Bangladesh Journal of Otorhinolaryngology最新文献

{"title":"Surgical Outcome and Quality of Life After Total Laryngectomy in Advanced Laryngeal Cancer- A Study in Combined Military Hospital, Dhaka","authors":"M. A. Azad, B. Siddiquee, A. Asaduzzaman, F. Mohsin, M. Hasnat","doi":"10.3329/BJO.V27I1.53199","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53199","url":null,"abstract":"Introduction: Total laryngectomy is the gold standard treatment for advanced laryngeal cancer. Sacrifice of voice is one of the most important shortcomings of the procedure. Possibility of achieving good quality voice is greater with prosthesis compared to other method. Post laryngectomy voice rehabilitation with prosthesis yield excellent outcome in most of the cases. Swallowing, pulmonary and olfactory rehabilitation should be managed by multidisciplinary team for better quality of life (QoL). Objectives: The purpose of this study was to observe the outcomes of voice, swallowing pulmonary and olfactory rehabilitation and QoL following total laryngectomy. Methods: This cross sectional retrospective clinical study was conducted at the Head & Neck Oncology Unit, Combined Military Hospital (CMH), Dhaka. Total 57 candidates were selected. Diagnosis was done by thorough clinical examination, Fibre Optic Laryngoscopy. Contrast Enhanced Computed Tomography (CECT) scan of neck was done except few cases where MRI of neck was done for subtle cartilage erosion was suspected. Examination under anaesthesia, direct larangoscopy and biopsy was done for every cases. Candidates were post chemo-radiated/ radiated biopsy proven recurrent cases, clinically nonfunctional larynx with aspiration and radiologically evident of cartilage erosion. In all cases artificial voice prosthesis was used. All the laryngectomees underwent voice, swallowing, pulmonary and olfactory rehabilitation in laryngectomy club of head & neck oncology unit, CMH Dhaka for a period of 3 months as per standard protocol. 1. Classified ENT Specialist & Head-Neck Surgeon, Dept of ENT and Head-Neck, Surgery, Combined Military Hospital, Chattogram. 2. Professor & Chief, Head & Neck surgery Division, BSMMU, Dhaka. 3. Classified ENT Specialist & Head Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Cumilla. 4. Classified ENT Specialist & Head – Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Barishal. 5. Graded ENT Specialist & Head – Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Bir Uttam Shaeed Mahbub Senanibash, Kholahati, Parbatipur. Address of correspondence: Lieutenant Colonel (Dr.) Muhammad Ali Azad, Classified ENT Spl & Head Neck Surgeon, Dept. of ENT and Head-Neck Surgery, Combined Military Hospital, Chattogram, Bangladesh. Mobile: +8801714056245, E-mail: aliazad101052@gmail.com Introduction: Total laryngectomy is still indispensable procedure in treating advanced or recurrent cancer of larynx and hypopharynx. The larynx has important functions in olfaction and respiration and is more than just an organ of voice production. Its removal requires rehabilitation of all three systems. Perhaps loss of voice is the most distressing to the patients as they loss power of communications and establishment of an acceptable voice is critical for successful psychological adjustment. Multidisciplinary team effort is m","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45904950","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":"Congenital Cholesteatoma in Adult: Is it Still Possible?","authors":"H. Tan, A. Idris, C. Ong, A. Asma","doi":"10.3329/BJO.V27I1.53214","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53214","url":null,"abstract":"Congenital cholesteatoma is a mass of squamous epithelium located medial to an intact tympanic membrane without previous history of tympanic membrane perforation, otorrhoea or otological surgery. We described a 24 year old gentleman with a left postauricular discharging fistula for 3 years with recent history of gradual hearing loss, tinnitus and recurrent episodes of positional vertigo. Clinical examination noted left postauricular fistula opening and otoscopy showed a whitish mass medial to a bulging intact tympanic membrane. High-resolution computed tomography of temporal bone was suggestive of cholesteatoma. Left modified radical mastoidectomy was done and he recovered with resolution of symptoms.