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COVID-associated rhino-orbito-cerebral mucormycosis: A comparative study between computed tomography and magnetic resonance imaging for its early detection in suspected cases of rhino-orbito-cerebral mucormycosis 新型冠状病毒相关鼻-眶-脑毛霉菌病:计算机断层扫描与磁共振成像对疑似鼻-眶-脑毛霉菌病早期检测的对比研究
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_51_22
Priyanka R Megharaj, Vikram Patil, Santosh Reddy
INTRODUCTION: Rhino-orbito-cerebral mucormycosis (ROCM), a life-threatening, acute fungal infection of the nasal cavities and paranasal sinuses, once considered a rare and lethal complication in immunocompromised patients, is now having a massive increase in ROCM incidence in India associated with COVID-19, i.e., COVID-associated mucormycosis with more than 15,000 cases as of May 2021. Early imaging by computed tomography (CT) and magnetic resonance imaging (MRI) is not only helpful in assessing the extent of involvement of this lethal disease but also helps in early diagnosis leading to prompt and aggressive treatment. The present study is aimed at determining and comparing the imaging findings on CT and MRI in ROCM patients, for early diagnosis in suspected cases of ROCM. MATERIALS AND METHODS: The present study is a comparative study of CT and MRI done on 11 patients suspected of ROCM, for 2 months from May to June 2021. RESULTS: Among 11 patients in the study group, ranging from 29 to 65 years of age, 45.4% belonged in 41–60 years of age group, with female predominance. 90.90% cases (10 patients) had maxillary sinus involvement among which 7 cases were diagnosed with ROCM, followed by 63.60% cases (7 patients) had ethmoidal sinus involvement among which 6 cases were diagnosed with ROCM. The involvement of retromaxillary space, pterygopalatine fossa space and masticator space, and cellulitis in premaxillary and preseptal spaces were findings seen only in diagnosed cases of ROCM. Erosions of bones were seen in ROCM cases, 27.20% cases (3 patients) had erosions of walls of maxillary sinus and lamina papyracea each. Orbital involvement in the form of intraconal space and extraocular muscles involvement was seen in 27.20% cases (3 patients) each. Optic nerve involvement was seen in 18.10% cases (2 patients) followed by extraconal space involvement in 9.01% cases (1 patient). Taking KOH staining and/or histopathology (HPR) as standard of reference, CT has a Sensitivity (Sn) of 71.40%, Specificity (Sp) of 100%, Positive predictive value (PPV) of 100%, Negative Predictive Value (NPV) of 66%, and Diagnostic accuracy (DA) of 81% as compared to MRI which has a Sn of 85.7%, Sp of 100%, PPV of 100%, NPV of 80%, and DA of 90.9%. CONCLUSIOIN: CT and MRI play a complementary role in diagnosis of ROCM, as CT is better in detecting bone erosions, whereas MRI is better in detecting soft tissue, orbital and central nervous system involvement. In the acute state of emergency as in the current pandemic with rising cases of ROCM and acute shortage of amphotericin-B, MRI is the single best modality for accurate detection of ROC, helping clinicians in the judicious use of Amphotericin-B.
