Pub Date : 2023-05-01DOI: 10.4103/jopcs.jopcs_26_22
Nikhil Gupta, P. Prayag, R. Porwal, P. Rao
Invasive mold infections (IMIs) are a major cause of morbidity and mortality in hospitalized and immunocompromised patients. Over the last decade, the incidence of IMIs has increased at an alarming rate in India. Radiology, histopathology, and validated biomarkers play an important role in the diagnosis of IMIs, including aspergillosis and mucormycosis. Despite major advances in the field of diagnostics, newer diagnostic aids are not available in India. Further, the cost is a major consideration in the Indian context. While antifungal therapies are the mainstay of treatment for aspergillosis, surgery along with antifungal therapy is the mainstay treatment for patients with mucormycosis. Furthermore, there is a paucity of data regarding the diagnosis and management of IMIs, especially in India. This study presents an expert opinion on the diagnosis and management of IMIs in Indian settings. The key opinions proposed by the subject expert group are summarized in this paper.
{"title":"Management of invasive mold infections: An Indian perspective review","authors":"Nikhil Gupta, P. Prayag, R. Porwal, P. Rao","doi":"10.4103/jopcs.jopcs_26_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_26_22","url":null,"abstract":"Invasive mold infections (IMIs) are a major cause of morbidity and mortality in hospitalized and immunocompromised patients. Over the last decade, the incidence of IMIs has increased at an alarming rate in India. Radiology, histopathology, and validated biomarkers play an important role in the diagnosis of IMIs, including aspergillosis and mucormycosis. Despite major advances in the field of diagnostics, newer diagnostic aids are not available in India. Further, the cost is a major consideration in the Indian context. While antifungal therapies are the mainstay of treatment for aspergillosis, surgery along with antifungal therapy is the mainstay treatment for patients with mucormycosis. Furthermore, there is a paucity of data regarding the diagnosis and management of IMIs, especially in India. This study presents an expert opinion on the diagnosis and management of IMIs in Indian settings. The key opinions proposed by the subject expert group are summarized in this paper.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"44 1","pages":"45 - 51"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88352075","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}
Pub Date : 2023-05-01DOI: 10.4103/jopcs.jopcs_58_22
A. Kumari, R. Chauhan, H. Prajapati
Introduction: Prescription of generic drugs reduces the out-of-pocket expenditure on medicines by the patients. However, the lack of knowledge about generic medicines and unfavourable attitude toward them can adversely impact their prescription by doctors, as well as utilization by the patients. Hence, this study was conducted to assess the knowledge and attitude of medical students toward generic medicines. Materials and Methods: It was questionnaire-based, cross-sectional study. The study participants were final year MBBS students. Institutional Ethics Committee (IEC) approval and written informed consent of study participants were taken before starting the study. SPSS software version 26 was used for the data analysis. Results: A total of 82 participants were included in this study, 52.4% were male and 47.6% female. Fifty-two (63.41%) students were aware that generic medicines are interchangeable with innovator drugs. Forty-two (51.21%) students knew that generic medicine can be marketed after expiry date of patent drug. 91.46% agreed that generic medicines have the same strength, safety, and effectiveness as brand name medicines. 47 (57.31%) students were aware of Jan Aushadhi scheme and 62 (75.60%) participants knew that generic medicines are bioequivalent to brand name medicines. Perception: Sixty-one (74.3%) felt that use of generic medicines can decrease health-care expenditure. Fifty-seven (69.5%) students felt that the rationale behind prescribing generic medicine must be discussed with the patients while 46 (56.1%) students disagreed that therapeutic failure is more with generic medicines. Conclusion: Our study shows that medical students have inadequate knowledge but favourable attitude toward generic medicines. Regular awareness and training programs should be held for doctors, students, and general public, for enhancing the knowledge and positive perceptions toward generic medicines.
