scholarly journals INTRAUTERINE CONTRACEPTIVE DEVICE

2018 ◽  
Vol 25 (10) ◽  
pp. 1518-1524
Author(s):  
Faryal Sardar ◽  
Ifat Balouch ◽  
Naseem Bajari
Keyword(s):  
Tertiary Care ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Intrauterine Contraceptive ◽  
Group A ◽  
Group B ◽  
Stratified Analysis ◽  
Effect Of Age ◽  
Trial Setting

Objectives: To compare the frequency of effectiveness of postpartum IUCD(PPIUCD) with interval IUCD at Tertiary care Hospital in Hyderabad. Study Design: Randomizedcontrolled trial. Setting: Gynaecological and Obstetrical Department, Liaquat UniversityHospital, Hyderabad. Period: Six months from February 2016 to July 2016. Material andMethods: Total 100 women were studied. All the women with age 18 to 40 years, having atleast one alive child were included in the study. Women were divided in two groups according tocontraception methods of IUCD (50 women in each group). In Group-A IUCD were inserted afterplacental delivery within 10 minutes to 48 hours (PPIUCD) and in group-B IUCD were insertedany time of women’s menstrual cycle (Interval IUCD). All the women were followed for 6 months.All the data regarding effectiveness among both groups was recorded. Results: Mean ± SDage of group-A (PPIUCD) patients was 26.02 ± 5.87 years while group-B (Interval IUCD) was26.34 ± 5.95 years. Majority of patient’s i-e; 76.0% of group-A and 68.0% of group-B were fromurban areas. IUCD was successfully place among 94.0% women of group-A and among 98.0%women in group-B. At the end of 6 months follow-up, 86.0% patients of group-A continuedPPIUCD while in group-B, 96.0% women continued Interval IUCD. After 6 months follow-up,effectiveness of IUCD was 90.0% in group-B and 80.0% in group-A. Stratified analysis revealedthat there was a non-significant effect of age on effectiveness of IUCD among both groups (Pvalues= 0.094 & 0.223 respectively) so was the parity (P values= 0.384 & 0.747 respectively).Conclusion: It was concluded that interval IUCD found to be effective method as compare topost postpartum IUCD (PPIUCD). While women have recently given birth to neonate were moreagreed to practice of PPIUCD, due to its quick insertion.

scholarly journals Prospective study on comparison of efficacy of topical anti-fungal agents: clotrimazole 1% and sertaconazole 2% in treatment of tinea cruris

2019 ◽  
Vol 6 (1) ◽  
pp. 43
Author(s):  
Som J. Lakhani ◽  
Dhaval B. Joshi ◽  
Kalindi R. Kumbhani ◽  
Rajesh B. Haldia
Keyword(s):  
Tertiary Care ◽  
Clinical Parameters ◽  
Care Hospital ◽  
Hospital Visit ◽  
Tinea Cruris ◽  
Group A ◽  
Group B ◽  
Anti Fungal ◽  
Rapid Relief

<p class="abstract"><strong>Background:</strong> Tinea cruris is a common superficial dermatophytic infection of the skin occurring in 20-25% population worldwide. The various types of antifungal agents are available for topical use in treatment of tinea cruris. Clotrimazole is conventional imidazole antifungal drug whereas sertaconazole is newer imidazole antifungal claimed to be superior to clotrimazole in tinea infection. The aim of the study was to determine and compare the efficacy of potent topical azole agents 1% clotrimazole and 2% sertaconazole in patients diagnosed with tinea cruris attending out-patient department of skin and VD of tertiary care hospital in Vadodara.</p><p class="abstract"><strong>Methods:</strong> A total of 71 patients diagnosed with tinea cruris were divided into two groups. Group A received topical clotrimazole (1% cream), and Group B received topical sertaconazole (2% cream). Outcome parameters such as erythema, scaling, itching, margins of lesions and size of lesions were noted atthe time of hospital visit, by 3rd week and by 6th week for the assessment of efficacy. The statistical test used was independent student t-test and software used was SPSS 20.0.<strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of follow-up phase, both the drugs were found to be effective with no recurrence or relapse of tinea cruris. However, compared to clotrimazole 1% cream, sertaconazole 2% cream had statistically significant rapid relief in terms of reduction in clinical parameters such as erythema (p&lt;0.001), scaling (p&lt;0.001), itching (p&lt;0.001), size of lesion (p&lt;0.001) and margin of lesion (p&lt;0.011).</p><p class="abstract"><strong>Conclusions:</strong> Topical sertaconazole 2% cream was found to be highly efficacious and superior to clotrimazole 1% cream in improvement of clinical parameters of tinea cruris.</p>

scholarly journals Disease progression and antiretroviral therapy in newly seropositive HIV subjects in a tertiary care hospital in North India

