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A Case for Horizontal Distribution of Activities between General Surgery and Surgical Super Specialties 普通外科与外科超级专科活动横向分布的案例
Pub Date : 2023-04-01 DOI: 10.1055/s-0043-1763271
V. Minocha, Sanjay Gupta, Arun Gupta
Abstract Under the current practice in organizing surgical services, proportionate representation of disciplines is provided in the curricular planning and in corresponding clinical functions. This is based on the level of competence expected by the end of training period. The disciplines as a “whole” are placed in general surgery or super specialty. The system of vertical arrangement has some serious concerns. Paradoxically, patients with diseases of simple and routine nature of discipline categorized as super specialty are neglected. Super specialist is unable to attend on account of preoccupation with serious challenging problems. The general surgeon hesitates because of privileging issues, fear of allegations of negligence and litigation. The system of vertical division is based on premise that some disciplines deal with complex procedures and others with only simple and routine nature. This premise is incorrect. Each discipline is a mix of simple and complex cases requiring specialized treatment. Alternate modified organization of surgical service is proposed. Activities of all disciplines are scrutinized according to the level of expected competence by the end of training. Categorization is shifted from the “discipline' to “activities.” Criteria applied for classification of activities are as follows: on completion, the trainee is capable to assume full responsibility-category 1; has gained sufficient experience-category 2; and is conversant with broad understanding of management-category 3. Activities of category 1 from all disciplines are assigned to general surgery and those of category 3 from all disciplines are assigned to respective super specialty. Those in the middle, comprising difficult cases but not requiring specialized training or heavy inputs in equipment, are in category 2. They are assigned to general surgery as additional/optional items, or super specialty, guided by local factors. The scope and practice of general surgery are broadened with a shift from “residual” to “comprehensive” discipline. Advantages, concerns, collateral issues of horizontal distribution of activities, its positive impact on research and education are discussed. It is concluded that the proposed organization of surgical services is a rational, logical, and practical strategy for good-quality surgical care in the society. The super specialists need to be convinced that “taking load off” is good for the specialty.
摘要在当前组织外科服务的实践中,在课程规划和相应的临床职能中提供了学科的比例代表。这是基于培训期结束时预期的能力水平。这些学科作为一个“整体”被归入普通外科或超专科。垂直排列系统有一些严重的问题。矛盾的是,被归类为超级专科的简单和常规学科性质的疾病患者却被忽视了。超级专家由于忙于处理具有挑战性的严重问题而无法出席。由于特权问题、对疏忽指控和诉讼的恐惧,这位普通外科医生犹豫不决。垂直划分系统的前提是,一些学科处理复杂的程序,而另一些学科只处理简单和常规的性质。这个前提是不正确的。每个学科都是需要专门治疗的简单和复杂病例的混合体。提出了手术服务的替代性修改组织。培训结束时,根据预期能力水平对所有学科的活动进行审查。分类从“学科”转向“活动”。活动分类的标准如下:学员完成后能够承担第一类的全部责任;已获得足够的第2类经验;并且熟悉对管理类别3的广泛理解。所有学科的1类活动分配给普通外科,所有学科的3类活动分配到各自的超级专业。处于中间的,包括困难的情况,但不需要专门培训或大量投入设备,属于第2类。在当地因素的指导下,他们被分配到普通外科作为附加/可选项目,或超级专科。随着从“残余”学科向“综合”学科的转变,普通外科的范围和实践得到了拓宽。讨论了活动横向分布的优势、关注点、附带问题及其对研究和教育的积极影响。结论是,建议的外科服务组织是一种合理、合乎逻辑和实用的策略,可在社会中获得高质量的外科护理。超级专家需要确信“减轻负担”对专业有好处。
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引用次数: 0
Solid Pseudopapillary Epithelial Neoplasm of the Pancreas: A Rare Entity with Diagnostic Dilemma 胰腺实性假乳头状上皮瘤:一种诊断困境的罕见实体
Pub Date : 2023-04-01 DOI: 10.1055/s-0042-1760354
Sucheta Gandhe, R. Patil, V. R. Yasam, R. Nagarkar
Abstract The solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is a relatively uncommon entity. The aim of the present study was to summarize our experiences with regard to diagnostic dilemma, surgery, postoperative follow-up, and management. This retrospective data were collected during the period from January 1, 2018 to December 31, 2020. A total of four patients (three females and one male) were identified within an age range of 13 to 25 years. All the patients were presented with nonspecific symptoms such as abdomen lumps, swelling in the abdomen, and abdominal pain. To reach a definite diagnosis, imaging studies were conducted along with endoscopic ultrasound fine-needle aspiration (EUS-FNA) and biopsy. After confirmation of SPEN on biopsy, all the patients underwent surgery without any complications. Patients are on follow-up, and to date, no metastasis has been detected. SPEN is a rare pancreatic tumor with unusual pathological features leading to a diagnostic dilemma. The pathologist should be familiar with SPEN and its salient histological characteristics that differentiate it from other look-alike pancreatic tumors and can help in timely surgery and management.
