Health & medicine : journal of the Health and Medicine Policy Research Group最新文献

{"title":"Patellar Resurfacing and Assessment of Total Knee Arthroplasty in Patients in King Abdullah Bin Abdulaziz University Hospital","authors":"Ma’ad Al-Saati, Mohammed Al-Raei, Tala Al-Rawaf, Fai Al-Shalhoob, Youssef Yasser Al-Jallad, Hamza Yasser Al-Jallad","doi":"10.56557/jomahr/2023/v8i28328","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i28328","url":null,"abstract":"The most effective surgical procedure for treating advanced knee osteoarthritis is total knee arthroplasty. On radiographs, knee osteoarthritis was present in about 37% of individuals over the age of 60. This study, a retrospective cohort study, compared the anterior knee pain, range of motion, and abnormal sound among patients who underwent total knee replacement surgery with or without postoperative patellar resurfacing. The King Abdullah bin Abdulaziz University Hospital in Riyadh, Saudi Arabia, has an orthopedic department where the study will be carried out. This study included 80 patients who had undergone total knee replacement surgery, either with or without patellar resurfacing.
 They were chosen in accordance with specific inclusion criteria, including being elderly patients (over 50) with knee osteoarthritis that was not responding to conservative treatment. Total knee arthroplasty is an effective treatment for advanced knee arthritis, particularly when the contentious patellar resurfacing procedure is used. Non-patellar resurfacing total knee arthroplasty demonstrated in compression a high rate of pain and an inability to achieve full range of motion. Our research supports our main goal, and numerous studies have agreed that patellar resurfacing provides painless treatment and better outcomes for people with knee arthritis.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136020290","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":"Outpatient Healthcare Utilisation among Elderly in Ambalappuzha North Panchayath, Kerala, India: A Cross-Sectional Study","authors":"Naveen Kizhakkayil Tency, Archak Roy, S. Namitha, Nidin Mohan, S. M. Sahal, M. Munnas, Mohammed Shehsad, M. Haseeb, V. M. Rameez, A. Musthafa, M. Mohammed, T. V. Nandana, R. Nandita, Nasla Kunhi Muhammed, K. Hanna, N. George, Nithin Dev","doi":"10.56557/jomahr/2023/v8i28312","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i28312","url":null,"abstract":"Background: The rising elderly population in Kerala presents challenges in healthcare utilization due to factors such as accessibility, affordability, and availability. Many elderly individuals avoid seeking healthcare, and their satisfaction levels vary. This study aims to assess healthcare utilization among elderly residents of Ambalappuzha North Panchayath.\u0000Objectives: Primarily, to examine healthcare utilization patterns among elderly individuals in Ambalappuzha North Panchayath. Secondarily, to find the factors associated with the non-utilization of healthcare. Additionally, we sought to explore the correlation between satisfaction with the outcome of care and the type of healthcare facility, as well as the association between the type of facility and the perceived level of explanation and respect received by patients.\u0000Methods: A community-based cross-sectional study was conducted from October to November 2018 in Ambalappuzha North Panchayath. 500 elderly individuals aged 50 and above participated. Data were collected using a modified semi-structured SAGE questionnaire after obtaining informed verbal consent. The information encompassed demographics, healthcare utilization, quality, satisfaction, and reasons for not seeking healthcare.\u0000Results: The majority of participants (41.4%) were aged 50-60, with 53.6% males and 46.4% females. 55.4% were above the poverty line. Public hospitals (66.2%) and clinics (10.8%) were commonly utilized. Hypertension (16.5%), acute conditions (15.4%), diabetes (12.5%), and chronic joint pain (12.4%) were prevalent. 91% of the participants regularly utilized healthcare. Reasons for not seeking healthcare included perceived lack of severity, affordability, and past negative experiences. The cost of visits was covered by their children by 45.72%. Satisfaction was expressed by 91.5% of users, with 86.7% reporting improved outcomes. Female respondents utilized more healthcare compared to males. A positive association was found between satisfaction, treatment outcomes, and type of facility. Provider explanation and perceived respect were more in the private sector.\u0000Conclusion: The majority of elderly individuals in Ambalappuzha North Panchayath utilized healthcare, favoring the public sector. Hypertension, acute conditions, diabetes, and joint problems were common healthcare needs. Satisfaction correlated with treatment outcomes and the type of facility visited. Private sector providers demonstrated superior explanations and respect compared to the public sector. Future studies should focus on comparative studies across different regions and must delve deeper into socioeconomic factors of healthcare utilization.