Seyed Amir Miratashi Yazdi, E. Nazar, Golnaz Moradi
{"title":"Atypical invasive secondary meningioma with extensive intracranial invasion: A case report","authors":"Seyed Amir Miratashi Yazdi, E. Nazar, Golnaz Moradi","doi":"10.37897/rjn.2023.1.5","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.5","url":null,"abstract":"Invasive and metastatic version of meningioma as an atypical type of the tumor has been rarely described in the literatures. Recurrent secondary meningioma invaded to pre-orbital soft and hard tissues can be found in extremely rare cases. We described a case of atypical invasive meningioma invaded to deep orbital soft tissue due to recurrence of the primary tumor previously treated by surgical removing and chemoradiotherapy. In this case, invasion to orbit, paranasal sinuses and masticator, infratemporal and buccal spaces leading to destruction of adjacent bony structures and mass engulfing the right globe resulting in considerable proptosis was the prominent feature.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41676829","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}
M. Malik, Sarita, S. Punia, Jaspreet Kaur, Varun Singh
{"title":"Effect of posture correction on blood pressure in persons with Forward Head Posture","authors":"M. Malik, Sarita, S. Punia, Jaspreet Kaur, Varun Singh","doi":"10.37897/rjn.2023.1.11","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.11","url":null,"abstract":"Objectives. Hypertension is also known as Elevated Blood Pressure in which SBP is equal to 120-129 mm Hg while DBP is equal or less than to 80 mm Hg or if a person taking antihypertensive drugs at any stage of higher BP according to American college of Cardiology/American Heart Association 2017 guidelines The main objective of this study was to evaluate the efficacy of posture correction on Blood Pressure in persons with Forward Head Posture: A Randomized Control Trial. Materials and methods. 86 patients with a mean age of 56.83±11.40 who had Forward Head Posture and raised blood pressure were randomly assigned to 2 group (N= 43 in each group) Group 1 is experimental group who performed strengthening exercise (Cervical isometrics, Rhomboids and Longus Capitis) and stretching exercises (Trapezius, Scalene, Sternocleidomastoid and Pectoralis Major and minor) 6 repetitions of each exercise, twice per week for 4 weeks). Group 2 is a control which was on antihypertensive drugs for 4 weeks. The outcome measures used was BP using Sphygmomanometer. Patients were assessed at baseline, after 4 weeks of treatment. Outcomes. Of 86 patients, 43 patients who received stretching and strengthening exercise, received intervention twice per week for 4 weeks. There was significant within group effects (p=0.000) for Blood Pressure. The findings obtained by comparing both groups were, SBP & DBP reduced significantly after 4 weeks SBP (MD = 2.86; 95% CI 3.23 to 2.48; p=0.000) DBP (MD = 2.48; 95% CI 2.82 to 2.15; p= 0.000) Conclusions. The efficacy of posture correction in persons with Forward Head Posture is an effective treatment and could considerably decrease the Blood Pressure in Hypertensive patients.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48354692","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}
A. Bakhshi, A. Saberi, Naeim Norouzi, Nasrin Sedighi
{"title":"Association between multiple sclerosis and Helicobacter pylori in the acute and chronic phases of infection: A systematic review and meta-analysis","authors":"A. Bakhshi, A. Saberi, Naeim Norouzi, Nasrin Sedighi","doi":"10.37897/rjn.2023.1.2","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.2","url":null,"abstract":"Multiple sclerosis is a demyelinating autoimmune disease in the central nervous system. It is associated with several factors, one of which is Helicobacter pylori. We suggested that HP may have different effects on MS in the acute and chronic phases; therefore, we evaluated the HP and MS association in acute and chronic phases of infection. Scopus, PubMed, and Web of Science databases were used for systematic search. Finally, according to the inclusion criteria, eight studies were selected. According to the result of this study, there was no significant difference in the disease duration and EDSS between MS with HP. Pooled results showed that the standard difference in the mean EDSS was - 0.910, and the standard difference in the mean duration was - 0.067. Also, by comparing antibody levels in the acute and chronic phases of HP with the control group. Finally, we evaluate the mean EDSS between the two phases of infection, which shows that the mean EDSS and the clinical weaknesses of MS in the acute phase were slightly higher than in the chronic. In conclusion, HP infection can have a stimulating or inhibiting effect on the immune system based on the onset and activity of the infection.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41799111","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}