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44400903","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":"Surgical Outcome of Parapharyngeal Tumour","authors":"Kazi Shameemus Salam, S. Quadir, M. Uddin, Syed Farhan Ali Razib, A. Sattar, M. Uddin, B. Siddiquee","doi":"10.3329/BJO.V27I1.53209","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53209","url":null,"abstract":"Background: Parapharyngeal tumours are rare accounting for 0.5-1.5% of all head neck tumuors. The anatomy of the Parapharyngeal space (PPS) is responsible for a wide variety of tumours arising from PPS. Objective: Evaluation of the strategy for parapharyngeal tumor surgery based on preoperative symptoms, clinical signs, imaging investigations and histopathology. Methodology: This retrospective study was carried out in the Department of Otolaryngology and Head Neck surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU) included 32 patients were underwent surgery for primary parapharyngeal tumors between January 2018 and December 2019. Informed written consent was obtained from the patients prior to their inclusion in the study. In regard to histologic type there were 21 cases salivary gland origin tumors and 11 of neuro-genic tumors. The following data were evaluated preoperative symptoms, histological type, surgical approach and complications patients were evaluated following a laboratory investigations. Results: The most common symptoms of these tumors were a neck swelling. Total of 18 tumors were located in the prestyloid and poststyloid space cases were located 10(31.25%) and 4(12.50%) in the pre and poststyloid. Majority 12(37.50%) was found pleomorphic adenomaof deep lobe of parotid gland followed by 6(18.75%) were schwannoma,4(12.50%) were neurofibroma, 3(9.38%) were ectopic salivary gland tumor,2(6.25%) were mucoepidermoid carcinoma, 2(6.25%) were adenocarcinoma. First bite syndrome and lower lip palsy were common post operative complications. Transcervical approach was the most often performed approach in this study (56.25%). 1. Associate professor, Department Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 2. MD (Radiology and Imaging), Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. 3. Classified ENT Specialist and Head and Neck surgeon, CMH, Jashore cantonment. 4. Associate professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 5. Professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 6. Professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. 7. Chief, Head and Neck Surgery Division & Chairman, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Address of Correspondence: Dr. Kazi Shameemus Salam, Associate professor, Department of Otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. e-mail: drkssalam@gmail.com. Mobile: 01711-846700","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44104948","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":"Quality of Life Assessment after Canal Wall Down Mastoidectomy: Our Experiences in Shaheed Ziaur Rahman Medical College Hospital, Bogura","authors":"Khorsed Alam, Saiduzzaman, Asadur Rahman, S. S. Islam, Mohammad Anisur Rahman, K. Sarker","doi":"10.3329/BJO.V27I1.53205","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53205","url":null,"abstract":"Objective: To determine subjective outcomes after cholesteatoma surgery. Design: Cross sectional observational study Methods: Study place: Shaheed Ziaur Rahman Medical college Hospital (SZMCH), Bogura, Bangladesh Study population: Chronic otitis media (COM) with extensive cholesteatoma. Interventions: Canal wall down mastoidectomy for cholesteatoma. Main Outcome Measures: In this study, the Chronic Ear Survey (CES) was provided to all patients preoperatively and one year after surgery. The preoperative and postoperative score differences were analyzed. We also assessed correlations between chronic ear survey scores and air conduction threshold. Results: Seventy six patients were enrolled in our study & marked improvements were found in total CES score & all subscale scores postoperatively (P value: 0.00). The total CES score and symptom subscale scores were observed greater improvement (P value: 0.00).Significant negative linear correlations were observed among total CES scores, symptom subscale scores and air conduction thresholds (P<.05). Conclusion: The present study suggests that canal wall down mastoidectomy (CWDM) provides a significant improvement in the post-operative Quality of life (QoL) &b there is a significant association between subjective outcomes &the objective audiometric results.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48785436","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":"Parathyroid Adenoma: an experience in BIRDEM General Hospital","authors":"S. Mahbub, S. S. Biswas, B. K. Dey, S. Alam, J. Hoq","doi":"10.3329/BJO.V27I1.53204","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53204","url":null,"abstract":"Background: Parathyroid adenoma is most commonly associated with primary hyperparathyroidism which leads to hypercalcaemia. Hypercalcaemia results in multiple stone formation in Kidney and biliary tract which indicates surgical removal of tumor. Perioperative management of patient is essential to prevent mortality and morbidity. The purpose of this study is to analyze a case series of patient having parathyroid adenoma with difficulties, to localize the adenoma and to take the measures to maintain the normal level of calcium in pre, per and postoperative period. \u0000Methods: This retrospective study was carried out in BIRDEM General Hospital and Ibrahim Medical College from May 2017 to December 2019. 