Cardiovascular Journal最新文献

{"title":"Mycobacterium Endocarditis- A Case Report","authors":"Md. Abu Zahid, Mst Ferdousy Sultana, S. Ghafur, Hasanul Islam","doi":"10.3329/cardio.v14i1.55379","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55379","url":null,"abstract":"Mycobacterium Endocarditis is a very rare case. A 5 years old boy presented us with the history of fever and breathlessness. CXR shows huge cardiomegaly, patient is anemic and temperature is raised. On echo revels vegetation on Tricuspid &Mitral valve ç huge pericardial effusion ç features of early tamponade. Pericardial fluid was drawn and the symptoms improved. Pericardial fluid colour was milky and exudative in nature. ADA for mycobacterium tuberculosis was positive. The patient was given anti tuberculosis drug & improved with time.\u0000Cardiovasc j 2021; 14(1): 76-78","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90142561","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 Comparative Study between Radiocephalic and Brachiocephalic Arteriovenous Fistula in End Stage Renal Disease","authors":"Nazmus Sabah, S. Ahmed, S. Khan, R. Hasan, Fidah Hossain, Manifa Naz Fatma","doi":"10.3329/cardio.v14i1.55373","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55373","url":null,"abstract":"Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD).\u0000Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation.\u0000Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%).\u0000Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site.\u0000Cardiovasc j 2021; 14(1): 44-49","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"198 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73277846","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":"Case report of Double Valve Replacement with Coronary Artery Bypass Grafting with Supracoronary Ascending Aortic Replacement in a Single Patient - A Chimera","authors":"S. Gupta, Jagadananda Roy, M. Hoque, Bhabesh C Mandol, P. Chanda","doi":"10.3329/cardio.v14i1.55381","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55381","url":null,"abstract":"Double valve replacement is now-a-days a common procedure to treat diseased cardiac valves and the primary aim of prophylactic aortic replacement during concomitant valve replacement is to prevent dreadful complication like dissection, aortic rupture and even death. Although aortic surgeries are complex and have high morbidity and mortality rates, additional double valve procedure with coronary surgery can make it even worse. But for these patients, surgery remains the one and only treatment option for symptom relieve and prolongation of life. We herein present a case of severe aortic stenosis (AS) with severe aortic regurgitation (AR) with severe mitral regurgitation (MR) with coronary artery disease (CAD) and aortic aneurysm treated successfully by us at Square Hospitals; and to our best knowledge and according to the published articles, this is probably the first time, this type of combined cardiac procedure has been accomplished along with aortic surgery, in our country. We recommend that surgeons should perform bypass grafting along with aortic replacement and valve replacement surgery when indicated, without worrying that adding such a procedure will escalate post-operative adverse effect.\u0000Cardiovasc j 2021; 14(1): 82-87","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84398004","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":"Thoracic Endovascular Aortic Repair for Penetrating Aortic Ulcer in a Patient with Renal Failure: A Case Report","authors":"A. Bashar, H. Kabir, Mokhlesur M. Rahman, Md. Ahsanul Alam","doi":"10.3329/cardio.v14i1.55382","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55382","url":null,"abstract":"Thoracic Endovascular Aortic Repair (TEVAR) is a state-of-the art endovascular intervention used to treat various thoracic aortic pathologies such as aneurysm, dissection and penetrating aortic ulcers (PAU). The procedure demands significant technical skill and involves considerable cost burden for the patients. The latter is the main reason why the procedure has not yet made it to the routine clinical practice in Bangladesh. We recently performed TEVAR for the successful treatment of an ominous-looking PAU in the descending thoracic aorta in a patient with renal failure.