Journal of Kermanshah University of Medical Sciences最新文献

{"title":"Effect of Localized Cold Compress on Pain Severity with the Subcutaneous Injection of Enoxaparin: A Randomized Controlled Trial","authors":"F. Taghlili, A. Kiapour, Maryam Ebrahimi Nia Zavardeh","doi":"10.5812/JKUMS.110984","DOIUrl":"https://doi.org/10.5812/JKUMS.110984","url":null,"abstract":"Background: Subcutaneous injection of enoxaparin causes local reactions, such as bruising and pain at the injection site. The pain induced by subcutaneous injection may lead to anxiety, fear of needle, and distrust in healthcare providers in the long run. Objectives: The present study aimed to evaluate the impact of topical cold compress on bruising and pain intensity at the subcutaneous injection site of enoxaparin. Methods: This clinical trial was conducted on 100 patients in five groups. In the control group, subcutaneous injection was performed using the routine method. In the intervention groups, local cold compress was applied five minutes prior to the injection, five minutes before and following the injection, five minutes after the injection, 20 minutes following the injection, and five minutes before and 20 minutes following the injection within 10 seconds. Data were collected using a researcher-made checklist containing two sections of individual characteristics and pain severity. In addition, pain intensity was evaluated using the visual analog scale (VAS) immediately after each injection. Results: Group five showed a significant difference with the control group only in the mean pain severity (P < 0.05), while the mean pain intensity scores had no significant difference in the other groups compared to the control group. Conclusions: According to the results, the application of local cold compress before and after the subcutaneous injection of enoxaparin sodium could effectively reduce pain intensity at the injection site.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90596560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Spinning Workout and Green Tea Consumption on the Anti-inflammatory and Inflammatory Markers and Body Composition of Overweight Women","authors":"Shahla Alikhani, Z. Etemad, Kemal Azizbeigi","doi":"10.5812/JKUMS.110116","DOIUrl":"https://doi.org/10.5812/JKUMS.110116","url":null,"abstract":"Background: Systematic inflammations are associated with cardiovascular diseases. The production of inflammatory mediators increases in a sedentary lifestyle and reduces with regular exercise. Objectives: The present study aimed to evaluate the effects of eight weeks of spinning workout and green tea supplementation on the anti-inflammatory and inflammatory markers and body composition of overweight women. Methods: This study was conducted on 32 overweight women who voluntarily participated in the research and were randomly assigned to the groups of spinning-green tea (SP-GT; n = 11), spinning-placebo (SP-PL; n = 11), and control (no exercise/placebo; n = 10). The experimental groups carried out eight weeks of spinning workout three days a week non-consecutively with the intensity of 11 - 17 rating of perceived exertion (RPE). Serum concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured before the intervention and 48 hours after the last training session. In addition, body mass index (BMI) and body fat percentage (BF%) were measured. Results: After eight weeks of the intervention, BMI, BF%, and TNF-α significantly reduced in the SP-GT and SP-PL groups (P ≤ 0.05). Although the change in IL-6 was not significant in the intervention groups (P > 0.05), it significantly increased in the control group (P = 0.011). Moreover, a significant increase was observed in IL-10 in the SP-GT and SP-PL groups (P = 0.001). Conclusions: According to the results, spinning workout improved the inflammatory markers and body composition independent of supplementation, while green tea had a greater effect on IL-10. Therefore, spinning workout could be used for the prevention of cardiovascular risk factors through the improvement of systematic inflammation.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77696731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Problem-solving Skills Training on the Anxiety and Sleep Quality of Patients After Coronary Artery Bypass Graft Surgery","authors":"Sepideh Omidi, Keivan Kakabaraee, Asadollah Amiripour","doi":"10.5812/JKUMS.107638","DOIUrl":"https://doi.org/10.5812/JKUMS.107638","url":null,"abstract":"Background: Cardiovascular diseases are the leading cause of mortality worldwide, and sleep disturbance and anxiety play a key role in the prognosis of these patients. Objectives: The present study aimed to evaluate the effects of problem-solving skills training (PSST) on the anxiety and sleep disturbance of cardiac patients. Methods: This quasi-experimental study was carried out in three stages before, after, and during a two-month follow-up after eight PSST sessions (one hour each). Sample population included 20 male patients with heart failure who had undergone coronary artery bypass graft (CABG) surgery at Imam Ali Hospital of Kermanshah, Iran. The patients were randomly divided into the experimental (n = 10) and control groups (n = 10). Data were collected using Spielberger’s state-trait anxiety inventory (STAI) and Pittsburgh sleep quality index (PSQI). Data analysis was performed in SPSS using the analysis of covariance to compare the groups. Results: MANCOVA and Tukey’s post-hoc test indicated a significant difference in the sleep quality score of the patients at the posttest (P = 0.001) and follow-up (P = 0.017), as well as in the score of anxiety at the posttest (P = 0.01) and after the PSST intervention. However, no significant differences were observed in the scores of the control group at different stages of the study (P > 0.05). Conclusions: According to the results, PSST could improve anxiety and sleep quality in patients with heart failure. Therefore, it is recommended that such training be provided to cardiac patients.