简介:鼻眶脑毛霉菌病(ROCM)是一种危及生命的鼻腔和鼻窦急性真菌感染,曾被认为是免疫功能低下患者的罕见致命并发症,现在印度与COVID-19相关的ROCM发病率大幅增加,即与COVID-19相关的毛霉菌病,截至2021年5月超过15,000例。计算机断层扫描(CT)和磁共振成像(MRI)的早期成像不仅有助于评估这种致命疾病的影响程度,而且有助于早期诊断,从而及时和积极地治疗。本研究旨在确定和比较ROCM患者的CT和MRI影像学表现,以便早期诊断疑似ROCM病例。材料与方法:本研究对11例疑似ROCM患者进行了为期2个月的CT和MRI对比研究,时间为2021年5月至6月。结果:研究组11例患者,年龄29 ~ 65岁,41 ~ 60岁年龄组占45.4%,以女性为主。90.90%(10例)上颌窦受累,其中7例诊断为ROCM; 63.60%(7例)筛窦受累,其中6例诊断为ROCM。上颌后间隙、翼腭窝间隙和咀嚼间隙受累性,上颌前间隙和前庭间隙蜂窝织炎仅在诊断为ROCM的病例中可见。ROCM患者有骨侵蚀,27.20%(3例)患者上颌窦壁和纸莎草层均有骨侵蚀。眼眶受累表现为眶内间隙受累和眼外肌受累,各占27.20%(3例)。视神经受累2例(18.10%),外腔受累1例(9.01%)。以KOH染色和/或组织病理学(HPR)为参照标准,CT的敏感性(Sn)为71.40%,特异性(Sp)为100%,阳性预测值(PPV)为100%,阴性预测值(NPV)为66%,诊断准确率(DA)为81%,而MRI的Sn为85.7%,Sp为100%,PPV为100%,NPV为80%,DA为90.9%。结论:CT与MRI对ROCM的诊断具有互补作用,CT对骨糜烂的检测较好,而MRI对软组织、眶部及中枢神经系统的累及较好。在当前大流行的急性紧急状态下,随着ROCM病例的增加和两性霉素- b的严重短缺,MRI是准确检测ROC的唯一最佳方式,有助于临床医生明智地使用两性霉素- b。
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引用次数: 0
Graded epidural anesthesia for fistulectomy with symptomatic obstructive hypertrophic cardiomyopathy 分级硬膜外麻醉治疗有症状的梗阻性肥厚性心肌病瘘管切除术
Pub Date : 2022-07-01 DOI: 10.4103/jss.jss_20_22
V. Nivedha, R. Brindha, S. Vigneshwaran
Hemodynamic fluctuations can occur when fistulectomy is usually done under spinal anesthesia that can cause detrimental effects for a patient with obstructive cardiomyopathy. This is a case of 51-year-old male with fistula in ano sustaining obstructive hypertrophic cardiomyopathy as suggested by chest pain, palpitation, breathlessness on exertion was scheduled for fistulectomy. Electrocardiography (ECG) showed left ventricular hypertrophy with deep narrow Q waves in V1 to V6. Echo showed asymmetrical septal hypertrophy, grade 1 diastolic dysfunction, EF – 60%. Regional anesthesia technique such as graded epidural anesthesia can be safe and cost effective by prolonging the postoperative pain relief and thus also effective in blunting autonomic, somatic, and endocrine response triggered by surgical insult.
当瘘管切除术通常在脊髓麻醉下进行时,可能会出现血流动力学波动,这可能对阻塞性心肌病患者造成不利影响。这是一个51岁的男性患者,由于胸痛、心悸、运动时呼吸困难而导致瘘管持续梗阻性肥厚性心肌病,计划行瘘管切除术。心电图示左室肥厚,V1 ~ V6深窄Q波。超声显示不对称室间隔肥厚,1级舒张功能不全,EF - 60%。区域麻醉技术,如分级硬膜外麻醉,可以通过延长术后疼痛缓解,从而有效地减弱由手术损伤引起的自主神经、躯体和内分泌反应,是安全且经济有效的。
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引用次数: 0
A comparative study on knowledge and awareness regarding type-2 diabetes mellitus and its complications among urban and rural patients 城乡患者对2型糖尿病及其并发症知识知晓情况的比较研究
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_35_22
S. Darivemula, G. Vishwajeeth, G. Pooja, G. Prathyusha, G. Pavani, G. Sahithya, G. Dharani, G. Shankar, S. Katkuri
BACKGROUND: Type-2 diabetes mellitus (DM) is the most challenging public health problem. Most of the people are unaware of the disease and its preventive measures and complications. It is important to acknowledge the gap in the knowledge and awareness of the disease to prevent the disease and effectively plan public health care. METHODOLOGY: This was a cross-sectional study with the objective to assess the level of knowledge and awareness regarding type-2 DM and its complications among urban and rural population and to compare them. The sample size was calculated as 404 among >30 years of age with Type-2 DM with >1 year of duration with or without complications. Data was collected on demographic details, knowledge, awareness, complications and lifestyle modifications by using the structured questionnaire. The collected data was compared among urban and rural patients and the association was seen between different factors by appropriate statistical test. RESULTS: The knowledge on normal blood sugar was (45.6% and 27.2%) in urban and rural, HbA1C (63.8% and 49.5%), family history of diabetes (59.4% and 43.1%), whether DM2 is a multi system disorder, monitoring of blood sugar levels and frequency of monitoring and checkups were found to be more in the urban compare to the rural with P < 0.05. The awareness on complications like the rate of complications with increase in time (66.3% and 57.0%), awareness of diabetic foot (52.9% and 37.1%), prone to infections (67.3% and 58.9%), prone to COVID 19 infection (74.7% and 64.9%), most common organ involved as the complication arise was kidney (39.6% and 33.7%) with P < 0.05. CONCLUSION: The study suggests that there is a need to improve knowledge about DM and its complications, and there is a need for diabetes-specific health awareness campaigns on behavior and lifestyle changes, adherence to treatment and self-care.