2013 ◽  
Vol 7 (02) ◽  
pp. 110-115 ◽  
Author(s):  
Sanjim Chadha ◽  
Preena Bhalla ◽  
Arun Kumar Jha ◽  
Hitender Gautam ◽  
Sanjeev Saini ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Disease Progression ◽  
Highly Active Antiretroviral Therapy ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Cd4 Counts ◽  
Group A ◽  
Group B

Introduction: In developing countries the standard methods used to monitor HIV disease progression and therapy response are clinical assessment, CD4+ T lymphocyte count measurement, and plasma viral load (PVL) quantification. These tests require expensive equipment and skilled technicians, so monitoring HIV in resource-limited countries remains challenging as few laboratories can offer these tests free of cost. Methodology: Newly diagnosed HIV seropositive subjects (n = 130) were categorized into three study groups: CD4 counts <200 cells/µl (group A, 43 subjects); 200-500 cells/µl (group B, 44 subjects); and >500 cells/µl (group C, 43 subjects). At recruitment, PVL estimation was performed for group A subjects only, who were then initiated on highly active antiretroviral therapy (HAART) and were followed up after six months for evaluation of response to HAART by measuring the CD4 counts and PVL. Groups B and C were followed up after six months to monitor disease progression by measuring only CD4 counts. Results: Among group A subjects, a rise in the median CD4 counts after six months of HAART was observed. At baseline, PVL ranged from 2636 to >750,000 copies/ml with a median PVL at baseline of 165,000 copies/ml. At follow-up, 90% of the study subjects had undetectable levels of viraemia. Among group B and C subjects, a fall in the CD4 counts at follow-up was observed. Conclusions: CD4 count is a powerful tool to determine response to antiretroviral therapy (ART) and monitor disease progression in HIV/AIDS. PVL is important to assess response to ART, especially in immunovirologic discordant responses.

scholarly journals Acceptance, safety and complications of postpartum intra uterine contraceptive device: a prospective study in tertiary care hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 1916
Author(s):  
Rekha Jain ◽  
Manisha Sharma ◽  
Shruti Gupta
Keyword(s):  
Side Effects ◽  
Retention Rate ◽  
Post Partum ◽  
Tertiary Care ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Intrauterine Contraceptive ◽  
Reversible Method

Background: Intrauterine contraceptive device is a long acting, effective and reversible method of contraception. It can be inserted post placental during vaginal or LSCS delivery and within 48 hours of delivery.  This study evaluates the acceptance, safety, side effects and complications associated with immediate post-partum intrauterine contraceptive device (PPIUCD) insertion.Methods: The study was conducted at Hindu Rao Hospital and NDMC Medical College, Delhi for a period of 18 months. Patients admitted and delivered at Hindu Rao Hospital were counseled for PPIUCD, CuT 380 A / CuT 375 insertions and it was inserted within 10 minutes of delivery of placenta during vaginal delivery or LSCS or within 48 hours of delivery. Patients were followed at 6 weeks and then between 6 to 12 months of delivery for continuation, side effects or any complications.Results: After counseling 1253 (9.8%) patients agreed for PPIUCD insertion out of which 650 patients came for follow up. 46% women came for routine follow up while 54.06% came with one or the other complications. Missed thread was most common complications, followed by bleeding P/V and pain abdomen. Expulsion in 5.5% and CuT failure was seen in 0.92% women only. Removal of IUCD was done in 94 patients for one or other reasons. There was retention of PPIUCD in 84.5% while removal was done in 14.5% during period of 6 months to one year follow up. Missed thread was main cause of anxiety among acceptors.Conclusions: Immediate PPIUCD is safe and effective method of contraception with a high retention rate. Though acceptance in initial months was less but it gradually increased over time with increasing awareness, counseling of patients and training of health personnel.

