Journal of Applied Sciences and Clinical Practice最新文献

{"title":"Story of a cisternography: Did we awaken a sleeping \"Giant?\"","authors":"D. Chakraborty, Sanjay Bhaumik, Gobinda Pramanick, Devarati Biswas","doi":"10.4103/jascp.jascp_23_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_23_22","url":null,"abstract":"A 53-year-old lady with no known comorbidity had undergone cisternography for persistent rhinorrhea. Rhinorrhea resolved, and the report was normal. However, a week later, she complained of low back pain, followed by progressive quadriparesis and sphincter dysfunction. A detailed imaging revealed evidence of leptomeningitis around the brain stem, intradural cervical and dorsal collection with nodular enhancement, and clumping of cauda equina roots. Cerebrospinal fluid (CSF) showed pleocytosis with increased protein and hypoglycorrhachia. CSF cell count was 6000 (all lymphocytes), CSF proteins were 1138 mg%, and CSF glucose was 30 mg% (corresponding blood glucose level of 110 mg%). We did not get any systemic clue about the illness except progressive weight loss. Our team concluded either it is directly a deadly sequel of the dye-related complication of cisternography or activation of a chronic infection in the spine. We treated her with antitubercular drugs and steroids along with physiotherapy. We kept in mind the chronicity of the illness and endemicity of tuberculosis. She responded well and was mobilizable with minimal support. Hence, we continued the same regimen, keeping in mind the responsiveness of the patient to the same. We report this case to realize the possibility of this type of complication even with advanced dye and modern techniques of cisternography. Our case also underscores the requirement of prior imaging (magnetic resonance imaging of the spine) before undertaking such a procedure (cisternography). Last but not the least, sometimes we also need to make decisions based on our clinical knowledge as neurological investigations may be inconclusive in many circumstances.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115361720","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 curious case of classic biphasic pulmonary blastoma","authors":"V. Vinay, Jitendra Saini, M. Dinesh Kanna, Alpana Srivastava","doi":"10.4103/jascp.jascp_26_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_26_22","url":null,"abstract":"Classic biphasic pulmonary blastoma is an uncommon and highly aggressive primary pulmonary malignancy characteristically arising from fetal lung tissues comprising biphasic histology that is made up of both epithelial and mesenchymal components. We present this rare case in which a young adult presented with chest pain for 3 months and dyspnea for 1 month. Contrast-enhanced computed tomography of the thorax revealed a right-sided homogeneous mass. The diagnosis was confirmed by transthoracic biopsy and histopathological examination. Surgical excision remains the treatment of choice. Recurrence usually occurs within 12 months of surgery, with 5-year survival rates <20%. We report this rare malignancy with a special focus on improving the management of this malignancy.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131900782","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":"D-dimer in Coronavirus Disease 2019 pneumonia: A valuable inflammatory marker in predicting trends of systemic effects in addition to thromboembolic events! A single-center experience","authors":"S. Patil, S. Toshniwal, Shubhangi Khule","doi":"10.4103/jascp.jascp_46_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_46_22","url":null,"abstract":"Introduction: Robust data are available regarding the role of D-dimer as a marker of coagulation abnormality in infectious, inflammatory, and malignant process. Its role in predicting coagulation abnormality in the currently ongoing coronavirus disease 2019 (COVID-19) pandemic is evolving. In present we have studied its role in predicting severity, coagulation, and vascular abnormalities such as deep-vein thrombosis (DVT) and pulmonary thromboembolism (PTE). We have also studied the role of D-dimer in the prediction of final radiological outcome as post-COVID lung fibrosis in follow-up. Materials and Methods: Prospective, observational study included 1000 COVID-19 cases confirmed with reverse transcription polymerase chain reaction. All cases were assessed with high-resolution computed tomography thorax, oxygen saturation, inflammatory marker as D-dimer at entry point and follow-up. Age, gender, comorbidity, use of bilevel positive airway pressure/noninvasive ventilation (BiPAP/NIV), and outcome as with or without lung fibrosis as per computed tomography (CT) severity were key observations. In selected cases, we have performed lower limb venous Doppler and CT pulmonary angiography to rule out DVT or PTE respectively. Statistical analysis is done by using Chi-square test. Results: Age (<50 and >50 years) and gender (male vs. female) has significant association with D-dimer level (P < 0.00001) and (P < 0.010) respectively. CT severity score at entry point with D-dimer level has significant correlation (P < 0.00001). D-dimer level has significant association with duration of illness (DOI) before hospitalization (P < 0.00001). Comorbidities have a significant association with D-dimer level (P < 0.00001). D-dimer level has a significant association with oxygen saturation (P < 