Effect of intradermal anaesthesia on success rate and pain of intravenous cannulation: a randomized non-blind crossover study

2011 ◽  
Vol 56 (4) ◽  
pp. 210-213 ◽  
Author(s):  
F Hendry ◽  
M R Checketts ◽  
G A Mcleod
Keyword(s):  
Success Rate ◽  
Intervention Group ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
The Mean ◽  
The Difference ◽  
Clinically Significant ◽  
Log Linear

Intravenous cannulation is a commonly performed procedure. This study aimed to determine whether the success rate and pain of intravenous cannulation is affected by prior injection of intradermal lidocaine. Intravenous cannulation was performed twice in 45 healthy volunteers. Intradermal lidocaine was administered prior to one of these cannulations. The outcome measures were success or failure of cannulation, and pain of cannulation, measured with a 100 mm visual analogue pain scale. The success rate of intravenous cannulation with and without prior intradermal lidocaine was 54% and 76%, respectively. The difference was 22.0% (95% CI 1.5-27.8%; P = 0.03). Log-linear analysis for three-way interaction between the variables (outcome, vascular condition and use of lidocaine) showed a significant influence of vascular condition on outcome ( G 2 24.6, P < 0.001). The mean (SD) pain scores in the control and intervention group were 34.8 (21.0) and 13.6 (13.2) mm, respectively. The difference between the mean pain scores was 21.2 mm (95% CI 15.1-27.3 mm). In conclusion, the success rate of intravenous cannulation may be reduced with the use of intradermal lidocaine, but success rate is primarily dependent on vascular condition. Intradermal lidocaine achieves a clinically significant reduction in the pain of intravenous cannulation.

scholarly journals LO037: A randomized double-blind trial comparing the effect on pain of an oral sucrose solution versus placebo in children 1 to 3 months old needing urethral catheterization

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S42-S43
Author(s):  
M. Desjardins ◽  
S. Gouin ◽  
N. Gaucher ◽  
D. Lebel ◽  
J. Gravel
Keyword(s):  
Heart Rate ◽  
Sucrose Solution ◽  
Pain Scale ◽  
Urethral Catheterization ◽  
Double Blind ◽  
Solution Versus ◽  
Pain Scores ◽  
The Mean ◽  
Oral Sucrose ◽  
The Difference

Introduction: Oral sweet solutions have been accepted as effective analgesics for procedures in the neonatal population. However, there have been a limited number of trials in older infants. These studies have conflicting results. The objective of the study was to compare the efficacy of an oral sucrose solution versus placebo in reducing pain during urethral catheterization in infants 1 to 3 months old in the Emergency Department (ED). Methods: A randomized, double-blind clinical trial was conducted in a pediatric university-affiliated hospital ED. Infants, 1 to 3 months of age, were recruited and randomly allocated to receive 2 ml of 88% sucrose solution (SUC) or 2 ml of placebo solution (PLA) orally, 2 minutes before planned urethral catheterization. The primary outcome measure was the difference in pain scores as assessed by the Face, Legs, Activity, Cry and Consolability (FLACC) Pain Scale at 1 min post procedure. Secondary outcome measures were the difference in pain scores using the Neonatal Infant Pain Scale (NIPS), crying time and variations in heart rate. Results: Seventy-six participants were recruited and completed the study, 37 (group SUC) and 39 (group PLA) respectively. The mean difference in FLACC scores compared to baseline was 5.62 ± 1.32 (SUC) vs. 6.21 ± 1.15 (PLA) (p=.51) during catheterization, 2.70 ± 1.21 (SUC) vs. 2.26 ± 1.41 (PLA) at 1 min (p=.64) and 0.66 ± 1.32 (SUC) vs. 1.26 ± 1.00 (PLA) at 3 mins (p=.38). For the NIPS scores, it was 4.27 ± 1.06 (SUC) vs. 4.69 ± 0.92 (PLA) (p=.56) during procedure, 2.05 ± 0.91 (SUC) vs. 1.97 ± 1.19 (PLA) (p=.92) at 1 min and 0.49 ± 0.89 (SUC) vs. 0.89 ± 0.97 (PLA) (p=.54) at 3 mins. The difference in the mean crying time was not different between both groups: 99 ± 34 secs (SUC) vs. 100 ± 25 (PLA) (p=.99). No significant difference was found in participants’ heart rate variations during procedure 23 ± 8 BPM (SUC) vs. 26 ± 7 (PLA) (p=.60), after 1 min 19 ± 12 BPM (SUC) vs. 17 ± 7 (PLA) (p=.76) and after 3 mins -1 ± 12 BPM (SUC) vs. 3 ± 6 (PLA) (p=.53). Conclusion: In infants 1 to 3 months of age undergoing urethral catheterization in the ED, administration of an oral sweet solution did not statistically decrease pain scores as measured by the FLACC and NIPS scales. Participants’ heart rate variations and crying time were not significantly decreased when sucrose was provided.

