International Journal of Medicine and Medical Research最新文献

{"title":"FLUORIDES AND ORAL HEALTH","authors":"S. Boitsaniuk, M. Levkiv","doi":"10.11603/ijmmr.2413-6077.2022.2.13121","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13121","url":null,"abstract":"Background. The importance of fluorides in caries prevention is discussed in the article and practical recommendations for the use of fluoride containing products are presented.\u0000Objectives. The primary objective of this systematic review is to assess the evidence on the comparative effectiveness of topical fluoride therapy (TFT) in the form of toothpastes, mouth rinses, gels and varnishes in prevention of dental caries in children and adolescents.\u0000Methods. A systematic electronic literature search was conducted in the PubMed and Web of Science databases using search terms. Current reports in the literature concerning means and methods of use of fluoride-containing medications are considered.\u0000Results. A large number of scientific studies, reviews based on them and meta-analyses conclude that the central element of caries prevention, on which the decrease in caries prevalence and caries experience is based, is the regular topical use of fluoride medications for oral cavity.\u0000Conclusions. Topical use of fluorides is a key element in successful caries prevention.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43544456","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":"SICKLE CELL THALASSEMIA IN AN ADULT FROM CENTRAL INDIA SHOWING MASSIVE SPLENIC INFARCTION AND GAMNA-GANDY BODIES IN SPLENIC PARENCHYMA WITH CONCOMITANT PLASMODIUM FALCIPARUM INFECTION","authors":"T. Singh, R. Singh, R. Pandey","doi":"10.11603/ijmmr.2413-6077.2022.2.13152","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13152","url":null,"abstract":"Background. Sickle cell thalassemia is a heterozygous state of HbS/β+ or HbS/β0 manifested clinically either as an asymptomatic carrier or have features akin to sickle cell anemia.\u0000Objective. The aim of the study is to review the literature and discuss the varied clinical manifestations and diagnosis of a case report of haemoglobinopathy in an adult from Central India.\u0000Methods. A case of haemoglobinopathy from central part of India is being investigated.\u0000Results. A case of haemoglobinopathy in an adult presenting to a tertiary hospital with chronic back ache was reported. The patient was found to have massive splenomegaly with evidence of splenic infarction. Gross examination of spleen revealed multiple soft yellowish pasty areas, which on microscopic examination showed significant necrosis with presence of great amount pale amorphous yellow substance, Gamna-Gandy bodies (GGBs) and massive foreign body cell reaction in splenic parenchyma. Post-splenectomy peripheral blood smear (PBS) showed thrombocytosis and plasmodium falciparum gametocytes. The Hb electrophoresis revealed both elevation of Hb S (49.7%), Hb F (46.7%); Hb A2 (3.0%) and (Hb A 0.7%) consistent with as Sickle Cell Thalassemia Hb S/β+ Thalassemia.\u0000Conclusion. Sickle cell thalassemia with long standing huge splenomegaly, splenic infarction with GGBs deposition and concomitant falciparum malaria in clinically stable patient is rare indeed.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46149833","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":"IMPACT OF COVID-19 PANDEMIC ON THE RADIOTHERAPY AND CANCER PATIENTS IN A TERTIARY HEALTH CARE CENTER OF ASSAM, NORTHEAST INDIA: A RETROSPECTIVE SINGLE INSTITUTION STUDY","authors":"C. Baruah, K. Deka, T. Paul, B. Sarma, P. Patowary, S. Sreeni, B. Mahanta","doi":"10.11603/ijmmr.2413-6077.2022.2.13282","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13282","url":null,"abstract":"Background. The COVID-19 pandemic has affected every sector of health care system including the cancer care. \u0000Objective. The purpose of the study is to analyse the impact of the current COVID‑19 pandemic on routine radiotherapy practice at a tertiary hospital of Northeast India.\u0000Methods. This is a retrospective study of all patients planned for radiotherapy at Assam Medical College, a tertiary care centre, in Assam, India from January 1, 2020 to May 31, 2020. The study samples are divided into two groups: group A – patients treated from January 1, 2020, to March 20, 2020 (pre-lockdown,) and group B – patients treated from March 21, 2020, to May 31, 2020 (lockdown). The department registration numbers of all the patients were collected from the entry register, and the respective paper files were then accessed to obtain the required data.\u0000Results. A total of 153 patients were planned for radiotherapy during the study period, of these 113 patients receiving radiotherapy in the pre-lockdown period and 40 patients receiving it in the lockdown period. The number of female patients decreased from 66 (58.40%) in the pre-lockdown period to 20 (50%) during the lockdown. The number of male patients also decreased from 47 to 20 but the proportion increased from 41.5% to 50%. The proportion of patients who completed radiotherapy was 90.8% in group B compare to 88.3% in group A.