Journal of Nepalgunj Medical College最新文献

{"title":"Perinatal Outcome in Term Pregnancy with Isolated Oligohydramnios: Retrospective Observational Study","authors":"A. Adhikari, T. K. Gurung, S. Adhikari","doi":"10.3126/jngmc.v19i2.42989","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42989","url":null,"abstract":"Introduction: Isolated Oligohydramnios complicates 3 to 5% of pregnancy at term both in terms of fetal outcome and mode of delivery. \u0000Aims: To study the perinatal outcome in isolated oligohydramnios (Amniotic Fluid Index≤8) and compare the outcome between Borderline (Amniotic Fluid Index=5.1-8 cm) and Severe (<5 cm) oligohydramnios. \u0000Methods: Retrospective observational study of pregnancy outcome with isolated oligohydramnios (Amniotic Fluid Index≤8 cm) at term was carried out in Gandaki Medical College Teaching Hospital, Pokhara for one year from January 2019 to December 2019. Patients were divided into Borderline Oligohydramnios (Amniotic Fluid Index=5.1 to 8 cm) and Severe Oligohydramnios (Amniotic Fluid Index ≤5 cm). The two groups were compared in terms of fetal outcome like: meconium passage, low birth weight, low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 and 5 min, Neonatal Intensive Care Unit (NICU) admission and neonatal death. Similarly mode of delivery was also compared. \u0000Results: There were total of 100 patients with isolated oligohydramnios. Of which 51(51%) were with Borderline Oligohydramnios and 49(49%) with Severe Oligohydramnios. The incidence of adverse perinatal outcome and caesarean delivery was high in patients with isolated oligohydramnios. When compared with the two groups there was significant difference in terms of meconium passage (11% vs 48.9%), low birth weight (5.8% vs 18%), low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 min (1.9% vs 14%), NICU (Neonatal Intensive Care Unit) admission (11% vs 67%) and Caesarean delivery (39% vs 79.5%). \u0000Conclusion: Isolated oligohydramnios at term has been associated with an increased risk for caesarean delivery for fetal distress and adverse perinatal outcomes. Severe oligohydramnios is a sensitive predictor for the adverse perinatal outcome both in terms of fetal outcome and termination of pregnancy.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128055997","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":"Risk Factors Associated with Urinary Tract Infection in Children","authors":"Murli M. Gupta, Suman Shrestha","doi":"10.3126/jngmc.v19i2.43000","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.43000","url":null,"abstract":"Introduction: Urinary tract infection is infection leading to an inflammatory response in the epithelium of the urinary tract. Urinary tract infection is defined as the growth of significant number of organisms of a single species in the urine, in the presence of symptoms. Significant bacteriuria is a growth with colony count of >105 / ml of a single species in a mid-stream clean catch urine sample.\u0000Aims: To find the prevalence of urinary tract infection in children with fever and its risk factor.\u0000Methods: A hospital based cross sectional observational study was performed in Nepalgunj Medical College, Kohalpur from October 2019 to October 2020.Children of age two months to 14 years admitted in Department of Pediatrics and visiting in outdoor fulfilling inclusion criteria were taken for the study. Detailed history and examination was performed. Data related to age, sex, predisposing risk factors of Urinary tract infection, symptoms and relevant investigations was carried out in all patients.\u0000Results: Among 135 children, maximum 62(45.92%) children were in the age group 1-5 years. There were 70(51.85) male and 65(48.14) female children. The prevalence of culture positive of urinary tract infection was 19.20%. Pyuria was more significant in females in comparison to male, more common in age group less than 5 years. 26 children were culture positive among which males to female ratio in urine culture positive cases were 1: 2.3 and majority had E.coli positive in urine culture sample. Apart from the female children urinary tract infection was commonly seen in uncircumcised male comprising of 8(11.42%) of total male children.\u0000Conclusion: In children presenting with fever, urinary tract infection was one of the common causes. It was most common in children less than 5 years, female gender and uncircumcised male children were two commonly associated risk factors","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129478830","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":"Stretching Exercise versus Local Corticosteroid Injection in Plantar Fasciitis: A Comparative Study","authors":"S. Gurung, G. Dc, Biswas Pant","doi":"10.3126/jngmc.v19i2.42861","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42861","url":null,"abstract":"Introduction: Plantar fasciitis is an inflammatory painful condition, one of the most common causes of heel pain. The cause of it is multifactorial; and different treatment modalities are available.