摘要胰腺实性假乳头状上皮肿瘤(SPEN)是一种相对罕见的实体瘤。本研究的目的是总结我们在诊断困境、手术、术后随访和管理方面的经验。这些回顾性数据是在2018年1月1日至2020年12月31日期间收集的。共发现4名患者(3名女性和1名男性),年龄在13至25岁之间。所有患者均出现非特异性症状,如腹部肿块、腹部肿胀和腹痛。为了获得明确的诊断,进行了影像学研究以及内镜超声细针抽吸(EUS-FNA)和活检。在活检证实SPEN后,所有患者都接受了手术,没有任何并发症。患者正在接受随访,到目前为止,还没有发现转移。SPEN是一种罕见的胰腺肿瘤,具有异常的病理特征,导致诊断困难。病理学家应该熟悉SPEN及其与其他类似胰腺肿瘤的显著组织学特征,并有助于及时进行手术和管理。
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引用次数: 0
Options of Funding and Ethical Clearance for Medical Researchers in India 印度医学研究人员的资金选择和伦理审查
Pub Date : 2023-04-01 DOI: 10.1055/s-0042-1760084
Semanti Das, Ankit Chandra, B. Nongkynrih
Abstract Research forms an integral part of present world development and interest. It is the primary source of speculation and outcome-based decision making. Medical research work proves to be a big challenge in low- and middle-income countries due to the constraint of resources and capacity building. The disparities in the distribution of resources, inadequate policy implementation, and lack of prioritization of research make the research challenging. There has been an increase in medical research in India but it is not adequate when compared to other countries or areas. Medical researchers face multiple issues, mainly funding and ethical approval and are stunted by the unacceptance in high-indexed journals. In this paper, we have compiled the options for funding and ethical options and ways available for researchers in India. This will help and encourage researchers pro-actively by providing some guidance on the issues related to finance and ethics required for conducting scientific research.
研究是当今世界发展和兴趣的一个组成部分。它是投机和基于结果的决策的主要来源。由于资源和能力建设的限制,医学研究工作在低收入和中等收入国家被证明是一个巨大的挑战。资源分配的不均衡、政策实施的不到位以及缺乏研究的优先顺序使研究具有挑战性。印度的医学研究有所增加,但与其他国家或地区相比还不够。医学研究人员面临着多重问题,主要是资金和伦理批准,并因高索引期刊的不接受而受到阻碍。在本文中,我们整理了印度研究人员可获得的资助和伦理选择和途径。这将通过为开展科学研究所需的财务和伦理问题提供一些指导,积极地帮助和鼓励研究人员。
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引用次数: 0
Detection of Antibiotic Resistance and Biofilm-Producing Ability of Staphylococcus Species in Clinical Isolates 临床分离葡萄球菌耐药及产膜能力检测
Pub Date : 2023-04-01 DOI: 10.1055/s-0043-1768461
Shila Kumari Singh, M. Bhattacharjee, B. Unni, R. Kashyap
Abstract Background  Staphylococci are responsible for life-threatening infections in hospitals and community. Their ability to produce multiple virulence factors and antibiotic resistance is an important reason of high mortality in staphylococcal infections. Biofilm production by these organisms makes it difficult to treat. Most of the treating antibiotics are failing and making it a matter of concern. Aims  This study aims to detect the increased antibiotic resistance in biofilm-producing Staphylococcus and to compare the performance of three potential methods of detection. Methods  A total of 81 isolates of staphylococci including coagulase negative staphylococci (CoNs), methicillin resistant S. aureus (MRSA), and methicillin sensitive S. aureus (MSSA) are included in this study. After the identification, an antibiotic sensitivity test was performed. Biofilm detection was done by three different methods: Congo red agar method, tube adherence method, and microtiter plate method. Result  Out of the 81 samples, 37 CoNs, 17 MRSA, and 27 MSSA were identified. Out of them we got 43 (53%) biofilm producers by Congo red agar method, 40 (49%) by tube adherence method, and 52 (64%) producers by tissue culture plate/microtiter plate method. Most of the biofilm producers showed multiple drug resistance. Conclusion  We found out that the microtiter plate method is sensitive and reliable as compared with the other two methods. Antibiotic resistance was found to be very common in biofilm producers. This was due to the resistance developed as a result of the matrix that does not let the antibiotic bind with the organisms. This can make the treatment of Staphylococcus very difficult in the future as the rate of drug resistance is faster as compared with newly emerging antibiotics.