14 patients who were diagnosed as primary hyperparathyroidism due to parathyroid adenoma who had been managed at the BIRDEM General Hospital, Dhaka, Bangladesh from May 2017 to December 2019 were reviewed and included. \u0000Result: Among 14 patients 8 were female and 6 male (M: F=3:4). Age ranges from 26 to 71 years with mean age was 52 years. Serum PTH were above normal (>65 pg/ml) in all cases. Serum calcium level were above normal in 12 cases (85.71 %) and 2 (14.29%) had normal levels. Serum phosphate levels were within normal range. Excision of adenoma done in all cases which were confirmed by frozen section per-operatively. None of our patients develop any complication during and after surgery \u0000Conclusion: Successful management of parathyroid adenoma requires combined skills of surgeons, endocrinologists, anesthesiologists and pathologists. Improvement after operation is quite remarkable and rewarding. \u0000Bangladesh J Otorhinolaryngol; April 2021; 27(1): 44-51","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46246100","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":"Relationship between Thickness of Early Oral Tongue Carcinoma (T1, T2) with Cervical Lymph Node Metastasis","authors":"A. Razzak, B. H. Siddique, Azharul Islam, H. Haque, A. Sattar, Sayed Farhan Ali Razib, Effat Zahan Abdullah, A. M. Jewel, Jaber Al Sayied, Quamruzzaman","doi":"10.3329/BJO.V27I1.53202","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53202","url":null,"abstract":"Background: Carcinoma of oral tongue is the most common oral cancer and because of its structure and function is prone for early local and regional spread of cancer. The final outcome of a primary tongue carcinoma patient depends upon various prognostic factors like thickness of tumor, depth of invasion, size of lesion and neck node 67metastasis. Risk of metastasis and spread to neck nodes increases with increase in tumor thickness Methods: This prospective observational study was carried out in the Department of OtolayngologyHead & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for 18 months. Thirty patients with early oral tongue carcinoma i.e.T1 & T 2 as per UICC and AJC criteria were included in this study by purposive non-randomized sampling technique. Result of the study were expressed as mean, standard deviation (+SD), frequency and percentages. Unpaired Student’s t-test and Pearson’s correlation co-efficient (r) test were performed. Results: Result of the study showed the mean (+SD) thickness of the tumor was 3.62 (+1.46) mm. Minimum thickness 1.1mm and maximum thickness 7.8mm. Only 21 (70%) subjects neck node were metastasized from tongue and mean (+SD) tumor thickness of the positive neck node metastasis was 5.54 (+1.07) mm and negative neck node metastasis was 2.87 (+0.75) mm. This indicated a significant difference between the groups. Pearson’s correlation co-efficient r (+0.981) which indicated tumor thickness was positively correlated with neck node metastasis. Conclusion: Tumor thickness of the early oral carcinoma positively correlated with neck node metastasis. Correlation between thickness and metastatic lymph node can help planning the treatment regimen and indicate the disease prognosis.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69459132","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":"Correlation of Ultrasonography Guided Fine Needle Aspiration Cytology with Postoperative Histopathology in Diagnosis of Thyroid Nodule","authors":"Jaber Al Sayied, A. Choudhury, Sonia Jahan Bithi, A. Biswas, Riashat Azim Majumder, A. Razzak, H. Haque, Quamruzzaman","doi":"10.3329/BJO.V27I1.53203","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53203","url":null,"abstract":"Background: Fine-needle aspiration cytology (FNAC) is recommended as a decisive diagnostic step in the workup of patients with nodular thyroid disease. Unfortunately, FNAC can miss malignancies in smaller and deeper nodule. Ultrasound guided FNAC (US-FNAC) can reduce this error in suspicious thyroid nodule. Objectives: To find out the correlation of USG guided FNAC with postoperative histopathology in diagnosis of thyroid nodule. Methods: After obtaining clearance and approval from Institutional Review Board, all 45 patients of thyroid nodule who were admitted in the Department of Otolaryngology – Head & Neck surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2017 