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84859378","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":"Menstrual Hygiene Management- Practices, Perceptions and Prevalence of Myths among College Girls in Alappuzha, Kerala: A Cross-Sectional Study","authors":"Archak Roy, Naveen Kizhakkayil Tency, A. Jacob, Arjun Vinod, Binoy V. Wilson, N. S. Apporva, Dipu Maria John, Aisha Anshad, Akhila V. Das, Amal Geroge, M. Ammu, M. S. Anjana","doi":"10.56557/jomahr/2023/v8i28302","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i28302","url":null,"abstract":"Menstruation, a crucial indicator of women's health, is accompanied by myths and misconceptions in India, leading to several restrictions. Menstrual hygiene faces social and cultural barriers, resulting in complications such as reproductive tract infections and toxic shock syndrome. Issues such as lack of awareness, availability, privacy, disposal challenges, inadequate support, and reproductive health education require attention. \u0000This community-based cross-sectional study was conducted at the Arts and Science College in Alappuzha, Kerala, with 485 female students aged 18-25. Sociodemographic data, knowledge about menstruation, and practices were collected using a semi-structured questionnaire. Menarche occurred at 12 years or later, with 79% feeling unprepared. Mothers were the primary sources of information on menstruation. Positive perceptions and good knowledge of menstruation were observed. Most pads were disposed of in incinerators (54.6%) at college and burned at home (84%). Socially, participants felt discomfort in being seen by a colleague during the disposal of pads and conversing about menstruation. Several cultural practices related to menstruation were prevalent, with beliefs varying among respondents. \u0000It also emphasizes the importance of family support, privacy, and the stigma associated with menstruation. Understanding the challenges faced by girls during menstruation and their coping strategies is essential. The findings contribute to the existing knowledge of menstrual hygiene practices and perceptions among college-going girls, aiding the development of targeted interventions for better menstrual health management highlighting the need for increased awareness of menstruation, addressing cultural barriers, and providing reproductive health education.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85321911","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":"Robson Classification in a Private Hospital in the City of Oaxaca de Juarez, Oaxaca, Mexico during 2019-2021","authors":"Adriana Cuevas-Martínez, M. C. Martinez‐Martinez, I. García-Montalvo","doi":"10.56557/jomahr/2023/v8i28287","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i28287","url":null,"abstract":"The cesarean section is a surgical procedure to remove the fetus; there are several indications that merit this surgical process, which involves a risk to the mother and the fetus; a constant concern is that in many private and public hospitals the percentage of cesarean sections suggested by the WHO is far exceeded. For our study population, 81% of pregnant women attending the care underwent a cesarean section, which exceeds the allowed value. It is necessary to evaluate the determinants of this decisión-making process. The Robson classification suggested by the WHO at the beginning of 2015 classifies each cesarean section into distinct groups that allow the quality of maternal and infant care to be evaluated. From the universe of 107 cases, a simple random sampling was performed with a confidence percentage of 95% and an error of 0.05%, resulting in 84 cases. The average age of the patients was 28 years, 78% had no associated comorbidities and the average age of sexual activity was 20 years, with a predominance of those who had had at least two sexual partners. The group of pregnancies has a predominant two previous pregnancies, most of them attended delivery and 53% are primigravidae; In previous cesarean sections, excluding primigravidae, 50% have had at least one previous cesarean section, although intergestational periods predominate (67% older than 3 years). Of the total number of cases, 81% are classified as elective cesarean section; 100% have an APGAR greater than 7 and a SILVERMAN less than 3. The groups that contribute to the Robson scale are patients with a single pregnancy, cephalic presentation with more than 37 weeks of gestation, and a previous cesarean section, followed by the group with two previous cesarean sections (14%).","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"175 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76765848","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":"Efficacy of Fecal Microbiota Transplant in the Treatment of Severe Alcoholic Hepatitis Compared to Standard of Care in Humans: A Systematic Review","authors":"Archak Roy, Naveen Kizhakkayil Tency","doi":"10.56557/jomahr/2023/v8i28273","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i28273","url":null,"abstract":"Severe alcoholic hepatitis (SAH) is a life-threatening condition with limited treatment options. Fecal microbiota transplant (FMT) has emerged as a potential therapeutic approach, targeting the imbalance in the gut microbiota observed