{"title":"Knowledge and perceptions of medical students about generic medicines in a medical college in North India","authors":"A. Kumari, R. Chauhan, H. Prajapati","doi":"10.4103/jopcs.jopcs_58_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_58_22","url":null,"abstract":"Introduction: Prescription of generic drugs reduces the out-of-pocket expenditure on medicines by the patients. However, the lack of knowledge about generic medicines and unfavourable attitude toward them can adversely impact their prescription by doctors, as well as utilization by the patients. Hence, this study was conducted to assess the knowledge and attitude of medical students toward generic medicines. Materials and Methods: It was questionnaire-based, cross-sectional study. The study participants were final year MBBS students. Institutional Ethics Committee (IEC) approval and written informed consent of study participants were taken before starting the study. SPSS software version 26 was used for the data analysis. Results: A total of 82 participants were included in this study, 52.4% were male and 47.6% female. Fifty-two (63.41%) students were aware that generic medicines are interchangeable with innovator drugs. Forty-two (51.21%) students knew that generic medicine can be marketed after expiry date of patent drug. 91.46% agreed that generic medicines have the same strength, safety, and effectiveness as brand name medicines. 47 (57.31%) students were aware of Jan Aushadhi scheme and 62 (75.60%) participants knew that generic medicines are bioequivalent to brand name medicines. Perception: Sixty-one (74.3%) felt that use of generic medicines can decrease health-care expenditure. Fifty-seven (69.5%) students felt that the rationale behind prescribing generic medicine must be discussed with the patients while 46 (56.1%) students disagreed that therapeutic failure is more with generic medicines. Conclusion: Our study shows that medical students have inadequate knowledge but favourable attitude toward generic medicines. Regular awareness and training programs should be held for doctors, students, and general public, for enhancing the knowledge and positive perceptions toward generic medicines.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"24 1","pages":"82 - 86"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73532514","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}
Pub Date : 2023-01-01DOI: 10.4103/jopcs.jopcs_35_22
Uttam Paul, P. Paul, KaliSankar Bhattacharyya, Nikhil Era, Sritama Paul
{"title":"A successful method of treating recurrent labial synechia","authors":"Uttam Paul, P. Paul, KaliSankar Bhattacharyya, Nikhil Era, Sritama Paul","doi":"10.4103/jopcs.jopcs_35_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_35_22","url":null,"abstract":"","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"53 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72614408","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}
Pub Date : 2023-01-01DOI: 10.4103/jopcs.jopcs_20_22
P. Sharma, S. Pareek, G. Singh
{"title":"Impact of COVID-19 on tuberculosis spectrum","authors":"P. Sharma, S. Pareek, G. Singh","doi":"10.4103/jopcs.jopcs_20_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_20_22","url":null,"abstract":"","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"34 1","pages":"42 - 42"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78011990","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}
Pub Date : 2023-01-01DOI: 10.4103/jopcs.jopcs_13_23
MahmoodDhahir Al-Mendalawi
{"title":"Study of prevalence of prehypertension and hypertension among urban school-going children in Tripura","authors":"MahmoodDhahir Al-Mendalawi","doi":"10.4103/jopcs.jopcs_13_23","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_13_23","url":null,"abstract":"","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267177","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}
Pub Date : 2023-01-01DOI: 10.4103/jopcs.jopcs_25_22
SatyaKishore Chivukula, TamminanaSai Kumar
{"title":"Knowledge, attitude, and practices toward first aid against occupational injuries and their determinants among agricultural workers: A cross-sectional study","authors":"SatyaKishore Chivukula, TamminanaSai Kumar","doi":"10.4103/jopcs.jopcs_25_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_25_22","url":null,"abstract":"","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135311707","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}
Pub Date : 2023-01-01DOI: 10.4103/jopcs.jopcs_21_22
D. Chakraborty, Pradipta Bhattacharjee, S. Dey, Sanjay Bhaumik, Aditya Choudhary, Kishalay Karan, Priyanjita Sen, Mohuya Mukherjee, Gobinda Pramanick, Nirmalya Ray, A. Chakrapani, S. Singh, B. Singhania, B. Sengupta, K. Das, Aditya Mantry, Bhaskar Ukil, R. Ghosh
Objectives: Stroke is the second-leading cause of death and the third-leading cause of death and disability combined in the world. We need to find easy, available, and reliable parameters on which we can depend to prevent stroke, predict outcome, and determine prognosis. This will help in stroke management in the future. Materials and Methods: We noted blood counts and serum homocysteine levels in acute stroke patients after the exclusion of confounding factors. Our team recorded the detailed demographic and blood parameters (blood counts and homocysteine) of acute stroke patients who got admitted to different departments of our hospital in 5 months. We later correlated or tried to find the association between these parameters and stroke severity (NIHSS), other clinical parameters such as dysarthria and stroke outcome (Modified Rankin Score (mRS) at discharge and at 3 months). The team also tried to find relationships, if any, with different stroke subtypes as per the Trial of ORG 10172 in Acute Stroke Treatment classification. Results: Out of 100 patients (34 females and 66 males), we had 28 patients with hyperhomocysteinemia (HHcy). The high neutrophil count and total leukocyte count correlated with stroke severity, dysarthria, and outcome at 3 months (poor mRS). While, it was the opposite in the case of lymphocyte count. Homocysteine level did not correlate with stroke severity or outcome but with dyslipidemia. HHcy was more prevalent among patients with large artery atherosclerotic disease. Conclusion: Findings of our study were agreeable to earlier studies on the relationship between blood counts and stroke prognosis. Although high homocysteine level was associated with stroke, its level was not found to be related to stroke severity or outcome. However, further study with a larger sample size is required to draw a confident conclusion.