scholarly journals The Patient Focused Outcomes of Neuroma Excision at a Mean Follow-up of 8 Years and 10 Months

2020 ◽  
Author(s):  
Andrew Coutts ◽  
Tim Kilmartin
Keyword(s):  
Clinical Examination ◽  
Pain Scale ◽  
Nerve Tissue ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Incorrect Diagnosis ◽  
The Mean ◽  
Surgical Treatments ◽  
Age Range

Abstract Background - While the majority of patients do well following neuroma excision, good outcomes are far from universal. Hence we always provide a course of non-surgical treatment prior to surgery – footwear advice, orthotics, patient education and up to 3 corticosteroid injections. Furthermore, we wanted to understand and quantify the risks and complication to allow us to be able to provide this information to patients during informed consent.Methods - Between 2000 and 2012 neuroma excision from the 2nd intermetatarsal or 3rd intermetatarsal space was carried out consecutively on 42 cases (36 patients), for the treatment of IM neuroma pain. Three patients from the cohort died prior to follow-up and 6 cases failed to attend for review. The outcomes of surgery were measured in a service review using a visual analogue pain scale, the Manchester Oxford Foot Questionnaire, clinical examination of the foot and consultation with the patient where any adverse issues were recorded. The mean follow-up period was 8-years and 10-months (range 61-194 months). At the time of surgery, the mean age of the patients was 54-years of age (range 25-74 years) and at follow-up the mean age was 63-years of age (range 31-85 years). Results - Twenty four cases (73%) reported they were completely satisfied with the results of their surgery, 8 cases (24%) were satisfied with reservations and 1 case (3%) reported they were dissatisfied. All cases agreed they would be happy to undergo surgery under similar circumstance again if required, i.e. under local anaesthesia on a day case basis. 2 cases (6%) reported recurrence of symptoms and required revision surgery which was performed in one case at 9-years and in the other at 11-years. After further excision of nerve tissue, their symptoms resolved.Conclusion - Neuroma excision is a reasonably safe and effective treatment for neuroma pain when non-surgical treatments fail to resolve symptoms. Our approach requires meticulous clinical examination and history taking, up to three cortisone injections and then ultrasound examination before the patient is listed for surgery. In this way we hope to minimise the risk of incorrect diagnosis and continued pain post excision due to the presence of undiagnosed capsulitis.

scholarly journals A service review of the patient focused outcomes of neuroma excision at a mean follow-up of 8 years and 10 months

2020 ◽  
Author(s):  
Andrew Coutts ◽  
Tim Kilmartin
Keyword(s):  
Clinical Examination ◽  
Pain Scale ◽  
Nerve Tissue ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Incorrect Diagnosis ◽  
The Mean ◽  
Surgical Treatments ◽  
Age Range

