{"title":"Depresi sebagai Prediksi Kematian dalam 1 Tahun pada Pasien Hemodialisis","authors":"Langgeng Perdhana, Shofa Chasani, S. Nuraini","doi":"10.25077/jka.v10i3.1808","DOIUrl":"https://doi.org/10.25077/jka.v10i3.1808","url":null,"abstract":"Depression is a mental disorder that is often found in hemodialysis patients. Depression had bad effects on patients. The study that determines the relationship between depression and all-cause mortality risk in hemodialysis patients is debatable. Objectives: To determine the role of depression as a predictor factor of all-cause mortality within one year in hemodialysis patients. Methods: This cohort study was conducted from February to August 2020 at the hemodialysis unit of Roemani Muhammadiyah Hospital, Semarang. The inclusion criteria were undergoing hemodialysis ≥3 months, hemodialysis frequency twice a week, being willing to participate in this study, being able to communicate well, and there was no history of previous mental disorders. Meanwhile, those whose data were incomplete, transferred to another hemodialysis unit, HBSAg +, and had other stressors unrelated to hemodialysis or Chronic Kidney Disease (CKD) were excluded from this study. Depression was assessed using the Beck Depression Inventory-II questionnaire. The collected data was then analyzed using Kaplan Meier and Cox regression. Results: From 82 respondents, 20 (24,4%) respondents categorized into depression group and 62 (75,6%) respondents into non depression group. Cox Regression analysis showed that depression plays a role as a predictor factor of all-cause mortality within one year in hemodialysis patients (p value=0,007, and Hazard ratio=3,587). Conclusion: Depression plays a role as a predictor factor of all causes of mortality within one year in hemodialysis patients.Keywords: depression, hemodialysis, mortality, end-stage renal disease","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46461743","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":"Eumisetoma pada Toraks dan Abdomen: Suatu Kasus Jarang","authors":"Jimy Fran, Istiana Fiatiningsih, Ilhami Romus","doi":"10.25077/jka.v10i3.1803","DOIUrl":"https://doi.org/10.25077/jka.v10i3.1803","url":null,"abstract":"Mycetoma is a chronic granulomatous infectious disease of the skin, subcutis, fascia and bones caused by bacteria (actinomycetoma) or fungi (eumycetoma) in adults aged 20-40 years old, male to female ratio is 3,7:1 respectively. The clinical finding is a painless, solid and cold subcutaneous node. It has been reported a 43-year-old woman with a painless suppurative lump in her chest, stomach, armpits and legs in the past year. The lump were hypertrophic scars, atrophic scars, nodules and erythematous papules with pustules and sinuses, which excretes exudate greenish-yellow. The patient had a history of working in an oil palm farm. Histopathological examination of hematoxylin-eosin showed suppurative granulomatous inflammation consisting of epitheloid histiocytes, solid lymphocytes and neutrophils, and datia cells. PAS (Periodic acid-Schiff) staining showed positive results. The diagnosis of deep mycosis eumycetoma was confirmed based on physical examination and histopathological examination. Eumycetoma is a rare deep fungal disease. Supporting investigations such as direct microscopy, histopathology with biopsy, and culture are needed to establish the diagnosis. The therapies are antifungal drugs and surgery. Death is possible if the infection occurs in the chest or head cavity.Keywords: deep mycosis, eumycetoma, granules, mycetoma, sinuses","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43728479","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":"Gambaran Drug Related Problems (DRPs) Terapi Farmakologi Pasien ISPA Pediatrik di Rumah Sakit PKU Muhammadiyah Gamping Yogyakarta","authors":"Nadia Husna, Siwi Padmasari","doi":"10.25077/JKA.V10I2.1790","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1790","url":null,"abstract":"Acute Respiratory Infection has become the major cause of death in children in developing countries. There were about 11.9 million episodes of severe acute lower respiratory infection that resulted in hospital admission in young children worldwide. The method of drug administered was the common Drug-Related Problems found in young children. Objectives: To evaluated Drug-Related Problems of Acute Respiratory Infection drug therapy in pediatric patients. Methods: Ninety-four pediatric patients were included in this study. Drug therapy data were obtained from medical records from January 2018 until July 2019, as this study was using a retrospective method. Drug-Related Problems of drug therapy were analyzed based on the Cipolle classification system. Results: Prevalence of female and male patients are in the same number (50%) with the highest prevalence on 2-11 years (72.34%) in young children. The number of Drug-Related Problems was found about 61.49% from 148 numbers of used drugs with improper drug selection as the major Drug Related Problems (51,65%) followed by drugs without indication and underdose by 23.08% and 15.38%, respectively.Keywords: acute respiratory infection, hospital, pediatrics, pharmacologic therapy","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47633181","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}
