Birat Journal of Health Sciences最新文献

{"title":"Randomized controlled trial of lactulose and lactulose with probiotic in the treatment of minimal hepatic encephalopathy in chronic liver disease","authors":"D. Peeyush, Bickram Pradhan","doi":"10.62065/bjhs464","DOIUrl":"https://doi.org/10.62065/bjhs464","url":null,"abstract":"Introduction: Minimal Hepatic Encephalopathy (MHE) has impact on future clinical outcomes, such as occurrence of overt hepatic encephalopathy, quality of life and survival.\u0000Objectives: To compare lactulose and lactulose with probiotic in treatment of MHE in chronic liver disease and to determine Prevalence of minimal hepatic encephalopathy in patients with chronic liver disease. \u0000Methodology: This was stratified randomized controlled trial. A total of 62 patients with MHE were analyzed. Child-Pugh Score was used to stratify the patients into three blocks of Child-Pugh Class (CPC) i.e., CPC-A, B and C. Patient in each block were randomized into two groups (lactulose alone and lactulose with probiotic). The primary end point was to evaluate cognitive status after one month of treatment with Figure Connection Test (FCT) A and B scores in comparison to the baseline. The secondary end points were to estimate the prevalence of MHE in chronic liver disease and assess association of inflammatory markers, total leucocyte count (TLC) and MHE. \u0000Results: The prevalence of MHE was 41.33%. There was improvement in FCT A and B in 90% of patients in both the groups of CPC-A. Lactulose improved FCT A and B in 45.45% and 40% while lactulose with probiotic improved it in 54.54% and 30% in CPC-B and C respectively. Patients with higher baseline values had less improvement in FCT A and FCT B. Those who didn’t improve had higher TLC in all the groups.\u0000Conclusion: There was no difference in cognitive status between lactulose alone and lactulose with probiotic in treatment for chronic liver disease patients with MHE. High baseline FCT scores and TLC had poor recovery.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139603762","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":"Fear of Tooth Extraction among Patients Visiting a Tertiary Care Center","authors":"Gopal Gurung, Mona Pokharel, Sabana Thapa, Asmita Parajuli","doi":"10.62065/bjhs473","DOIUrl":"https://doi.org/10.62065/bjhs473","url":null,"abstract":"Introduction: Extraction of teeth is the most commonly performed procedure in dentistry. Extraction of teeth is known to be in the top five most frightening procedures in dental practice.Objectives: To find out the prevalence of fear of tooth extraction, its association with gender, age, education, and previous extraction experience, and ranking of the fear of tooth extraction. \u0000Methodology: A descriptive cross-sectional study was conducted among the patients visiting the Department of Dental Surgery at Birat Medical College and Teaching Hospital for the extraction of teeth from 1st March 2023 to 31st August 2023. \u0000Results: Out of 278 patients, 219 (78.70%) patients had a fear of tooth extraction. Gender wise 153 (85%) females and 66 (67.3%) males had a fear of tooth extraction. Fear of tooth extraction was highest in the age group of 18-27 years (n= 67; 87.01%). The prevalence of fear of extraction among previous extraction patients was 106 (69%) and 113 (90.4%) in non-extraction patients. The association of fear of tooth extraction with gender, age, and experience of previous extraction was found to be significant (p<0.05) using the Chi-square test. The association of fear of extraction of a tooth with the level of education was found to be not significant (p>0.05). While ranking the fear of extraction by patients, the first (most feared) was pain during extraction (n=134; 61.20%). \u0000Conclusion: The fear of extraction of teeth was seen in the majority of patients and was more prevalent in females, younger patients, and previous non-extraction patients.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"65 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139604285","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":"Correlation Study of Inferior Venacava Collapsibility Index And Perfusion Index as Predictors of Fluid Responsiveness in Critically ill Patients","authors":"K. Pyakurel, Lalit Kumar Rajbanshi, Kanak Khanal, A. Pokhrel, Deepak Poudel, Anant Piyush Jha","doi":"10.62065/bjhs478","DOIUrl":"https://doi.org/10.62065/bjhs478","url":null,"abstract":"Introduction: Fluid responsiveness assessment is crucial in managing critically ill patients. This study evaluates the correlation and efficacy of Inferior Vena Cava Collapsibility Index (IVCCI) and Perfusion Index (PI) in predicting fluid responsiveness. \u0000Objectives: The primary objective was to evaluate the correlation between the IVCCI and PI as predictors fluid responsiveness in critically ill patients. Secondary objectives involved studying the individual accuracy of the IVCCI and PI in predicting of fluid responsiveness and exploring whether their combined use improves overall accuracy in predicting fluid responsiveness in this patient population. \u0000Methodology: This prospective study enrolled 80 critically ill patients requiring hemodynamic monitoring and fluid