The International Journal of Frontier Sciences最新文献

{"title":"Healthcare Quality Management System in Pakistan","authors":"Wajahat Hussain","doi":"10.37978/tijfs.v3i2.50","DOIUrl":"https://doi.org/10.37978/tijfs.v3i2.50","url":null,"abstract":"The competitive healthcare system and healthcare environment, modern hospitals with substantial investment, healthcare reforms, availability of specialized persons in hospital management, health services management, the success of quality management programs in developed nations and high interest of international health organizations like WHO has led the developing countries like Pakistan to pay due attention to quality in national healthcare system.  Since the time of independence healthcare system in Pakistan is striving for improvements. Despite of the physical infrastructure and availability of qualified workforce for service delivery there are gaps in strategic and operational planning which resulted in poor quality health services. The leaders in healthcare has little awareness that the quality management is an organized specialty to improve the quality of healthcare. It is need of the hour that healthcare leaders in Pakistan must integrate quality improvement activities in strategic and operational planning process of healthcare system. This the only way to maximize the benefits of healthcare system and restore the rapidly deteriorating public trust.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42372508","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 Step Towards Lowering Maternal Mortality: Adoption of Elements of WHO’s Safe Childbirth Checklist at A Tertiary Care Hospital of Rawalpindi, Pakistan: A Cross Sectional Survey","authors":"Saira Maroof, Zubaida Rashid, Imtenan Sharif, M. Alam, Rida Nawaz, S. Nawaz, Maaz Amin, N. U. Islam, Syed Irshad Hussain, Aimal Khan","doi":"10.37978/tijfs.v3i2.53","DOIUrl":"https://doi.org/10.37978/tijfs.v3i2.53","url":null,"abstract":"Abstract \u0000Background: Use of the World Health Organization’s (WHO) Safe Childbirth Checklist (SCC) has been associated with a significant reduction of maternal mortality. \u0000Method: A descriptive cross-sectional survey conducted at a tertiary care hospital of Rawalpindi in labour room and postnatal ward from February 2018 to July 2018. A sample size of 359 was estimated using WHO sample size calculator and were enrolled using purposive sampling technique. A close ended WHO standardized questionnaire covering the 22 elements of WHO SCC was used. Frequencies and percentages were documented of variables and data was analysed using SPSS version 23. \u0000Results: Mean age of participants was 27 ± 4.25 years. On admission, it was observed that being centre of excellence and referral, there was 100% availability of gloves and supplies to clean hands before and after each vaginal examination. Just before pushing or caesarean, it was found that in 342 (95.3%) patients, assistant was identified to help at time of birth. Immediately after one hour of birth, it was noted that 79 (22%) patients were bleeding abnormally and were immediately addressed. We also found out that only 79 (22%) of the mothers were counselled regarding family planning. Almost half of the participant mothers 182 (50.7%) or their companions were counselled regarding danger signs and to seek care immediately which should have been 100%. \u0000Conclusion: Excellent adoption of some of the element up to 100% was observed while some of the elements of checklist were poorly adopted; noticeable was counselling regarding family planning options immediate postpartum.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46488595","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":"Assessment of Knowledge, Attitude and Practice of Hand Hygiene in Healthcare Workers of Gulab Devi Chest Hospital Lahore, Pakistan","authors":"Mehwish Ishaq, Q. Ullah, Usman Ali Rehman, S. Bhatti, A. Hanif, Z. Ulhaq, R. Saba, Syeda Hina Zahra, A. Parvaiz","doi":"10.37978/tijfs.v3i2.54","DOIUrl":"https://doi.org/10.37978/tijfs.v3i2.54","url":null,"abstract":"Background: Hand hygiene is a general term referring to any action of hand cleansing by using water and detergent and for the removal of transient microorganisms from hands. Hand hygiene is recognized as the leading measure to prevent cross-transmission of microorganisms and to reduce the incidence of healthcare associated infections. There are many experiences that the lack of knowledge, attitude and poor practice in hand hygiene in healthcare workers transmit infection in patients and in other healthcare workers. \u0000Methodology: This descriptive study was conducted in Gulab Devi Chest Hospital. I had taken 100 healthcare workers to complete my research. The sampling technique of my research was cross-sectional sampling technique, use to collect the data. \u0000Results: In this research knowledge was not good in all HCWs, Overall knowledge of hand hygiene by all HCWs was less than 50%. The attitude in nurses and medical student in this research was moderate doctors and technologists have poor attitude in hand hygiene. The practices among HCWs in Gulab Devi Chest Hospital were also poor which was less than 50%. \u0000Conclusion: The HCWs in Gulab Devi Hospital had poor knowledge, practices on hand hygiene. However, attitudes of medical student and nursing had satisfactory.