摘要背景 葡萄球菌是医院和社区中危及生命的感染的罪魁祸首。它们产生多种毒力因子和抗生素耐药性的能力是葡萄球菌感染高死亡率的重要原因。这些生物产生的生物膜使其难以处理。大多数治疗抗生素都失败了,这让它成为一个令人担忧的问题。目标 本研究旨在检测产生生物膜的葡萄球菌中抗生素耐药性的增加,并比较三种潜在检测方法的性能。方法 本研究共包括81株葡萄球菌,包括凝固酶阴性葡萄球菌(CoNs)、耐甲氧西林金黄色葡萄球菌(MRSA)和对甲氧西林敏感的金黄色葡萄杆菌(MSSA)。鉴定后,进行抗生素敏感性试验。生物膜检测采用刚果红琼脂法、试管贴壁法和微量滴定板法三种不同的方法。后果 在81个样本中,鉴定出37个CoN、17个MRSA和27个MSSA。其中,通过刚果红琼脂法获得43个(53%)生物膜生产者,通过管粘附法获得40个(49%),通过组织培养板/微量滴定板法获得52个(64%)生产者。大多数生物膜生产者表现出多重耐药性。结论 与其他两种方法相比,微量滴定板法灵敏可靠。抗生素耐药性在生物膜生产商中非常常见。这是由于基质不让抗生素与生物体结合而产生的耐药性。这可能会使葡萄球菌的治疗在未来变得非常困难,因为与新出现的抗生素相比,耐药性更快。
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引用次数: 0
Essential Service Products as Channels for COVID-19 Awareness and Behavior Change: A Narrative Review 作为新冠肺炎意识和行为改变渠道的基本服务产品:叙述性评论
Pub Date : 2023-04-01 DOI: 10.1055/s-0043-1768137
V. Pathak, Karpaga Priya P., S. Panigrahi, Utsav Raj, Mohan Kumar
Abstract Coronavirus disease 2019 (COVID-19) is here to stay. Nonpharmacological interventions such as hand hygiene, social distancing, and respiratory hygiene have remained the mainstay to curb the spread of the virus, and these are sustainable. To understand the information, education, and communication (IEC) efforts undertaken during previous pandemics and successful behavior change strategies that may be applicable to ongoing COVID-19 pandemic, we conducted a narrative review of articles using PubMed search on September 11, 2022. The results highlighted that reinforced IEC is the need of the hour in efforts against COVID-19 pandemic. The communication strategy during a pandemic should be of three stages aligned to the objectives of building a basic understanding and knowledge in the target population: building an awareness of the threat; personal actions to minimize the impact; and reinforcing the need for appropriate actions to minimize disease transmission, in that order. An innovative strategy of displaying IEC on the daily essential products can result in a sustainable solution that might result in a “felt need” in the community to follow COVID-19 appropriate behavior. A broad base of stakeholders' engagement with civil bodies, nongovernmental organizations, private sectors with well-defined responsibilities and accountability would offer an enabling environment for these efforts in ultimately curbing the COVID-19 pandemic.
