计学意义。NS组的恶心、呕吐、苍白和颤抖发生率较高。然而,麻醉诱导后10分钟只有恶心和呕吐明显。麻黄碱和阿托品的摄入量在NS组较高,但不显著。结论:目前的研究没有显示在生理盐水预负荷中添加1%葡萄糖对脊柱麻醉剖宫产的低血压患者有任何明显的益处。
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引用次数: 0
Association Between Helicobacter pylori, Adverse Gynecological and Pregnancy Outcomes, and Some Cancers: An Overview of Metanalyses 幽门螺杆菌、不良妇科和妊娠结局以及某些癌症之间的关系:荟萃分析综述
Q4 Medicine Pub Date : 2023-08-22 DOI: 10.5812/mejrh-133623
Masoudeh Babakhanian, Masumeh Ghazanfarpour, Fahimeh Shakeri, Farzaneh Rashidi Fakari, Sara Saadat, Fatemeh Abdi
Context: The number of meta-analyses published about Helicobacter pylori-associated diseases that clinicians must comprehensively know about are scarce. This overview aims to give comprehensive knowledge on the fascinating topic of Helicobacter pylori-associated diseases. Methods: The search strategy was to systematically screen the articles evaluating the association between H. pylori infection and gynecological and reproductive health issues and cancers published on the authentic databases of Scopus, MEDLINE, and Web of Sciences from the inception until 2022 Results: Fifteen meta-analyses were included in the overview. The H. pylori infections were significantly associated with general adverse pregnancy outcomes such as gestational diabetes mellitus, preeclampsia, and hyperemesis gravidarum and adverse birth outcomes such as birth defect and fetal growth restriction. H. pylori infection was not associated with a deficiency of micronutrients (B2, folate, and ferritin) but was associated with an increased risk of iron-deficiency anemia during pregnancy. In esophagus cancer, H. pylori infection was significantly reduced in adenocarcinoma but not in esophageal squamous cell carcinoma. There was no significant association between H. pylori infection and the risk of asthma. The results also indicated a significant association between H. pylori infection and an elevated risk of colorectal cancer, colorectal adenoma, and the risk of asthma and lung cancer. Results of metanalysis are not consistently reproducible regarding spontaneous abortion and pancreatic cancer. Conclusions: Our overview revealed a significant relationship between H. pylori infection and several cancers, namely colorectal, lung, and colorectal adenoma, as well as gynecological and reproductive health issues.
背景:关于临床医生必须全面了解的幽门螺杆菌相关疾病的meta分析发表的数量很少。本综述旨在提供有关幽门螺杆菌相关疾病的迷人主题的全面知识。方法:检索策略是系统筛选Scopus、MEDLINE、Web of Sciences等权威数据库自成立至2022年发表的评价幽门螺杆菌感染与妇科、生殖健康问题及癌症相关性的文章。幽门螺杆菌感染与一般不良妊娠结局(如妊娠糖尿病、先兆子痫、妊娠剧吐)和不良出生结局(如出生缺陷和胎儿生长受限)显著相关。幽门螺杆菌感染与微量营养素(B2、叶酸和铁蛋白)缺乏无关,但与妊娠期间缺铁性贫血的风险增加有关。在食管癌中,幽门螺杆菌感染在腺癌中明显减少,而在食管鳞状细胞癌中则无明显减少。幽门螺杆菌感染与哮喘风险之间无显著关联。研究结果还表明,幽门螺杆菌感染与结直肠癌、结直肠腺瘤、哮喘和肺癌风险升高之间存在显著关联。关于自然流产和胰腺癌的荟萃分析结果不一致。结论:我们的综述揭示了幽门螺旋杆菌感染与几种癌症,即结直肠癌、肺癌和结直肠腺瘤,以及妇科和生殖健康问题之间的显著关系。
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引用次数: 0
The Impacts of Excessive Use of Social Media on Iranian Adolescents’ Health: A Qualitative Study 过度使用社交媒体对伊朗青少年健康的影响:一项定性研究
Q4 Medicine Pub Date : 2021-10-23 DOI: 10.5812/MEJRH.109561
T. Kamalikhah, Masoumeh Bajalan, L. Sabzmakan, A. Mehri
Background: The widespread use of social media (SM) is an emerging phenomenon in today’s world, especially among adolescents. Objectives: The present study was designed to examine the impacts of excessive use of SM on adolescents’ health. Methods: This was a qualitative study conducted in 2018 on 27 high school students (14 boys and 13 girls) in Tehran, Iran. To explain the experience of using SM, six open-ended questions along with some follow-up questions were asked through in-depth interviews by two interviewers. The content analysis with an inductive approach was used to analyze the data. Results: The mean age of the students was 16.5 ± 1.34 years. The mean duration of having a smartphone was 3.11 ± 0.97years. Moreover, the duration of using smartphone in a day was 4 ± 1.5 hours. In this study, the themes emerged from 1,273 phrases, sentences, or semantic units separated from the interviews. After refining the semantic units, 861 refined units were created; these phrases of sentences or paragraphs appeared in the form of 7 themes, 18 main categories, and 38 sub-categories. The themes included the reasons for using SM (educational and non-educational, avoidance of negative emotions), emotional (changes in moods, academic failure), social (problems with family and society, relationships with relatives, cultural changes), physical (sensorineural hearing loss, changes in the sleep cycle, musculoskeletal pain), sexual (sexual fantasies, high-risk sexual behaviors), mental health (changes in mental powers and processing, loss of concentration), and the process of using SM (beliefs in the use and pattern of using SM). Conclusions: Most of the complaints and impacts were related to emotional health, mostly with the experience of mood changes and academic failure and social health, respectively. The results indicated the need for planning educational and social interventions to increase media literacy in adolescents.