scholarly journals Comparative analysis of postpartum IUDC versus interval IUCD insertion: a study conducted in a tertiary care hospital in Karachi, Pakistan

2020 ◽  
Vol 8 (6) ◽  
pp. 2213
Author(s):  
Zakia Bano ◽  
Sanober Memon ◽  
Fiza Ali Khan ◽  
Mala Jitendra Shahani ◽  
Urooj Naz ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Hemoglobin Level ◽  
P Value ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Continuous Variables ◽  
Group A ◽  
Group B ◽  
Baseline Hemoglobin

Background: To compare the effectiveness of postpartum intrauterine contraceptive device (PPIUCD) with interval IUCD in terms of effectiveness, expulsions, bleeding pain and other complications at Tertiary care Hospital.Methods: Current study was conducted among 224 women, at Gynaecology and Obstetrics of Reproductive Health Services-A (RHS-A) Centre of Jinnah Post Graduate Medical center, Karachi, for a period of Six months. Approval from Ethical committee and informed consent was taken from women and her husband before starting the study. The WHO medical eligibility criteria for contraceptive use (MEC) were followed and IUCD was inserted in 112 women in PPIUCD group and in 112 women in interval IUCD group. These cases were followed at 15 days, 6 weeks and 6 months. Results of PPIUCD group were compared with interval IUCDs group. Data was analyzed by using SPSS version 18.0. Continuous variables like age, parity, hemoglobin level were analyzed as mean±standard deviation. Frequencies and percentages were calculated for infection, expulsion, bleeding per vagina and effectiveness. Chi-square was applied to assess the difference between the categories. p value <0.05 was taken as significant.Results: The two groups were identical in mean ± SD age, parity, residence and baseline hemoglobin level. PPIUCD (Group-A) was more effective i.e., 87.5% as compared to interval IUCD (Group-B) i.e., 83.9%. Pain, PID, bleeding and expulsion of IUCD were more prevalent with interval IUCD (Group-B) than PPIUCD (Group-A) patients. Stratified analysis showed that age, parity & mean baseline hemoglobin were non-significant effect modifiers on the effectiveness among the two groups.Conclusions: Postpartum IUCD use was found to be a safe, simple, inexpensive and reversible procedure with higher chances of retention for a longer period. Additionally, there is decreased risk of complications and lower expulsion rates when compared with interval IUCD.

scholarly journals Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

2018 ◽  
Vol 4 (6) ◽  
pp. 1417
Author(s):  
Subodh Kumar ◽  
Awadhesh Kumar Mishra ◽  
Ajay Mallick ◽  
Ashwani Sethi
Keyword(s):  
Hearing Loss ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Tertiary Care ◽  
Care Hospital ◽  
Distortion Product ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> A large proportion of blast victims suffers ear injuries; however, these injuries are often overlooked.</p><p class="abstract"><strong>Methods:</strong> We assessed 411 blast victims to detect ear injury employing detailed history, otological examination, pure tone audiometry, auditory steady state response and distortion product otoacoustic emissions. TM perforations were managed by thorough cleaning of ear by suctioning, edges approximation and gelfoam splinting in group A and only suctioning in group B. Prednisolone in tapering doses was prescribed for managing hearing loss in all except those in whom it was contraindicated.  </p><p class="abstract"><strong>Results:</strong> Out of 411 blast victims, 228 (55.47%) had aural trauma. All cases were males (being serving soldiers) between ages of 21 and 57 years. (Mean 37.77 years, SD 10.38). 285 ears had a perforated TM. Of these, 145 were assigned to group A while 140 were in group B. There was no significant difference in spontaneous healing of perforation between the two groups but at 5 years’ follow up group A had significantly higher number of unscarred, healthy TMs than group B (Z score=2.2111, p=0.0271). Mean pure tone average was 51.16 dB (SD 8.79 dB) at presentation and 38.91 dB (SD 7.86 dB) at 5 years. Recovery of SNHL component was significantly better in steroid treated patients.</p><p class="abstract"><strong>Conclusions:</strong> Edges approximation and gelfoam splinting helped in reducing scarring of TM on healing, on long follow up. Steroid treated group showed better recovery of hearing loss.</p>