Anthony Stephen Halim, Edward Limantara, Wienta Diarsvitri
{"title":"Delayed Speech Dengan dan Tanpa Gangguan Pendengaran pada Anak Usia 6 Bulan sampai 3 Tahun di Jala Puspa RSPAL Dr. Ramelan Surabaya Periode 2017-2020","authors":"Anthony Stephen Halim, Edward Limantara, Wienta Diarsvitri","doi":"10.25077/JKA.V10I2.1710","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1710","url":null,"abstract":"Late or untreated delayed speech can be a risk for social, emotional, behavioral and cognitive problems in adulthood. Delayed speech is associated with hearing loss, mental retardation, autism spectrum disorder (OSD), bilingualism, and lack of psychosocial stimuli. Objectives: To determine the prevalence of delayed speech with and without hearing loss in children aged six months until three years. Methods: This study used 872 medical records of delayed speech children aged six months until three years with and without hearing loss in 2017 until 2020 period at Jala Puspa RSPAL Dr. Ramelan, Surabaya. The presence or absence of hearing loss was examined using Brainstem Evoked Response Audiometry (BERA), and the degree of hearing loss was examined using Auditory Steady-State Response (ASSR) test. Results: From a total of 872 medical records data studied, 558 (64.0%) were males and 314 (36.0%) were females. The majority (44.8%) of delayed speech children were from the two-year age group. There were 565 (64.8%) delayed speech children with hearing loss and 307 (35.2%) without hearing loss. Of those with hearing loss, 48.0% showed a profound degree. There was an increase in delayed speech children without hearing loss compared to those with hearing loss, from 1:2.04 in 2017 to 1:1.12 in 2020. Conclusion: There was an increase in delayed speech children without hearing loss compared to those with hearing loss.Keywords: ASSR, BERA, delayed speech, hearing loss","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43304538","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}
Dela Hangri Jalmas, Fauzar Fauzar, Roza Kurniati, Deka Viotra, Harnavi Harun, Vesri Yoga, Alexander Kam
{"title":"Coronavirus Disease 2019 in Chronic Kidney Disease: A Case Report","authors":"Dela Hangri Jalmas, Fauzar Fauzar, Roza Kurniati, Deka Viotra, Harnavi Harun, Vesri Yoga, Alexander Kam","doi":"10.25077/JKA.V10I2.1718","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1718","url":null,"abstract":"The COVID-19 pandemic has caused substantial morbidity and mortality worldwide. Older patients, male gender and those with preexisting comorbidities such as chronic kidney disease are reported to be more likely infected with SARS CoV-2 and are at higher risk of severe illness or death. It has been reported a 24 years old male was admitted to the hospital with shortness of breath, coughing, fever and paleness. The history of contact with confirmed COVID-19 cases was unclear. The patient works as a security officer. A history of hypertension is present. Laboratory results showed hemoglobin 7 g/dl, ureum 261 mg/dl, and creatinine 22,9 mg/dl. On the second day of admission, the patient experience increased shortness of breath, decreased consciousness and epistaxis. From the result of the nasopharyngeal swab, the patient tested positive for COVID-19 and was given Oseltamivir 75mg. The patient is prepared for hemodialysis, which was performed in the isolation room. After hemodialysis, the patient's condition improved with decreased shortness of breath and increased of consciousness. The patient comes out from the isolation room and discharges home in good condition. Antiviral therapy in CKD patients with Covid-19 infection requires dose adjustment. Immediate hemodialysis is required in patients with CKD and coexisting COVID-19 infection to improve the patient's condition. Prompt management for patients with CKD and COVID-19 will reduce the risk of mortality.Keywords: COVID-19, chronic kidney disease, hemodialysis","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47516015","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}
Cokorda Istri Padmi Suwari, Bayu Puradipa, N. Wulandari