背景:社交媒体的广泛使用是当今世界的一种新兴现象,尤其是在青少年中。目的:本研究旨在检验过量使用SM对青少年健康的影响。方法:这是一项2018年对伊朗德黑兰27名高中生(14名男孩和13名女孩)进行的定性研究。为了解释SM的使用体验,两位受访者通过深入访谈提出了六个开放式问题以及一些后续问题。采用归纳法对数据进行内容分析。结果:学生平均年龄为16.5±1.34岁。拥有智能手机的平均持续时间为3.11±0.97年。此外,一天使用智能手机的持续时间为4±1.5小时。在这项研究中,主题来自1273个从访谈中分离出来的短语、句子或语义单元。在细化语义单元之后,创建了861个细化单元;这些句子或段落短语以7个主题、18个主要类别和38个子类别的形式出现。主题包括使用SM的原因(教育和非教育、避免负面情绪)、情绪(情绪变化、学业失败)、社交(家庭和社会问题、与亲属的关系、文化变化)、身体(感音神经性听力损失、睡眠周期变化、肌肉骨骼疼痛)、性(性幻想、高风险性行为),心理健康(精神力量和处理能力的变化、注意力的丧失),以及使用SM的过程(对SM的使用和使用模式的信念)。结论:大多数投诉和影响与情绪健康有关,分别与情绪变化、学业失败和社会健康有关。研究结果表明,有必要规划教育和社会干预措施,以提高青少年的媒体素养。
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引用次数: 2
The laboratory and clinical factors associated with mortality in COVID-19 patients 与新冠肺炎患者死亡率相关的实验室和临床因素
Q4 Medicine Pub Date : 2021-07-31 DOI: 10.5812/mejrh.113451
Amin Izadi, M. Darban, Milad Khanzadeh Germi, Sourena Nabavi, M. A. Kouloubandi, Homa Dadras Toussi, Aysan Vaez, Malihe Ghazvini, M. Mirmohammadkhani
Background: In December 2019, the Chinese government declared the prevalence of a new epidemic belonging to the coronavirus family;later, this epidemic was called COVID-19. Objectives: To determine the clinical and laboratory factors involved in the mortality of hospitalized COVID-19 patients. Methods: This descriptive-analytic study was performed in Kowsar Hospital of Semnan, Iran, using medical files of 107 patients hospitalized during February-April 2020 with COVID-19 diagnosis with the presence of chest CT findings. The patients’ demographic information, vital signs, clinical symptoms, lab test results, the prescribed medicines during hospitalization, past medical history, and outcomes were analyzed. The relationship between each of the explanatory variables with death outcome was examined using univariate and multivariate logistic regression models, reporting crude and adjusted odds ratios (OR & Adj. OR). Results: The mean age of the patients was 63.36 ± 16.43 years, 67 (62.6%) patients were male, and 85 (79.4%) patients were discharged. Low level of consciousness (Glasgow coma scale < 14) (discharged: 8.2% vs. expired: 40.2%, Adj. OR [95% confidence interval] = 17.9 [3.1, 102.7]), higher body temperature (37.1°C vs. 37.74°C, 3.62 [1.55, 8.43]), and higher blood alkaline phosphatase (177.6 vs. 247.6, 1.01 [1.00, 1.01]) at the time of hospitalization were associated with increased mortality. Also, having the symptom of fatigue or weakness at the time of hospitalization (61.2 vs. 36.4%, 0.06 [0.01, 0.46]), higher red blood cells count (4.67 vs. 4.15, 0.21 [0.08, .55]), and higher blood oxygen saturation levels (89 vs. 82%, 0.92 [0.85, 0.99]) were associated with a lower risk of mortality. Conclusions: Decreased level of consciousness at the time of admission was shown to be a critical and independent predictor of mortality. Several factors are associated with death in patients with COVID-19, which due to the complexity of the relationship between each of them, it is not practical and plausible to make a definite prediction of patients’ prognosis only by noting few factors without considering all the clinical symptoms and laboratory findings. The results of individual studies like ours should be interpreted alongside the results of previous and future clinical studies and not alone. © 2021, Semnan University of Medical Sciences. All rights reserved.
