Northern International Medical College Journal最新文献

{"title":"Community Acquired Pneumonia (CAP) in Children in Developing countries -A Review","authors":"Md Abbas Uddin Khan, R. Akhtar","doi":"10.3329/nimcj.v11i1.50733","DOIUrl":"https://doi.org/10.3329/nimcj.v11i1.50733","url":null,"abstract":"Community-acquired pneumonia (CAP) is a potentially serious infection and is the single commonest and leading cause of death in under 5 children in developing countries. But the crucial first step in tackling childhood pneumonia is being able to diagnose it accurately, particularly after introduction of 2 effective vaccines against two major pathogens responsible for childhood bacterial pneumonia. Radiology and determination of hypoxia by pulse oximetry have been considered the optimal methods for diagnosing pneumonia. This review article has updated the important aspects of childhood pneumonia in developing countries. Early recognition and prompt, appropriate and adequate management can reduce the case fatality as well as morbidity associated with pneumonia. \u0000Northern International Medical College Journal Vol. 11 No. 1 July 2019, Page 406-410","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125286515","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":"Recent Trend of Bacteriological Profile and Drug Sensitivity Pattern of Neonatal Septicemia in A Tertiary Care Hospital in Bangladesh","authors":"Maksudur Rahman, B. Yasmeen, N. Jahan, M. Hoque, S. Halder, A. Halder, Nondini Rahman Nupur, I. Zerin, Fatema Akter Rini","doi":"10.3329/nimcj.v11i1.50738","DOIUrl":"https://doi.org/10.3329/nimcj.v11i1.50738","url":null,"abstract":"Background : In Bangladesh about 67% of under-five mortality is neonatal mortality. One of three major causes of neonatal morbidity and mortality is septicemia. Recently there is increasing incidence of multidrug resistant neonatal organisms which is alarming. \u0000Objective : The aim of this study was to see the bacteriological profile and drug sensitivity pattern of neonatal septicemia. \u0000Methods : This prospective observational study was done in Dhaka Shishu (children) Hospital over one-year period from June 2018 to May 2019. The admitted neonates were suspected as neonatal septicemia considering the risk factors, clinical profile and investigations (CBC, CRP etc.). Blood from all suspected neonatal septicemia cases were sent for culture and drugs sensitivity along with others necessary investigations. Then data was analyzed with SPSS version-20. \u0000Results : Among the suspected cases only 111(10%) patients were culture positive. Preterm were 77(69%) and term 34(31%). One hundred six cases (95%) had sepsis with gram negative organisms and 5(5%) had sepsis with gram positive organisms with more predominant of Klebsiella (76,68%) followed by Acinetobacter (16,14%), Pseudomonas (6,5%), Escherichia coli (3,3%). Majority 80 (72%) cases had Early onset neonatal sepsis (EONS). Klebsiella (57, 51%) was more common organism followed by Acinetobacter (11,10 %) causing EONS and in late onset neonatal sepsis (LONS), similar type of causative organism were found. Ampicillin, Gentamicin and Ceftazidime were mostly resistance to gram negative organisms - 104(94%), 99(89%) and 93(84%) respectively. Besides these, Amikacin (104,94%), Imipenem (85, 77%) and Ciprofloxacin (73, 66%) were more resistance. Klebsiella in 17 cases and Acinetobacter in 4 cases were resistant to all commonly used antibiotics. \u0000Conclusion : Klebsiella followed by Acinetobacter and Pseudomonas are now common pathogens of neonatal septicemia found in this study. Ampicillin, Gentamicin and Ceftazidime are more resistant to most of the organisms causing neonatal sepsis. Imipenem is alarmingly resistant. In 19% cases, the organisms are resistance to all commonly used antibiotics. \u0000Northern International Medical College Journal Vol. 11 No. 1 July 2019, Page 427-431","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132858330","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":"Management of Meconium Ileus: 5 years' experience at Dhaka Shishu (Children) Hospital","authors":"K. M. N. Ferdous, Md Samiul Hasan, K. Kabir, M. K. Islam, T. Banu","doi":"10.3329/NIMCJ.V10I1.39314","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39314","url":null,"abstract":"Background : Meconium ileus (MI) is one of the common cause of intestinal obstruction in neonate. It can be present with various complications (about 50%) like volvulus, atresia, and gangrene of the gut, perforation and meconium cyst. \u0000Objective : This study aimed to compare various surgical procedures used in the treatment of meconium ileus and to assess their efficacy regarding survival and complications in our center. \u0000Methods : This retrospective study was done to all cases of meconium ileus admitted in the Department of neonatal surgery of Dhaka Shishu (Children) Hospital during the past 5 years (2011 to2016). The medical records of