\u0000Aims:To compare the effectiveness between the stretching exercise and corticosteroid injection.\u0000Methods:This study was conducted at Nepalgunj medical college, in the department of orthopedics from September 2019 to September 2020. Patients were equally divided into two groups. In Group A corticosteroid injection was given and in group B stretching exercise was advised. Patients were followed up at two weeks, 8weeks and 16weeks; pretreatment and post-treatment pain level was assessed by Visual Analog Scale (VAS) and Functional outcome was assessed by Foot and Ankle Ability Measure (FAAM) Scale.\u0000Results: Both groups were comparable in relation to age and sex. There was significant decrease in pain and improvement of function in steroid group at two weeks and eight weeks follow up; whereas at 16weeks follow up plantar fascia stretching groups improved significantly.\u0000Conclusion: For short term relief local corticosteroid injection is superior; but for long term relief in pain and improvement in function plantar fascia stretching exercise is better treatment option.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115382485","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":"Oral Squamous Cell Cancer Scenario in a Tertiary Hospital in Western Region of Nepal","authors":"Dwarika Prasad Bajgai, Bela Agrawal, N. Lamichhane","doi":"10.3126/jngmc.v19i2.42848","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42848","url":null,"abstract":"Introduction: Oral squamous cell cancer involves oral subsites namely lip, buccal mucosa, gingivobuccal sulcus, mandible, retromolar trigone, tongue, floor of the mouth, maxilla and hard palate. It has multifactorial etiologies. Alcohol, tobacco chewing, smoking, betel quid chewing, trauma and HPV viruses are implicated as the predisposing factors of oral squamous cell carcinoma. If detected early, oral cavity cancer is easily preventable and curable.\u0000Aims: To evaluate oral squamous cell cancer demographics, as well as risk factors, site, grades, and stages.\u0000Methods: This prospective cross-sectional descriptive type of study was done in patients attending dental outdoor patient department of Nepalgunj medical college from July 2018 to August 2020. 46 patients selected by enumerative sampling method in the study after they were histopathologically confirmed with oral squamous cell carcinoma by biopsy. All included patients were having primary oral cancer, single, unilateral and untreated. After data collection current oral squamous cell cancer demographics, as well as risk factors, site, grades, and stages were established.\u0000Results: Out of 46 patients ranging from 32 to 79 years 28(60.8%) were males and 18(39.1%) were females with mean age range of 55.41 ± 10.84 years. 26(56.5%) of total displayed oral squamous cell carcinoma at buccal mucosa. 25(54.3%) of total consumed gutkha and paan with betel nut plus tobacco. 30(65.2%) of total were exposed to carcinogen for a period of 21-40 years. 32(69.5%) of total had well differentiated oral squamous cancer. 32(69.5%) of total were at stage III at the time of presentation.\u0000Conclusion: Oral cancer occurred more in males, at buccal mucosa and in people above 51 years, and in those who consumed gutka and paan, betel nut plus tobacco. It was also more in people with longer history of exposure to carcinogens.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122007821","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":"Forgotten Double-J Stent – An Extra Burden to both Patient and Urosurgeon: A Single Center Experience","authors":"N. M. Shrestha","doi":"10.3126/jngmc.v19i2.42793","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42793","url":null,"abstract":"Introduction: Double-J stent is widely used in urological as well in few non urological operations, which must be removed or replace timely. Otherwise unnecessary complications can be encountered. Forgotten Double-J stent is one of them.\u0000Aims: To find out the cause of forgotten Double-J stent, its complications and prevention.\u0000Methods: It is a hospital based study done from 2017-2020 in Nepalgunj Medical College. 33 patients fulfilling the inclusion criteria were included and reviewed for the cause, complications and management of forgotten Double-J stent.\u0000Results: Out of 33 patients, 25 (75.75 %) were operated at Nepalgunj Medical College and 8(24.24%) were in other hospitals. Among them, major causes of forgotten Double- J stent were found due to Poor financial condition and ignorance 10(30.30%) and remote inhabitant 10(30.30%). Major symptoms were flank painalone in 10(30.30 %) and recurrent fever with flank pain with positive urine culture in 8(24.24%). 21 patients (63.63%) required additional surgical treatment such as percutaneous nephrolithotripsy, ureterorenoscopic lithotripsy, percutaneous cystolithotripsy, perurethtalcystolithotripsy, open cystolithotomy.\u0000Conclusion: Forgotten Double-J stent is one of the major complications if not removed timely which may increases morbidity, mortality and financial burden. The rate of it may minimize if patients are made aware for the complications of Double-J stent and maintain stent registry properly.