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46879725","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":"Eye Makeup Use, Adoption of Makeup Safety Guidelines among Women and Its Association with Ocular Surface Disease Index (OSDI): Analytical Cross-Sectional Study","authors":"Saira Maroof, Humaira Mehmood, Saleh Khurshied, Syeda Kinza Bukhari, Muhammad Bilal Shabir, Khizar Malik, Kanwal Shan, Usama Zameer","doi":"10.37978/tijfs.v3i2.51","DOIUrl":"https://doi.org/10.37978/tijfs.v3i2.51","url":null,"abstract":"Abstract: \u0000Objectives: To assess the frequency of eye makeup use among female doctors and its association with ocular surface disease Index (OSDI). \u0000Study Design: Analytical Cross-Sectional Study \u0000Place and Duration of Study: It was conducted from Jan 2018 to May 2018 at a tertiary care hospital Rawalpindi. \u0000Materials and Methods: Sample size calculated using WHO sample size calculator was 272 with margin of error 5% and confidence level of 95%. A WHO Standardized OSDI Questionnaire was used to asses for the severity of ocular surface disease and frequency of application of eye makeup. Females were also inquired about adoption of safety guidelines while applying and removing eye makeup. Results were displayed as frequencies and percentages and Chi Square test was applied to assess statistical significance among frequency of makeup use and severity of ocular symptoms. \u0000Results: Frequency of Eye makeup use as stated by the participants was less than three times among 37% and it was more than three times a week among 63% participants. Once a week users were only 24.7%. Among users it was found that majority 49.3% had normal scores while 55(24.2%) had mild disease, 11.5% had moderate disease and only 15% had severe disease. Some questions were added in questionnaire to assess the safety practices regarding eye makeup use. It was quite satisfactory to know that 73.1% of the participants do check expiry date of products before use, don’t share their products with others 62.1% and take off makeup before going to sleep 78.4%. However, the situation was quite opposite in some other practices as only 42.3% do patch test before applying makeup and 34.8% check constituents before purchasing the make up as to some of the constituents they might be sensitive. \u0000Conclusion: This study shows the utilization of eye make-up is extensive and related to the perception of ocular discomfort. With such widespread use of these products, more research is needed to assess the effect on the ocular surface and tear film, which can be underestimated.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47262305","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":"Cardiovascular Disease and Its Risk Factors Among Employees of Sindh Government; A Cross Sectional Survey from Karachi, Pakistan","authors":"Madiha Shafi, Humaira Mehmood, Saeed Afsar, Zoaib Raza Bokhari, S. Abbasi","doi":"10.37978/tijfs.v3i2.52","DOIUrl":"https://doi.org/10.37978/tijfs.v3i2.52","url":null,"abstract":"Abstract: \u0000Introduction:  Globally it is documented that CVD has multi-factorial aetiology and many factors like increased BMI, hypertension (HTN), stress and diabetes determine the risk of CVD. The prevalence of risk factors for cardio vascular disease (CVD) is on increase in the developing nations of the world. \u0000Objectives: The purpose of the study was   to find out the prevalence of cardiovascular disease and its risk factors among employees of Sindh Government in Karachi, Pakistan.Method: It was hospital based cross sectional study. A total of 150 subjects (govt employees of Sindh Government) were interviewed by using consecutive sampling technique. Data on serum cholesterol, BMI, blood pressure, history of hypertension, diabetes and cardiovascular diseases was collected, in addition to demographic data. \u0000Results: Out of 150 subjects interviewed, 20.6% reported to have CVD. The most prevalent risk factor was hypertension, found in 58% respondents. Other risk factors were diabetes (45%), sedentary life style (50%), obesity (28%), dyslipidaemia (30%), smoking (20%), positive family history (26%). In 6% of subjects, three major risk factors were present. The risk factors, strongly associated with CVD in our study were diabetes (p<0.01), hypertension (p<0.001) and family history of CVD (p<0.02). There is strong association of increasing age on risk of developing CVD (p< 0.001). \u0000Conclusion: The results show that there is high frequency of CVD risk factors in employees of health department in Karachi. The high prevalence of risk factors, especially hypertension, sedentary life style, obesity and diabetes should be of great concern.