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

scholarly journals Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

2019 ◽  
Vol 8 (10) ◽  
pp. 2197
Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig
Keyword(s):  
Tertiary Care ◽  
Nausea And Vomiting ◽  
Research Centre ◽  
Care Hospital ◽  
Serious Adverse Events ◽  
Female Ratio ◽  
First Line Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

scholarly journals A prospective study of lornoxicam as pre-emptive analgesic in abdominal surgeries in tertiary care hospital in Salem, India

2017 ◽  
Vol 6 (7) ◽  
pp. 1778
Author(s):  
Mohammed Ziauddin Sarkhil ◽  
Hemant Kumar Dutt ◽  
Rajaram S.
Keyword(s):  
Rating Scale ◽  
Tertiary Care ◽  
Open Appendectomy ◽  
Care Hospital ◽  
Pain Rating ◽  
Pain Scores ◽  
Analgesic Regimen ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: Preemptive analgesia, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain.Methods: To determine the efficacy and safety of Lornoxicam when administered preemptively by using Wong-Baker FACES Pain Rating scale. The patients undergoing abdominal surgery were randomly categorized into group A and B of 25 each. Group A- Received Lornoxicam 8mg (1ml) one hour before surgery. Group B- Not received any analgesic before surgery. Primary measurement of the efficacy was done by using Wong-Baker Faces Pain Rating Scale at 2, 4, 8, 12 and 24 hour. All parameters were analyzed by using student t test.Results: Surgeries which were included in the study are hernia repair, open appendectomy, laparoscopic (appendectomy, cholecystectomy). Reduction in pain scores at 12th hourly and 24th hourly pain scores (<0.05) was significant. Tramadol usage decreased significantly with laparoscopic surgeries.Conclusions: In this study we could demonstrate that lornoxicam when used preemptively reduces the pain score slightly and reduces the requirement of post-operative analgesics significantly.

scholarly journals A study to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT 380A in Indian women at a premier hospital in New Delhi, India

2017 ◽  
Vol 6 (9) ◽  
pp. 3992 ◽  
Author(s):  
Mansi Kumar ◽  
Mahesh Kumar ◽  
Parul Aggarwal ◽  
Archna Gangania ◽  
Rupali Dewan
Keyword(s):  
Removal Rate ◽  
New Delhi ◽  
Contraceptive Device ◽  
Indian Women ◽  
Significant Difference ◽  
Group A ◽  
Post Placental ◽  
Group B ◽  
Continuation Rates

Background: The Study was planned to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT380A in Indian women at Safdarjung Hospital New Delhi, after approval was obtained from Institutional Ethical committee.Methods: Study group consisted of 300 women, divided into two groups: Group A and Group B. The data was analysed by using ‘student “t” test/ non-parametric ‘Wilcoxon Mann Whitney’ for quantitative variables to evaluate the safety, efficacy and acceptability.Results: Mean age was 24.99 years (range: 19-35years), All women were married (off which 64% literate) and Mean parity in group A was 1.97 and 2.06 in group B. Mean pain score during intrauterine contraceptive device (IUCD) insertion on visual analogue scale was 2.93 in group A and 3 in group B and was not statistically different. 84% women completed 12 months follow up in group A and 83.33% women in group B. Strings were visible in 74% women in group A and in 34% women in group B at 1 month of IUCD insertion. Visibility of strings increased in successive follow up visits and was visible in >80% of women at the end of one year in the both groups. String visibility after intra-Caesarean insertion was delayed. Fifty one percent (n=77) subjects in group A and 54% (n=81) in group B experienced amenorrhea up to six months. Menorrhagia was reported in 7.33% in group A and women 8.66% in group B at the end of 1 year of follow up. Pain was complained by 26 out of 150 (17.3%) women in group A as compared to 36 out of 150 (24%) women in group B after 1 month of insertion. There was no case of PID in group A whereas there were 3 cases of PID in group B. There was no perforation/trauma and pregnancy in either group.Conclusions: Overall expulsion rate was 13% and removal rate was 5% in our study. Continuation rate was 83.3% in Cu 375 and 80.6% in CuT380A at 12 months. There was no significant difference between the IUCDs regarding the safety, efficacy and complications such as expulsion, bleeding etc.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

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