背景:2型糖尿病(DM)是最具挑战性的公共卫生问题。大多数人不知道这种疾病及其预防措施和并发症。认识到对该病的认识和认识存在差距,对预防该病和有效规划公共卫生保健至关重要。方法:这是一项横断面研究,目的是评估城市和农村人口对2型糖尿病及其并发症的知识和意识水平,并进行比较。计算样本量为404例,患者年龄>30岁,病程>1年,伴有或不伴有并发症。使用结构化问卷收集人口统计细节、知识、意识、并发症和生活方式改变方面的数据。收集的数据在城市和农村患者之间进行比较,并通过适当的统计检验发现不同因素之间的相关性。结果:城乡居民对正常血糖的知知率分别为45.6%和27.2%,对糖化血红蛋白(HbA1C)的知知率分别为63.8%和49.5%,对糖尿病家族史的知知率分别为59.4%和43.1%,对DM2是否为多系统疾病、血糖监测情况及监测检查频次的知知率均高于农村,差异有统计学意义(P < 0.05)。并发症知知率随时间增加分别为66.3%和57.0%、糖尿病足知知率分别为52.9%和37.1%、易感感染(67.3%和58.9%)、易感COVID - 19感染(74.7%和64.9%),并发症发生时最常累及的器官为肾脏(39.6%和33.7%),差异均有P < 0.05。结论:该研究表明,有必要提高对糖尿病及其并发症的认识,并有必要开展针对糖尿病的健康意识运动,以改变行为和生活方式,坚持治疗和自我保健。
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引用次数: 0
Diagnostic criteria and role of multimodality imaging in complicated autosomal dominant polycystic kidney disease 复杂常染色体显性多囊肾病多模态影像学诊断标准及作用
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_54_22
Ravikanth Reddy
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引用次数: 0
Assessment of clinical skill competency of medical postgraduate students – Recommendations for upcoming CBME curriculum for postgraduates 医学研究生临床技能能力评估-对即将到来的研究生CBME课程的建议
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_9_22
R. Rajashree, Smita Kottagi, Triveni A. Jambale, G. Channashetti
Direct observation of postgraduate medical trainees with actual patients by clinical faculty has traditionally been a standard tool to assess knowledge and skills in clinical subjects. By assessing and providing feedback to medical trainees performing a medical interview, physical examination, or counselling patients, faculty can facilitate budding physicians to have successful practice of medicine in their future. Despite the advances in clinical skills evaluation, direct observation has been a most popular and time tested method. However, observation of postgraduate medical students by faculty is very subjective and unfortunately often sporadic and non-standardized. Substantial amount of literature identifies several threats to its construct validity as an assessment tool. Although many tried to demonstrate methods to minimize those threats, there are many lacunae that remain inherent to direct observation method. Hence the need of the time is to relook at the observation as an assessment tool, instead of discarding the whole as inappropriate one. The authors initially made an effort to analyse the problems in present settings in India. After an extensive literature search authors advocate few additions and modifications to the existing system. Thus the present study not only highlights the pitfalls in the direct observation method but also suggests solutions for the problem.