\u0000Conclusion. There was a decrease in number of cancer patients, especially female during the lockdown. The pandemic has severely disrupted every aspect of cancer care.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45279088","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":"PROSPECTIVE DESCRIPTIVE STUDY OF NON-THYROIDAL NECK SWELLINGS IN WESTERN INDIAN POPULATION","authors":"J. Husain, S. Rajagopalan, V. Nair, R. Nagamahendran, P. Sharma, N. Roy, P. P. Rao","doi":"10.11603/ijmmr.2413-6077.2022.2.13120","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13120","url":null,"abstract":"Background. Nonthyroidal neck swellings are common and cause diagnostic challenges. This study highlights various diagnosis associated with non-thyroidal neck swellings and their management challenges. \u0000Objective. This pilot study highlights the various diagnosis associated with nonthyroidal neck swellings and their management challenges. The clinical spectrum of two most common aetiology of nonthyroidal neck swelling: tubercular cervical lymphadenopathy and lymphomas, are also compared.\u0000Methods. This prospective study was conducted in a tertiary care teaching hospital from 01 Jun 2018 to 31 Dec 2019. The first 100 nonthyroidal neck swellings presented to the surgical outpatient department were included and assessed clinically, radiologically and histopathologically. Comparison was carried out between the first two common diagnosis of tubercular cervical lymphadenitis and lymphoma. Continuous variables were analysed using Student’s t-test and categorical data were analysed using the Chi square test. A statistical p value <0.05 was taken as significant.\u0000Results. There were 73 lymph node swellings and 27 non-lymph node swellings in the study. The most common diagnosis was tubercular cervical lymphadenitis (n=38) and lymphoma (n=17). The mean volume of lymph nodes in the lymphoma group (38.72±22.12 cm3) was significantly bigger than in the tuberculosis group (9.44±5.99 cm3) P=0.00001. The mean age (33.81±11.8 years) of tubercular patients was significantly less than the lymphoma (52.38±25.3 years) with P=0.000167. The clinical diagnosis was nearly accurate in 85% of cases. However, in 15 cases clinical diagnosis was changed after fine needle aspiration cytology.\u0000Conclusions. Ultrasonography and fine needle aspiration cytology are very useful adjunct in arriving at a definite diagnosis of a lymph node swelling in neck. Tubercular cervical lymphadenopathy and lymphoma were two major diagnosis. Tubercular cervical lymphadenopathy is significantly different from lymphomas in terms of early age of presentation and smaller size at the time of presentation.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48703654","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":"COMMUNICATION OF ONCOLOGICAL PATIENTS WITH ONCOLOGISTS: MAIN PROBLEMS AND PROBLEM-SOLVING STRATEGIES","authors":"V. Zub, A. Kotuza, O. Tolstanov","doi":"10.11603/ijmmr.2413-6077.2022.2.13594","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13594","url":null,"abstract":"Background. Physician-patient сommunication is one of the main supportive care provided to oncological patients. It affects treatment outcomes, as well as the interaction of patients within the society, their family and colleagues. Furthermore, COVID-19 and military invasion of Russia into Ukraine makes the issue of improvement of physician-patient communication urgent. \u0000Objective. The aim of the study is to develop recommendations based on the analysis of denfined problems in physician-patient communication in of oncological treatment. \u0000Methods. The sociological research involved 419 patients during their inpatient treatment in the period from November 2021 to February 2022 using the EORTC QLQ-COMU26 questionnaire. \u0000Results. In the pre-war period, in Ukrainian patients with oncological diseases the worst indicators were established for “Active role of a patient” (82.00) and “Correction of misunderstandings by a specialist” (89.19). The best indicators were established for “Skills of the specialist (verbal/non-verbal)” with the score of 93.25 by a 100-point grading scale, as well as “Satisfaction with communication” – 97.04 by a 100-point grading scale. \u0000Conclusions. When developing programs for organization of oncological care, mechanisms for providing psychological care to patients through effective communication between patients and specialists regarding providing medical and psychological care must be taken into account.