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132666529","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":"Morphological Variations and Morphometric Analysis of the Caudate Lobe of Liver: A Cadaveric Study","authors":"Ram Jiban Prasad, K. Amgain, Tirtha Narayan Shah","doi":"10.3126/jngmc.v19i2.43004","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.43004","url":null,"abstract":"Introduction: The caudate lobe is most referred area of the liver radiologically. In cirrhosis, the right lobe exhibits relatively greater shrinkage, while the caudate lobe undergoes relative enlargement as it is the only segment which receives blood independently from left and right branches of portal veins.\u0000Aims: To assess the morphological variations and morphometric analysis of the caudate lobe of liver in the cadavers.\u0000Methods: This was a cross-sectional descriptive study conducted on 48 formalin fixed human liver specimens available in the gross anatomy laboratory of Department of Anatomy, National Medical College, Birgunj, Nepal. The caudate lobe of liver specimens was studied for morphological variations and different measurements were taken, and the result was presented in tables.\u0000Results: The caudate lobe showed a wide range of variations in shape. Caudate lobe was present in all 48 specimens of liver out of which, 15 specimens were rectangular (31.25%), 26 specimens were pyriform (54.16%) and 7 specimens were irregular (14.58%) respectively. In 6 liver specimens (12.50% of total number of liver specimens), there was vertical fissure that extended upwards from the lower border of caudate lobe was seen in 6 specimens (12.50%). Notch was present in 10 specimens (20.83%).\u0000Conclusion: The caudate lobe of the liver showed a great degree of variations and the most common shape was pyriform. The ratio of the transverse diameter of the caudate lobe to that of the right lobe of the liver (CT/RL) ratio was found to be 0.14.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127080573","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":"Single Layer versus Double Layer Technique for Intestinal Anastomosis: A Comparative Study","authors":"B. Adhikari","doi":"10.3126/jngmc.v19i2.42792","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42792","url":null,"abstract":"Introduction: Intestinal anastomosis is a surgical procedure executed to ascertain communication between two segments of the intestine, after the removal of pathology affecting the bowel. It depends on factors like anastomosis site, bowel capability and the type of the pathogenesis.\u0000Aims: To compare single versus double layer method in terms of time taken for anastomosis, hospital stay, post-operative leak and cost effectiveness.\u0000Methods: This is a comparative hospital based study carried out at the department of surgery Nepalgunj Medical College from September 2017 to August 2020. Patients requiring emergency laparotomy with resection and anastomosis of small bowel were included. Patients requiring colonic anastomosis, diversion stoma and multiple anastomoses were excluded. Patients were divided in to two groups- single layer and double layer group. Each group was compared for outcome measures like time taken to construct the anastomosis, hospital stay, post-operative leak and cost of surgery.\u0000Results: The total number of patients was 50. The mean age was 45.57±17.42 years for single layer and 48.67±18.16 years for double layer group. Time taken for intestinal anostomosis in single and double layer were 18.28±5.08 and 25.27±6.18 respectively which was statistically significant (p - <0.012). Hospital stay was 10.9±1.43 in single layer and 11.2±1.87 which was statistically not significant (p - >0.342). Similarly, the anastomosis leak was seen in 2 patients in single layer and 3 in double layer. Which was statistically not significant (p - >0.318). While comparing the cost effectiveness single layer technique was cost effective.\u0000Conclusion: The single layer anastomosis is a preferable, safe and economic technique in comparison to the conventional double layered anastomosis.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124752396","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":"Prevalence and Characteristics of Gastrointestinal Symptoms and Hepatic Manifestation in Covid-19 Infection in Tertiary Care Center","authors":"D. Khadka, S. Kc, K. Regmi, Binus Bhandari","doi":"10.3126/jngmc.v19i2.42791","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42791","url":null,"abstract":"Introduction: Although the primary clinical manifestation of COVID-19 is pulmonary disease, but there are increasing data to support the gastrointestinal and hepatic involvement.\u0000Aims: We aimed to see the prevalence and characteristics of gastrointestinal symptoms and hepatic manifestation in COVID-19 infection.