背景:2019年12月,中国政府宣布一种属于冠状病毒家族的新冠疫情流行;后来,这种流行病被称为新冠肺炎。目的:确定新冠肺炎住院患者死亡率的临床和实验室因素。方法:这项描述分析研究在伊朗塞姆南Kowsar医院进行,使用了2020年2月至4月期间107名诊断为新冠肺炎并有胸部CT表现的住院患者的医疗档案。分析患者的人口统计信息、生命体征、临床症状、实验室检测结果、住院期间的处方药、既往病史和结果。使用单变量和多变量逻辑回归模型检查每个解释变量与死亡结果之间的关系,报告粗略和调整后的比值比(OR&Adj.OR)。结果:患者平均年龄为63.36±16.43岁,男性67例(62.6%),出院85例(79.4%)。住院时意识水平低(格拉斯哥昏迷评分<14)(出院:8.2%对过期:40.2%,调整OR[95%置信区间]=17.9[3.102.7])、体温升高(37.1°C对37.74°C,3.62[1.55,8.43])和血液碱性磷酸酶升高(177.6对247.61.01[1.00,1.01])与死亡率增加有关。此外,住院时出现疲劳或虚弱症状(61.2 vs.36.4%,0.06[0.01,0.46])、红细胞计数较高(4.67 vs.4.15,0.21[0.08,.55])和血氧饱和度较高(89 vs.82%,0.92[0.85,0.99])与死亡率较低有关。结论:入院时意识水平下降是死亡率的一个重要且独立的预测因素。新冠肺炎患者的死亡与几个因素有关,由于每个因素之间关系的复杂性,仅通过注意几个因素而不考虑所有临床症状和实验室结果来对患者的预后做出明确预测是不切实际和不合理的。像我们这样的个别研究的结果应该与以前和未来的临床研究结果一起解释,而不是单独解释。©2021,塞姆南医学科学大学。保留所有权利。
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引用次数: 1
A Study on the Factor Structure, Construct Validity and Reliability of the Activities of Daily Living of Iranian Children (ADLIC) Scale 伊朗儿童日常生活活动量表(ADLIC)的因子结构、结构有效性和信度研究
Q4 Medicine Pub Date : 2021-03-07 DOI: 10.5812/MEJRH.110946
H. Soltaninejad, Mehdi Alizadeh Zarei, M. Akbarfahimi, A. Azad, Negar Miri Lavasani
Background: The first and most basic area of occupational performance is the activities of daily living. These activities of life highly depend on the contextual and ecological (environmental) factors. Cultural values, parental expectations, social routines, and physical environment influence acquisition time of a child’s daily activities. At present, there is no comprehensive and adapted-culturally tool to evaluate the daily life activities of Iranian children aged 3 - 6 years. Objectives: This study aimed to investigate the factor structure, construct validity, and reliability of the Activities of Daily Living in Iranian Children (ADLIC) scale. Methods: The participants were 470 Iranian parents of children among the ages from 3 to 6. Exploratory factor analysis, internal consistency, and test-retest reliability were conducted for data analysis. Convergent validity was measured by correlation to the Pediatric Evaluation of Disability Inventory (PEDI). Results: The results indicated that ADLIC has excellent reliability due to internal consistency (Cronbach’s alpha 0.96). Furthermore, the temporal stability of ADLIC was supported using the Intra-class correlations coefficient, which ranged between 0.95 and 0.98. Convergent validity between the ADLIC and two subscales of PEDI, including self-care (0.88) and mobility (0.80), was good. The ADLIC scale showed a clear factor structure with five main components and ten factors based on the findings. Conclusions: ADLIC has excellent psychometric properties, including internal consistency and temporal stability, and can be used as a reliable and valid measure to assess the daily living activities of children aged 3 - 6 years.