{"title":"Blood counts and homocysteine in acute stroke: What is the relation?","authors":"D. Chakraborty, Pradipta Bhattacharjee, S. Dey, Sanjay Bhaumik, Aditya Choudhary, Kishalay Karan, Priyanjita Sen, Mohuya Mukherjee, Gobinda Pramanick, Nirmalya Ray, A. Chakrapani, S. Singh, B. Singhania, B. Sengupta, K. Das, Aditya Mantry, Bhaskar Ukil, R. Ghosh","doi":"10.4103/jopcs.jopcs_21_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_21_22","url":null,"abstract":"Objectives: Stroke is the second-leading cause of death and the third-leading cause of death and disability combined in the world. We need to find easy, available, and reliable parameters on which we can depend to prevent stroke, predict outcome, and determine prognosis. This will help in stroke management in the future. Materials and Methods: We noted blood counts and serum homocysteine levels in acute stroke patients after the exclusion of confounding factors. Our team recorded the detailed demographic and blood parameters (blood counts and homocysteine) of acute stroke patients who got admitted to different departments of our hospital in 5 months. We later correlated or tried to find the association between these parameters and stroke severity (NIHSS), other clinical parameters such as dysarthria and stroke outcome (Modified Rankin Score (mRS) at discharge and at 3 months). The team also tried to find relationships, if any, with different stroke subtypes as per the Trial of ORG 10172 in Acute Stroke Treatment classification. Results: Out of 100 patients (34 females and 66 males), we had 28 patients with hyperhomocysteinemia (HHcy). The high neutrophil count and total leukocyte count correlated with stroke severity, dysarthria, and outcome at 3 months (poor mRS). While, it was the opposite in the case of lymphocyte count. Homocysteine level did not correlate with stroke severity or outcome but with dyslipidemia. HHcy was more prevalent among patients with large artery atherosclerotic disease. Conclusion: Findings of our study were agreeable to earlier studies on the relationship between blood counts and stroke prognosis. Although high homocysteine level was associated with stroke, its level was not found to be related to stroke severity or outcome. However, further study with a larger sample size is required to draw a confident conclusion.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"59 1","pages":"3 - 9"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73976022","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}
Pub Date : 2023-01-01DOI: 10.4103/jopcs.jopcs_15_22
P. Ravi, V. Venugopal, Deenadayalan Boopalan, Akila Anandhan, Yogapriya Chidambaram, Maheshkumar Kuppusamy
Sinusitis is a common inflammatory condition affecting paranasal sinuses encountered by people of all age groups. Vatakarma Kapalbhati is a yogic cleansing technique and pranayama found to be beneficial in sinus headaches. We reported the effect of Vatakarma Kapalbhati on three individual cases with sinus headaches. Three women who had chronic headaches due to paranasal sinusitis were given Vatakarma Kapalbhati as an intervention. Outcome measures such as Pittsburgh Sleep Quality Index (PSQI), Sinonasal Outcome Test-22 (SNOT-22), Headache Impact Test-6 (HIT-6), and Visual Analog Scale (VAS) were used to assess the efficacy of the intervention. Significant improvement in PSQI, SNOT-22, HIT-6, and VAS was found postintervention when compared to the baseline. Vatakarma Kapalbhati could be a potential supportive therapy for the management of sinusitis headaches alongside conventional management.