resuscitation. IVCCI was measured using bedside ultrasonography, and PI was derived from pulseoximetry. Hemodynamic parameters were recorded before and after a standardized fluid bolus. Receiver Operating Characteristic (ROC) curves were generated to assess the predictive performance of IVCCI and PI. \u0000Results: Among 80 enrolled patients, responders (N=35) demonstrated significantly lower baseline cardiac output (4.5 ± 0.23 vs 4.76 ± 0.22, p<0.01) and higher IVCCI (35.13 ± 13.41 vs 28.53 ± 10.17, p=0.015) compared to non-responders. After a standardized fluid bolus, responders exhibited higher cardiac output (5.31 ± 0.24 vs 4.9 ± 0.27, p<0.01) and lower IVCCI (22.01 ± 15.84 vs 28.88 ± 11.71, p=0.029). IVCCI and PI before fluid bolus showed a very weak positive correlation (r = 0.080, p = 0.478). Moreover, IVCCI before fluid bolus had better sensitivity (0.745) and specificity (0.727) than PI before fluid bolus (sensitivity: 0.574, specificity: 0.485), with AUC values of 0.693 and 0.455, respectively. \u0000Conclusion: IVCCI demonstrates efficacy in predicting fluid responsiveness, with a very weak positive correlation to PI. Notably, IVCCI before fluid bolus outperforms PI before fluid bolus in sensitivity and specificity, highlighting its superior predictive accuracy in critically ill patients.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"65 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139604370","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":"Outcome of fracture shaft of humerus fixed with dynamic compression plate in B. P. Koirala Institute of Health Sciences, Dharan, Nepal","authors":"Rosan Prasad Shah Kalawar, P. Chaudhary","doi":"10.62065/bjhs460","DOIUrl":"https://doi.org/10.62065/bjhs460","url":null,"abstract":"Introduction: Open reduction and internal fixation with dynamic compression plate (DCP) is necessary for fracture shaft of humerus (SoH) whose closed reduction is not acceptable or cannot be retained in slab or cast. \u0000Objectives: Aim of the study was to evaluate outcome of fracture SoH fixed with DCP. \u0000Methodology: Patients with fracture SoH fixed with DCP in BPKIHS in 2015-16 were prospectively studied for one year for perioperative issues and functional outcome using DASH score. \u0000Results: There were 87 patients of fracture SoH fixed with DCP. Among 87 patients, 65.5% were male and 34.5% were female. The mean age was 36.4 years. The most common mode of injury was road traffic accident followed by fall from height, work place injury. The average operating time was 71 minutes with standard deviation 15.6. The mean blood loss was 205ml ± 45.60. Post-operative hospital mean stay was 4.5 days. There was post-operative radial nerve palsy in 4.6%. Only 69 patients can be followed up for one year for evaluation. Radial nerve palsy recovered fully in those with post-operative palsy. Disability of shoulder arm and hand (DASH) score was 82.50±9.6 after one year of surgery. Fracture was not united in 3(4.3%) patients out of 69 patients who reported for follow up at one year of injury and needed bone grafting and secondary intervention. This shows satisfactory functional outcome in fracture SoH fixed with DCP. \u0000Conclusion: Dynamic compression plating for SoH fracture has satisfactory outcome.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"121 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139605564","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":"Effectiveness of corticosteroid injection vs platelet rich plasma (PRP) injection in the treatment of plantar fasciitis","authors":"Santosh Nepal, Mithilesh Kumar Gupta, Rajan Panthee, Gokul Kafle, Raj Kumar Sah","doi":"10.62065/bjhs465","DOIUrl":"https://doi.org/10.62065/bjhs465","url":null,"abstract":"Introduction: Plantar fasciitis is one of the most common causes for inferior heel pain in adults. Many noninvasive and invasive treatment modalities are available for its treatment. Local injection of corticosteroid and Platelet-rich plasma (PRP) is usually used in the treatment of chronic plantar fasciitis not responding to noninvasive conservative treatments.\u0000Objectives: To compare the efficacy of local injection of corticosteroids and platelet rich plasma (PRP) in the treatment of plantar fasciitis.\u0000Methodology: Patients diagnosed as plantar fasciitis and treated conservatively for at least 3 months and had no response to conservative treatment modalities were involved in this study and randomly allocated into 2 groups of 38 each (Group A and Group B). Patients were treated with local corticosteroid injection in group A and autologous PRP injection in group B. Clinical assessment was done prior to the injection and at 3 weeks and 3 months following the injection, which included visual analog pain scale (VAS), subjective rating using the modified Roles and Maudsley score (MRMS), functional outcome score by the Foot function Index (FFI).\u0000Results: The mean age, sex and body mass index was comparable for both groups. Postinjection, there was significant improvement (p < 0.05) of visual analog score (VAS), modified Roles and Maudsley score (MRMS), Foot Function Index in both the groups. However, there was no significant difference (p > 0.05) in improvement of VAS, MRMS and FFI when compared between the 2 groups. \u0000Conclusion: This study revealed that the treatment of plantar fasciitis with steroid or PRP injection was equally effective in patients who do not respond to conservative treatment.