Abstract Background - While the majority of patients do well following neuroma excision, good outcomes are far from universal. Hence we always provide a course of non-surgical treatment prior to surgery – footwear advice, orthotics, patient education and up to 3 corticosteroid injections. Furthermore, we wanted to understand and quantify the risks and complication to allow us to be able to provide this information to patients during informed consent.Methods - Between 2000 and 2012 neuroma excision from the 2nd intermetatarsal or 3rd intermetatarsal space was carried out consecutively on 42 cases (36 patients), for the treatment of IM neuroma pain. Three patients from the cohort died prior to follow-up and 6 cases failed to attend for review. The outcomes of surgery were measured in a service review using a visual analogue pain scale, the Manchester Oxford Foot Questionnaire, clinical examination of the foot and consultation with the patient where any adverse issues were recorded. The mean follow-up period was 8-years and 10-months (range 61-194 months). At the time of surgery, the mean age of the patients was 54-years of age (range 25-74 years) and at follow-up the mean age was 63-years of age (range 31-85 years).Results - Twenty four cases (73%) reported they were completely satisfied with the results of their surgery, 8 cases (24%) were satisfied with reservations and 1 case (3%) reported they were dissatisfied. All cases agreed they would be happy to undergo surgery under similar circumstance again if required, i.e. under local anaesthesia on a day case basis. 2 cases (6%) reported recurrence of symptoms and required revision surgery which was performed in one case at 9-years and in the other at 11-years. After further excision of nerve tissue, their symptoms resolved.Conclusion - Neuroma excision is a reasonably safe and effective treatment for neuroma pain when non-surgical treatments fail to resolve symptoms. Our approach requires meticulous clinical examination and history taking, up to three cortisone injections and then ultrasound examination before the patient is listed for surgery. In this way we hope to minimise the risk of incorrect diagnosis and continued pain post excision due to the presence of undiagnosed capsulitis.

scholarly journals Effect of Posterior Bite Raiser on Periodontium of Lower Molars in Orthodontic Patients

2021 ◽  
Vol 10 (23) ◽  
pp. 1756-1759
Author(s):  
Arya S. Prasad ◽  
Arvind Sivakumar
Keyword(s):  
Pain Score ◽  
Pain Scale ◽  
Rank Test ◽  
Visual Analogue Pain Scale ◽  
Posterior Teeth ◽  
Deep Bite ◽  
Visual Analogue Pain ◽  
Probing Depth ◽  
Class 1 ◽  
The Mean

BACKGROUND Temporary bite opening with occlusal composite is performed routinely during orthodontic treatment of patients with deep bite and cross bite. There have been no studies yet to assess its effect on periodontium. This study was done to assess the effect of temporary bite-raising on periodontium when placed on the mandibular molars. METHODS A prospective clinical trial which was a pilot study conducted on fifteen subjects attending the Department of Orthodontics, Saveetha Dental College and Hospitals, (SIMATS), Chennai. Probing depth and pain score on percussion were recorded bilaterally on subjects with class 1 malocclusion, before and after placing bite blocks in the posterior teeth. The bite-raising was done using light cured orthodontic composite Blu BiteTM on both mandibular first molars. Probing depth was measured using a Williams probe at mesiobuccal, mid-buccal and distobuccal sites on molars and pain score on percussion was recorded using visual analogue scale. The pocket probing, before (T0) and after one month of temporary bite-raising (T1) was recorded and statistically analysed using paired t test and Wilcoxon sign rank test based on normality of variables. RESULTS There was a significant increase in the mean probing depth after bite raising with a mean difference of 1.07 ± 0.04 (P = 0.000). The mean pain score also significantly increased after temporary bite-raising (P = 0.002). CONCLUSIONS There were minor yet significant changes in the periodontium that occurred after temporary bite rising with Blu BiteTM. KEY WORDS Composite Resin, Periodontium, Occlusal Force, Orthodontic Adhesive, Visual Analogue Pain Scale

scholarly journals Comparison of post operative pain in tonsillectomy: a three year prospective study

