Cardiovascular Journal最新文献

{"title":"Coronary Artery Involvement in Kawasaki Disease-Echocardiographic Evaluation of Cases in a Tertiary Care Hospital","authors":"N. Fatema, J. Ferdous, Ashik Md Raihan Chowdhury, Mashiyat Mayisha Ahmad","doi":"10.3329/cardio.v15i2.65629","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65629","url":null,"abstract":"Background: Kawasaki disease (KD) is the leading cause of childhood acquired heart disease. Cardiovascular manifestations can be prominent in the acute phase of the illness. Echocardiography is useful in recognizing these cardiac manifestations. We carried out a retrospective study by analyzing the data of Kawasaki disease patients in a tertiary care hospital.\u0000Methods: The prevalence of coronary artery dilatation and clinical outcome were documented. Clinical, laboratory, and echocardiographic findings were obtained at baseline and 1 week, 6 weeks after initial therapy with intravenous immunoglobulin in addition to high doses of Aspirin which reduces the risk of coronary artery aneurysm.\u0000Results: One hundred and forty-nine patients with mean age 3± 2 years old, 60% males with Kawasaki disease were included. One hundred and thirty-two patients had coronary involvement (left main coronary artery 36.37 %, left anterior descending artery 28.03%, right main coronary artery 24.25%, circumflex branch in 11.37%). Administration of intravenous immunoglobulin (IVIG) and aspirin has greatly reduced the incidence of coronary lesions in affected children. The initial cardiac findings developed over first few weeks of illness resolved in most of the cases in the subsequent echocardiogram studies after IVIG. The mean duration to normalization of abnormal echocardiography findings is 6±3 months.\u0000Conclusion: Coronary artery involvement is seen in most of children with Kawasaki disease. Intravenous gamma globulin and aspirin has been reported to reduce the likelihood of development of giant coronary artery aneurysms and appears to have a direct beneficial effect on abnormalities in cardiac function associated with the acute phase of Kawasaki disease.\u0000Cardiovasc j 2023; 15(2): 144-150","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91148708","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 Great Pioneers of Coronary Artery Bypass Surgery: Is it Necessary to Ascertain Anybody the Fatherhood of CABG?","authors":"M. Anisuzzaman, N. Hosain, M. Kabir","doi":"10.3329/cardio.v15i2.65636","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65636","url":null,"abstract":"Coronary bypass operation is one of the greatest achievements of medical science in the 20th century. Alexis Carrel in 1910 and Arthur Vineberg in 1945 tried to perform surgical revascularization of the diseased coronary arteries.  In the beginning of the 1950s many surgeons attempted experimentally to anastomose internal thoracic artery to the coronary arteries. Success was achieved simultaneously and independently by Vladimir Demikhov in Russia and Gordon Murray in Canada. Then the real success come of mammary-coronary bypass with tantalum ring by Robert H Goetz and with suture technique by Vasilii I Kolesov. Then autogenous great saphenous vein used by Rene G Favaloro and others and made the procedure popular worldwide. Which contribution is greater, when medicine depends on evolution and big accomplishment reached by means of the contribution of many. There comes the interesting question who should be given the credit of introducing this major surgical procedure, and along comes the ethical issue whether any single individual should be ascertained the fatherhood of CABG or any historic event at all!\u0000Cardiovasc j 2023; 15(2): 185-188","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74560551","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":"Pharmacoinvasive Therapy in Treating Acute STEMI Patients in Covid-19 Era","authors":"A. Islam, A. Reza, S. Talukder, S. Munwar, Atahar Ali, T. Ahmed, Kazi Atiqur Rahman, A. H. Bhuiyan, Aparajita Karim, P. Bala, Nighat Islam, Abeda Tasnim Reza, Tanbir Hossain, M. Z. Haque","doi":"10.3329/cardio.v15i2.65628","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65628","url":null,"abstract":"Background: Treating acute ST segment elevated myocardial infarction (STEMI) patients by primary PCI (pPCI) has dramatically fallen globally in covid era as there is chances of potential threat of spreading COVID among the non-COVID patients. Thereby, thrombolysis of acute STEMI patient in grey zone till COVID RT PCR report to come, was the mode of treatment of acute myocardial infarction patient in our hospital. We have carried out this prospective observational study to see the outcomes of thrombolysis and subsequent intervention.