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"53 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139602727","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":"Giant Dental Calculus Mimicking a Tumor: A Case Report","authors":"Asmita Parajuli, Gopal Gurung","doi":"10.62065/bjhs482","DOIUrl":"https://doi.org/10.62065/bjhs482","url":null,"abstract":"Dental calculus consists of mineralized bacterial plaque that forms on the surfaces of natural teeth and dental prostheses. Giant dental calculus mimicking a tumor is an unusual presentation. Buccal surfaces of the maxillary molars and the lingual surfaces of the mandibular anterior teeth are the most common location for calculus deposition. This case report presents a case of giant dental calculus mimicking a tumor on the labial surface of the mandible and its diagnostic dilemma, treatment and role of proper oral hygiene measures.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"57 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139603016","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":"Study of rapid detection of Mycobacterium Tuberculosis through GeneXpert MTB/RIF assay from acid fast bacilli smear-negative specimens in a Tertiary Care Hospital, Biratnagar Nepal","authors":"Kumari Ragani Yadav, K. Shrestha","doi":"10.62065/bjhs476","DOIUrl":"https://doi.org/10.62065/bjhs476","url":null,"abstract":"Introduction: Tuberculosis (TB) is an important public health concern around the world. It is well known that acid-fast bacilli (AFB) smear-negative TB cases are a major source of spreading TB to others when left untreated. \u0000Objectives: Our study aim to detect Mycobacterium tuberculosis (MTB) in AFB smear-negative samples through GeneXpert MTB/RIF assay and also to evaluate the drug resistance patterns towards Mycobacterium tuberculosis in hospitals.Methodology: This descriptive cross-sectional study was conducted among smear-negative presumptive TB patients at a tertiary care center with effect from September 2022 to September 2023 after approval from the Institutional Review Committee of the college. A convenience sampling method was used. \u0000Results: Out of 653 smear-negative samples, 71 (10.9%) were positive for TB and 17 (2.6%) were rifampicin resistance cases detected by GeneXpert MTB/RIF assay. The cases of tuberculosis were more in age groups between 46->60 years and least in 17-30 years of age. Pulmonary samples yielded a higher number of MTB 66 (92.95%) as compared to extra-pulmonary samples 5 (7.04%). There is an almost equal proportion of mycobacterium infection in males 37(52.11%) and females 34(47.88%). All the rifampicin resistance cases detected in our study were from pulmonary samples. \u0000Conclusion: Our study shows that the sensitivity of GeneXpert MTB/RIF assay is higher than AFB smear microscopy. We are missing actual TB cases while using AFB smear microscopy only. Hence the GeneXpert MTB/RIF assay is important for the rapid detection of MTB in smear-negative as well as smear-positive drug resistance MTB cases.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"135 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139604755","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":"Clinical Profile and Outcome of Neonates and Children Diagnosed with COVID-19 in Tertiary Level Teaching hospital in Eastern Nepal","authors":"Manoj Chaudhary, Hem Sagar Rimal, Sonia Dahal, Pankaj Chaudhary","doi":"10.62065/bjhs468","DOIUrl":"https://doi.org/10.62065/bjhs468","url":null,"abstract":"Introduction: COVID-19 is an acute respiratory infection caused by SARS-CoV-2. The disease spread all over the world so rapidly that WHO has declared global health emergency and pandemic on 30 January 2020.Neonates and children are affected less frequently as compared to adults. Impact and outcome of COVID on neonates are unknown and a major public health concern. However, evidence on neonatal covid is still limited. \u0000Objetives: To explore the clinical profile and to find outcome of neonates and children with COVID-19. Methodology: This was an observational, descriptive study done in the pediatric department. Sixty-three neonates and children up to the age of 14-year, diagnosed as Covid-19 by RT-PCR and antibody were included. \u0000Results: Sixty-three neonates and children were admitted in PICU, NICU and COVID ward in BMCTH. Thirty-five (56%) were male with predominant age group of 10-14 year (20,31.7%). Children mostly presented with fever (48,76.2%), cough (34,54%) and shortness of breath (24,38.1%). Nine (14.3%) newborns developed late onset neonatal Covid-19 with 6 (66.7%) were term and AGA while 3(33.3%) were preterm and LBW. They presented with fever (5,55%), respiratory distress (5,55%), cough (2,22.2%). Jaundice (22.2%) and cyanosis (11.1%). Respiratory (42,66.7%), gastrointestinal (28,44.5%) and neuromuscular (13, 20.6%) were commonly involved system. Mild, moderate and severe categories of disease were 11 (17%) , 34 (54%)and 18(29%) respectively . 