背景:职业表现的第一个也是最基本的领域是日常生活活动。这些生命活动在很大程度上取决于环境和生态(环境)因素。文化价值观、父母期望、社交习惯和物理环境会影响孩子日常活动的习得时间。目前,还没有一个全面的、适应性强的文化工具来评估3-6岁伊朗儿童的日常生活活动。目的:本研究旨在探讨伊朗儿童日常生活活动量表的因素结构、结构有效性和信度。方法:参与者是470名3至6岁儿童的伊朗父母。数据分析采用探索性因素分析、内部一致性和重测信度。聚合有效性通过与儿童残疾评估量表(PEDI)的相关性来衡量。结果:由于内部一致性(Cronbach’s alpha 0.96),ADLIC具有良好的可靠性。此外,类内相关系数支持ADLIC的时间稳定性,该系数在0.95和0.98之间。ADLIC与PEDI的两个分量表(包括自理能力(0.88)和行动能力(0.80))之间的收敛有效性良好。ADLIC量表显示了一个清晰的因素结构,包括五个主要成分和基于研究结果的十个因素。结论:ADLC具有良好的心理测量特性,包括内在一致性和时间稳定性,可作为评估3-6岁儿童日常生活活动的可靠有效指标。
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引用次数: 1
Peaceful Coexistence Between Human and Novel Coronavirus-2019; Where Do Researchers Stand 人类与新型冠状病毒的和平共处-2019;研究人员的立场
Q4 Medicine Pub Date : 2020-11-23 DOI: 10.5812/mejrh.107572
A. Alami, M. Mirmohammadkhani, Mohammadhossein Hajiebrahimi
: COVID-19, as an emerging viral disease, has rapidly become a new pandemic in human life. According to the similarities between novel coronavirus-2019 and Severe acute respiratory syndrome (SARS) virus, the initial assumptions were about the temporary spread of the disease and its rapid control. Nevertheless, increasing human knowledge of the characteristics of the new coronavirus, as well as how the disease has spread, has questioned these assumptions. Currently, it seems that the virus has entered the human life cycle, and individuals should adhere to new lifestyles to return to their normal life. We should select those lifestyles to reduce the risk of contact with the virus and getting COVID-19 as well as to lead a normal life. It is believed that basic medical scientists could play an important role in identifying the most appropriate lifestyles by considering the characteristics of the virus and the desires of different social groups. They could also provide the best answers to the countless questions concerning how to live peacefully, considering the novel COVID-2019.
:新冠肺炎作为一种新出现的病毒性疾病,已迅速成为人类生活中的一种新的流行病。根据2019新型冠状病毒与严重急性呼吸综合征(SARS)病毒的相似性,最初的假设是该疾病的暂时传播及其快速控制。尽管如此,人类对新型冠状病毒的特征以及疾病如何传播的了解不断增加,这对这些假设提出了质疑。目前,病毒似乎已经进入人类生命周期,个人应该坚持新的生活方式,回归正常生活。我们应该选择这些生活方式,以降低接触病毒和感染新冠肺炎的风险,并过上正常的生活。据信,基础医学科学家可以通过考虑病毒的特征和不同社会群体的愿望,在确定最合适的生活方式方面发挥重要作用。考虑到2019年的新冠肺炎,他们还可以为无数关于如何和平生活的问题提供最佳答案。
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引用次数: 0
Planning Rehabilitation and Allied Health Professional Input for Older Inpatients During the COVID-19 Pandemic 新冠肺炎大流行期间老年住院患者的康复规划和联合卫生专业投入
Q4 Medicine Pub Date : 2020-10-12 DOI: 10.5812/mejrh.106695
S. Teo
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引用次数: 2
COVID-19 Pandemic: The Effectiveness of Telehealth COVID-19大流行:远程医疗的有效性
Q4 Medicine Pub Date : 2020-10-01 DOI: 10.5812/mejrh.107809
Faisal Muhammad
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引用次数: 1
Comments on Misconceptions About the Management of Low Back Pain: A Brief Note for Physiotherapists by Musa Sani Danazumi 关于腰痛管理的误解评论:Musa Sani Danazumi对物理治疗师的简要说明
Q4 Medicine Pub Date : 2020-06-21 DOI: 10.5812/mejrh.103112
F. Kashoo, Mehrunnisha Ahmad
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引用次数: 0
期刊
Middle East Journal of Rehabilitation and Health
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