all patients with meconium ileus were studied. The surgical procedures were Mikulicz procedure, Bishop-Koop procedure done in case of complicated cases and Mikulicz procedure, Bishop-Koop and T tube ileostomy done in uncomplicated cases. Outcomes were compared between complicated and uncomplicated group and between the surgical procedures. \u0000Results : Total patients were 224. Among them 8 were excluded due to incomplete data. The mean age was 3.23 days. Twenty four neonates were preterm. Fifty-two percent were uncomplicatedMI and 48.15% were complicated. Among 112 uncomplicated cases, Mikulicz procedure done in 33 cases, Bishop-Koop procedure done in 37 cases and rest were treated by T tube ileostomy procedures. Among 104 cases of complicated meconium ileus, Mikulicz procedure done in 75 cases and 42 cases were treated by Bishop-Koop stoma. Predominant complications in Mikulicz procedures were high output fistula (67.6%), sepsis (34.84%) and skin excoriation (58.33%), while in Bishop-Koop procedure were sepsis (59.25%), anastomotic leak and reoperation (25.75%). In T tube ileostomy, complications were intra-peritoneal leak with reoperation and sepsis (9.52%). Twenty five (11.6%) stoma prolapse were found in Mikulicz ileostomy. The overall mortality of meconium ileus was 36.6%, in simple MI 23 out of 112 and in complicated MI 56 out of 104. This difference was significant. \u0000Conclusion : Considering the study result we concluded that complications occur more frequently in Mikulicz procedure and it is significantly associated with mortality, Bishop- Koop ileostomy can be considered but anastomotic leak is still an important complication of this procedure. In uncomplicated cases T tube ileostomy found as the best option. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 326-329","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114570187","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 Human Recombinant Erythropoietin (rHuEPO) in Perinatal Asphyxia-a randomized controlled trial","authors":"S. Mehnaz, M. Chowdhury, B. Yasmeen, Masudur Rahman, R. Akter, Manifa Afrin, M. Begum","doi":"10.3329/NIMCJ.V10I1.39326","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39326","url":null,"abstract":"Background : Perinatal asphyxia is an insult to the fetus or newborn infant due to lack of oxygen (hypoxia) and/or a lack of perfusion (ischemia) to various organs, which will manifest as difficulty in establishing spontaneous respiration evident by delayed cry after birth, at least after one minute. World-wide, perinatal asphyxia accounts for about 900,000 deaths each year. In Bangladesh it is a major cause of neonatal death. A substantial proportion of the children that survive suffer late effects such as cerebral palsy and epilepsy. \u0000Objective : To determine the efficacy of erythropoietin in improving the neurological outcome of term neonates with perinatal asphyxia (HIE stage II and III). \u0000Materials and methods : A Randomized Controll Trial was carried out in the Neonatal ward and NICU of Dhaka Shishu Hospital from 1st April 2014 to 30th Sep 2015. A total 68 neonates with perinatal asphyxia (both HIE stage II and III) who fulfill the inclusion criteria were enrolled and randomly assigned to intervention group (n=35) and control group (n=33). Intervention group received rHuEPO 300- 500 U/kg/dose daily subcutaneously for 5 days within first 48 hours of birth along with the standard treatment protocol and control group received standard treatment protocol only. \u0000Results : Baseline clinical characteristics, USG of brain during hospital stay were almost similar in both groups. Statistically significant effect was noted in seizure control, tolerance of oral feeding, hospital stay and neurological outcome at 3 months of age (p=008). USG of brain at 3 months of age also improved significantly (p=0.027). \u0000Conclusion : This study demonstrates the effectiveness of early administration of rHuEPO to term neonates with moderate to severe asphyxia, beneficial effect on short term outcomes like seizure control, tolerance of oral feeding and neurological outcome at 3 months of age. A large multicenter study would be done for further evaluation of these findings. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 330-334","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128851594","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 Newborn with Maple Syrup Urine Disease","authors":"R. Akhter, K. Chowdhury, Saenat Haque, A. Noor, S. Zaman","doi":"10.3329/NIMCJ.V10I1.39333","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39333","url":null,"abstract":"Abstract not available \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 357-358","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126841740","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":"Knowledge, Attitude and Practice of Staff nurses on Hospital Acquired Infections in tertiary care Hospital of Dhaka city","authors":"A. A. Kabir, Farjana Akhter, Mahbuba Sharmin, K. Akhter, Mosammat Beauty Begum, A. Saha, I. Ahmed","doi":"10.3329/NIMCJ.V10I1.39330","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39330","url":null,"abstract":"Introduction : Hospital acquired Infections (HAIs) are called those infections that were not present at the time of patient’ hospitalization in a hospital and have been acquired after hospitalization. Nurses are an important part of the any healthcare team who play a unique role in the control of Hospital acquired infections. \u0000Objective : The aim of this study was to investigate the level of knowledge, attitudes, and practices of staff nurses about preventing the spread of hospital acquired infections (HAIs) at tertiary care Hospital of Dhaka city. \u0000Methods and Materials : This descriptive cross-sectional study was done among nurses having two years experience from two tertiary level hospitals in Dhaka city during January to June 2017. Self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used as a tool for data collection. Questionnaire was supplied to all staff nurses available at different in-patient wards of these two hospitals. Only 234 staff nurses who completed and returned the questionnaire were included in this study. Data were analyzed using Microsoft excel 2013 software. \u0000Result : Staff nurses were found to have good knowledge, moderately positive attitude but poor practice in prevention of hospital acquired infections. About 95% of the participants considered that prevention of HAIs were a valuable part of their role. About 65% of the staff nurses had received formal training regarding hand hygiene. The 100 % of participants felt that they would be less likely to transmit infection to the patients if they performed hand-hygiene. About 64% of them argued that hand hygiene agents were not readily available in current settings. Regarding practice, only 6% performed hand hygiene before patients contact and 27% of the staff nurses reported that they often forgot to perform hand hygiene. \u0000Conclusion : The finding of this study revealed a good knowledge of infection prevention among the majority of participants with relatively minimal level of practice. For strengthening the knowledge, attitude and practice towards HAIs, there is in need of developing regular training program and monitoring on performance feedback regarding hand hygiene is recommended. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 347-350","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124806334","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":"Androgen Secreting Adrenal Adenoma – A Case report","authors":"Suraiya Begum, F. Sharmin, D. Biswas, I. Jahan, Munira Hossain","doi":"10.3329/nimcj.v10i1.39332","DOIUrl":"https://doi.org/10.3329/nimcj.v10i1.39332","url":null,"abstract":"Abstract not available \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 355-356","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128028334","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":"Alpha Feto Protein in vaginal fluid as a diagnostic marker of Premature rupture of membrane","authors":"N. Sultana, S. Rahman, F. Ahmed, S. Ullah","doi":"10.3329/NIMCJ.V10I1.39327","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39327","url":null,"abstract":"Background : Premature Rupture of Membrane (PROM) is a significant obstetric emergency where a normal pregnancy suddenly becomes a high risk one. It can cause serious complications of mother and fetus. Patient’s history, per speculum vaginal with Nitrazine paper test and Fern test considered as gold standard for diagnosis of PROM. But these multiple tests are hazardous and time consuming. Therefore Alpha-Feto Protein (AFP) test is a single sensitive test for proper diagnosis of PROM. \u0000Objective : To evaluate the accuracy of Alpha-Feto protein in vaginal fluid as a diagnostic tool of PROM. \u0000Method : It was a cross sectional study, carried out among 120 pregnant women who had the gestational age between 28th to 40th week of pregnancy. Sample was collected purposively and divided into two groups. In group-I-62 suspected PROM patients were selected who gave the history of per vaginal watery discharge and was found positive in per speculum examination (P/S). In group-II-58 non PROM pregnant patients were selected. Then in group-I, Nitrazine paper test and Fern test were done to confirme PROM patients. Both groups AFP test was done by AxSYM auto analyzer. Finally the accuracy of AFP was evaluated against the gold standard test. \u0000Result : It was found that AFP concentration was significantly higher in group-I of suspected PROM patients (30- 502ng/ml) than in group-II (0-40ng/ml). Among 62 suspected PROM patients 49 were found gold standard (Nitrogen paper test and Fern test) positive. Out of these 49 confirmed PROM patients 48 was found positive in Alpha-Feto protein test. The sensitivity of AFP test was found 98%, specificity was 84.6% and accuracy was 95.1%. \u0000Conclusion : As Alpha-Feto protein in vaginal fluid was found highly accurate (95.1%) for diagnosis of PROM. Therefore, AFP test can be used as a single sensitive test for diagnosis of PROM. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 335-338","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126027270","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 on Exclusive Breastfeeding practice and related factors among mothers attending in a tertiary care hospital of Bangladesh","authors":"F. Chowdhury, B. Yasmeen, S. Rahman","doi":"10.3329/NIMCJ.V10I1.39329","DOIUrl":"https://doi.org/10.3329/NIMCJ.V10I1.39329","url":null,"abstract":"Back ground : Exclusive breastfeeding (EBF) means that the infant receives only breast milk for the first six months of life after birth. In Bangladesh, 55% of children less than 6 months of age are exclusively breastfed according to BDHS 2014. \u0000Objectives : To assess the exclusive breast feeding practice and associated factors among children in an urban area ofBangladesh. \u0000Method : This cross-sectional study was conducted in Popular Medical College, Dhanmondi, Dhaka, among 80 mothers having infants aged 7-12 months, attending the outpatient department were selected purposively for the study during the period of 1st August 2017 to 31st December 2017. Sample were selected purpasively for the study and predesigned questionnaire were used for data collection. Data analysis was done by using SPSS software version 22. \u0000Result : It was found that only 30(37.5%) mother went for regular antenatal checkup and remaining 50 (62.5%) had irregular antenatal check up. But none of them got breastfeeding advice during antenatal visit. Breastfeeding was initiated with in 1 hour of birth in 36(40%) cases and 44 (60%) cases after 1hour of birth. Exclusive breastfeeding (EBF)was found in 40 (50%) children. Among them 30 (75%) were children of housewife mothers. Mixed feeding (breast milk plus formula/ cow’s milk) was given to 30 children among them18 (60%) were the children of housewife mothers.Only formula milk was given to 10 children of them 8(80%) were the children of housewife mothers.Exclusive breast milk was not given by 18(45%) mothers due to job or other occupation whereas 22 (55%) mother did not give EBF due to insufficient breast milk. \u0000Conclusion : In the study rate of exclusive breast feeding was 50%. This study also showed that frequency of exclusive breast feeding practice was lower in working mothers than housewife mothers. This study also showed that the speculation of not getting sufficient milk was one of the main reasons for not giving exclusive breastfeeding. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 343-346","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134239020","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":"Antenatal care practice among Pregnant Women in a selected rural area of Bangladesh","authors":"N. Begum, N. Begum, Sk Akbar Hossain, Afm Ashik Imran, Mst Laizuman Nahar","doi":"10.3329/nimcj.v10i1.39328","DOIUrl":"https://doi.org/10.3329/nimcj.v10i1.39328","url":null,"abstract":"Background : Antenatal care (ANC) is an important determinant of high maternal mortality rate and one of the basic components of maternal care on which the life of mothers and newborn babies depend. \u0000Objective : To study the Antenatal care practice among pregnant women in a selected rural area. \u0000Methodology : This descriptive cross-sectional study was conducted among pregnant women in a selected rural area from July 2016 to December 2016. Total sample was 121. Purposive sampling technique was followed. Data collection was done by face to face interview by using pretested structured questionnaire. Data was analyzed by SPSS version 17.0. \u0000Results : A total of 121 women were interviewed. Sixty nine (57.02%) pregnant women were registered for ANC. Among them 47(68.11%) of respondents completed more than 4ANC visits. For the current pregnancy 56(46.28%) preferred Upazila Health Complex (UHC) and home delivery was preferred by 34(28.09%) respondents. Among the respondent age group 25-30 yrs were 61(50.41%) and educated upto primary level were 59(48.76%). Monthly income between 5000-10000 taka was among 48(39.66%) respondents. Most of their husbands (52.06%) were educated up to primary level and 25.61 % of them were garments worker and 23.96 % were day laborers. \u0000Conclusion : ANC practice was not satisfactory. Only half of the pregnant women attended for ANC and completed minimum four visits. Nearly half of the pregnant women preferred UHC. Educated women from lower economic status were found to attend for ANC. \u0000Northern International Medical College Journal Vol.10(1) Jul 2018: 339-342","PeriodicalId":389586,"journal":{"name":"Northern International Medical College Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114937193","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}