60 (95.2%) children survived and three (4.8%) children died. Average LOS was 4.85 days(median;4days). Eight (12.7%)children developed MIS-C. \u0000Conclusion: COVID-19 presentation in children ranged from mild to severe disease with low mortality. Fever, cough and difficulty in breathing were common features in children while fever, difficulty in breathing and sepsis in neonates.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"110 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139605727","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 of respiratory morbidities and lung function outcome in Traffic Police in eastern Nepal","authors":"P. Koirala, Ram Kumar Mehta, Surya B Parajuli","doi":"10.62065/bjhs472","DOIUrl":"https://doi.org/10.62065/bjhs472","url":null,"abstract":"Introduction: Outdoor air pollution is a cause for occupational lung disease. A community vulnerable to lung health hazards of outdoor air pollutants from vehicle emissions is traffic police, whose long duration of outdoor work, with no proper protective equipment, predisposes them to respiratory symptoms such as cough, dryness of nose, throat irritation and wheezing due to the air pollutants causing inflammation of the airways. The risks to lung function and development of respiratory disease are not known in traffic police in eastern Nepal.\u0000Objectives: To determine respiratory morbidities and lung function values of traffic police working in eastern Nepal.\u0000Methodology: This cross-sectional study was conducted for 6 months, from 1st January to 30th June 2022, in traffic police using a structured questionnaire adapted from American Thoracic Society and National Heart & Lung Institute and portable spirometry, at the duty posts or office. Data were represented using descriptive statistics. \u0000Results: The study enrolled 129 traffic police in eastern Nepal, 109 (84.50%) were male and 20 (15.50%) females, mean age 34.50 (±8). Mean duration of active duty was 9.76 years (±6.19). Cough was present in 33 (25.58%), 50 (38.76%) phlegm, 37 (28.68%) dyspnea, and 28 (21.71%) noisy breathing. Mean FEV1% in ≤ 5 years exposure was 76.75 (±17.28), and 65.26 (±18.88) in > 15 years. Mean FVC% in ≤ 5 years exposure was 81.81 (±20.56) and 76.18 (±19.77) in those working >15 years. Mean FEF25-75% in ≤ 5 years was 73.69 (±23.73), which was 62.04 (±33.97) in those > 15 years. The spirometry analysis suggested obstructive airways disease in 90 personnel (69.8%), restrictive disease in 80 (62%), mixed airways disease in 72 (55.8%), and small airways disease in 52 (40.3%).\u0000Conclusion: There was increased burden of respiratory problems such as cough with sputum production, noisy breathing, and dyspnea and lower lung volumes and flows among traffic police working in different parts of eastern Nepal. Long duration of exposure to traffic environments resulted in spirometry analyses suggestive of obstructive and restrictive airways diseases.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"42 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139603622","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":"Intrauterine fetal death: A hospital based cross sectional study","authors":"Jiba Nath Dhamala, Amit Deo, Siddhartha Kumar Yadav, Sanam Dhakal, Sulochana Neupane, Heera K.C Parajuli","doi":"10.62065/bjhs475","DOIUrl":"https://doi.org/10.62065/bjhs475","url":null,"abstract":"Introduction: Intrauterine fetal death (IUFD) is not only a medical concern but also a deeply emotional and societal one which affects the intrinsic human desire for healthy and thriving offspring. Therefore, it is important to meticulously identify the potential causal factors contributing to fetal deaths, which will help to ascertain the likelihood of its recurrence, and subsequently, to strategize for prevention or necessary interventions. \u0000Objectives: The objective of the study is to describe the socio-epidemiological and etiological characteristics ofIUFD.Methodology: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Birat Medical College and Teaching Hospital, Biratnagar for a duration of 16 months from May 11st, 2022 to August 31st, 2023. All pregnant women who had IUFD with gestational age of 22 weeks and above were included in the study. \u0000Results: During the study period there were total of 5,404 deliveries and among them 73 deliveries were IUFD (13.5 per 1000 live birth). The majority of IUFD, specifically 37 cases (50.4%), were attributed to unexplained etiology. The most common coexisting condition was hypertensive disorder of pregnancy contributing 20.5% followed by Intra-Uterine Growth Retardation (IUGR) in 11(15.1%) cases. \u0000Conclusion: There is a significant burden of stillbirths, which will have effect in physical and psychological well-being along with socio-economic impact for grieving parents. Though hypertensive disorder, IUGR and diabetes were the major identified co-morbidities, more than half of the stillbirths were unexplained. This warrants the need of consistent antenatal care (ANC) visits and timely hospital admission for its aversion.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"54 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139603454","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}