in SAH patients. This review aims to assess the efficacy of FMT in improving outcomes and compare it with the standard of care in SAH. A systematic review of five multi-patient studies conducted in India was performed. Out of these studies, four were conducted as clinical trials, whereas one was a retrospective observational study design. The primary outcome assessed was survival rates at various time points, including day 28, day 90, and one year. Secondary outcomes included the resolution of complications such as hepatic encephalopathy, ascites, and infections. \u0000Analysis of the studies revealed a significant improvement in survival rates among SAH patients who underwent FMT compared to the standard of care. FMT also demonstrated a reduction in the incidence of complications, including hepatic encephalopathy, ascites, and infections. Additionally, FMT has been associated with positive changes in gut microbiota diversity and a decrease in the colonization of pathogenic taxa. However, the review identified several limitations, including the small sample sizes and the lack of randomized controlled trials. Further research, including conducting larger clinical trials, is necessary to strengthen the evidence for the efficacy of FMT in treating SAH. Additionally, future studies should explore the long-term effects of FMT, its impact on inflammatory cytokine levels, and the potential for personalized approaches based on individual gut microbiota profiles. \u0000In conclusion, this review provides evidence supporting the potential benefits of FMT in the management of severe alcoholic hepatitis. FMT represents a promising alternative to the standard of care and holds promise as a cost-effective treatment modality for eligible SAH patients. Future research should address the identified limitations and explore the optimal implementation of FMT in clinical practice.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75377241","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":"Comparison of Loratadine and Ketotifen Pharmacotherapy in Cases of Chronic Cough in Children: A Study at Petrokimia Gresik Hospital, Indonesia","authors":"Natalia Erica Jahja","doi":"10.56557/jomahr/2023/v8i28224","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i28224","url":null,"abstract":"Objectives: To compare the efficacy of loratadine and ketotifen pharmacotherapy in cases of chronic cough in children at Petrokimia Gresik Hospital, Indonesia. \u0000Materials and Methods: A retrospective case-control study on 127 chronic cough children aged less than 6 years old was done. All subjects went through a period of restrictive diet for 2-4 weeks. If the symptoms relieved, subjects were reintroduced previous daily diet gradually. All subjects were randomized to take loratadine powder (54%), once daily or ketotifen powder (46%), twice daily for 2-4 weeks, for chronic cough pharmacotherapy. Cough symptoms was evaluated during next visit. At those visits, the adverse event was also evaluated. \u0000Results: Of the 187 subjects enrolled, 60 dropped out. Thus, 69 children remained on loratadine, and 58 on ketotifen. Of all research subjects, only 10% experienced improvement (P= 0.582). In the non-improved group, 35% of the subjects also suffered from acute maxillary sinusitis. There were no adverse events in all groups. \u0000Conclusion: There were no significant difference between loratadine and ketotifen pharmacotherapy in cases of chronic cough in children at Petrokimia Gresik Hospital, Indonesia. Further investigation to look after other common uncontrolled triggers such as house dust mite sensitization, need to be done in this study, so that comprehensive therapy can be given.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84739071","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 CBCT in Dental Implant Treatment Plan: A Review","authors":"Nairita Saha, Vineet Nair","doi":"10.56557/jomahr/2023/v8i28216","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i28216","url":null,"abstract":"Now a days, people want dental implants to replace the missing teeth. Needless to say, a highly accurate alveolar and implant site measurement technique to avoid damage to adjacent vital structures during surgery is essential. Here comes the role of CBCT imaging as a new diagnostic tool for clinical assessment and treatment planning for dental implant practice. Using CBCT scanners, we can visualize the height and width of the available bone for implant placement, root anatomy of adjacent teeth, the exact location of the maxillary sinuses, mandibular canal, mental foramen and incisive canal.