传统上,临床教师对医学研究生实习生与实际患者的直接观察是评估临床学科知识和技能的标准工具。通过评估和提供反馈给医学实习生进行医学访谈,身体检查,或咨询病人,教师可以促进崭露头角的医生有成功的医学实践在他们的未来。尽管在临床技能评估方面取得了进展,但直接观察一直是最受欢迎和经过时间考验的方法。然而,教师对医学研究生的观察是非常主观的,不幸的是,往往是零星的和不规范的。大量的文献指出了对其作为评估工具的结构效度的几个威胁。尽管许多人试图展示将这些威胁最小化的方法,但直接观察法仍然存在许多固有的缺陷。因此,现在需要的是将观察作为一种评估工具重新审视,而不是将整体视为不适当的工具而抛弃。作者最初努力分析了印度当前环境中的问题。经过广泛的文献检索,作者主张对现有系统进行少量的补充和修改。因此,本研究不仅突出了直接观察法的缺陷,而且提出了解决问题的方法。
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引用次数: 0
The burden of the unnoticed rotational motion disorder 不被注意的旋转运动障碍的负担
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_32_22
J. Rissardo, Ana Letícia Fornari Caprara
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引用次数: 0
Comparison of demographic, socioeconomic, and lifestyle determinants in infertile and fertile males and females from two big cities of Punjab 旁遮普两个大城市不育和可育男性和女性的人口统计学、社会经济和生活方式决定因素比较
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_99_22
S. Kaur, R. Thaman, R. Sood, V. Sambyal, I. S Sandhu, Archana Beri, M. Chawla
BACKGROUND: Infertility is an apparent failure of a couple to conceive. The demographic, socioeconomic, and lifestyle determinants in infertility and its related factors should be seen more realistically. Regional variations in the causes of infertility need a completely comprehensive approach that helps to dive deeper into the root cause of the disease and manage it holistically. MATERIALS AND METHODS: A study on selected risk factors of infertility among 100 infertile couples and 200 fertile males, females attending tertiary health-care centers and in vitro fertilization centers from two big cities of Punjab was conducted. The data were collected using semi-structured pro forma questionnaire. The data collected included the anthropometric measurements, demographic profile, lifestyle variables impacting infertility, and socioeconomic attributes. Data were analyzed to look out for risk factors and their association using the odds ratio. RESULTS: The findings of the study revealed that nonvegetarian diet, more tea and alcohol usage, smoking abuse, and duration of mobile phone usage were seen more in infertile couples which was statistically significant in relation to fertile participants. Occupation, physical activity, sleep, socioeconomic variables, and education status did not show any statistical significance when compared between the two groups. Interestingly, statistical significance was seen in the obese class II category only in infertile males in comparison to fertile males. CONCLUSION: An all-inclusive perspective is needed for the diagnosis, treatment, and management of infertility. Health-care professionals need to dive into aspects of infertility treatment other than medical interventions to provide an integrated treatment regimen for couples facing infertility.
背景:不孕症是一对夫妇怀孕的明显失败。不孕症的人口、社会经济和生活方式决定因素及其相关因素应更现实地看待。针对不孕症原因的区域差异,需要采取一种全面的方法,帮助更深入地了解该疾病的根本原因,并对其进行全面管理。材料和方法:对旁遮普省两个大城市的100对不育夫妇和200名在三级保健中心和体外受精中心就诊的有生育能力的男性和女性进行了一项选定的不育风险因素研究。采用半结构化的形式问卷收集数据。收集的数据包括人体测量、人口统计资料、影响不孕症的生活方式变量和社会经济属性。使用比值比对数据进行分析,找出风险因素及其关联。结果:研究结果显示,非素食、更多的茶和酒精使用、吸烟滥用和使用手机的持续时间在不育夫妇中更为常见,这与生育参与者有统计学意义。职业、体力活动、睡眠、社会经济变量和教育状况在两组间比较无统计学意义。有趣的是,与可育男性相比,只有在不育男性中,肥胖II类才有统计学意义。结论:不孕症的诊断、治疗和管理需要一个全面的视角。保健专业人员需要深入研究医疗干预以外的不孕症治疗方面,为面临不孕症的夫妇提供综合治疗方案。
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引用次数: 0
A rare case report of bilateral ruptured tubal ectopic pregnancy 双侧输卵管破裂异位妊娠1例
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_65_22
Preeti Malapure, Rajasri G Yaliwal, P. Jaju, Gauri Bankapur
Implantation of the fertilized ovum outside the uterine cavity is called ectopic gestation. The common presenting symptoms are per vaginal bleeding till 12 weeks, pain in the lower abdomen, and absence of menses. ß-HCG level is increased (>1000IU/L) and transvaginal ultrasonography shows an empty uterus. These findings essentially confirm the diagnosis. In this, we have a 23-year-old, G2P1L1 with a history of 3 months of amenorrhea, presenting to the labor ward with a history of per vaginal bleeding and lower abdominal pain. The diagnosis was 10 weeks right-sided ruptured ectopic pregnancy and intraoperatively found to be ruptured ectopic pregnancy in both fallopian tubes which we managed successfully by performing emergency laparotomy with bilateral partial salpingectomy.