0.00001). BIPAP/NIV requirement has a significant association with D-dimer level (P < 0.00001). Timing of BIPAP/NIV requirement during hospitalization has a significant association with D-dimer level (P < 0.00001). Follow-up D-dimer titer during hospitalization compared to normal and abnormal to entry point level has a significant association with post-COVID lung fibrosis, DVT and PTE (P < 0.00001). Conclusions: D-dimer is an easily available, and universally acceptable inflammatory marker, which has documented a very crucial role in COVID-19 pneumonia in predicting the severity of illness, and assessing response to treatment during hospitalization. D-dimer has an important role during interventions in the intensive care unit, as follow-up titers have a significant role in step-up or step-down interventions in critical care settings. Correlating D-dimer with variables like DOI, oxygenation status, and timing of BIPAP/NIV at the entry point is important to have a satisfactory treatment outcome.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122298169","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":"Acceptance of cord stem cell banking among pregnant women attending outpatient department of tertiary care hospital of Delhi","authors":"Ashutosh Kumar Singh, V. Chellaiyan, Shivam Dixit, T. Midha, Pragati Garg, Aarthy Arumugam, Neetu Singh","doi":"10.4103/jascp.jascp_19_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_19_22","url":null,"abstract":"Introduction: Cord blood banking, an alien concept till a few years ago, in India, is becoming popular nowadays. Cord blood banking is the practice of preserving, for future use, fetal blood that remains in the umbilical cord at the time of birth. Advancement in medical research has established the use of cord blood-based stem cells in the treatment of more than 70 diseases. It has a success rate of 99.6%. Objectives: The objective of the study is to access the awareness, determine the acceptance, and evaluate the practice of \"cord stem cell banking\" among pregnant women visiting the antenatal care clinic at Safdarjung Hospital. Methodology: This hospital-based cross-sectional study was carried out among 400 pregnant females attending antenatal clinics in Safdarjung Hospital, New Delhi. Through systemic random sampling, every third pregnant female attending the antenatal clinic was approached for the study. A pretested semi-structured questionnaire was used to collect data from the participants, which had questions related to the sociodemographic profile of the participant and questions on awareness, acceptance, and practice of cord stem cell banking. The collected information was analyzed using SPSS software version 21.0. Qualitative variables will be expressed in proportions and quantitative variables in mean (standard deviation)/median (interquartile range). A Chi-square test was applied. Results: 228 (57%) study participants were 20–23 years old. Although only 104 (26%) study participants were illiterate, 348 (87%) women remained unemployed. Women who participated in the study had atleast one living child. It is found from the study that only 80 (20%) women were aware of cord stem cell banking and social media was found to be the major source of information for all the participants. 50% of the total participants and 52.9% of those who wanted to know more about it were willing to do cord stem cell preservation in a future pregnancy. When coming to practice, none of the study participants had done cord stem cell banking in previous pregnancy, nor were they willing to do it in the current pregnancy. Among the participants who are not willing to do cord stem cell banking, 80 (40%) women found the procedure expensive, 60 (30%) women did not believe in the benefits of the procedure, and the remaining 60 (30%) women felt it as culturally unacceptable. It is to be noted that women are willing to do cord stem cell banking in a future pregnancy if their doctor recommends it (P = 0.000) and those women who are aware are also willing to do cord stem cell banking in a future pregnancy (P = 0.00). Conclusion: Awareness, acceptance, and practice of cord stem cell banking are not up to the mark. It is to be noted that social media serves as the only platform for the participants to know about cord stem cell transplants. However, if doctors educate and motivate their patients about it, a drastic change can be seen. It is also to be noted that educating mother","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"213 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123869430","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":"Malignant pericardial effusion 7 years after treatment of ductal carcinoma in situ of breast","authors":"Aashita, Rajiv Sharma, Vikas K Yadav, Pragyat Thakur","doi":"10.4103/jascp.jascp_2_23","DOIUrl":"https://doi.org/10.4103/jascp.jascp_2_23","url":null,"abstract":"Ductal carcinoma in situ (DCIS) is a precursor of invasive breast cancer (IBC) that may or may not lead to IBC. Although the incidence is increasing, it usually has a good prognosis. Local recurrence can occur in the form of DCIS or IBC. Distant metastasis is uncommon and in the absence of local recurrence is extremely rare. Here, we report a case of a 47-year-old female with DCIS, who, 7 years after treatment developed malignant pericardial effusion along with lung and marrow metastasis. This is the second reported case of distant multiple metastases without local recurrence in a known case of DCIS. This shows the possibility of aggressive behavior in DCIS that usually has a favorable prognosis.