A. Saberi, Mandana Ashkan, H. Hatamian, A. Ashraf, Enayatollah Homaie Rad, A. Bakhshi, Kasra Sarlak, Kamal AmirAshjei Asalemi, Nima Broomand Lomer
{"title":"Migraine headache in Multiple Sclerosis. Is more frequent among MS patients?","authors":"A. Saberi, Mandana Ashkan, H. Hatamian, A. Ashraf, Enayatollah Homaie Rad, A. Bakhshi, Kasra Sarlak, Kamal AmirAshjei Asalemi, Nima Broomand Lomer","doi":"10.37897/rjn.2023.1.9","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.9","url":null,"abstract":"Objectives. Multiple sclerosis (MS) is a chronic disease of the central nervous system that is associated with inflammation, demyelination of neurons and gliosis. There are different reports about the association between migraine and MS. Taking note of headaches experienced by people with MS and providing appropriate treatment can help enhance their quality of life. We aimed to determine the frequency of migraine headache in MS patients. Materials and methods. This was a descriptive cross-sectional study, conducted in 2020 among 125 MS patients referred to neurology clinic of Poursina Hospital or registered in Guilan MS Registry System and 125 controls with minor head trauma in Rasht. After obtaining written consent, all the subjects were asked to fulfil a checklist about their demographics, MS and headache characteristics by phone call. Outcomes. In this study 96 RRMS, 19 PPMS and 10 SPMS patients participated among which frequency of mild, moderate and severe disability was 74.4%, 22.4% and 3.2%, respectively. The frequency of migraine in MS patients was significantly higher than the control group [28.8% (n=36) vs. 12.8% (n=16) p=0.002]. After adjusting the confounding factors a significant relationship was found between MS and migraine (OR: 2.76, p = 0.004). Conclusions. MS patients experience migraine headaches approximately twice the general population.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43975235","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}
Sheetal, S. Punia, Varun Singh, Shabnam Joshi, M. Boora
{"title":"Effect of Semont maneuver and Brandt-Daroff exercises on Benign Paroxysmal Positional Vertigo","authors":"Sheetal, S. Punia, Varun Singh, Shabnam Joshi, M. Boora","doi":"10.37897/rjn.2023.1.3","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.3","url":null,"abstract":"Objective. This study aimed to examine the efficacy of single session of Semont maneuver and Brand Daroff exercises in treatment of BPPV. Methods. This controlled single blinded randomized control trial (RCT) approved by “IEC, GJUS&T, Hisar” on vide letter no. PTY/2022/155 dated on 21/04/2022. 30 patients (18 years of age and above) of posterior semicircular canal BPPV divided into two groups; Group 1 (N=16) was intervention group treated with Semont maneuver & Brandt-Daroff exercises and Group 2 (N=14) was control group in which Brandt-Daroff exercises were given. Subjects were diagnosed with the help of Dix-Hallpike maneuver, visual vertigo analysis scale, questionnaire for self-diagnosis of BPPV and dizziness handicap inventory score. Paired t-test was used to compare data within groups and unpaired t-test was used to compare data between intervention and control group. Results. VAS and total DHI scores at the start of the study were not statistically significant (p=0.28, p=0.80, respectively) between the treatment group and control group. VAS and DHI scores statistically significantly improved after the intervention in group 1 (VAS 6.75±.68, p<0.001; Total-DHI =42.87±8.69; p<0.001). On the other hand, in the group 2, no significant difference was observed (VAS 1.21±.68, p=0.56; Total-DHI =2.29±8.69; p=.67). In addition, significant improvements were observed in VAS and total DHI scores in patients who underwent the Semont maneuver and Brandt-Daroff compared to those in the group 2 (p<0.01, p<0.01, respectively). Conclusion. Semont maneuver and Brandt Daroff exercises are safe and more effective in treatment of BPPV in majority of patient.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44565401","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}
Seyyed Hassan Abedi Valokolaei, Seyyed Hassan Abedi Valokolaei, P. Saadat, A. A. Ahangar, H. Gholinia