{"title":"Junctional Bradikardia pada Pasien Hiperkalemia","authors":"Cokorda Istri Padmi Suwari, Bayu Puradipa, N. Wulandari","doi":"10.25077/JKA.V10I2.1772","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1772","url":null,"abstract":"Hyperkalemia is a life-threatening electrolyte abnormality resulting in cardiac arrhythmia. Hyperkalemia may also cause bradycardia with junctional rhythm. However, the prevalence of hyperkalemia accompanying symptomatic bradycardia has only been explored in a few case reports. Thus we present a case of hyperkalemia with uncommon ECG findings. It has been reported that a 76 years old woman with type 2 diabetes mellitus, hyperkalemia and suspected coronary artery disease complaining about palpitation. Electrocardiography (ECG) showed junctional bradycardia with tall T wave and laboratory examination showed mild hyperkalemia (5.8 mmol/L). After one day of observation, severe hypotension was detected. Unexpectedly the cardiac rhythm was returned into the sinus after correction of hyperkalemia using calcium gluconate, insulin, dextrose, and salbutamol. As serum potassium level rises, sinoatrial and atrioventricular conduction was blocked, causing escape rhythm (junctional escape rhythm). In hyperkalemia, cardiotoxicity can be caused by an increase in resting membrane potential, decreased depolarization and duration of depolarization. When detected on ECG, hyperkalemia should be treated urgently and important to identify underlying causes or precipitating factors of hyperkalemia. Sinus node dysfunction is not excluded in this case. Hyperkalemia can present a bradycardia junctional rhythm. Although the increasing serum potassium levels were low, hyperkalemia may have affected the conduction system leading to the ECG changes.Keywords: hyperkalemia, junctional bradycardia, symptomatic bradycardia","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41745370","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":"Gambaran Castelli’s Risk Index-1 pada Pasien Sindrom Koroner Akut di RSUP Dr. M. Djamil Padang","authors":"Eka Musmita Sabebegen, Rismawati Yaswir, Efrida Efrida","doi":"10.25077/JKA.V10I2.1719","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1719","url":null,"abstract":"Atherogenic dyslipidemia is one of the risk factors for the acute coronary syndrome (ACS). Castelli's risk index-1 (CRI-1) is one of which risk markers for ACS. Castelli's risk index-1 is the ratio of total cholesterol and HDL cholesterol. The test is cheap and easy to do in the hospital setting. Objectives: To described CRI-1 in ACS patients in Dr. M. Djamil Padang Hospital. Methods: This descriptive study was carried out in the central laboratory and the CardioVascular Care Unit (CVCU) of Dr. M. Djamil Hospital Padang from September 2017 to September 2018. The population was all ACS patients who have been diagnosed by the clinician. The samples were part of the population that meet the inclusion and exclusion criteria. Colorimetric enzymatic method using automated clinical chemistry used to measure total cholesterol and HDL cholesterol. Results: This study used CRI-1> 4. Data were presented descriptively in a frequency distribution table. Seventy ACS patients were consisting of 50 (71.43%) males and 20 (28.57%) females, with a median age of 60.1 (8.93) years old. The median total cholesterol and HDL cholesterol levels were 178.66 (46.84) mg / dL respectively and 35.71 (10.86) mg / dL. CRI-1 mean is 5.43 (2.27). 81.43% CRI-1 subject results were more than four. Conclusion: The low levels of HDL cholesterol and within normal median total cholesterol level made CRI-1 value increased.Keywords: Acute coronary syndrome, Castelli’s risk index-1","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46699180","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":"Korelasi Kadar Protein C-Reaktif dengan Rasio Kolesterol Total / HDL pada Penyandang Obes di RSUP Dr M Djamil Padang","authors":"Nanda Oktavia, Ellyza Nasrul, Efrida Efrida","doi":"10.25077/JKA.V10I2.1714","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1714","url":null,"abstract":"C-reactive protein is an acute-phase protein produced by the liver in response to inflammation. Dyslipidemia can trigger the inflammatory reaction in the blood vessels, causing atherosclerosis. The ratio of total cholesterol/High Density Lipoprotein (HDL) is considered as one of the sensitive predictor lipid ratio for the cardiovascular disease risk factor. Objectives: To determined the correlation of C reactive protein between cholesterol levels with total cholesterol/HDL ratio in obese people. Methods: This study was an analytical study with a cross-sectional design of 59 people who met the inclusion and exclusion criteria at the RSUP Dr. M. Djamil Padang from January to September 2019. Research subjects consisted of first degree obesity (25.0 ≤IMT <30.0 kg/m2) and second degree (≥30.0 kg/m2). C reactive protein levels were measured as high-sensitivity C-reactive protein. Total cholesterol and HDL levels were measured using automated clinical chemicals with the enzymatic colorimetric method. Data were analyzed by Pearson, significant if p <0.05. Results: The study subjects were 59 people (17 men and 22 women) with an average age was 35 (8.04) years. CRP levels in stage II obesity were slightly higher than grade I, with a mean difference