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46504338","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":"Obesity: A Risk Factor of Preeclampsia","authors":"Wajahat Hussain, S. Badar, Huda Abbas, M. Imran, M. Khan, Muhammad Ramzan Soomra","doi":"10.37978/tijfs.v3i2.55","DOIUrl":"https://doi.org/10.37978/tijfs.v3i2.55","url":null,"abstract":"Background: Obesity is a major epidemic of developed world that is now extending to developing countries and is the risk factor of pre-eclampsia which is the major contributor to maternal and foetal morbidity & mortality. \u0000Objective: To determine the frequency of preeclampsia in obese primigravida women visiting the Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan. \u0000Methodology: This cross-sectional descriptive study was conducted in Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan from January 2018 to December 2018. All the Primigravida women with singleton pregnancy of gestational age ≥ 26 weeks assessed by ultrasound between 20-35 years of age were included in the study by non-probability consecutive method. After obtaining ethical approval from hospital ethical committee and informed written consent from all the study subjects, relevant data were documented in a predefined data sheet and body mass index (BMI) was calculated by using the formula: Weight (kg) / Height2 (m). Women having blood pressure (BP) of 140/90 mmHg or above in third trimester of gestation measured on at least two occasions, 6 hours or more apart accompanied by proteinuria of 300 mg per 24 hours or above in previously normotensive were labelled as preeclampsia and first-time pregnant women having BMI ≥ 30 were taken as obese. Statistical analysis was performed by using computer-based software, Statistical Package for Social Science (SPSS) for windows version 17.0. Mean and standard deviation was calculated for numerical data like age. Frequencies and percentages were calculated for categorical variables. Chi-square test was performed to find the statistical difference regarding preeclampsia distribution between groups and ‘p’ value <0.05 was considered as a lowest level of significance. \u0000Results: Mean age of the respondents in the study was 27.08±3.59 years. Majority of the women were between the ages of 26-30 years (53.30%). The mean gestational age of the respondents was 34.50±4.33 weeks and most of the women had gestational age ≥ 36 weeks (46.70%). Frequency of obesity in pregnancy was 15.4% and frequency of preeclampsia in obese primigravida was 55.3%. Conclusion: It is concluded that frequency of preeclampsia is higher in obese primigravida compared to non-obese primigravida.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47761788","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":"Frequency of Predisposing Factor of Nausea and Vomiting after Chest Surgery under General Anaesthesia","authors":"Q. Ullah, Ayesha Shahnawaz, Usman Ali Rehman, A. Hanif, S. Bhatti, Z. Ulhaq","doi":"10.37978/tijfs.v3i1.48","DOIUrl":"https://doi.org/10.37978/tijfs.v3i1.48","url":null,"abstract":"Abstract: \u0000Background: Postoperative nausea and vomiting are common and distressing postsurgical symptoms. These symptoms are of particular concern in outpatient surgery because they may require additional direct resources, such as supplies and antiemetic drugs, and may delay discharge. The objective of this study was to measure the frequency of factors which can cause nausea and vomiting under general anaesthesia after chest surgery. \u0000Methodology: This descriptive case series evaluated frequency of predisposing factor of nausea and vomiting in patients of anaesthesia department of Gulab Devi Hospital Lahore. Questionnaire is made and patients were asked about their age, fever, previous surgery, NPO status, smoking history and hospital stay. This study included 140 patients with post-operative nausea and vomiting. \u0000Results: In this study, 140 patients were taken in which  65 (46.43%) were female and 75 (53.57%) were male. In 140 patient 134 (95.7%) were NPO and 6 (4.3%) were not  NPO, 25 (17.9%) were obese and 115 (82.1%) were not obese, 88 (62.9%) patients were suffering fever and 52 (37.1%) were not suffering fever, 80 (57.1%) were infected and 59 (42.1%) were not infected, 53 (37.9%) patients had previous surgery and 87 (62.1%) had no previous surgery, 94 (67.1%) patients had received nitrous oxide and 46 (32.9%) didn’t, 97 (69.3%) received volatile gases and 43 (30.7%) not received, 29 (20.7%) received ketamine and 111 (79.3%) not received, 87 (62.1%) received suxamethonium and 53 (37.9%) not received, 119 (85.0%) received propofol and 21 (15.0%) not received, 110 (78.6%) received naluphine and 28 (20.0%) not received. Out of 140 patients, there were 122 (87.1%) who were suffering from pain and 18 (12.9%) were not. 91 (65.0%) patients had gastric distention and 49 (35.0%) patients didn’t. Opioids were given to 34 (24.3%) patients and not given to 106 (75.7%) patient. \u0000Conclusion: It is concluded that the nausea and vomiting after surgey under genral anesthesia is due to patient related factors in which most frequent is NPO. Drug related factors include propofol and nalbupin administration. Post operative factors include pain. In whole study of 140 patients, the  most frequent is patient related factor (NPO) other than drug related factors and post-operative factors.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41775469","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":"Role of Epidemiological Studies in Disease Prevention","authors":"M. Akthar","doi":"10.37978/tijfs.v3i1.42","DOIUrl":"https://doi.org/10.37978/tijfs.v3i1.42","url":null,"abstract":"Today’s society is full of disease that are of different natures including genetic, infectious and metabolic etc. Every disease has its own mechanisms of affecting humans and different prevention mechanisms as per disease nature. These factors are included in epidemiology of disease. Other factors include prevalence and incidence of diseases in different populations. Exactly knowing about disease epidemiology helps governing authorities to prevent the disease. Unfortunately, under-developed and developing nations are not focusing on diseases epidemiology. On the other hand, all developing nations developed best public health practices based on diseases epidemiology data. These studies may vary from basic epidemiological surveys to identification of microorganism strains etc.