B. Rajkrishna, Saikat Das, D. Masih, Tharani Putta, R. Raghunath, T. Ram
Aim and Objective: To assess the magnetic resonance imaging (MRI) downstaging, pathological response, and the relationship between microsatellite instability (MSI) and radiotherapy response in signet-ring cell carcinoma rectum. Materials and Methods: Twenty two patients were recruited prospectively and retrospectively in this observational study. Six weeks following radiotherapy, the response was assessed using an MRI pelvis, and patients who were operable underwent total mesorectal excision followed by adjuvant chemotherapy. The outcome of radiotherapy was correlated with post radiation MRI downstaging, pathological response, and MSI status. Results: The post radiotherapy response assessment MRI showed tumor regression grading (TRG) 5 in 5 patients. TRG 4 seen in 12, TRG 3 in 3, and TRG 2 in 1 patient. Fifteen patients were operable and post-operativ histopathology showed that 40% had pathological complete response (pCR) and 26.7% had near-complete response. Even those who had no response in MRI had pCR. MSI done 17 patients were stable. Of the 6 patients who had complete pathological response, two were MRI TRG 5, three were MRI TRG 4, and one was MRI TRG 3. The median survival was 23 months. The 2-year and 3-year disease-free survival was 46% and 38%, respectively. Conclusion: The predictive value of MRI downstaging in these tumors following neoadjuvant long-course chemoradiation therapy is not often in concurrence with the histopathological response and needs to be interpreted carefully. Even though the pCR rate seen in this cohort is encouraging, this needs to be evaluated in studies with large cohorts.
目的:探讨直肠印戒细胞癌的磁共振成像(MRI)降分期、病理反应及微卫星不稳定性(MSI)与放疗反应的关系。材料和方法:本观察性研究前瞻性和回顾性地招募了22例患者。放疗后6周，使用骨盆MRI评估疗效，可手术的患者接受全肠系膜切除术，然后进行辅助化疗。放疗结果与放疗后MRI降分期、病理反应和MSI状态相关。结果:5例患者放疗后反应评估MRI显示肿瘤消退分级(TRG) 5级。12例出现TRG 4, 3例出现TRG 3, 1例出现TRG 2。15例患者可手术，术后组织病理学显示40%的患者病理完全缓解(pCR)， 26.7%的患者接近完全缓解。即使那些在MRI中没有反应的人也进行了pCR。MSI检查17例患者情况稳定。病理完全缓解的6例患者中，2例MRI TRG 5级，3例MRI TRG 4级，1例MRI TRG 3级。中位生存期为23个月。2年和3年无病生存率分别为46%和38%。结论:MRI降分期在这些肿瘤新辅助长期放化疗后的预测价值往往与组织病理反应不一致，需要仔细解释。尽管在该队列中观察到的pCR率令人鼓舞，但这需要在大型队列研究中进行评估。
{"title":"Magnetic resonance imaging downstaging, pathological response, and microsatellite instability status in patients with signet-ring cell carcinoma rectum undergoing preoperative long-course chemoradiation","authors":"B. Rajkrishna, Saikat Das, D. Masih, Tharani Putta, R. Raghunath, T. Ram","doi":"10.4103/cmi.cmi_23_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_23_22","url":null,"abstract":"Aim and Objective: To assess the magnetic resonance imaging (MRI) downstaging, pathological response, and the relationship between microsatellite instability (MSI) and radiotherapy response in signet-ring cell carcinoma rectum. Materials and Methods: Twenty two patients were recruited prospectively and retrospectively in this observational study. Six weeks following radiotherapy, the response was assessed using an MRI pelvis, and patients who were operable underwent total mesorectal excision followed by adjuvant chemotherapy. The outcome of radiotherapy was correlated with post radiation MRI downstaging, pathological response, and MSI status. Results: The post radiotherapy response assessment MRI showed tumor regression grading (TRG) 5 in 5 patients. TRG 4 seen in 12, TRG 3 in 3, and TRG 2 in 1 patient. Fifteen patients were operable and post-operativ histopathology showed that 40% had pathological complete response (pCR) and 26.7% had near-complete response. Even those who had no response in MRI had pCR. MSI done 17 patients were stable. Of the 6 patients who had complete pathological response, two were MRI TRG 5, three were MRI TRG 4, and one was MRI TRG 3. The median survival was 23 months. The 2-year and 3-year disease-free survival was 46% and 38%, respectively. Conclusion: The predictive value of MRI downstaging in these tumors following neoadjuvant long-course chemoradiation therapy is not often in concurrence with the histopathological response and needs to be interpreted carefully. Even though the pCR rate seen in this cohort is encouraging, this needs to be evaluated in studies with large cohorts.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"37 1","pages":"154 - 160"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85353264","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: The COVID-19 pandemic has had a significant impact on the mental health of individuals which has sometimes led to attempts at deliberate self-harm including the ingestion of caustic substances. This study was aimed to compare the rates of caustic substance ingestion during the pandemic to a similar period in the preceding year at our center. Methodology: We carried out a retrospective analysis, in which patients' details (demographic, clinical, endoscopic, and outcomes) were collected and compared between April 2019 and December 2019 (pre-COVID-19 pandemic) and from April 2020 to December 2020 (during the COVID-19 pandemic). Results: A total of 41 patients were included in this study, 26 (63.4%) in the pandemic period and 15 (36.5%) in the prepandemic period. The majority were female in both the prepandemic (60%) and pandemic periods (53.9%). More adolescents (<18 years of age) were seen in the pandemic period (15.3%) than in the prepandemic period (6.7%). The proportion of patients admitted with caustic substance ingestion in the pandemic period (3.53%) was significantly higher than in the prepandemic period (1.57%) (P = 0.0094). Conclusion: Caustic substance ingestion almost doubled in our center during the COVID-19 pandemic highlighting the burden of mental health issues during a pandemic.