\u0000Methods: STEMI patient who presented to our emergency department with chest pain and ECG and hs-Troponin-I evidenced acute STEMI, were enrolled in the study. Total 139 patients enrolled (Male:120, Female :54); average age for Male: 54 yrs., female was: 56yrs. All patients were admitted in the grey zone of CCU where thrombolysis was done.  COVID-19 patients were excluded from intervention and managed conservatively. Covid Negative patients were kept transferred to CCU green zone. On average 2.1 days after Fibrinolysis, elective PCI carried out. Data analysis from 48 patients who underwent pharmacoinvasive therapy was done.\u0000Results: Among the study population, Covid-19 positive was in 11 (7.9%) patients and Covid-19 was negative in 128 (92.1%) patients. Primary PCI was performed in 7 (5.03%) patients. Rest of the patients were managed by Pharmacoinvasive therapy. Thrombolysis by Tenecteplase (TNK) was done in 89 (64%) patients, and by Streptokinase in 25 (17.9%) patients, 18 (12.9%) patients did not receive any thrombolysis due to late presentation. Chest pain to needle time was 7.2 ±12.7hrs., thrombolysis to balloon time was 117.5 ±314.8hrs. More than 50% stenosis resolution observed in 20 (41.6%) patients, chest pain resolution within one hour of thrombolysis observed in 21 (43.8%) patients. Ten (20.8%) patients developed. Door to needle time was 30 mins. Total, 88 stents were deployed in 83 territories. CABG was recommended for 7 (5.03%) patients. Stented territory was LAD 37 (45.7%) and RCA 32 (39.5%) and LCX 12 (14.8%).\u0000Conclusion: In the era of COVID-19, in this prospective cohort study, on acute STEMI patient management, we found that Pharmacoinvasive therapy, reduced patients’ symptoms and ST resolution occurred partially.\u0000Cardiovasc j 2023; 15(2): 136-143","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91025679","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 Urinary Sodium and Potassium Excretion between Hypertensive and Normotensive Individuals","authors":"MD. Rokun Uddin, A. Islam, Muhammad Badrul Alam, Asaduzzaman Khondoker, M. Roy, Rahela Ferdous, M. Rahman","doi":"10.3329/cardio.v15i2.65604","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65604","url":null,"abstract":"Background: Sodium and potassium intake is known to be a modifiable determinant of hypertension. Also, daily intake of these electrolytes is subject to much geographical and ethnic variation. The impact of sodium and potassium intake on blood pressure in Bangladeshi subjects in incompletely known. Our objective was to determine the relationship between urinary sodium and potassium excretion, and blood pressure in Bangladeshi subjects.\u0000Methods: Patients attending the Outpatient Department of the Department of Cardiology, SSMC & MH, who fulfilled the inclusion and exclusion criteria, were taken as study sample. Hypertensive individuals were considered as group 1 and apparently healthy individuals who did not have hypertension were considered as group 2 for the study. Estimates of 24-hour sodium and potassium excretion were made from a single spot urine specimen and were used as surrogates for intake. We assessed the relationship between sodium and potassium excretion and blood pressure.\u0000Results: The spot urinary sodium excretion was significantly higher in hypertensive group than in normotensive group (98.03 ± 71.13 mmol/L vs. 77.11 ± 41.71 mmol/L) (p=0.011). On the other hand, the spot urinary potassium excretion was lower in hypertensive group than normotensive group (33.95 ± 41.03 mmol/L vs. 39.43 ± 31.47 mmol/L), but the differences did not reach statistical significance (p=0.679). The estimated 24-hour urinary sodium excretion was higher in hypertensive group than in normotensive group (8.84 ± 3.57 gm vs. 7.67 ± 3.16 gm) and the difference was statistically significant (p = 0.015). Estimated 24-hour urinary potassium excretion was lower in hypertensive group (4.15 ± 1.37 gm) than in normotensive group (4.48 ± 1.56 gm), but the difference between 2 values did not reach statistical significance (p=0.114).\u0000Conclusion: Compared to the normotensive counterparts, sodium intake is significantly higher and potassium intake is lower in hypertensive Bangladeshi subjects.