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84077181","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":"The Prevalence and Pattern of Acinetobacter Antibiotic Resistance in the Patients Admitted to Imam Reza Hospital in Kermanshah, Iran (2016 - 2018)","authors":"M. Shirvani, M. Zamanian, A. Janbakhsh, B. Sayad, S. Vaziri, Zeinab Mohseni Afshar, R. Miladi, S. Khazaei, F. Mansouri, M. Afsharian, Mitra Tarlan","doi":"10.5812/JKUMS.110125","DOIUrl":"https://doi.org/10.5812/JKUMS.110125","url":null,"abstract":"Background: Acinetobacter is a gram-negative coccobacillus, which is widespread in nature and causes several nosocomial infections, such as pneumonia, meningitis, endocarditis, skin and soft tissue infections, conjunctivitis, and bacteremia. Acinetobacter has also demonstrated resistance against multiple antimicrobial agents. Objectives: The present study aimed to investigate the antibiotic resistance pattern of the isolated Acinetobacter strains from the patients admitted to various wards of Imam Reza hospital in Kermanshah, Iran. Methods: This descriptive, cross-sectional study was performed on 726 patients with positive Acinetobacter cultures at Imam Reza hospital during 2016 - 2018. Bacterial isolates were identified using laboratory tests and based on the CLSI protocol, and the standard disc-diffusion method was used assess antibiotic susceptibility. Data analysis was performed in SPSS version 20. Results: Most of the Acinetobacter-positive cases were isolated from the intensive care units (75.88%) and sputum (73.3%) and urine samples (10.1%). In addition, the highest and lowest resistance rate of the isolates was observed against ceftriaxone (96.6%) and ampicillin-sulbactam (58.7%), respectively. Conclusions: According to the results, the bacterial isolates were multiple-drug resistant and showed resistance to ciprofloxacin, ceftazidime, cotrimoxazole, ceftriaxone, cefepime, gentamicin, imipenem, ampicillin, ampicillin-sulbactam, and amikacin. The high resistance to imipenem is rather alarming as it is considered the 'last resort' in the treatment of the infections caused by gram-negative bacteria. Therefore, monitoring programs are recommended to prevent the misuse of this drug in hospitals.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"181 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77237627","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":"The Prevalence and Pattern of Enterobacter Antibiotic Resistance in the Patients Admitted to Imam Reza Hospital in Kermanshah, Iran (2016 - 2018)","authors":"Zeinab Mohseni Afshar, R. Miladi, A. Janbakhsh, F. Mansouri, B. Sayad, S. Vaziri, M. Afsharian, M. Zamanian, M. Shirvani, S. Yavari, Mitra Tarlan, S. Khazaei","doi":"10.5812/jkums.112518","DOIUrl":"https://doi.org/10.5812/jkums.112518","url":null,"abstract":"Background: Antibiotic resistance is spreading worldwide against the Gram-negative bacteria that cause nosocomial infections. Objectives: The present study aimed to determine the antibiotic resistance pattern of Enterobacter isolated from the blood, urine, wound, and sputum samples of the patients referring to Imam Reza Hospital in Kermanshah, Iran. Methods: This descriptive, cross-sectional study was conducted on 649 patients with positive Enterobacter cultures at Imam Reza Hospital during 2016 - 2018. The isolates were obtained using laboratory tests based on the CLSI protocol. In addition, the standard disc-diffusion method was used to assess antibiotic susceptibility. Data analysis was performed in SPSS version 20. Results: Most cases of positive Enterobacteriaceae were isolated from the patients admitted to the intensive care unit (35.6%) and emergency ward (21.9%), as well as the urine (51.6%) and sputum samples (20.5%), respectively. Levofloxacin, ciprofloxacin, and imipenem were the most effective antibiotics against Enterobacter with the susceptibility of 56.7%, 54.8%, and 53.3%, respectively. Conclusions: According to the results, the antibiotic resistance of Enterobacter to ampicillin and ceftriaxone was high, and these antibiotics must be used correctly and reasonably. Furthermore, more epidemiological studies are required in Iran to provide national programs for preventing the spread of antibiotic resistance.