{"title":"Correlation of Parkinson’s disease with diabetes mellitus, obesity, dyslipidemia and their association with severity of disease","authors":"Seyyed Hassan Abedi Valokolaei, Seyyed Hassan Abedi Valokolaei, P. Saadat, A. A. Ahangar, H. Gholinia","doi":"10.37897/rjn.2023.1.12","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.12","url":null,"abstract":"Introduction. The present study aimed to investigate Parkinson’s disease with diabetes, obesity, dyslipidemia and their relationship with disease severity. Methods. In this case-control study, all patients referred to Rouhani Hospital in Babol with clinical diagnosis of Parkinson’s disease were excluded in the case study and the control group was selected from the patients of the clinic and neurology ward. Parkinson’s disease diagnosis was based on common criteria and the four classic sign (symptoms) of the disease. Results. Obesity in patients with Parkinson’s disease was 65.4%, which was higher than the control group with 34.6%. The association between obesity and Parkinson’s disease was significant (OR = 2.14 and p = 0.01). Diabetes was 59.7% in patients with Parkinson’s disease and was 40.3% in patients in the control group that diabetes is also associated with the incidence of Parkinson’s disease (OR = 2.59 and p <0.001). 59.6% of patients with Parkinson’s disease had anemia, while 40.4% of the control group had anemia, and the relationship between anemia and Parkinson’s disease was significant (OR = 1.78 and p = 0.02). 55.5% of patients with Parkinson’s disease had dyslipidemia, while 44.5% of the control group had dyslipidemia, and the relationship between dyslipidemia and Parkinson’s disease was significant (OR = 2.09 and p = 0.004). Conclusion. In summary, this study showed that Parkinson’s is associated with obesity, diabetes, anemia and dyslipidemia. The above cases were effective as risk factors for Parkinson’s disease and how it requires further research in this area.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44786581","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}
Mohammad Sajjad Afsharzada, Sajjad Sohrabijam, S. Saadat, Azita Golestanian
{"title":"The mediating role of resilience in the relationship between stress and couple burnout in people with multiple sclerosis","authors":"Mohammad Sajjad Afsharzada, Sajjad Sohrabijam, S. Saadat, Azita Golestanian","doi":"10.37897/rjn.2023.1.13","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.13","url":null,"abstract":"Objective. This study was aimed at determining the mediating role of resilience in the relationship between stress and couple burnout in people with multiple sclerosis (MS). Materials and Methods. In this cross-sectional analytical study, 200 people with MS from Guilan province participated, chosen by convenience sampling method and using the Connor-Davidson Resilience Scale (CD-RISC), Perceived Stress Scale (PSS), and Couple Burnout Measure (CBM). Data analysis was performed in SPSS-24 and Amos-24 software using structural equation model method. Results. According to the results, the proposed model has a good fit (ꭕ2= 18.36, df=13, p=.145, ꭕ2/df=1.41, CFI=.99, GFI=.97, TLI=.99, RMSEA=.04). Moreover, according to the path analysis results, stress directly effects couple burnout (β=-.631, p=.001) with the mediating role of resilience (β=.418, p=.001). Conclusion. In general, it can be claimed that in people with MS, stress is a factor affecting couple burnout; besides, this relationship is mediated by resilience. Accordingly, the implementation of psychological interventions based on stress management and resilience promotion is recommended.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48518123","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}
I. Lupescu, M. Iacob, R. Iacob, D. Anghel, Octaviana A. Dulamea, C. Vîlciu, L. Gheorghe
{"title":"Benefits and drawbacks of current copper chelators in Wilson disease","authors":"I. Lupescu, M. Iacob, R. Iacob, D. Anghel, Octaviana A. Dulamea, C. Vîlciu, L. Gheorghe","doi":"10.37897/rjn.2023.1.4","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.4","url":null,"abstract":"Background. Wilson disease (WD) is an autosomal-recessive disorder of copper metabolism, caused by mutations in the ATP7B gene, which codes for a membrane-bound copper-binding ATPase. This leads to progressive copper accumulation in the liver, with hepatic injury and subsequent copper release into the blood. Aim. To analyze the efficacy and side-effects of the current copper chelating agents used in treatment of Wilson disease. Material and methods. Retrospective study of 37 adult patients diagnosed with Wilson disease at the Gastroenterology and Neurology Departments of Fundeni Clinical Institute between 2012-2017. Patients were grouped into three categories: (a) those with isolated liver disease, (b) those with isolated neurologic (or psychiatric) involvement and (c) those with both liver and neurologic involvement. Results. There were 54% females (n=20). Mean age at diagnosis was 23 ± 10 years-old. Liver cirrhosis was diagnosed in 54% of cases. Neurologic involvement was described in 65% of patients. Dysarthria was the most common neurologic feature (43%), followed by parkinsonism (41%). D-Penicillamine was used as initial treatment in 89% of patients, but was interrupted in 27% of them (n=9) due to its adverse reactions. Keyser-Fleischer rings were absent in a significant proportion (40%) of patients with neurologic involvement. Both Trientine and D-Penicillamine were associated with improved or stationary liver fibrosis, however results were slightly better for Trientine. D-Penicillamine appeared to be a better option than Trientine in patients with neurologic involvement. Conclusions. Based on our study, we recommend treatment with D-Penicillamine as first-line therapy in patients with neurologic involvement. However, due to the frequent side-effects of D-Penicillamine, Trientine could be considered firstline treatment in patients with isolated hepatic involvement.