\u0000Cardiovasc j 2023; 15(2): 118-123","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87705994","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":"Vasilii I Kolesov: The First Series of Best Option Coronary Bypass Pioneer","authors":"M. Anisuzzaman, N. Hosain","doi":"10.3329/cardio.v15i2.65637","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65637","url":null,"abstract":"Heart surgery is one of the areas of greatest achievement in 20th century medical science. As the number one killer, Ischemic heart disease (IHD) was a big hurdle in achieving health for all. In this century, cardiovascular scientists put effort to combat the disease. Vasilii Ivanovich Kolesov is the early and successful contributor among them in the field of coronary surgery. On 25 February 1964, V.I. Kolesov successfully performed the first anastomosis between the left internal thoracic artery and the left circumflex artery. This was the beginning of a new era of coronary bypass surgeries, carried out on a regular basis to re-establish coronary flow in patients with IHD. This operation, in combination with Rene G. Favaloro’s method of using the saphenous vein in coronary surgery become the most commonly performed surgical procedure in the world.\u0000Cardiovasc j 2023; 15(2): 189-194","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84437630","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":"Young Female’s Heart was Bitten by Unknown Ghost -Isolated Cardiac Sarcoidosis: A case report","authors":"Heru Al Amin, Rahatul Quadir, Sk Ziarat Islam, Md Shafiqur Rahman Patwary, Mohammad Shafiqullah Akbar, Md Anisul Goni Khan","doi":"10.3329/cardio.v15i2.65634","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65634","url":null,"abstract":"Sarcoidosis is an inflammatory granulomatous disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is very rare condition which causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity.\u0000Cardiovasc j 2023; 15(2): 175-181","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73688729","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":"Association of Serum Vitamin D Level with Angiographic Severity of Coronary Artery Disease in Patients of Acute Myocardial Infarction","authors":"Md. Mostafizur Rahman, A. Chowdhury, M. Uddin, M. Hasan, K. Islam, M. Ullah","doi":"10.3329/cardio.v15i2.65625","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65625","url":null,"abstract":"Background: Besides conventional risk factors, a novel risk factor hypovitaminosis D may play unique role in the development of coronary artery disease. Evidences suggest that people with low serum vitamin D level  is associated  with risk of acute MI  even after adjusting for the known risk factors. This study was conducted to find out the association between serum vitamin D Level and angiographic severity of coronary artery disease in patients of acute myocardial infarction.\u0000Methods: One hundred and four patients of acute myocardial infarction undergoing coronary angiography in DMCH during May 2017 to April 2018 were the study population. The population were divided into 2 groups based on their serum vitamin D level; normal vitamin D   (>30 ng/ml)   and low vitamin D (≤30 ng/ml). Low vitamin D level again divided into 3 groups; insufficient (vitamin D 21 to 30 ng/ml), deficient (Vitamin D 10-20 ng/ml) and severely deficient having vitamin D <10 ng/ml. Coronary angiogram was done during index hospitalization. The severity of the coronary artery disease was assessed by vessel score and Gensini score.After calculation of Gensini score, 36 points was chosen as an appropriate cut-off value and patients were divided into two groups; those with a Gensini score ≤36 points was considered as having absent or mild coronary artery disease and those with a Gensini score >36 points was considered as having moderate to severe coronary artery disease. Association between serum vitamin D Level and angiographic severity of CAD was looked for. \u0000Results: Seventy seven (74.0%) of study population had vitamin D level ≤ 30 ng/ml, while 27(26.0%) patients had normal level. There was no significant association between common cardiovascular risk factors with vitamin D level. Double or triple-vessel CAD were more frequent in those with vitamin D levels ≤30 ng/ml as compared to those with normal vitamin D levels (>30 ng/ml) (P<0.05). Majority (48.1%) of patients had double vessel disease (DVD). Among them 4(8%) patients had normal serum vitamin D levels (>30 ng/ml) and 46 (92%) patients had low vitamin D (≤30 ng/ml). Mean Gensini score was found 20.8±5.1 in normal vitamin D (>30 ng/ml) and 48.3±13.3 in low vitamin D (≤30 ng/ml) (p<0.05). Moderate to severe CAD (Gensini score >36) was found in 54.1% of patients with vitamin D insufficiency (21-30 ng/dl) and 83.3% of patients with vitamin D deficiency (10-20 ng/dl) (p<0.05). Moderate negative correlation (r= -0.641; p=0.001) was found between Gensini score and serum vitamin D level of patients with acute myocardial infarction.  \u0000Conclusion: Low serum vitamin D level is associated with increasing severity of coronary artery disease, docsumented angiographically among patients of acute myocardial infarction. Low serum vitamin D levels may be an emerging, independent, and potentially modifiable cardiovascular risk factor.\u0000Cardiovasc j 2023; 15(2): 124-131","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74926360","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":"Myxoma in Pediatric Patients: A Single Centre Experience","authors":"M. Islam, Sakila Israt Jahan, Abu Shadat Mohammad Saem Khan, M. K. Hassan, Khondokar Shamim Shahriar Ziban Rushel","doi":"10.3329/cardio.v15i2.65626","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65626","url":null,"abstract":"Background: Pediatric cardiac tumor is a very rare entity with an autopsy frequency 0.0017-0.28%. This study aims to analyze the characteristics and outcome of pediatric patients with myxoma.\u0000Methods: Nine Patients with myxoma treated between January 2008 & December 2019 were included into this retrospective study. The patients’ age ranged from 4 years to 11 years and weight from 10-20 kg. All patients were diagnosed by transthoracic echocardiography.\u0000Results: We did complete resection of tumor in all patients under cardiopulmonary bypass. Mean cardiopulmonary bypass time was 55 minutes & mean cross clamp time was 34 means. Mean ICU stay was 3 days. Six (66.33%) tumors found in left atrium, while 2 (22.11%) found in right atrium and 1(11.06%) in right ventricle. Histopathological report of all 9 tumors revealed myxoma. 1 patient developed left sided hemiparesis and another 1 patient developed wound infection. No mortality or recurrence in follow up period.\u0000Conclusion: Myxoma is the commonest primary cardiac tumor. Surgery of cardiac tumor can result in good early and long-term outcome.   \u0000Cardiovasc j 2023; 15(2): 132-135","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77967277","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":"Ruptured sinus of Valsalva aneurysm: A Case Report","authors":"Nighat Islam, S. Srivastava, R. Mehrotra, Arif Mustaqueem, P. Bala","doi":"10.3329/cardio.v15i2.65635","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65635","url":null,"abstract":"One of the rare cardiac anomaly is Sinus of Valsalva aneurysm (SVA) that can rupture spontaneously into other cardiac chambers or the pericardial space.1 Here, we report a rare case of a right coronary sinus of Valsalva aneurysm with rupture into the Left ventricular outflow tract (LVOT).\u0000Cardiovasc j 2023; 15(2): 182-184","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74379916","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":"Aetiology and Clinical Profile of Giant Left Atrium – An Observational Study","authors":"A K M Monwarul Islam, Abdullah AS Majumder, Mohammad Ullah, Md Toufiqur Rahman, Md Khalequzzaman, Md Kabiruzzaman, Sujit Kumar Ghosh, Shovan Rahman, Bijoy Dutta, Shahriar Azad, Tanveer Ahmad, Shahriar Kabir, AbuI Hasan Muhammad Bashar, Mezbah Uddin Ahmed","doi":"10.3329/cardio.v15i2.65630","DOIUrl":"https://doi.org/10.3329/cardio.v15i2.65630","url":null,"abstract":"Background: The predominant cause of giant left atrium (GLA) is rheumatic mitral valvular disease. GLA is commonly defined echocardiographically by measuring the left atrial diameter (LAD). In the context of changing epidemiology of rheumatic heart disease (RHD) globally, and introduction of left atrial volume index (LAVI), the aetiology of GLA and utility of LAVI for defining GLA may be necessary. Methods: The prospective observational study was carried out at a dedicated tertiary care cardiac centre of a developing country to know the aetiology and clinical pattern of GLA over 8 years. GLA was defined echocardiographically as a left atrium (LA) having a diameter ≥80 mm in the left parasternal long-axis view. Follow-up was made over the telephone. Results: Thirty cases of GLA were diagnosed over 8 years from 2013 to 2021. Twenty two were due to rheumatic heart disease (RHD), 7 due to MVP, and 1 due to flail anterior mitral leaflet. Mean LAD was 92.13 ± 16.72 mm, and the mean LAVI was 288.77 ± 134.40 ml/m2. LA thrombus was present in 5 patients, 6 had spontaneous echo contrast (SEC) in LA, 2 had both LA thrombus and SEC. Mean follow-up was 0.99 ± 1.06 years. Out of 15 patients, 5 died, while 10 were alive. Mean survival was 1.8 ± 1.17 years, ranging from less than 1 year to 4 years. Conclusion: RHD continues to be the predominant cause of GLA; however, MVP is also important. The cut-off value of LAVI for defining GLA needs further study. Cardiovasc j 2023; 15(2): 151-158","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136319511","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}