受精卵着床在子宫腔外称为异位妊娠。常见的症状是阴道出血,直到12周,下腹疼痛,没有月经。ß-HCG水平升高(>1000IU/L),经阴道超声示子宫空。这些发现基本上证实了诊断。在这个病例中,我们有一个23岁的G2P1L1,有3个月的闭经史,以阴道出血和下腹部疼痛的病史来到产房。诊断为右侧破裂异位妊娠10周,术中发现双输卵管破裂异位妊娠,我们通过紧急剖腹手术并双侧输卵管部分切除术成功处理。
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引用次数: 0
Pulmonary function tests, fatigue levels and functional capacity in head and neck cancer patients undergoing cancer therapy: An evaluation study 接受癌症治疗的头颈癌患者的肺功能测试、疲劳水平和功能能力:一项评估研究
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_46_21
Renu B Pattanshetty, Varsha Huddar, Prasad Kharwandikar
BACKGROUND: The changes in pulmonary functions and fatigue; occurring in the months and years following cancer therapy have been well documented. The changes that occur in the hours of the cancer treatment are less clear. AIMS AND OBJECTIVES: The changes detected in the early stage of cancer treatment may help to prevent late pulmonary & associated complications. MATERIALS AND METHODS: The pre and post scores were taken after 3 days of treatment. PFT was recorded by vitalograph & peak flow meter, fatigue levels were assessed by FACIT-F scale and functional capacity was assessed by distance covered in 6- minute walk test. RESULTS: One hundred and seventeen patients with head and neck cancer were recruited 108 were males and 09 females with mean age of 52.2 years; there is a significant statistical reliable difference between the pre & post treatment values, with P-value is 0.001< 0.05. It justifies the deuteriations in health outcome post intervention. CONCLUSION: There is significant deterioration seen in the PFT, fatigue levels, functional capacity; could cause significant clinical problems. Early detection of all these changes can helps the patients as well as therapist to avoid or minimal late complications.
背景:肺功能和疲劳的变化;发生在癌症治疗后的几个月或几年里,已经有了很好的记录。在癌症治疗的几个小时内发生的变化就不太清楚了。目的和目的:在癌症治疗早期检测到的变化可能有助于预防晚期肺部及相关并发症。材料与方法:治疗3 d后取前后评分。PFT采用活体记录仪和峰值流量仪记录,疲劳水平采用FACIT-F量表评估,功能能力采用6分钟步行测试中覆盖的距离评估。结果:共纳入头颈癌患者117例,男性108例,女性09例,平均年龄52.2岁;治疗前后差异有统计学意义,p值为0.001< 0.05。它证明干预后健康结果的恶化是合理的。结论:患者PFT、疲劳程度、功能能力均明显恶化;可能导致严重的临床问题。所有这些变化的早期发现可以帮助患者和治疗师避免或尽量减少晚期并发症。
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引用次数: 0
Effect of long-distance load marching on physiological responses at desert environment 沙漠环境下长距离负重行军对生理反应的影响
Pub Date : 2022-07-01 DOI: 10.4103/bjhs.bjhs_73_22
K. Arya, A. Yadav, D. Bhattacharyya, Subhojit Chatterjee, M. Pal
AIM: The present study was undertaken to examine the effect of long-distance load marching on the physiological responses, walking efficiency, and mobility of soldiers at sandy desert environment. METHODS: A total of nine physically fit soldiers (age, 30.00 [SE 0.9] years; height, 175.56 [SE 1.18] cm; and weight, 77.83 [SE 1.37] kg) volunteered for long-distance (6 km) load marching by self-selected speed when carrying 22 kg (28.27% of body weight [BW]) load and no load (NL). Heart rate (HR), respiratory frequency (RF), and core body temperature (CBT) were recorded. Relative workload (RWL) and Physiological Cost Index (PCI) were calculated to assess the work intensity and mobility. RESULTS: It was observed that HR (P = 0.01), RWL (P = 0.01), and PCI (P = 0.01) were significantly increased by 23.79, 39.71, and 77.73%, respectively, and mobility was significantly reduced (P = 0.01) by 18.56% during marching with 22 kg load as compared to NL. CONCLUSION: It may be that marching without external load at speed of 4.85 ± 0.54 km/h should not be continued for more than 2 h, whereas marching with load of 28.27% of BW at speed of 3.95 ± 0.55 km/h should be restricted to maximum 30 min. This combination of load, speed, and duration provides information about soldiers' routine load carriage tasks, which may help in optimizing the load carriage task to reduce the chances of cumulative carriage-related injuries and, therefore, may contribute to improved soldiers' operational readiness and mobility.