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"2003 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125788126","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":"Pulmonary functions assessment in Post-COVID-19 pneumonia cases by spirometry: Study of 600 cases in tertiary care setting in India","authors":"Shital Patil, Rajesh Patil, G. Gondhali","doi":"10.4103/jascp.jascp_3_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_3_22","url":null,"abstract":"Background: Although lung is the primary target organ involvement in coronavirus disease-19 (COVID-19), post-COVID lung pathology and its impact on lung functions are still uncertain. Materials and Methods: Prospective multicentric study conducted during May 2020 to June 2021, to find pulmonary function assessment in post-COVID-19 recovered pneumonia cases irrespective of their symptoms, included 600 cases in symptomatic and asymptomatic group and subjected to inclusion and exclusion criteria. All cases were subjected to Spirometry analysis. Statistical analysis was done by using Chi-test. Results: In Spirometry assessment of post-COVID-19 pneumonia cases at 12 weeks' postdischarge from hospital, abnormal lung function in 77.5% post-COVID-19 pneumonia cases; restrictive pattern was predominant type and documented in 43.33% cases, normal lung functions were documented in 22.5% cases. In age and gender assessment in normal and abnormal lung functions assessment, statistically significant association in males 90/150 versus females 45/315 (P < 0.00001); and in the age of population in study cases as below 50 years 110/300 versus above 50 years 25/165 (P < 0.0001). Computed tomography severity score has shown a negative impact on lung function after recovery at 12 weeks' postdischarge; cases with score <8, 8–15, and >15 documented normal and abnormal lung functions as in 36/54, 60/80, and 39/331 respectively of total 600 study cases (P < 0.00001). The duration of illness has associated negative impact on lung function; <7 days, 8–15 days and >15 days of onset of symptoms documented normal and abnormal lung functions in 108/132, 22/168 and 5/165 cases respectively (P < 0.00001). Low oxygen saturation at entry point has a negative impact on overall outcome on lung function; cases with oxygen saturation < 75%, 75%–90%, and >90% observed as normal and abnormal lung functions in 92/18, 35/135 and 6/314 cases, respectively (P < 0.00001). Timing of biphasic positive airway pressure/noninvasive ventilation (BIPAP/NIV) has a significant association in attaining normal lung functions after post COVID19 pneumonia recovery; cases received BIPAP/NIV at entry point <1 day, 3–7 days and after 7 days of hospitalization were documented normal and abnormal lung functions in 30/150, 40/35 and 5/50 cases, respectively (P < 0.00001). Conclusions: Pulmonary functions abnormality in post-COVID-19 pneumonia cases has been documented and should be assessed cautiously to have successful treatment outcome. Restrictive lung disease is the predominant lung function impairment in post-COVID 19 recovered lung pneumonia cases. Age above 50 years, male gender, diabetes, High CT severity, longer duration of illness, proper timing of initiation of BIPAP/NIV therapy, has documented significant impact on post-COVID lung functions at 12 weeks assessment.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126820729","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":"Is it Non-Hodgkin's lymphoma or tubercular lymphadenitis: A diagnostic dilemma?","authors":"Aashita, Vikas Yadav, Rajiv Sharma, Anuja Kapoor, Pragyat Thakur","doi":"10.4103/jascp.jascp_21_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_21_22","url":null,"abstract":"The incidence of non-Hodgkin's lymphoma (NHL) is increasing, more so in tuberculosis (TB) endemic low and middle-income countries. Both of them have overlapping presentation that makes it difficult to differentiate them clinically. Here, we describe a case of 60-year-old male with oropharyngeal NHL with cervical and axillary lymphadenopathy. After completion of chemotherapy, there was complete resolution of oropharyngeal mass, but lymph nodes (LN) had responded partially. At this point, he was diagnosed with pulmonary TB and was started on antitubercular treatment (ATT). The residual LN resolved completely with the ATT. The patient is currently disease free. The case reported here highlights the dilemma in diagnosing a LN to be tubercular or lymphomatous.