between groups of 0.26 mg/L (95% CI: -1.80-1.2; p=0.74). The average ratio of total cholesterol/HDL levels in the obese group I and II was 5.13 and 4.80 (p=0.93). The correlation showed a very weak positive (r=0.12) and was statistically not significant (p=0.35). The results of the subanalysis showed relatively similar patterns between the first-degree obesity population (r=0.10; p=0.58) and second-degree (r=0.16; p=0.41). Conclusion: There is no significant correlation between protein C-reactive and total cholesterol/HDL ratio.Keywords: Obesity, C-Reactive Protein, total cholesterol/HDL ratio","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45621623","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":"Perbandingan Perubahan Luas Luka dan Angiogenesis pada Luka Bakar Derajat IIB Tikus Sprague Dawley yang Diberikan Advanced Platelet-rich Fibrin dan Advanced Platelet-rich Fibrin Plus","authors":"E. Stella, K. A. Wahyuningsih","doi":"10.25077/JKA.V10I2.1616","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1616","url":null,"abstract":"Platelet-rich fibrin (PRF) has a lot of benefits in the process of healing. The new generation of PRF, namely advanced PRF plus (A-PRF+), has a different fibrin structure and more growth factors compared to Advanced PRF (A-PRF), the generation before A-PRF+. Objectives:To compared the effects of A-PRF and A-PRF+ on the IIB degree burn. Methods: This experimental study used 20 male Sprague Dawley rats. All rats were given IIB degree burn and divided into four groups. Group 1 was treated with saline, Group 2 was treated with silver sulfadiazine 1%, Group 3 was treated with A-PRF, and Group 4 was treated with A-PRF+. Wound size reduction will be calculated every two days and measured with ImageJ and the wound would be made into a histological slide on day 14 to calculate angiogenesis. Results: Changes in the wound surface area for the group that was given A-PRF dan A-PRF+ are 2,333cm and 4,827cm. The wound surface area’s data were analyzed using Kruskal-Wallis and the results are statistically not significant (p>0,05). The number of angiogenesis for the group that was give A-PRF and A-PRF+ as followed are 5,88 and 4,867. The angiogenesis data were analyzed using one-way ANOVA and the results are statistically not significant (p>0,05). Conclusion: There is no difference between the effect of A-PRF and A-PRF+ towards changes in wound surface area and angiogenesis in IIB degrees burn wounds.Keywords: A-PRF, A-PRF+, burn wound, angiogenesis, wound surface area","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46370931","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}
Mariel Daba, Hanna Goenawan, Vita Murniarti Tarawan, Aziis Mardanarian Rosdianto, R. Lesmana
{"title":"Efek Suplementasi Selenium terhadap Marker Darah Pasca Cedera Kontusio","authors":"Mariel Daba, Hanna Goenawan, Vita Murniarti Tarawan, Aziis Mardanarian Rosdianto, R. Lesmana","doi":"10.25077/JKA.V10I2.1787","DOIUrl":"https://doi.org/10.25077/JKA.V10I2.1787","url":null,"abstract":"Selenium is a trace element that has antioxidant properties and is a component of selenoproteins. In certain circumstances, such as injury, selenium supplementation is required to regulate the inflammatory response. Contusion injury increases the inflammatory response to a muscle or tissue that begins with vasodilation, increases blood flow, increases vascular permeability, and leads to edema formation at the site of injury. Objectives: To determine the effect of selenium supplementation on changes in blood markers in rats treated with contusion injury. Methods: Experimental design, using experimental male rats (Rattus norwegius), eight weeks old, weighing 200-220 grams, divided into three groups, namely: The Control group, the contusion group, the contusion + Selenium group. Selenium supplementation was given orally on days 1-3 after injury at a dose of 0.0153 mg into 2% PGA. Examination of markers such as White Blood cells (WBC), lymphocytes, monocytes, and neutrophils was carried out on day three after treatment. Results: This study found that the administration of post-muscular selenium supplementation based on examination of blood markers such as WBC, Lymphocytes, Monocytes was higher in the contusion group and lower in the selenium group. Neutrophils were higher in the contusion and selenium groups. This was not significantly different from the control group. The result of blood marker examination tended to change, but it was not statistically significant. Conclusion: Selenium supplementation in post-contusive injury mice did not provide significant changes in blood markers such as WBC, lymphocytes, monocytes, and neutrophils.Keywords: antioxidant, blood marker, contusion, selenium","PeriodicalId":30736,"journal":{"name":"Jurnal Kesehatan Andalas","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47423846","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}