{"title":"The impact of COVID-19 pandemic on caustic ingestion at a tertiary care center in South India","authors":"N. Rao, E. Simon","doi":"10.4103/cmi.cmi_118_21","DOIUrl":"https://doi.org/10.4103/cmi.cmi_118_21","url":null,"abstract":"Background: The COVID-19 pandemic has had a significant impact on the mental health of individuals which has sometimes led to attempts at deliberate self-harm including the ingestion of caustic substances. This study was aimed to compare the rates of caustic substance ingestion during the pandemic to a similar period in the preceding year at our center. Methodology: We carried out a retrospective analysis, in which patients' details (demographic, clinical, endoscopic, and outcomes) were collected and compared between April 2019 and December 2019 (pre-COVID-19 pandemic) and from April 2020 to December 2020 (during the COVID-19 pandemic). Results: A total of 41 patients were included in this study, 26 (63.4%) in the pandemic period and 15 (36.5%) in the prepandemic period. The majority were female in both the prepandemic (60%) and pandemic periods (53.9%). More adolescents (<18 years of age) were seen in the pandemic period (15.3%) than in the prepandemic period (6.7%). The proportion of patients admitted with caustic substance ingestion in the pandemic period (3.53%) was significantly higher than in the prepandemic period (1.57%) (P = 0.0094). Conclusion: Caustic substance ingestion almost doubled in our center during the COVID-19 pandemic highlighting the burden of mental health issues during a pandemic.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"16 3 1","pages":"168 - 171"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78022388","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}
Anand M Tiwari, K. Zirpe, R. Wadia, S. Gurav, A. Deshmukh
Intentional ingestion of organophosphorus compound (OP) poisoning continues to be a frequent reason for critical care admission in India. For the past 6 decades, the OP compounds used in India for the poisoning had effects on cholinergic and neurogenic fibers producing the respiratory and neurologic presentation. Recently, a less frequent OP poison has appeared which acts on cardiac sympathetic fibers with bradycardia and hypotension as presenting features. The shock which was nonresponsive to dopamine/dobutamine was identified as a major cause of death in patients with dimethoate poisoning in a large prospective cohort study. Severe dimethoate poisoning in contrast to other OP compounds has a high case fatality rate. There have been case reports from outside India. We report the first two cases with successful treatment of this toxicity in India.
{"title":"Dimethoate self-poisoning–Induced severe hypotension","authors":"Anand M Tiwari, K. Zirpe, R. Wadia, S. Gurav, A. Deshmukh","doi":"10.4103/cmi.cmi_12_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_12_22","url":null,"abstract":"Intentional ingestion of organophosphorus compound (OP) poisoning continues to be a frequent reason for critical care admission in India. For the past 6 decades, the OP compounds used in India for the poisoning had effects on cholinergic and neurogenic fibers producing the respiratory and neurologic presentation. Recently, a less frequent OP poison has appeared which acts on cardiac sympathetic fibers with bradycardia and hypotension as presenting features. The shock which was nonresponsive to dopamine/dobutamine was identified as a major cause of death in patients with dimethoate poisoning in a large prospective cohort study. Severe dimethoate poisoning in contrast to other OP compounds has a high case fatality rate. There have been case reports from outside India. We report the first two cases with successful treatment of this toxicity in India.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"76 1","pages":"187 - 190"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75072449","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}
Kolb's cycle of experiential learning is the new method of pedagogy for medical education. It is helpful in the integration of book knowledge and practical knowledge, which is an essential component in competency-based medical education. Experiential learning is helpful for students and more interesting also for them.