\u0000Cardiovasc j 2021; 14(1): 88-92","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84009120","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":"Socio-demographic and Clinical Profile of Bangladeshi COVID 19 Patients with their Clinical Outcome in National Institute of Cardiovascular Diseases, Dhaka","authors":"F. Jahan, Md Shahed Kamal Bhuya, Muhammed Shahed Anwar Bhuya, Jamal Uddin Gaji, Rumana Nushrat, Zulfikar Ali, N. Sultana","doi":"10.3329/cardio.v14i1.55374","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55374","url":null,"abstract":"Background: The novel corona virus (COVID 19) pandemic is a major global health threat of the twenty-first century. Clinical presentation, rapid identification of causes and isolation are vital for containments of rapidly spreading disease. The objective of the study was to report early findings on demographic profile, clinical presentation of the confirmed COVID 19 patients with their clinical outcome.\u0000Methods: This observational study was conducted in Microbiology Department of National Institute of Cardiovascular Diseases (NICVD) for the period of October 01, 2020 to November 30, 2020. Total 300 positive COVID 19 patients were included and interviewed. Informed written consent was ensured before participation. After collection, Data were analyzed to show the characteristics of COVID 19 cases and their clinical outcome after treatment.\u0000Results: Among the 300 cases 228 (76%) patients were male and 72 (24%) patients were female. Average age of the patients was 39 years. The most commonly observed symptoms were fever (70%), followed by cough (55%), breathlessness (42%), dysgeusia (38%), anosmia (25%). Respiratory symptom was the dominant feature of clinical presentation. The most prevalent affected age groups were 114 (38%) patients in 41-50 years age, 102 (34%) patients in 31- 40 years age. Among the total cases 255 (85%) patients were Urban residents and 234 (78%) had contact history. Among 300 patients 102 (34%) patients had co-morbidities and presence of co-morbidities (p<0.01) were significantly associated with mortality. The death rate was 2%.\u0000Conclusion: Typical presentations of COVID-19 were fever, cough, breathlessness, dysgeusia and anosmia. Requirement of ICU was 6% and overall mortality was 2% which was associated with comorbidities.\u0000Cardiovasc j 2021; 14(1): 50-54","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"243 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76555879","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":"Experience of Minimal Invasive Cardiac Surgery for repair of Atrial Septal Defects- A Single Center Study","authors":"M. Rokonujjaman, Naveen Sk, S. Islam, N. Ghafoor, Syed Tanvir Ahmad, A. Shoeb, Atiqur Rahman, I. Khalilullah, S. Islam, Nowshin Siraj, S. Roy, P. Saha","doi":"10.3329/cardio.v14i1.55372","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55372","url":null,"abstract":"Background: Atrial Septal Defects (ASD) can be closed surgically using conventional midline sternotomy or minimal invasive technique. This study was done to evaluate the outcome and safety of the minimal invasive cardiac surgical (MICS) approach using right vertical infra axillary incision (RVAI) for the repair of ASD.\u0000Methods: We performed a prospective observational cross-sectional analysis on 50 patients who were diagnosed as ASD of various types and not amenable to device closure. Their surgery was done RVAI using central cardiopulmonary bypass. Outcome of the study was evaluated using the following variables: length of the incision, satisfaction of patients, mortality, infection of surgical site, blood transfusion, duration of total operation, intensive care unit (ICU) stay, mechanical ventilation, hospital stay and aortic occlusion. Operations were done between December 2013 to December 2020. All the recruited patients were treated through RVAI as per patient’s choice.\u0000Results: Mean age was 11.4± 6.4 years. 18(36%) were male and 32(64%) were female. Body weight ranged from 10 to 65 kg. Mean length of incision was 6.2±0.8 cm. Mean aortic occlusion time was 42±14 min. ASD closed directly, using autologous treated pericardial patch or dacron patch. Mean total operation time was 4.08±0.6 hours and mean mechanical ventilation time was 8.3±5 hours. Average ICU stay was 35.6±6 hours and total hospital stay was 7.2±0.9 days. There was no significant blood loss. Only 10 patients required intravenous (IV) analgesics in the post-operative period. One patient required re-exploration, one conversion to median sternotomy and one suffered from superficial skin infection. There were no operative or late mortalities. Patient satisfaction was excellent.