2020 ◽  
Vol 6 (12) ◽  
pp. 2189
Author(s):  
Akshay Jain ◽  
Smruti Milan Tripathy
Keyword(s):  
Prospective Study ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Bipolar Cautery ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Cold Dissection

<p><strong>Background:</strong> Tonsillectomy is the oldest surgery performed by otorhinolaryngologists worldwide. Through ages different techniques have been tried to improve the post surgical outcome and reduce morbidity among patients. Aim of the current study was to compare the post-operative pain among the patients undergoing tonsillectomy by cold dissection, bipolar cautery dissection and coblation dissection.</p><p><strong>Methods:</strong> 142 Patients undergoing tonsillectomy in ENT department of TMMC during the period of 3 year were included in the study. Patients were randomly distributed to undergo different techniques of tonsillectomy. The post-operative pain in patients was assessed using the pre-standardized visual analogue pain scale and results were analyzed.</p><p><strong>Results:</strong> No statistically significant difference was found among the groups undergoing tonsillectomy by cold dissection, bipolar dissection and coblator dissection as the p&gt;0.05. The immediate post-operative pain was found to be slightly higher among the group undergoing tonsillectomy by coblator dissection and the analgesics dose needed in the post-operative period remained the same for all for patients of all the three groups.</p><p><strong>Conclusions:</strong> No statistically significant difference was found in the post-operative pain scores of patients undergoing tonsillectomy by CD, BD and CBD techniques.</p>

scholarly journals Comparison of the clinical efficacy of sonography-guided percutaneous nephrolithotomy (PCNL) under local and general anesthesia

2019 ◽  
Vol 47 (9) ◽  
pp. 4143-4150
Author(s):  
Xunbao Wang ◽  
Qiongxiang Ye ◽  
Xinguo Liu ◽  
Jinjun Chen ◽  
Zhiyong Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Percutaneous Nephrolithotomy ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
The Mean

Objective This study aimed to compare the effect of percutaneous nephrolithotomy (PCNL) under local infiltration anesthesia (PCNL-LIA) and general anesthesia (PCNL-GA) to treat upper urinary tract calculi on clinical application values. Methods Patients were randomly divided into the PCNL-LIA (16 patients) and PCNL-GA (20 patients) groups. Data on safety, cost, complications, rate of residual calculi, and prognosis were compared. Results The mean operation time in the PCNL-LIA group was less than that in PCNL-GA group (100±7.7 versus 120±9.0 minutes). The mean length of hospital stay in the PCNL-LIA group was shorter than that in the PCNL-GA group (6.9±0.5 versus 10.5±1.2 days). The rate of patients who required blood transfusion because of blood loss during or after surgery was less in the PCNL-LIN group than in the PCNL-GA group (13% versus 40%). The intervention rate in the PCNL-GA group was higher than that in the PCNL-LIA group. Visual analogue pain scale assessment showed that the PCNL-LIA group showed slightly more pain than the PCNL-GA group. Conclusion PCNL-LIA is safer, faster, and more convenient, and it also provides the benefits of a lower rate of blood loss and complications, lower cost, faster recovery, and shorter hospital stay compared with PCNL-GA.

scholarly journals Glenohumeral Injection Using Anatomic Landmark Versus Sonographic Needle Guidance

2018 ◽  
Author(s):  
Timothy S. Moore ◽  
Cole L. Paffett ◽  
Wilmer L. Sibbitt ◽  
William A. Hayward ◽  
James I. Gibb ◽  
...  
Keyword(s):  
Corticosteroid Injection ◽  
Pain Scale ◽  
Injection Pain ◽  
Research Review ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Anatomic Landmark ◽  
Us Guidance ◽  
Pain Scores ◽  
Institutional Review