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46920792","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":"FETAL BILATERAL ADRENAL HEMORRHAGE","authors":"J. S. Randhawa, R. Nagamahendran, R. Shankaran","doi":"10.11603/ijmmr.2413-6077.2022.2.13162","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13162","url":null,"abstract":"Background. Fetal supra renal mass revealed incidentally by routine antenatal ultrasound is a great challenge for diagnosis and management by a surgeon. This is a matter of parental anxiety and diagnostic dilemma to a physician. Indeed, such masses turn out to be complicated by an intra-tumor hemorrhage in neuroblastoma or antenatally diagnosed adrenal hemorrhage. The first one needs intensive management and the latter needs watchful observation.\u0000Objective. A case of bilateral fetal adrenal mass revealed by routine fetal ultrasound examination at 28th week of gestation which turned out to be adrenal hemorrhage is presented. This is aimed to make awareness to ensure that clinicians always keep benign etiologies first and thoroughly investigate in case of incidentally detected fetal adrenal mass.\u0000Methods. The study is a single case report of incidentally revealed supra renal mass. This case report encompasses differentiating features between the two and investigations that aid the surgeon to avoid unnecessary intervention in a benign hemorrhage.\u0000Results. The baby was kept on follow up with serial ultrasound scans in the postnatal period and by the second scan in a month, the hemorrhage had resolved completely.\u0000Conclusion. In cases of benign looking masses like adrenal hemorrhage or spontaneously resolving neuroblastoma, appropriate antenatal assessment and close monitoring with serial ultrasound scans can avoid surgery.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46661337","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":"HYPOFRACTIONATED RADIOTHERAPY WITH CONCURRENT CHEMOTHERAPY WITH WEEKLY CISPLATIN IN LOCALLY ADVANCED RELATIVELY RADIORESISTENT SUBSITES OF HEAD AND NECK CANCERS","authors":"K. Baidya, Y. Devi, A. S. Devi, Y. Singh, D. Das, R. Mahawar, N. Devi","doi":"10.11603/ijmmr.2413-6077.2022.2.13118","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13118","url":null,"abstract":"Background. Locoregionally advanced head and neck cancers are more aggressive and locoregional failure rate after conventional radiotherapy is high.\u0000Objective. The aim of the study is to assess the tumor response and toxicities of hypofractionated radiation therapy with concurrent chemotherapy in treatment of four relatively radioresistent tumor sites of head and neck. \u0000Methods. A prospective randomised control trial was conducted in 27 head and neck cancer patients. All patients were treated with hypofractionated radiotherapy at 250cGy/fraction once daily to a maximum of 62.5Gy in 25 fractions with concurrent cisplatin 30 mg/m2. Data were evaluated with SPSS version 21.0 for Windows with p-value <0.05.\u0000Results. Complete and partial responses were achieved in 15 (57.7%) and 8 (30.8%) patients respectively with an overall response rate of 88.5% and three patients having stable disease. Grade 3 and 4 acute mucositis was experienced by 17 patients (65.4%) and seven patients (27%), respectively. Grade 3 dysphagia was found in 21 patients (80.7%) and grade 3 and 4 skin reactions – in 11 and 2 patients, respectively. Most patients had manageable acute toxicities. Most of the late complications were of grade 2 and 3. The median time to locoregional recurrence was 12 months and one year progression-free survival attained by 61.5% patients. \u0000Conclusion. Treatment with hypofractionated radiotherapy with concurrent cisplatin appears feasible and safe and is associated with a good response rate. Although grade 3 and 4 toxicities were comparatively high but it was manageable. Late toxicities were within tolerable levels.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64620435","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":"INTRAOPERATIVE STATE OF THE HEMOCOAGULATION SYSTEM IN PATIENTS WITH OPEN AND ENDOVASCULAR REVASCULARIZATION OF INFRAINGUAL ARTERIAL SEGMENT IN THE PRESENCE OF STENOTIC-OCCLUSIVE PROCESS OF TIBIAL ARTERIES","authors":"I. Venger, S. Kostiv, B. P. Selskyy, M. P. Orlov, N. Tsiupryk","doi":"10.11603/ijmmr.2413-6077.2022.2.13197","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13197","url":null,"abstract":"Background. Among all postoperative complications associated with revascularization of atherosclerotic steno-occlusive process of the femoral-distal artery, thrombosis of the reconstruction segment is 6-32%.\u0000Objective. Prevention of thrombotic complications through vascular revascularization of the lower extremity by using a pathogenetically reasonable system of postoperative thromboprophylaxis.