目的:研究沙质沙漠环境下长途负重行军对士兵生理反应、步行效率和机动性的影响。方法:9名身体健康的士兵(年龄30.00 [SE 0.9]岁;高度:175.56 [SE 1.18] cm;77.83 [SE 1.37] kg)的志愿者在负重22 kg(28.27%的体重[BW])和空载(NL)的情况下,自愿以自选速度进行长距离(6 km)负重行进。记录心率(HR)、呼吸频率(RF)和核心体温(CBT)。计算相对工作量(RWL)和生理成本指数(PCI)来评估工作强度和机动性。结果:22 kg负重行军时HR (P = 0.01)、RWL (P = 0.01)和PCI (P = 0.01)分别较NL显著提高23.79%、39.71%和77.73%,活动度显著降低18.56% (P = 0.01)。结论:也许游行没有外部负载4.85±0.54公里/小时的速度不应该持续了超过2 h,而游行在负载28.27%的BW 3.95±0.55公里/小时的速度应该限制最大30分钟。这种组合的负荷、速度和持续时间提供信息关于士兵的常规负载运输任务,这可能有助于优化负载运输任务减少累积carriage-related受伤的可能性,因此,可能有助于提高士兵的作战准备和机动性。
{"title":"Effect of long-distance load marching on physiological responses at desert environment","authors":"K. Arya, A. Yadav, D. Bhattacharyya, Subhojit Chatterjee, M. Pal","doi":"10.4103/bjhs.bjhs_73_22","DOIUrl":"https://doi.org/10.4103/bjhs.bjhs_73_22","url":null,"abstract":"AIM: The present study was undertaken to examine the effect of long-distance load marching on the physiological responses, walking efficiency, and mobility of soldiers at sandy desert environment. METHODS: A total of nine physically fit soldiers (age, 30.00 [SE 0.9] years; height, 175.56 [SE 1.18] cm; and weight, 77.83 [SE 1.37] kg) volunteered for long-distance (6 km) load marching by self-selected speed when carrying 22 kg (28.27% of body weight [BW]) load and no load (NL). Heart rate (HR), respiratory frequency (RF), and core body temperature (CBT) were recorded. Relative workload (RWL) and Physiological Cost Index (PCI) were calculated to assess the work intensity and mobility. RESULTS: It was observed that HR (P = 0.01), RWL (P = 0.01), and PCI (P = 0.01) were significantly increased by 23.79, 39.71, and 77.73%, respectively, and mobility was significantly reduced (P = 0.01) by 18.56% during marching with 22 kg load as compared to NL. CONCLUSION: It may be that marching without external load at speed of 4.85 ± 0.54 km/h should not be continued for more than 2 h, whereas marching with load of 28.27% of BW at speed of 3.95 ± 0.55 km/h should be restricted to maximum 30 min. This combination of load, speed, and duration provides information about soldiers' routine load carriage tasks, which may help in optimizing the load carriage task to reduce the chances of cumulative carriage-related injuries and, therefore, may contribute to improved soldiers' operational readiness and mobility.","PeriodicalId":9122,"journal":{"name":"BLDE University Journal of Health Sciences","volume":"35 1","pages":"204 - 210"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78173231","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
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BLDE University Journal of Health Sciences
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