ABSTRACTObjectiveWe hypothesized ultrasound (US) guidance improves outcomes of corticosteroid injection of the painful shoulder.Methods30 patients with symptomatic shoulders due to osteoarthritis were randomized to glenohumeral injection with 3 milliliters of 1% lidocaine and 60 mg of triamcinolone acetonide using the anterior approach with 1) conventional anatomic landmark palpation-guidance or 2) US-guidance. Injection pain (visual analogue pain scale (VAS)), pain at outcome (2 weeks and 6 months), therapeutic duration, time-to-next-injection, and costs were determined.ResultsInjection pain was less with US (VAS: 0.3±0.6 cm) vs. landmark-guidance (VAS: 1.4±2.4 cm, 95% CI of difference: 0.5<1.1<1.7, p=0.05). Pain scores were similar at 2 weeks: US: 2.2±2.4 cm; Landmark: 1.8±2.7 cm, 95% CI of difference: −2.2<−0.4<1.4, p=0.66 and 6 months: US: 5.8±2.8 cm; Landmark: 6.4±2.9 cm, 95% CI of difference: −0.4<0.6< 1.1, p =0.71. Therapeutic duration (US: 3.9±1.5 months; Landmark: 3.0±1.2 months, 95% CI of difference: − 1.4 <−0.9<−0.4, p=0.045) and time-to-next-injection (US: 8.1±3.5 months; Landmark: 5.7±2.9 months, 95% CI of difference: −3.6<−2.4<−1.3, p=0.025) were longer, and fewer injections per year (29% less) were required: US: 1.5±0.2 injections/year; Landmark: 2.1±0.2 injections/year (p<0.037; 95% CI of difference −0.9<−0.6<−0.3). However, cost/patient/year was modestly greater with US (US: $318±89, Landmark: $301±67; p=0.28).ConclusionAnatomic landmark guidance in the short-term is equally effective as US for injection of the osteoarthritic shoulder and modestly less costly, however, US may reduce the need for repetitive injections by prolonging the therapeutic effect and thus time to next injection.IRB StatementThis project was in compliance with the Helsinki Declaration, was approved by the Institutional Review Board (IRB) as ultrasound subset of a syringe safety trial (Human Research Review Committee approval 04-347), and was registered at ClinicalTrials.gov (Clinical Trial Identifier NCT00651625). The subjects gave informed consent to participate prior to all studies and interventions. Patient confidentiality was protected according to the U.S. Health Insurance Portability and Accountability Act (HIPAA) and all data was de-identified.

scholarly journals Incidence and management of inguinodynia after inguinal plasty

2020 ◽  
Vol 8 (10) ◽  
pp. 3432
Author(s):  
Juan J. Granados-Romero ◽  
Jesus C. Ceballos-Villalva ◽  
Israel García-Olivo ◽  
Cruz Escobar Jonathan E. ◽  
María J. Corona-Torres ◽  
...  
Keyword(s):  
Hospital Costs ◽  
Laparoscopic Approach ◽  
Systematic Investigation ◽  
Pain Scale ◽  
Diagnostic Methods ◽  
Visual Analogue Pain Scale ◽  
Open Approach ◽  
Cross Sectional ◽  
Visual Analogue Pain ◽  
Quality Life

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort   (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.

scholarly journals The Effect of Positive Mental Imagery on Labor Pain Tolerance in Primiparous Women Referred to Atieh Teaching-Medical Center of Hamadan, Iran, 2018

2019 ◽  
Author(s):  
Caroline Yavari ◽  
Seyedeh Zahra Masoumi ◽  
Farideh Kazemi ◽  
Mansoureh Refaei ◽  
Abolghasem Yaghoobi
Keyword(s):  
Mental Imagery ◽  
Medical Center ◽  
Intervention Group ◽  
Pain Scale ◽  
Pain Tolerance ◽  
Labor Pain ◽  
Control Group ◽  
Behavioral Pain Scale ◽  
The Mean ◽  
Primiparous Women