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48904073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk factors for drug-resistant epilepsy (DRE) in children and a model to predict development of DRE","authors":"R. A. Nugroho, P. Gunawan, B. Utomo","doi":"10.37897/rjn.2023.1.1","DOIUrl":"https://doi.org/10.37897/rjn.2023.1.1","url":null,"abstract":"Purpose. This study was conducted to investigate possible risk factors that could increase the occurrence of drug-resistant epilepsy (DRE), in hopes that the results could be used to educate the patient and their caregivers as well as increase early detection efforts. Methods. Case control study was conducted at neurology outpatient pediatric RSDS between May to December 2022. Risk factor of DRE such as sex, age of onset, type of seizure, initial seizure frequencies, history of cranial hemorrhage, cerebral infection, febrile seizure, status epilepticus, neonatal seizure, neonatal asphyxia, family history of epilepsy, present of neurological deficit, electroencephalogram (EE) finding, and result of neuroimaging examination were obtained through anamnesis and clinical examination. Risk factors were analyzed with bivariate analysis and multivariate analysis. A model was generated to predict probabilities of DRE in children with epilepsy. Results. DRE was observed in 84/137 (54%) patients. Bivariate analysis showed age of onset <1 years old (OR 2.31, p = 0.016), initial seizure frequencies >5 times/day (OR 3.0, p = 0.011), neonatal seizure (OR 3, p = 0.034), presence of neurologic deficit (OR 3.1, p=0.002), and abnormality of EEG (OR 2.82, p = 0.013) are significantly associated with DRE. Logistic regression revealed that initial seizure frequencies > 5 times/day (OR=2.5; 95%CI 1.051 to 6.028; P=0.038), present of neurological deficit (OR=2.58; 95%CI 1.205 to 5.531; P=0.031), and EE abnormality (OR=2.84; 95%CI 1.170 6.914; P=0.021) were significantly correlated with DRE. Our model sensitivity was 75.3% and 55.76% to predict DRE (AUC = 0.704, p=0.000). Conclusion. Seizure onsets of >5 times, neurological deficits, and EEG abnormality were found to be associated with drug resistant epilepsy.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48709158","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":"The characteristics of the patients of Sepsis-associated encephalopathy (SAE) in Sanglah Central General Hospital’s Emergency Room and Intensive Care Unit in the period from February 2019 to February 2022","authors":"Exaudi Caesario Parulian Sipahutar, I. Widyantara","doi":"10.37897/rjn.2022.4.3","DOIUrl":"https://doi.org/10.37897/rjn.2022.4.3","url":null,"abstract":"Background and purpose. This study aimed to explain that Sepsis-associated encephalopathy (SAE) is a term that describes sepsis-associated brain dysfunction, which most often occurs in intensive care and is becoming an increasingly common disease in the Emergency Room with high rates of morbidity and mortality. In SAE, the clinical description that appears consists of a description of the underlying disease, namely sepsis, and encephalopathy. The source and aetiology of infection are essential factors in developing SAE. Methods. It was a descriptive and retrospective study that described the characteristics of SAE patients. The data involved age, gender, vital signs, level of consciousness, haematological parameters, culture results, source of infection, underlying disease, and patient’s external condition. The samples were taken based on the medical record data of patients who met the inclusion criteria, which were then processed descriptively through the number and percentage. Results. There were 227 data in this study. The dominance of age ≥ 60 years was 56.32%, with a mortality rate of 61.73%. There were 157 patients with underlying disease of hypertension, and the most common source of infection was acute respiratory tract infection, with the most common microorganism involved Staphylococcus aureus. Conclusions. Elderly patients show higher mortality in SAE, especially when the underlying disease is hypertension and stroke, with the most infections originating from the respiratory tract, so it often progresses more quickly and has a poor prognosis.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43753916","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}