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45996451","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":"Dichromacy: Color Vision Impairment and Consanguinity in Heterogenous Population of Pakistan","authors":"M. Akhtar, M. Aslamkhan, M. S. Zar, A. Hanif, A. Haris","doi":"10.37978/tijfs.v3i1.47","DOIUrl":"https://doi.org/10.37978/tijfs.v3i1.47","url":null,"abstract":"Abstract: \u0000Background and Objectives: Dichromacy, an X-linked recessive disorder is identified worldwide, more in males than females. In European Caucasians, its incidence is 8% in males and 0.5% in females. In India, it is 8.73% in males and 1.69% in females, and in Iran, it is 8.18% in males and 0.43% in females. Population based epidemiological data about dichromacy in different ethnic groups in Pakistan is not available. The aim of this study was to find out the population prevalence of inherited red-green dichromacy in a heterogenous population of the district of Chiniot, Punjab, Pakistan, and to determine the impact of consanguinity and ethnicity. \u0000Methods: In this cross-sectional study, boys and girls of the higher secondary schools were examined in the three tehsils of district Chiniot. Pseudoisochromatic Ishihara Test has been employed for detection of dichromacy in the study population. The sample size was calculated statistically as 260, which was expanded to 705 and divided by population density of the three tehsils. \u0000Results: Screening of 359 males and 346 females revealed 19 (5.29%) dichromat males and only 2 (0.58%) females. The study population belonged to 23 castes / isonym groups. The consanguinity found in the district of Chiniot is 84.82% and in the dichromat families, it is 85.71%, of which 52.37% are first cousin. \u0000Interpretation & Conclusion: The study has shown that the incidence of dichromacy could be reduced through genetic counseling","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44376006","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":"Daily Activity Related Quality of Life in Chronic Obstructive Pulmonary Disease in Adults","authors":"Ruhamah Yousaf, M. Arif, Q. Ullah, S. Rafique, A. Hanif, Mustansar Ali","doi":"10.37978/tijfs.v3i1.44","DOIUrl":"https://doi.org/10.37978/tijfs.v3i1.44","url":null,"abstract":"Abstract: Background: The significant reason for anguish as well as incapacity is chronic obstructive pulmonary disease (COPD). Activities of daily living might be relentlessly curbed among patients with COPD and appraisal needs evaluation regarding influence of infirmity and detriments on day-to-day living. The primary objective was to know the daily activity associated quality of life in COPD adults. The secondary objective was to analyze demographical profile, such as gender and age of COPD subjects as well as evaluate the physical activity related breathlessness in COPD patients. Methodology: This study was executed at Gulab Devi Chest Hospital. We used cross sectional study design to collect the data. For collecting the statistics of 150 subjects aged 40-60 years of either gender Saint George’s Questionnaire was liable. It included the patient’s biodata, effect of COPD on physical activities and limitations in routine work. Results: The ages of 150 COPD patients selected were between 40 and 60 years. Patients were classified into two categories on the basis of disease severity according to GOLD criteria 71 (47.3%) were with moderate severity and 79 (52.7%) were with severe severity. 113 (75.3%) patients were smokers while 37 (24.7%) patients were non-smokers. 110 (73.3%) COPD patients were active smokers in comparison 40 (26.7%) COPD patients were passive smokers. COPD patients with current smoking status were 79 (52.7%) and with past smoking status were 71 (47.3%). 19 (12.7%) COPD patients felt breathlessness while sitting and lying. 53(35.3%) COPD patients felt breathless while getting washed or dressed. 85(56.7%) COPD patients felt breathless while walking around the home. 114 (96%) COPD patients discerned breathlessness while walking up a flight of stairs. 145 (96.7%) COPD patients had breathlessness while playing sports or games. 146 (97.3%) COPD patients experienced difficulty in breathing during activities like carrying load. 88 (58.7%) COPD patients discerned breathlessness during entertainment or recreation. 88 (58.7%) COPD patients discerned breathlessness during entertainment or recreation. 7 (4.7%) COPD patients felt breathlessness while moving from bed or chair. Conclusion: As with the progression of COPD impairment in activities become worse due to breathlessness causing decline in patient’s ability making them unable to complete their task to fulfill the needs of life and ultimately become bed bound due to shortness of breath.","PeriodicalId":33951,"journal":{"name":"The International Journal of Frontier Sciences","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69949568","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}