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86950629","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":"Antibiotic Resistance of Pseudomonas aeruginosa Strains in the Patients Admitted to Imam Reza Hospital in Kermanshah, Iran (2016-2018)","authors":"R. Miladi, M. Zamanian, A. Janbakhsh, F. Mansouri, B. Sayad, M. Afsharian, S. Vaziri, Zeinab Mohseni Afshar, M. Shirvani, Mitra Tarlan, S. Khazaei","doi":"10.5812/jkums.108939","DOIUrl":"https://doi.org/10.5812/jkums.108939","url":null,"abstract":"Background: Nosocomial infections are important medical concerns in developed and developing countries. Pseudomonas aeruginosa is considered the third leading cause of nosocomial infections following Staphylococcus aureus and Escherichia coli. Objectives: The present study aimed to determine the antibiotic resistance of isolated P. aeruginosa strains in the patients admitted to Imam Reza Hospital in Kermanshah, Iran. Methods: This descriptive, cross-sectional study was conducted on 900 patients with positive P. aeruginosa cultures who were admitted to Imam Reza Hospital in Kermanshah, Iran during 2016-2018. Bacterial isolates were separated using laboratory tests, and the standard disc-diffusion method was used to assess antibiotic susceptibility based on the CLSI protocol. Data analysis was performed in SPSS version 24. Results: The majority of the P. aeruginosa-positive cases were isolated from the emergency ward (44.3%), intensive care unit (21.9%), blood samples (40.4%), and urine samples (18.7%). The highest antibiotic resistance was observed against cotrimoxazole, ceftriaxone, ampicillin, ampicillin-sulbactam, nitrofurantoin, nalidixic acid, cefazolin, and cefixime. In addition, ciprofloxacin and imipenem were the most effective antibiotics against P. aeruginosa with the sensitivity of 68.1% and 57.2%, respectively. Conclusions: According to the results, P. aeruginosa had high resistance against antibiotics such as cotrimoxazole and ceftriaxone. Therefore, these antibiotics should be used correctly and reasonably, and epidemiological studies in this regard should be focused on proposing national programs to prevent the further spread of antibiotic resistance.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75136876","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":"Serum Alpha-(1, 3)-Fucosyltransferase IV, Copper, and Zinc Levels in Patients with Colorectal Cancer and Healthy Controls","authors":"Roya Abbasi Natajomrani, D. Qujeq, V. Hosseini, R. Hajihosseini","doi":"10.5812/jkums.107028","DOIUrl":"https://doi.org/10.5812/jkums.107028","url":null,"abstract":"Background: Colorectal cancer (CRC) has no significant clinical symptoms at the early stages, and the molecular differences in the serum of the patients and healthy subjects could be assessed to identify the biological markers that indicate the detection of this cancer at the levels of the biological system. Objectives: The present study aimed to assess the concentrations of the alpha-(1, 3)-fucosyltransferase IV (FUT4) enzyme and copper (Cu) and zinc (Zn) as biological elements. Methods: This case-control study was conducted on 40 patients with CRC, including 20 men and 20 women. A metal-free sterile tube was used to collect five milliliters of venous blood. The enzyme-linked immunosorbent assay (ELISA) based on the Biotin double-antibody sandwich technology was used to measure the human FUT4 in the sera. In addition, plasma zinc and copper values were determined using Zist Chem Diagnostics kits. Results: The mean FUT4 levels in the CRC patients was slightly higher than the control group (P = 0.17), and the mean serum copper and zinc levels of these patients were lower than the control group with a significance difference in this regard (P < 0.001). In addition, the AUC of FUT4, copper, and zinc was 0.58, 0.80, and 0.77, respectively. Conclusions: According to the results, the altered levels of FUT4, copper, and zinc in the serum of the CRC patients compared to the healthy controls could be an indicator associated with the CRC disease course. Furthermore, the unusual changes in the FUT4, copper, and zinc levels may signify CRC development, which plays a key role in the diagnosis and monitoring of this cancer.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81898285","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":"The Spectrum of Chest CT-Scans in the Hospitalized Patients with the Coronavirus Disease","authors":"M. Shirvani, A. Janbakhsh, F. Mansouri, B. Sayad, S. Vaziri, M. Afsharian, M. Zamanian, R. Miladi, Z. Aziziaram, M. Nouri, Zeinab Mohseni Afshar","doi":"10.5812/jkums.111407","DOIUrl":"https://doi.org/10.5812/jkums.111407","url":null,"abstract":"Background: Coronaviruses are a large family of RNA viruses, which range from the common cold virus to the causative agent of more severe diseases. Coronavirus was declared a pandemic in December 2019 in Wuhan, China. Iran has been an endemic zone for the spread of the coronavirus since the outset of this global epidemic and has remained among the countries largely affected by high rates of the disease. Objectives: The present study aimed to investigate the range of the chest computed tomography (CT) scan findings among the hospitalized patients with COVID-19 in Kermanshah, Iran during March-April 2020 to contribute to the accurate diagnosis of the infected patients. Methods: The sample population consisted of 286 hospitalized patients diagnosed with or suspected of the coronavirus disease. Chest CT-scan images and clinical data were