{"title":"Experiential learning: How pedagogy is changing in medical education","authors":"Debkumar Pal, M. Taywade, Kumbha Gopi","doi":"10.4103/cmi.cmi_35_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_35_22","url":null,"abstract":"Kolb's cycle of experiential learning is the new method of pedagogy for medical education. It is helpful in the integration of book knowledge and practical knowledge, which is an essential component in competency-based medical education. Experiential learning is helpful for students and more interesting also for them.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"25 1","pages":"198 - 200"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87282491","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 the outbreak of coronavirus in 2019, the health-care workers (HCWs) are tirelessly battling through these unprecedented times. Although the pandemic has shaken the health-care systems globally due to its unpredictable course and spread, HCWs continue to remain on the frontline. the focus is always on patient care and limiting the spread amidst which the mental health and challenges faced by HCWs takes a back seat, the purpose of this opinion is to focus on the mental health issues HCWs are facing globally while fulfilling their duties. The article discusses the clinical features and risk factors and also provides evidence-based management strategies for posttraumatic stress disorder in HCWs.
{"title":"Physiotherapy and behavioral techniques in management of posttraumatic stress disorder in health-care workers amid COVID pandemic","authors":"Srishti Banerjee","doi":"10.4103/cmi.cmi_33_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_33_22","url":null,"abstract":"Since the outbreak of coronavirus in 2019, the health-care workers (HCWs) are tirelessly battling through these unprecedented times. Although the pandemic has shaken the health-care systems globally due to its unpredictable course and spread, HCWs continue to remain on the frontline. the focus is always on patient care and limiting the spread amidst which the mental health and challenges faced by HCWs takes a back seat, the purpose of this opinion is to focus on the mental health issues HCWs are facing globally while fulfilling their duties. The article discusses the clinical features and risk factors and also provides evidence-based management strategies for posttraumatic stress disorder in HCWs.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"17 1","pages":"205 - 208"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86634444","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":"Monitoring treatment outcomes among tuberculosis patients: Implications for practice and policy","authors":"A. John, H. Avirneni, S. Swaminathan","doi":"10.4103/cmi.cmi_45_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_45_22","url":null,"abstract":"","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"18 1","pages":"209 - 209"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72796044","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":"Antimicrobial resistance in India – “A silent pandemic within the pandemic”","authors":"Karthik Gunasekaran","doi":"10.4103/cmi.cmi_47_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_47_22","url":null,"abstract":"","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"41 1","pages":"123 - 124"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76327413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Nirupama, Sirshendu Chaudhuri, C. Chittooru, K. Vani, Sravana Chittem
Introduction: The COVID-19 pandemic led to the disruption of medical teaching nation-wide and pushed the institutions to explore the probable role of online teaching methods. The aim of this review is to identify the untested perspectives and help in strategizing based on evidence generation for the preparation for future. Methods: We followed the Preferred Reporting Items for Systematic and Meta-Analysis guidelines for reporting the present review. We searched PubMed, Scopus, and Embase databases for the articles published between April 2020 and October 2021 for studies on online medical education in India during the COVID-19 pandemic. Results: We initially screened a total number of 1412 articles and finally recruited 45 articles for the analysis. Majority of the articles were from single institution, and reported the experience of the students and teachers on online teaching. The common teaching platform used such as Zoom and Google Meet were enumerated. Internet connectivity was the most reported challenge of online teaching. None of the selected articles reported on ethical issues related to online teaching. Conclusion: Even though there were some strong points reported for the successful implementation of e-learning, a more sustainable and well-informed plan should be devised for the future on online teaching.