摘要2019冠状病毒病(新冠肺炎)将持续存在。手部卫生、保持社交距离和呼吸卫生等非药物干预措施仍然是遏制病毒传播的支柱,而且这些措施是可持续的。为了了解在以前的大流行期间所做的信息、教育和沟通(IEC)工作,以及可能适用于正在进行的新冠肺炎大流行的成功行为改变策略,我们于2022年9月11日使用PubMed搜索对文章进行了叙述性审查。研究结果强调,加强IEC是当前抗击新冠肺炎大流行的需要。大流行病期间的传播战略应分三个阶段,与在目标人群中建立基本理解和知识的目标相一致:建立对威胁的认识;尽量减少影响的个人行为;并加强采取适当行动以尽量减少疾病传播的必要性。在日常必需品上展示IEC的创新策略可以产生可持续的解决方案,这可能会导致社区“感到需要”遵循新冠肺炎的适当行为。利益相关者与具有明确责任和问责制的民间机构、非政府组织和私营部门的广泛接触将为这些努力最终遏制新冠肺炎疫情提供有利环境。
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引用次数: 0
Evaluation of Clinical, Demographic, and Biochemical Profiles of Trinidadian Patients Undergoing Coronary Angiography 评估特立尼达患者接受冠状动脉造影的临床、人口统计学和生化特征
Pub Date : 2023-04-01 DOI: 10.1055/s-0043-1764349
S. Nayak B, T. Monplaisir, Geetha Bhaktha, R. Ali, S. Mohan, V. Priya
Abstract Background  Trinidad and Tobago ranks number 45 in the world for total deaths due to coronary heart disease. Predictive tests for coronary angiographic results set the basis for earlier monitoring of the disease before additional complications become obvious. Aims and Methods  This study aimed to evaluate the anthropometric and biochemical parameters of 124 patients with suspected coronary artery disease (CAD) in Trinidad and how these parameters correlate to the findings at angiography. Results  The biochemical parameters showed statistically significant correlations with CAD severity by Spearman's rank-order correlation. Two clinical parameters showed significant associations with CAD severity—ethnicity (χ 2 (4) = 12.925, p  = 0.012) and presence of type 2 diabetes at baseline (χ 2 (4) = 21.483, p  < 0.001). Conclusion  Biochemical parameters such as fasting blood sugar, N-terminal pro B-type natriuretic peptide, creatinine, and hemoglobin A1c were well correlated and well associated with the severity of CAD after diagnosis by the process of coronary angiography. Hence, these factors can be taken into consideration to predict the severity of CAD.
摘要背景 特立尼达和多巴哥因冠心病死亡的总人数居世界第45位。冠状动脉造影结果的预测性测试为在其他并发症明显之前早期监测疾病奠定了基础。目标和方法 本研究旨在评估特立尼达124名疑似冠状动脉疾病(CAD)患者的人体测量和生化参数,以及这些参数与血管造影结果的相关性。后果 通过Spearman秩序相关,生化参数与CAD严重程度具有统计学显著相关性。两个临床参数显示与CAD严重程度显著相关——种族(χ2(4) = 12.925,p = 0.012)和基线时是否存在2型糖尿病(χ2(4) = 21.483,p < 0.001)。结论 通过冠状动脉造影诊断后,空腹血糖、N-末端B型钠尿肽原、肌酐和血红蛋白A1c等生化参数与CAD的严重程度密切相关。因此,可以考虑这些因素来预测CAD的严重程度。
{"title":"Evaluation of Clinical, Demographic, and Biochemical Profiles of Trinidadian Patients Undergoing Coronary Angiography","authors":"S. Nayak B, T. Monplaisir, Geetha Bhaktha, R. Ali, S. Mohan, V. Priya","doi":"10.1055/s-0043-1764349","DOIUrl":"https://doi.org/10.1055/s-0043-1764349","url":null,"abstract":"Abstract Background  Trinidad and Tobago ranks number 45 in the world for total deaths due to coronary heart disease. Predictive tests for coronary angiographic results set the basis for earlier monitoring of the disease before additional complications become obvious. Aims and Methods  This study aimed to evaluate the anthropometric and biochemical parameters of 124 patients with suspected coronary artery disease (CAD) in Trinidad and how these parameters correlate to the findings at angiography. Results  The biochemical parameters showed statistically significant correlations with CAD severity by Spearman's rank-order correlation. Two clinical parameters showed significant associations with CAD severity—ethnicity (χ 2 (4) = 12.925, p  = 0.012) and presence of type 2 diabetes at baseline (χ 2 (4) = 21.483, p  < 0.001). Conclusion  Biochemical parameters such as fasting blood sugar, N-terminal pro B-type natriuretic peptide, creatinine, and hemoglobin A1c were well correlated and well associated with the severity of CAD after diagnosis by the process of coronary angiography. Hence, these factors can be taken into consideration to predict the severity of CAD.","PeriodicalId":53332,"journal":{"name":"Annals of the National Academy of Medical Sciences India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42052152","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}
引用次数: 0
Ethics in Publication 出版职业道德
Pub Date : 2023-04-01 DOI: 10.1055/s-0043-1770903
Shashank Srivastava, A. Jain