\u0000Conclusions: MICS technique using RVAI for surgical repair of ASD revealed a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard median sternotomy.\u0000Cardiovasc j 2021; 14(1): 37-43","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78271811","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":"In Hospital Outcome of Mitral Valve Replacement with Severe Pulmonary Hypertension","authors":"Rubaiya Reza Tumpa, Al Masum Ziaul Haque, Md. Kamrul Hasan","doi":"10.3329/cardio.v14i1.55371","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55371","url":null,"abstract":"Background: In patients undergoing surgery for mitral valve replacement (MVR) for valvular heart disease, pulmonary artery hypertension (PAH) has been considered a major risk factor. In this prospective study, we have studied the early hemodynamic changes and post-operative outcomes of MVR among patients with mild to severe PAH in Bangladesh perspective.\u0000Methods: Total 60 patients who underwent mitral valve replacement for predominantly mitral regurgitation (MR) and mixed lesion with mitral stenosis (MS) having pulmonary arterial hypertension ranging from mild to severe pulmonary artery pressure (PAP) were studied prospectively for immediate postoperative haemodynamic and outcome. The mean age of the patients was 36.23±9.18 years. Total 13 (21.66%) patients had mitral regurgitation and 47 (78.33%) had mixed lesion with mitral stenosis. Patients were divided into two groups based on preoperative pulmonary artery pressures. Group A patients with mild to moderate pulmonary hypertension (PASP 40-59 mm of Hg) and Group B patients with severe pulmonary hypertension (PASPe” 60 mm of Hg).\u0000Results: After mitral valve replacement, pulmonary arterial systolic pressure (PASP) decreased significantly in Group A to near normal levels (PASP41.25±7.25). In Group B also the PASP decreased insignificantly (PASP 61.85±9.12) but significant residual PAH remained. Operative mortality was nil (0%) in Group A and 6.7% in Group B.\u0000Conclusions: Mitral valve replacement is safe and effective at the presence of PAH as long as the PASP is below or equal to 60 mm of Hg. With PASP >60 mm of Hg, MVR carries a high risk of mortality and the patients continues to have severe PAH in the postoperative period.\u0000Cardiovasc j 2021; 14(1): 30-36","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88974414","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":"Dyslipidemia and Conventional Risk Factors in Patients with Acute Coronary Syndrome Admitted in a CCU of a Tertiary Care Hospital of Bangladesh","authors":"Md Mahfuzur Rahman, F. Ahmed, S. Sharmin, T. Hyder, Saifuddin Nehal","doi":"10.3329/cardio.v14i1.55370","DOIUrl":"https://doi.org/10.3329/cardio.v14i1.55370","url":null,"abstract":"Background: Coronary artery disease (CAD) is the single largest cause of death in the developed countries and is one of the leading causes of disease burden in developing countries. The prevalence of dyslipidemia and conventional risk factors profile at the time of admission in patients with Acute Coronary Syndrome (ACS) is not well described in our context. The aim of this study was to investigate the prevalence of dyslipidemia and conventional risk factors profiles of patients with ACS in a tertiary care center of Bangladesh.\u0000Methods: This descriptive cross-sectional study included 96 admitted patients of ACS [30 cases of Unstable Angina, 25 cases of Non ST segment Elevation Myocardial Infarction and 41 cases of ST segment Elevation Myocardial Infarction] from the Department of Cardiology, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January 2019 to June 2019. Fasting serum lipid profile was obtained within 24 hours of hospitalization and demographic and other cardiovascular risk factors were documented.\u0000Results: The mean age of the subjects were 57.7±14.4 years with majority (71.9%) being male. The most frequent reported risk factor was smoking, present in 55.2% of patients, followed by hypertension (47.9%), diabetes (37.5%), dyslipidemia (27.1%) and family history of CAD (15.6%). Based on Body Mass index 50% patients were obese (≥25kg/m2) and 69.8% had central obesity based on waist circumference. The lipid profile analysis revealed that 99% of patients had some type of dyslipidemia, and the most frequent was high level of triglyceride and low levels of high-density lipoprotein cholesterol (68.8% of cases in each).