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"132 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79647671","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 Prospective Study of Clinicoradiological Scores in Predicting risk of Strangulation in Bowel Obstruction","authors":"M. Elanchezhian, K. Kesavalingam","doi":"10.56557/jomahr/2023/v8i18167","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i18167","url":null,"abstract":"Introduction: Acute intestinal obstruction is one of the common surgical emergencies leading to variable amount of morbidity and mortality. Strangulation is the most important factor in influencing the outcome and it is critical to accurately and promptly identify the existence of intestinal strangulation. The objective of the study was to assess the clinicoradiological scores in predicting risk of strangulation in bowel obstruction. \u0000Methods: A prospective study of 50 patients with clinical diagnosis of acute intestinal obstruction attending General Surgery department of Government Mohan Kumaramangalam Medical College and Hospital, Salem during January 2021 and September 2022. \u0000Results: Most of the study population is between 51 – 60 years with mean age of 55 years with male predominance. Mean time between admission and surgery is 6 hours. All patients had previous history of surgery, with appendicectomy being most common followed by hollow viscous perforation. Of the 50 patients in the study 19 patients underwent resection. Pain > 4 days, Guarding, Total leucocyte count > 10000/mm3, CRP > 75mg/dl, reduced contrast enhancement in CECT is frequently found in strangulated obstruction. On comparing with Schwenter score, of 36 patients who scored 0 -3, 5 patients underwent resection whereas all 14 patients who scored > 4 underwent resection. \u0000Conclusions: A combination of clinical, laboratory and radiological parameters helps in earlier prediction of risk of ischaemia in acute intestinal obstruction and timely intervention.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74346544","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 Study to Evaluate the Validity of Diabetic Ulcer Severity Score in Predicting Outcome of patients with Diabetic Foot Ulcer","authors":"M. Elanchezhian, K. Kesavalingam","doi":"10.56557/jomahr/2023/v8i18160","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i18160","url":null,"abstract":"Aim: To evaluate the validity of Diabetic Ulcer Severity Score in predicting the outcome of patients with Diabetic Foot Ulcer \u0000Methods: The materials used in the study consisted of 150 patients with Diabetic Foot Ulcer were admitted in department of General Surgery in Government Mohan Kumaramangalam Medical College and Hospital, Salem during January 2021 and October 2022. \u0000Results: Most of the diabetic ulcers were scored with DUSS Score of 2 and 1. Almost 80 out of 150 people had amputations in this study. Amputations were more common in patients with DUSS score 4 followed by 3. Major amputations were common in diabetic ulcers with DUSS score 4 and no patients with score 0 and 1 had major amputation. Minor amputations were more common in diabetic ulcers  with DUSS score of 2. The probability of healing without amputation with score 0 was 100% and decreases to 17.3%% with score 3 and 0% with score 4. \u0000Conclusion: DUSS scoring system delivers an easy diagnostic tool for assessing need for surgery and expectation of probability of healing/amputation by combining four clinically assessable wound based parameters. This is a simple and easy scoring system which does not need  advanced investigations and can be easily followed.","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77260274","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":"Pterocarpus santalinoides and Pterocarpus mildbraedii Twigs Extracts Induced Changes on Early Stage Reproductive Chemistry of Male Oryctolagus cuniculus","authors":"R. Ohiri, C. Ogunka-Nnoka, Rotu A Rotu","doi":"10.56557/jomahr/2023/v8i18136","DOIUrl":"https://doi.org/10.56557/jomahr/2023/v8i18136","url":null,"abstract":"Background: Male reproductive anomalies have been so challenging to humans that many synthetic drugs are presently produced to aid affected subjects. Financial impediments during treatments and possible adverse effects of synthetic drugs has necessitated the need for a natural alternative. This study investigates the role of Pterocarpus santaliniodes and Pterocarpus mildbraedii twigs extracts on early stage reproductive chemistry of male. \u0000Materials and Methods: Fresh twigs of P. santaliniodes and P. mildbraedii were separately destalked, washed, dried, pulverized and extracted using a Soxhlet extractor, with dichloromethane as solvent. The effect of the extracts on testosterone, luteinizing hormone, follicle stimulating hormone, sperm counts, motility and morphology of male Orytolagus cuniculus examined. \u0000Results: Testosterone was highest in 200 mg/kg body weight P. santalinoides extract treated animals with a value of 7.05 + 0.44 ng/mg while Luteinizing hormone and Follicle stimulating hormone were highest in 200 mg/kg body weight P. mildbraedii extracts treated animals with values of 3.91 + 0.22 ng/mg and 15.14 + 1.86 µl/ml respectively. Control had highest sperm counts (87 million sperm per milliliter), motility (90.00 + 4.00%) and morphology (9.00 + 1.00%). \u0000Conclusion: Early stage elevation of reproductive hormones by the extracts indicates a possible enhancement of reproductive chemistry on continuous use of extract. ","PeriodicalId":79899,"journal":{"name":"Health & medicine : journal of the Health and Medicine Policy Research Group","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88154758","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}