The growth of Medical Sciences is very fast. The core of enrichment of Medical Sciences is dependent on the evidence gathered and published. Performing a well-organized experimental research and final submission of the same as an article is a tedious and painstaking process. Published research article is only the tip of the iceberg. It involves long planning, execution, analysis, and document preparation.1 Ethical principles apply at every stage of research starting from planning till the publication of the document. Ethics is derived from the Greekword “ethikos,”which is derived from the Greek word ethos, meaning custom or character. Ethical issues and principles are important for all the pillars of publication, that is, authors (during execution and reporting of research), reviewer (at the time of reviewing the article), and the editor of the journal. Research misconduct is defined by the Royal College of Physicians of Edinburgh as “any behavior by a researcher, whether intentional or not, that fails to scrupulously respect high scientific and ethical standards.”2 Various types of research misconduct include fabrication or falsification of data, plagiarism, problematic data presentation or analysis, failure to obtain ethical approval by the Research Ethics Committee or to obtain the subject’s informed consent, inappropriate claims of authorship, duplicate publication, and undisclosed conflict of interest. Recently there has been a decline in the ethical principles guiding scientific research. Serious thought has to be given on commercialization of scientific research, which has its effects on the ethical principles and advancement of scientific knowledge. Ethical misconduct done out of ignorance or intentionally has the same consequences, and seriousness of the event remains the same. Types of Research Misconduct
医学科学的发展非常迅速。医学科学丰富的核心是依赖于收集和发表的证据。进行一个组织良好的实验研究和最终提交一篇文章是一个繁琐而艰苦的过程。发表的研究论文只是冰山一角。它包括长期的计划、执行、分析和文件准备伦理原则适用于从计划到文件发表的每一个研究阶段。伦理学来源于希腊语“ethikos”,而“ethikos”又来源于希腊语“ethos”,意思是习俗或性格。伦理问题和原则对于出版的所有支柱都很重要,即作者(在执行和报告研究期间),审稿人(在审查文章时)和期刊编辑。爱丁堡皇家医师学院将研究不端行为定义为“研究人员的任何行为,无论是有意还是无意,都未能严格遵守高科学和道德标准。”“2各种类型的研究不端行为包括伪造或伪造数据、抄袭、有问题的数据展示或分析、未能获得研究伦理委员会的伦理批准或未获得受试者的知情同意、不适当的作者声明、重复发表和未披露的利益冲突。最近,指导科学研究的伦理原则有所下降。科学研究的商业化对伦理原则和科学知识的进步产生了影响,必须对此进行认真的思考。出于无知或故意的道德不端行为具有相同的后果,事件的严重性保持不变。研究不端行为的种类
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引用次数: 0
Identification of Bacterial Isolates and Their Antimicrobial Susceptibility Pattern from Wound/Pus Sample in a Tertiary Care Hospital, Gwalior, India 印度瓜廖尔某三级医院伤口/脓液样本中分离细菌的鉴定及其药敏模式
Pub Date : 2023-04-01 DOI: 10.1055/s-0043-1768136
Kamini Rajput, S. Johri, A. Goyal
Abstract Objective  The goal of this investigation was to look at the frequency and dispersal of bacteria isolated from pus/wound, as well as their susceptibility patterns. Materials and Methods  A study was conducted on 175 patients who provided pus and/or wound discharge samples in different wards (outpatient department or inpatient department). MacConkey agar and blood agar plates were immediately inoculated with samples and incubated at 37°C for 24 hours. The Gram stain and biochemical tests were used to identify all isolates after incubation. Kirby–Bauer's disc diffusion method was used to perform sensitivity tests on Mueller–Hinton agar plates. Results  This study covered 175 patients, with a bacterial isolation rate of 102 (58.28%). Males outnumbered females in the samples (M:F = 1.8:1), with a median age of 45 years as majority were in the age group of 40 to 60 years which was 41 (40.20%). Total 90.1% samples showed monomicrobial infection, whereas 9.8% showed polymicrobial infection, and total 112 bacterial strains were isolated. Conclusion   Escherichia coli was the most prevalent isolate in present investigation, followed by Pseudomonas aeruginosa . Chloramphenicol is the only antibiotic which is effective for both gram-negative bacilli and gram-positive cocci. This report's susceptibility statistic may be worth considering for developing empiric treatment regimens for pyogenic infections.