\u0000Conclusion: Dyslipidemia is a significant risk factor in patients with ACS and high TG and low HDL-C were more prevalent. Careful attention to its management may help to reduce further events.\u0000Cardiovasc j 2021; 14(1): 24-29","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90438831","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. Islam, A. Majumder, Shovan Rahman, K. Ananya, T. Ahmad, B. Dutta","doi":"10.22541/au.162838895.52054678/v1","DOIUrl":"https://doi.org/10.22541/au.162838895.52054678/v1","url":null,"abstract":"Background: The predominant cause of giant left atrium (GLA) is\u0000rheumatic mitral valvular disease. GLA is commonly defined\u0000echocardiographically by measuring the left atrial diameter (LAD). In\u0000the context of changing epidemiology of rheumatic heart disease (RHD)\u0000globally, and introduction of left atrial volume index (LAVI), the\u0000aetiology of GLA and utility of LAVI for defining GLA may be necessary.\u0000Methods: The prospective observational study was carried out at a\u0000dedicated tertiary care cardiac centre of a developing country to know\u0000the aetiology and clinical pattern of GLA over 8 years. GLA was defined\u0000echocardiographically as a left atrium (LA) having a diameter ≥80 mm in\u0000the left parasternal long-axis view. Follow-up was made over the\u0000telephone. Results: Thirty cases of GLA were diagnosed over 8 years from\u00002013 to 2021. Twenty two were due to rheumatic heart disease (RHD), 7\u0000due to MVP, and 1 due to flail anterior mitral leaflet. Mean LAD was\u000092.13 ± 16.72 mm, and the mean LAVI was 288.77 ± 134.40 ml/m2. LA\u0000thrombus was present in 5 patients, 6 had spontaneous echo contrast\u0000(SEC) in LA, 2 had both LA thrombus and SEC. Mean follow-up was 0.99 ±\u00001.06 years. Out of 15 patients, 5 died, while 10 were alive. Mean\u0000survival was 1.8 ± 1.17 years, ranging from less than 1 year to 4 years.\u0000Conclusion: RHD continues to be the predominant cause of GLA; however,\u0000MVP is also important. The cut-off value of LAVI for defining GLA needs\u0000further study.","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80061777","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":"Down’s Syndrome with Congenital Heart Disease: Our Surgical Experience","authors":"Z. Islam, Sakila Israt Jahan, S. Moinuddin, Khondokar Shamim Shahriar Ziban Rushel, S. Islam, F. Islam, K. Hasan","doi":"10.3329/cardio.v13i1.50562","DOIUrl":"https://doi.org/10.3329/cardio.v13i1.50562","url":null,"abstract":"Background: Our objective was to analyze the outcome of patients of Down’s syndrome with congenital heart diseases undergoing cardiac surgery. \u0000Methods: This was a retrospective study conducted between January 2013 and June 2019. 49 consecutive patients with Down’s syndrome with congenital heart disease admitted in pediatric cardiac surgery unit at National Institute of Cardiovascular Diseases (NICVD). Patients were followed up postoperatively for in-hospital outcome. \u0000Results: Among 49 patients the heart lesion ranked in incidence as follows- VSD 24(48.97%), AV canal defect 12(24.48%), TOF 6(12.24%), PDA 6(12.24%) and ASD 1(2.04%). Pulmonary hypertension was found in 63.25% patients. Moderate pulmonary hypertension was most common, found in 18(38.66%) patients. Severe and mild pulmonary hypertension was found in 10(32.38%) and 3(9.67%) patients respectively. All the patients had undergone surgical correction. The postoperative period was complicated in 44.89% of patients. The most frequent complication was pulmonary infection 20.40%, Wound infection 6.12% and low output syndrome 6.12% were the next. One patient had postoperative heart block, needed permanent pace maker implantation. In-hospital mortality was 12.24%. \u0000Conclusion: Patients with Down’s syndrome with congenital heart disease undergoing surgical correction had an acceptable postoperative morbidities and mortality. \u0000Cardiovasc. j. 2020; 13(1): 35-39","PeriodicalId":9438,"journal":{"name":"Cardiovascular Journal","volume":"87 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84275135","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}