\u0000Methods: This is a hospital based descriptive cross-sectional study which was carried out in medicine department of Nepalgunj Medical College. Consecutive patients of COVID-19 cases confirmed by polymerase chain reaction were included. The presenting complaints, laboratory parameters, clinical events were noted. The primary objective was to determine the prevalence of gastrointestinal manifestation and hepatic dysfunction and their correlation with severity of pneumonia.\u0000Results: Total patients enrolled in the study were 205. Majority of patients presented with respiratory symptoms 67.8%. Both respiratory and gastrointestinal symptoms were observed in 29.3% cases. Isolated gastrointestinal symptoms were observed in 2.9% cases. Common gastrointestinal symptoms were anorexia 14.1%, anorexia and nausea in 6.3%, pain abdomen in 3.9% and diarrhea in 2.4% cases. Hepatocellular type hepatic dysfunction reported in 53.2% cases. Rise in alanine aminotransferase (58.2% vs. 23.6%), aspartate aminotransferase (51.6% vs. 20.6%), alkaline phosphatase (44% vs. 15%), total bilirubin (76.6% vs12.5%) found significantly high in severe pneumonias compared with pneumonia only. Both gastrointestinal and hepatic dysfunctions were more common in severe cases (87.9% and 58.7%) than in mild disease (1% and 27%).\u0000Conclusion: One third of the patients of COVID-19 can have gastrointestinal symptoms and hepatic dysfunction. Around 3% of patients presented with isolated gastrointestinal symptoms. Thus, unexplained gastrointestinal symptoms in contacts of COVID-19 may demand polymerase chain reaction test to confirm the disease. Both gastrointestinal and hepatic dysfunction was more prevalent in severe pneumonia.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132172031","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":"Seasonal Hyperacute Panuveitis (SHAPU)","authors":"N. Gurung","doi":"10.3126/jngmc.v19i2.42790","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42790","url":null,"abstract":"IntroductionSHAPU is a mysterious disease seen and reported only from Nepal since 1975. It is an important cause of unilateralchildhood blindness and is the most devastating intraocular inflammatory disease leading to loss of sight within a week. Although initially presented as a case report at a Nepal prevention of blindness meeting in 1978 and reported in national journal Malla O, editor Endophthalmitis probably caused by Tussock moth. Report of the preceding of the first National seminar on Prevention of Blindness: 1978.Upadhyan MP: Eye problems of Nepalese Children in 1979.Now there are more than 10 published articles available in the Website.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117275804","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":"Trial without Catheter in Acute Retention of Urine secondary to Prostatomegaly","authors":"Digbijay Bikram Khadka, Anup Sharma, P. Maharjan","doi":"10.3126/jngmc.v19i2.42860","DOIUrl":"https://doi.org/10.3126/jngmc.v19i2.42860","url":null,"abstract":"Introduction: Acute Retention of Urine is one of the main presentations for Benign Prostatic hyperplasia. Trial without catheter is an ambulatory care protocol. The greater morbidity and mortality associated with emergency surgery, and the potential morbidity associated with prolonged catheterization have led to the increasing use of a trial without catheter. Trial without catheter involves catheter removal allowing patients to void successfully so that surgery can be performed at a later stage. Use of an alpha (1)-blocker before a Trial without catheter has demonstrated that it increases its success.\u0000Aims: Identifying the success and failure of Trial without Catheter in patients with Benign Prostatic Hyperplasia and evaluating factors influencing them.\u0000Methods: A total of 60 patients who presented with acute urinary retention were enrolled in this study at Nepalgunj Medical College which was conducted between February 2021 and August 2021. All the patients underwent Foley Catheterization. Tablet Alfuzosin 10mg one tablet at night and requested follow-up after a week. Trial without Catheter conducted and the amount of urine measured after removal of the Foley catheter.\u0000Results: The study evaluated various factors predicting success of Trail without Catheter. Age group of 61-70years had higher success. Patients with moderate American Urological Association score had higher success rates than the rest. About 10 (6%) patients had a Quality of Life of less than four. The prostate volume ranging from 30-39ml had higher success rates. Patients with Grade III Intravesical Prostatic Protrusion had fewer chances of successful Trial without Catheter. Duration of Lower Urinary Tract Symptoms less than six months was favorable for the success of Trial without Catheter. Thirty five (58.3%) patients voided more than 200ml during Trial without Catheter.\u0000Conclusion: Trial without catheter should be opted for selective patients having Benign Prostatic Hyperplasia presenting with Acute Urinary Retention.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123191627","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}