摘要目的了解脓液/创面分离细菌的频率、分布及其药敏模式。材料与方法对175例在不同病房(门诊部和住院部)提供脓液和/或伤口分泌物样本的患者进行研究。即刻将样品接种于MacConkey琼脂和血琼脂板,37℃孵育24小时。培养后用革兰氏染色法和生化试验对所有分离株进行鉴定。采用Kirby-Bauer圆盘扩散法对Mueller-Hinton琼脂板进行敏感性试验。结果共纳入175例患者,细菌分离率为102例(58.28%)。样本中男性多于女性(M:F = 1.8:1),年龄中位数为45岁,以40 ~ 60岁年龄组居多,占40.20%。单菌感染90.1%,多菌感染9.8%,共分离出112株细菌。结论大肠杆菌是本次调查中最常见的分离菌,其次是铜绿假单胞菌。氯霉素是唯一对革兰氏阴性杆菌和革兰氏阳性球菌都有效的抗生素。本报告的易感性统计数据可能值得考虑制定化脓性感染的经验性治疗方案。
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引用次数: 0
Chondromyxoid Fibroma of Clavicle Presenting as Radiological Disappearance of Bone 锁骨软骨粘液样纤维瘤影像学表现为骨消失
Pub Date : 2023-04-01 DOI: 10.1055/s-0043-1764435
S. Arora, Abhishek Kashyap, L. Maini, A. Prakash, R. Saran
Abstract Case   Presentation Chondromyxoid fibroma (CMF) is a relatively rare bone tumor of cartilaginous origin and it comprises less than 1% of all primary bony tumors. Clavicle is an unusual site of involvement for any bone tumor and may produce diagnostic dilemma. Approximately only 1% of all primary bone tumors may involve the clavicle. The literature on clinical features and outcome of CMF clavicle remains sparse. Conclusion  We present an unusual case of CMF clavicle in which the medial aspect of the clavicle gradually disappeared on radiographs. CMF should be included in the differential diagnoses of disappearing bone disease.
摘要案例  软骨黏液样纤维瘤(CMF)是一种相对罕见的软骨源性骨肿瘤,在所有原发性骨肿瘤中所占比例不到1%。锁骨是任何骨肿瘤的一个不寻常的受累部位,可能会产生诊断难题。大约只有1%的原发性骨肿瘤可能累及锁骨。关于锁骨CMF的临床特征和结果的文献仍然很少。结论 我们报告了一例不寻常的CMF锁骨病例,其中锁骨内侧在X线片上逐渐消失。CMF应纳入消失性骨病的鉴别诊断中。
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引用次数: 0
Successful Implementation of Yoga and Naturopathy Interventions for Coronavirus Disease 2019 Patients in Tamil Nadu 泰米尔纳德邦2019冠状病毒病患者成功实施瑜伽和自然疗法干预
Pub Date : 2023-03-03 DOI: 10.1055/s-0043-1762903
N. Manavalan, T. Prabu, M. Pandiaraja, K. Maheshkumar
1Department of Naturopathy, Govt. Yoga and Naturopathy Medical College and Hospital, Chennai, Tamil Nadu, India 2Department of Philosophy andNature cure, Govt. Yoga andNaturopathy Medical College and Hospital, Chennai, Tamil Nadu, India 3Department of Naturopathy, Govt. Yoga and Naturopathy Medical College and Hospital, Chennai, Tamil Nadu, India 4Department of Physiology andBiochemistry, Govt. Yoga andNaturopathy Medical College and Hospital, Chennai, Tamil Nadu, India
1印度泰米尔纳德邦钦奈政府瑜伽与自然疗法医学院和医院自然疗法部2印度泰米尔纳德邦钦奈政府瑜伽与天然疗法医学院与医院哲学与自然疗法部3印度泰米尔那德邦钦乃政府瑜伽与生物疗法医学院及医院自然疗法部门4。印度泰米尔纳德邦钦奈瑜伽与自然疗法医学院和医院
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引用次数: 0
期刊
Annals of the National Academy of Medical Sciences India
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