to August 2018 and had fulfilled the inclusion and exclusion criteria were selected for the study. Each patient was assessed before surgery by USG guided FNAC and post operatively","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69459191","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":"Comparison between Conventional Microdissection and CO2 Laser in the Treatment of Vocal Cord Polyp","authors":"M. Wahiduzzaman, Sayed Farhan Ali Razib, A. Hossain, Idrish Ali, H. Rahman, HM Mustafizur Rahman","doi":"10.3329/BJO.V27I1.53201","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53201","url":null,"abstract":"Background: Vocal cord polyp usually arises from the epithelium and the lamina propria. Minimally invasive dissection procedures are employed to treat these vocal cord polyp for an effective outcome. Two types of microsurgical techniques were developed gradually and practiced namely, the conventional laryngeal microsurgery, which involves the use of cold instruments and the laryngeal laser micro-surgery. Objective: To compare the conventional cold dissection and CO 2 laser methods in treatment of vocal cord polyp. Methods: A randomized prospective study was conducted at the Department of OtolayngologyHead & Neck Surgery, at Bangabondhu Sheikh Muzib Medical University (BSMMU) between July 2017 and June 2019. A total of 60 cases were studied on the following parameters: a. Visual analysis on stroboscopy b. Voice analysis –GRBAS (grade, roughness, breathiness, asthenia, strain) indices c. Duration of surgery d. Peroperative bleeding. Results: During first postoperative assessment, both groups had the normal symmetrical waves, while 50% of cases still had aperiodicity but all patients had the near normal periodicity in the second postoperative assessment. Regarding glottic closure, during preoperative assessment, almost all patients had incomplete glottic closure due to mass lesion as polyps. During first postoperative assessment, glottic closure was found to be better in group B (83% of cases) than group A (76% of cases), while during second postoperative assessment, all patients of both groups had around 95% glottic closure. The mean duration oflaser technique (7.1 ± 1.1 minutes) was less than the conventional technique time (15.6 ± 1.9 minutes), also mean of operative bleeding of laser technique (zero pack) is less than the conventional two(2 packs). Conclusion: There is no significant difference between both groups in all parameters except operative time and bleeding, as laser technique has less time and clear field.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47047124","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":"Medicolegal Issues in ENT Practice","authors":"M. Matin","doi":"10.3329/BJO.V27I1.53198","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53198","url":null,"abstract":"Abstract not available \u0000Bangladesh J Otorhinolaryngol; April 2021; 27(1): 1-3","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43103254","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":"Effects of Enlarged Adenoids on Middle Ear Pressure and Hearing","authors":"Noorain Alam, Sm Nazmul Huque, Abm Delowar Hossain, K. Atikuzzaman, M. Hussain, M. K. Arefin","doi":"10.3329/BJO.V27I1.53210","DOIUrl":"https://doi.org/10.3329/BJO.V27I1.53210","url":null,"abstract":"Background: Adenoids are common childhood upper respiratory tract problem which frequently obstruct the nasopharyngeal opening with tubal occlusion causes reduction in middle ear pressure with conductive hearing loss. Objective: To observe middle ear pressure and level of hearing in children with enlarged adenoids. Methods: This cross sectional observational study conducted among 72 children of enlarged adenoids admitted or attended in Dhaka Medical College Hospital and Bangabandhu Sheikh Mujib Medical University Dhaka. Results: 72 children of enlarged adenoids of age ranges between 5-12 years with male female ratio was 1.25:1. Mouth breathing (65.27%), hearing impairment (59.72%), nasal obstruction (55.55%) and snoring (56.94%) were the presenting symptoms of the patients. Majority of the patients of this study came from middle class (52.77%). Most of the patients with enlarged adenoids were grossly enlarged (51.38%). 43.05% grossly enlarged adenoids had significant hearing loss . In this series 65 ears (45.13%) had type A Tympanogram. 58 ears (40.27%) has Type B Tympanogram and 21 ears (14.58%) has Type C Tympanogram. Conclusion: This study revealed significant association between enlarged adenoids and conductive hearing loss of variable degree and negative middle ear pressure.","PeriodicalId":53915,"journal":{"name":"Bangladesh Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46944902","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}