{"title":"Effect of vatakarma kapalbhati on sinus headache","authors":"P. Ravi, V. Venugopal, Deenadayalan Boopalan, Akila Anandhan, Yogapriya Chidambaram, Maheshkumar Kuppusamy","doi":"10.4103/jopcs.jopcs_15_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_15_22","url":null,"abstract":"Sinusitis is a common inflammatory condition affecting paranasal sinuses encountered by people of all age groups. Vatakarma Kapalbhati is a yogic cleansing technique and pranayama found to be beneficial in sinus headaches. We reported the effect of Vatakarma Kapalbhati on three individual cases with sinus headaches. Three women who had chronic headaches due to paranasal sinusitis were given Vatakarma Kapalbhati as an intervention. Outcome measures such as Pittsburgh Sleep Quality Index (PSQI), Sinonasal Outcome Test-22 (SNOT-22), Headache Impact Test-6 (HIT-6), and Visual Analog Scale (VAS) were used to assess the efficacy of the intervention. Significant improvement in PSQI, SNOT-22, HIT-6, and VAS was found postintervention when compared to the baseline. Vatakarma Kapalbhati could be a potential supportive therapy for the management of sinusitis headaches alongside conventional management.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"4 1","pages":"32 - 34"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88695959","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: Notification of tuberculosis (TB) cases is an important step in its elimination from India by 2025. However, there has not been much rise in the notification from the private sector; COVID-19 is one of the reasons. Objective: The objective is to determine the notification of TB cases by private practitioners (PPs), their current practices in treatment, enablers, and barriers to TB notification from Una district, Himachal Pradesh. Methodology: The PPs of two TB units were enrolled in the study. A mixed method study design was used. The quantitative component comprised of interviewer-introduced questionnaire-based cross-sectional study. The qualitative component was conducted using a grounded theory design to provide an explanation behind the current notification practice. Results: Out of 71 practitioners, 20 were treating presumptive TB patients. Eighty percent of these were aware of the NIKSHAY portal and 75% were aware of mandatory reporting of TB patients through the portal. The focused group discussions with the study population yielded a major theme, “Barriers to notification,” which had the following themes, namely affective attitude, logistic problems, provider misconceptions regarding non-directly observed treatment shortcourse (DOTS) regimens, patient confidentiality, stigma and discrimination and lack of cohesion and coordination between the public and private sectors. Conclusion: The ignorance and lack of education regarding ever-changing management policy of TB were one of the important barriers in notifying TB cases.
{"title":"Barriers in notification of tuberculosis cases by private practitioners of an administrative block of District Una, Himachal Pradesh: A mixed method study","authors":"Mitasha Singh, Ashok Bhardwaj, AviKumar Bansal, Chirag Goel, Ajay Attri, Sanjay Kumar","doi":"10.4103/jopcs.jopcs_61_22","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_61_22","url":null,"abstract":"Background: Notification of tuberculosis (TB) cases is an important step in its elimination from India by 2025. However, there has not been much rise in the notification from the private sector; COVID-19 is one of the reasons. Objective: The objective is to determine the notification of TB cases by private practitioners (PPs), their current practices in treatment, enablers, and barriers to TB notification from Una district, Himachal Pradesh. Methodology: The PPs of two TB units were enrolled in the study. A mixed method study design was used. The quantitative component comprised of interviewer-introduced questionnaire-based cross-sectional study. The qualitative component was conducted using a grounded theory design to provide an explanation behind the current notification practice. Results: Out of 71 practitioners, 20 were treating presumptive TB patients. Eighty percent of these were aware of the NIKSHAY portal and 75% were aware of mandatory reporting of TB patients through the portal. The focused group discussions with the study population yielded a major theme, “Barriers to notification,” which had the following themes, namely affective attitude, logistic problems, provider misconceptions regarding non-directly observed treatment shortcourse (DOTS) regimens, patient confidentiality, stigma and discrimination and lack of cohesion and coordination between the public and private sectors. Conclusion: The ignorance and lack of education regarding ever-changing management policy of TB were one of the important barriers in notifying TB cases.","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135263502","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}
Pub Date : 2023-01-01DOI: 10.4103/jopcs.jopcs_1_23
GabrielUche Iloh, MiracleErinma Chukwuonye
{"title":"Family factors of COVID-19 vaccine hesitancy in a rural primary care environment in Eastern Nigeria: A cross-sectional study","authors":"GabrielUche Iloh, MiracleErinma Chukwuonye","doi":"10.4103/jopcs.jopcs_1_23","DOIUrl":"https://doi.org/10.4103/jopcs.jopcs_1_23","url":null,"abstract":"","PeriodicalId":93784,"journal":{"name":"Journal of primary care specialties : official publication of the Institute of Family Medicine and Primary Care","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135269112","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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