Abstract Background: Childbirth is an important experience in the woman's life; and its quality has short- and long-term effects on them. The present study aimed to determine the effect of positive mental imagery on the labor pain tolerance in primiparous women referred to Atieh teaching-medical center in Hamadan.Method: The present clinical trial study was conducted on 90 primiparous mothers referred to Atieh Hospital of Hamadan in interventional (n= 45) and control (n= 45) groups. Data collection tools included demographic information forms, Behavioral pain scale, Visual analogue scale (VAS), and the birth registration checklist that were responded by both groups through interviews and observation during labor. The intervention group participated in 4 weekly counseling sessions in groups of 5 to 7 participants, but the control group received only routine care. Finally, the obtained data from above questionnaires was analyzed using SPSS 21 and analysis of covariance (ANCOVA), Independent t-test and chi-square test and the significance level of tests was considered to be at the level of 5%.Results: The research results indicated that the mean age of control and intervention groups was 25.98±4.82 and 25.32± 4.85 respectively. The mean scores of Visual analogue scale (VAS) and the Behavioral Pain Scale significantly decreased compared to the control group (P <0.001). The mean scores of behavioral changes in the intervention group were 1.77 ± 0.68, 2.39± 0.54 and 3.09±0.60 in 4-5 cm, 6-7 cm and 8-10 cm dilatations respectively. That was statistically significant decrease compared to the control group (P=0.005). Conclusion: Positive mental imagery counseling reduced the visual analogue intensity and behavioral pain intensity in primiparous women. It seems that continuing education and counseling during pregnancy and empowering mothers to control themselves and learn mental imagery techniques and practice during pregnancy and childbirth can help mothers to more relax and alleviate the labor pain intensity.Trial registration: Trial Registration Clinical Trial Registry: IRCT20120215009014N242.Registered on 2017-09-10. https://en.irct.ir/trial/9621Sampling start date:2018-10-23

The effect of ear acupressure medicine at the “Shen Men” point on the nausea and vomiting during pregnancy

2021 ◽  
Vol 15 (5) ◽  
pp. 1774-1779
Author(s):  
Sanaz Nehbandani ◽  
Hajar Salehi ◽  
Khadije Rezaie Keikhaie ◽  
Hossein Rashki Ghalenow ◽  
Fatemeh Mirzaie ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Intervention Group ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Health Clinics ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Mean ◽  
The Difference

Introduction & Objective: Nausea and vomiting during pregnancy is one of the most common gastrointestinal disorders that more than 85% of pregnant women experience. However, controlling and treating this complication is still one of the most important issues in antenatal care. Therefore, the aim of this study was to investigate the effect of ear acupressure at Shen Men point on relieving nausea, vomiting and retching during pregnancy. Materials and Methods: In this quasi-experimental study, 100 pregnant women with a gestational age of less than 16 weeks attending the health clinics of Zabol city during 2019-2020 were studied in two control and intervention groups (n = 50 in each group). The samples in the intervention group were trained to apply pressure on their ears’ Shen Men point with the thumb for three minutes three times a day (morning, noon, and night), for a duration of one month. At the end of second and fourth weeks, the data were collected using the Rhodes index form and then, were analyzed by SPSS software version 22. Results: According to the results, there was no significant difference between the two groups in terms of age, gestational age, occupation and education. The difference in the mean scores of nausea, vomiting and retching was not statistically significant between the control and intervention groups before the study. But four weeks after the study, a significant difference was observed in the mean scores of vomiting, nausea and retching between the two groups, so that the mean scores of vomiting, nausea and retching were significantly lower in the intervention group than in the control group. Conclusion: The ear acupressure medicine at the Shen men point can be used as a non-invasive, safe and inexpensive method to relieve nausea, vomiting and retching during pregnancy. Keywords: Acupressure medicine, Shen Men, Vomiting, Pregnancy, Nausea, Retching, Rhodosis

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