{"title":"Undergraduate medical education in India during COVID-19 pandemic","authors":"A. Nirupama, Sirshendu Chaudhuri, C. Chittooru, K. Vani, Sravana Chittem","doi":"10.4103/cmi.cmi_38_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_38_22","url":null,"abstract":"Introduction: The COVID-19 pandemic led to the disruption of medical teaching nation-wide and pushed the institutions to explore the probable role of online teaching methods. The aim of this review is to identify the untested perspectives and help in strategizing based on evidence generation for the preparation for future. Methods: We followed the Preferred Reporting Items for Systematic and Meta-Analysis guidelines for reporting the present review. We searched PubMed, Scopus, and Embase databases for the articles published between April 2020 and October 2021 for studies on online medical education in India during the COVID-19 pandemic. Results: We initially screened a total number of 1412 articles and finally recruited 45 articles for the analysis. Majority of the articles were from single institution, and reported the experience of the students and teachers on online teaching. The common teaching platform used such as Zoom and Google Meet were enumerated. Internet connectivity was the most reported challenge of online teaching. None of the selected articles reported on ethical issues related to online teaching. Conclusion: Even though there were some strong points reported for the successful implementation of e-learning, a more sustainable and well-informed plan should be devised for the future on online teaching.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"326 1","pages":"177 - 181"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79715813","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}
Rajeswaran Thiagesan, V. Gopichandran, S. Subramaniam, Hilaria Soundari, K. Kosalram
Background: Type 2 diabetes is a major public health burden in the South-East Asian region. Persons with disabilities have a higher predilection for developing type 2 diabetes. Objective: The objective of this study was to estimate the prevalence of type 2 diabetes among persons with physical, development, sensory, and psychiatric disabilities in the South-East Asian regional countries. Methods: The Medline database was searched through PubMed using a specifically developed search strategy to identify observational studies that looked at the prevalence of type 2 diabetes among persons with various types of disabilities. Specific inclusion–exclusion criteria were used to shortlist the most relevant studies. The AXIS tool was used to assess the risk of bias in the identified studies. Data were extracted from the final list of studies and meta-analyzed using a random-effects model. Forest plot was used to study the pooled estimate and funnel plot was studied to assess publication bias. Subgroup analysis of prevalence of diabetes among persons with psychiatric and physical disabilities was performed. Results: A total of 771 papers were identified for screening. Of them, 740 were excluded and 31 were included in the full-text review. Finally, 12 studies were included in the meta-analysis. The prevalence of type 2 diabetes among persons with disabilities was 12.8% (95% confidence interval [CI]: 8.8%–16.8%). The studies showed a wide heterogeneity. The funnel plot did not show any publication bias. Subgroup analysis showed that while the prevalence of type 2 diabetes in persons with psychiatric disabilities was 14.0% (95% CI: 9%–18.9%), it was 10.6% (95% CI: 3.6%–17.6%) among persons with other forms of physical disabilities. Conclusion: The prevalence of type 2 diabetes is high among persons with disabilities. There is a need for well-conducted systematic studies in the South-East Asian region on prevalence of type 2 diabetes among persons with disabilities.
{"title":"Prevalence of type 2 diabetes among persons with disabilities in the South-East Asian region: A systematic review and meta-analysis","authors":"Rajeswaran Thiagesan, V. Gopichandran, S. Subramaniam, Hilaria Soundari, K. Kosalram","doi":"10.4103/cmi.cmi_27_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_27_22","url":null,"abstract":"Background: Type 2 diabetes is a major public health burden in the South-East Asian region. Persons with disabilities have a higher predilection for developing type 2 diabetes. Objective: The objective of this study was to estimate the prevalence of type 2 diabetes among persons with physical, development, sensory, and psychiatric disabilities in the South-East Asian regional countries. Methods: The Medline database was searched through PubMed using a specifically developed search strategy to identify observational studies that looked at the prevalence of type 2 diabetes among persons with various types of disabilities. Specific inclusion–exclusion criteria were used to shortlist the most relevant studies. The AXIS tool was used to assess the risk of bias in the identified studies. Data were extracted from the final list of studies and meta-analyzed using a random-effects model. Forest plot was used to study the pooled estimate and funnel plot was studied to assess publication bias. Subgroup analysis of prevalence of diabetes among persons with psychiatric and physical disabilities was performed. Results: A total of 771 papers were identified for screening. Of them, 740 were excluded and 31 were included in the full-text review. Finally, 12 studies were included in the meta-analysis. The prevalence of type 2 diabetes among persons with disabilities was 12.8% (95% confidence interval [CI]: 8.8%–16.8%). The studies showed a wide heterogeneity. The funnel plot did not show any publication bias. Subgroup analysis showed that while the prevalence of type 2 diabetes in persons with psychiatric disabilities was 14.0% (95% CI: 9%–18.9%), it was 10.6% (95% CI: 3.6%–17.6%) among persons with other forms of physical disabilities. Conclusion: The prevalence of type 2 diabetes is high among persons with disabilities. There is a need for well-conducted systematic studies in the South-East Asian region on prevalence of type 2 diabetes among persons with disabilities.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"108 6","pages":"161 - 167"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72459605","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}
Hypoglycemia is the most common metabolic abnormality in the neonatal period. Refractory hypoglycemia is challenging to manage in resource-limited settings. We aim to report the challenges faced and the lessons learnt while managing a neonate with refractory hypoglycemia.
{"title":"Resolve or refer? A difficult choice in the management of neonatal refractory hypoglycemia","authors":"Vinod Palaparthy, Karen Kiruba, Monica Thapwal","doi":"10.4103/cmi.cmi_17_22","DOIUrl":"https://doi.org/10.4103/cmi.cmi_17_22","url":null,"abstract":"Hypoglycemia is the most common metabolic abnormality in the neonatal period. Refractory hypoglycemia is challenging to manage in resource-limited settings. We aim to report the challenges faced and the lessons learnt while managing a neonate with refractory hypoglycemia.","PeriodicalId":72734,"journal":{"name":"Current medical issues","volume":"72 1","pages":"191 - 193"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79768034","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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