\u0000Methods. The study involved 97 patients with atherosclerotic stenotic-occlusive process of the infrainguinal artery in cases of stenotic-occlusive lesions of the tibial arteries. In order to study the state of the hemocoagulation system on patients, the methods for studying the indicators of coagulation, fibrinolytic and aggregation systems were used.\u0000Results. Development of hypercoagulable disorders in the patients who underwent endovascular revascularization of the arterial segment is more intense than in those who underwent open vascular revascularization methods. Hypercoagulation of blood at the intraoperative stage of revascularization takes place primarily due to the activity of factor IIa of the hemocoagulation cascade. Taking into account these circumstances, already at the surgery stage for thromboprophylaxis non-fractionated heparin (NFH) should be prescribed. At the same time for prevention of thromboembolic complications double anti-thrombocyte therapy: clopidogrel, acetylsalicylic acid should be prescribed.\u0000Conclusion. Hypercoagulant ability of the blood system, which develops after arterial reconstructive interventions, takes place against the background of low activity of the fibrinolytic blood system, nevertheless a gradual increase in the activity of the aggregation capacity of the blood. Development of hypercoagulable disorders at the intraoperative stage of surgery in the patients with endovascular methods of arterial reconstructions is more intense than in those treated with open methods of arterial revascularization. Taking into account these circumstances, already at the surgery stage for thromboprophylaxis an anticoagulant should be prescribed that has a targeted effect on factor IIa of the hemocoagulant cascade with simultaneous prevention of thromboembolic complications – double anti-thrombocyte therapy.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48584051","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":"A RARE TUMOR – ADRENAL ANGIOSARCOMA","authors":"A. Kumar M, N. Roy, H. Jafri, V. Popli, V. Karthik, T. Phuntsho","doi":"10.11603/ijmmr.2413-6077.2022.2.13221","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13221","url":null,"abstract":"Background. Primary adrenal angiosarcoma is an exceptionally rare tumor with an incidence of <1% of soft tissue sarcomas. Less than 50 cases being described in literature; most of them were nonfunctional presenting with symptoms of abdominal lump, weight loss, fatigue or weakness. The treatment remains multi-modal with involvement of surgeon as well as medical oncologist.\u0000Objective. The aim of this case report is to describe an entity which is rare in terms of incidence. It was functional as well as metastatic and managed with multimodality therapy.\u0000Methods. The case is a 47-year-old man diagnosed with metastatic adrenal angiosarcoma. The patient was managed with chemotherapy followed by surgery.\u0000Results. The final histopathological examination of the specimen and immunohistochemistry revealed angiosarcoma. At present the patient is under follow-up.\u0000Conclusion. Even though surgery forms the main stay of management, the role of multi-modality therapy forms the cornerstone for adrenal angiosarcomas.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46236151","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":"ANTHROPOMETRIC VARIABLES IN BREAST LESIONS OF WOMEN OF REPRODUCTIVE AGE IN UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL","authors":"C. Orupabo, C. G. Odoya","doi":"10.11603/ijmmr.2413-6077.2022.2.13154","DOIUrl":"https://doi.org/10.11603/ijmmr.2413-6077.2022.2.13154","url":null,"abstract":"Background. Benign breast diseases are a potential health concern to a large number of women. The incidence of cancer is increasing worldwide. A steady increase in incidence has been observed in most developed and developing counties.\u0000Objective. Thus, our study seeks to investigate the anthropometric variables implicated in breast lesions of women of reproductive age.\u0000Methods. This is a descriptive and prospective study with a random sampling method; the data was obtained from the Department of Surgery, Radiotherapy and Oncology Unit of University of Port Harcourt Teaching Hospital. A total number of 146 subjects (18-49 years) were involved into this study. A number of 90 were breast lump patients and 56 were breast cancer patients.\u0000Results. Data obtained was analysed with Microsoft Excel. Our results show no statistically significant difference (P> 0.05) in the body mass index (BMI) and waist-hip-ratio (WHR) of both the breast lump and breast cancer patients. This study supports the fact that high BMI is a predictive marker for breast lumps and cancer in women.\u0000Conclusion. The study has also identified that high BMI favours the incidence of breast lumps and breast cancers in women of reproductive age.","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41554803","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}