reviewed, and their correlation was analyzed. Results: In total, 176 patients (61.53%) were male, and 110 (38.47%) were female. The mean age of the patients was 56 years. Polymerase chain reaction (PCR) results showed that 35.31% of the cases had coronavirus, while the results were negative in 64.69% of the cases. In addition, the CT-scan findings indicated 77.27% abnormal and 22.73% normal chest CT-scans. Among the patients, 75.87% recovered completely, and 18.53% died. The major CT abnormalities were diffuse ground-glass opacification (35.66%), peripheral ground-glass opacification (bilateral; 21.33%), and a combination of diffuse and peripheral ground-glass lesions (18.88%). The consolidation lesion of one lobe was detected in 16 patients, and the consolidation lesion of more than one lobe was observed in 40 patients. Conclusions: According to the results, the most common chest CT-scan findings in COVID-19 include diffuse ground-glass opacification, peripheral ground-glass opacification (bilateral), central ground-glass opacification (bilateral), a combination of diffuse and peripheral ground-glass opacification, a combination of central and peripheral ground-glass opacification, the consolidation lesion of one lobe, and the consolidation lesion of more than one lobe. Furthermore, significant correlations were observed between the CT-scans and the main clinical symptoms, while no significant correlations were denoted between the chest CT-scan and PCR results.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80046527","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":"The First Case of COVID-19 Reinfection in Duhok City, Kurdistan Region of Iraq: A Case Report","authors":"N. Hussein, Dildar H. Musa, I. Naqid, Zana Sidiq M.Saleem, Nashwan Ibrahim","doi":"10.5812/jkums.111454","DOIUrl":"https://doi.org/10.5812/jkums.111454","url":null,"abstract":"Introduction: Coronavirus disease (COVID-19) causes a severe acute respiratory syndrome and is known as coronavirus 2 (SARS-CoV-2), which was first discovered in December, 2019 in Wuhan, China. The question of whether the COVID-19 patients that recover from the disease acquire immunity or are still susceptible to reinfection remains unanswered. Case Presentation: In this study, we presented the case of a 46-year-old male who recovered from the first round of COVID-19 infection. After symptom resolution, two consecutives negative real-time reverse transcription-polymerase chain reaction (RT-PCR) tests confirmed the negativity of the patient. Seven weeks after the first infection, the patient presented with fever and dry cough, and the infection was confirmed using real-time RT-PCR. The reinfection was associated with more severe symptoms, which required antiviral treatment. Conclusions: Our study indicated the possibility of COVID-19 reinfection. If the occurrence of reinfections is confirmed, it may implicate changes in the vaccine and community-based disease prevention strategies. Further studies are required to confirm the possibility of COVID-19 reinfection.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72660992","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":"Prophylactic Ablation in Asymptomatic Patients with Wolff-Parkinson-White Syndrome","authors":"L. Ong","doi":"10.5812/jkums.107589","DOIUrl":"https://doi.org/10.5812/jkums.107589","url":null,"abstract":"Context: Radiofrequency ablation is a highly effective and safe therapy for the management of patients with symptomatic Wolff-Parkinson-White (WPW) syndrome. However, the management of asymptomatic patients with radiofrequency ablation is controversial. This review aimed to investigate whether prophylactic ablation could improve the long-term outcomes of asymptomatic patients with WPW. Methods: A systematic literature search was performed in databases such as PubMed, Google Scholar, and Cochrane Library for the relevant articles published during 2000 - 2020. Only original studies, cohorts, and randomized controlled trials (RCTs) performed on the WPW patients undergoing radiofrequency ablation were selected. Results: In total, six studies were reviewed, some of which suggested that the patients undergoing radiofrequency ablation had a high incidence of atrial fibrillation even after ablation. On the other hand, some of the findings indicated that ablation could reduce the mortality rate of WPW patients. In addition, two RCTs suggested that prophylactic ablation may reduce arrhythmic events in high-risk pediatric and adult patients, while one clinical trial showed no significant risk reduction for arrhythmias in the patients undergoing the prophylactic radiofrequency catheter ablation of the accessory pathways. Conclusions: Available evidence suggests that prophylactic ablation is effective in the prevention of arrhythmic events and sudden cardiac death in asymptomatic patients with WPW. However, the risk of asymptomatic patients becoming symptomatic or sudden cardiac death has been reported to be low. Therefore, only high-risk patients are recommended to undergo prophylactic ablation.","PeriodicalId":16201,"journal":{"name":"Journal of Kermanshah University of Medical Sciences","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89757372","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}