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131329427","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 cross-sectional study of the olfactory fossa in Delta State, Nigeria","authors":"B. Ominde, J. Ikubor, W. Iju, P. Igbigbi","doi":"10.4103/jascp.jascp_1_23","DOIUrl":"https://doi.org/10.4103/jascp.jascp_1_23","url":null,"abstract":"Introduction: Evaluation of the olfactory fossa (OF) before endoscopic sinus surgery is important in minimizing inadvertent penetration into the anterior cranial fossa. This study assessed the depth of the OF using computed tomography (CT) images of adult Nigerians. Materials and Methods: Cranial CT images were obtained from the database of the radiological unit of a referral center in Delta State, Nigeria, after ethical clearance. The images belonged to 137 female and 199 male adults aged ≥20 years. The depth of OF was measured as the perpendicular distance between the cribriform plate (CP) inferiorly to the superior end of the lateral lamella of the CP on coronal sections. The fossae were classified as Keros Type I (0.1–0.39 cm), Type II (0.4–0.79 cm), and Type III (>0.8 cm). Data collected were analyzed using the Statistical Package for the Social Sciences version 23. Side and gender comparisons of the depth were evaluated using the Student's t-test, while the variations in the OF types were assessed using the Chi-square test. These comparisons were regarded significant when P < 0.05. Results: The mean OF depth was larger in males (0.543 ± 0.183 cm) than in females (0.527 ± 0.169 cm) (P = 0.018). The prevalence of symmetrical (64.9%) and asymmetrical (35.1%) OF showed significant sex differences (P < 0.05). Type II OF was the most common (77.2%), followed by Type I (15.8%) and Type III (7%). Conclusion: The presence of the deep (Type III) and asymmetric OF in the patients studied emphasizes the importance of their preoperative radiological identification to minimize complications.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123604429","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":"Association of inflammatory markers, neutrophil-lymphocyte ratio, and D-dimer with mortality in COVID-19 infection: A hospital-based retrospective analysis","authors":"D. Rai, Alok Ranjan, Sanjay Pandey, Harsh Vardhan","doi":"10.4103/jascp.jascp_4_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_4_22","url":null,"abstract":"Introduction: To assess the association of blood biomarkers such as C-reactive protein (CRP), serum ferritin, lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio, and D-dimer at admission with in-hospital mortality in COVID-19 and to determine best predictive cut-offs for them. Materials and Methods: This cross-sectional study included 984 confirmed cases of COVID-19 admitted in months of July and August 2020. The optimal biomarker cut-off points for mortality were defined by a receiver operating characteristic curve. Survival probabilities were estimated by the Kaplan–Meier method and compared with the log-rank test. Results: The overall mortality rate among the hospitalized cases was 254 (25.81%). All the markers were found to be significantly higher (P < 0.001) in nonsurvivor group as compared to the survivors at the time of admission. Serum CRP, ferritin, D-dimer and LDH were found to be elevated, i.e., higher than the upper limit of normal range in 426 (83%), 469 (68.37%), 449 (67.9%), and 380 (93.1%) respectively overall. However, these markers were significantly more elevated in nonsurvivor compared to survivors. A significant increasing trend of elevated level of all biomarkers was observed with increase of severity level (P < 0.0001). It was found that CRP ≥82 mg/L had sensitivity of 63.58% and specificity of 68.38% for predicting the mortality. Similarly, serum ferritin ≥475.6 mg/ml had sensitivity of 68.09% and specificity of 65.26%, D-dimer ≥0.65 had sensitivity of 90.71% and specificity of 55.45%, and LDH ≥915 U/L had sensitivity of 69.34% and specificity of 73.8% to predict the mortality. Furthermore, neutrophil and lymphocyte count ratio (NLR) ≥8.86 had sensitivity of 65.61% and specificity of 79.7% to predict the mortality. Conclusion: Levels of the blood biomarker such as CRP, serum ferritin, LDH, NLR, and D-dimer at admission can predict mortality in COVID-19 infection.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126274974","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":"Remote patient monitoring","authors":"Anannya Gupta","doi":"10.4103/jascp.jascp_42_22","DOIUrl":"https://doi.org/10.4103/jascp.jascp_42_22","url":null,"abstract":"Concerns about the unsatisfactory condition of chronic disease management prompted the design and development of a telemonitoring home system based on user input. Patients, caring for themselves through self-care and monitoring, can control and prevent chronic disorders, restructuring the treatment process into a constant cooperative interaction between patients and health-care professionals. The primary major goal of this study is to highlight future research directions in remote health care and patient monitoring for chronic illnesses treatment and management, as well as to provide an overview of the current state of remote patient monitoring (RPM), its contemporary constraints, and possible future prospects that will aid to resolve those contemporary constraints. The methodology of this review is that an independent literature search was conducted on Medline, PubMed, and Google Scholar for the below-mentioned keywords, and studies published till April 2022 that had used any type of RPM intervention were screened for inclusion in the review. The conclusion of this review is that continuous RPM may increase patient adherence to medication and other guideline-recommended therapy strategies that have been linked to a reduction in clinical mortality and better prognosis. However, a number of technological, medical legal and economic barriers must be overcome before they may be widely used.","PeriodicalId":272297,"journal":{"name":"Journal of Applied Sciences and Clinical Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130616645","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}