scholarly journals Association of Obstetric Risk Factors with Postpartum Urine Retention in Spontaneous Labor

Author(s):  
Pribakti Budinurdjaja ◽  
Ihya R. Nizomy ◽  
Hermin Sabaruddin

Objective: To determine the relationship between obstetric risk factors and the incidence of postpartum urinary retention in spontaneous labour at RSUD Ulin Banjarmasin.Methods: This clinical study used an analytical observational design with a cross-sectional approach. The population of this study was patients with a diagnosis of postpartum urinary retention in spontaneous labour in the delivery ward and postpartum ward of Ulin Banjarmasin Hospital between January 2018-January 2020. The sample for this study was a part of the target population selected by purposive sampling, which fulfilled the inclusion and exclusion criteria. Data were analyzed using the Chi square test and multivariate analysis using binary logistics.Results: The results showed 35 samples of patients diagnosed with postpartum urinary retention in spontaneous labour and had met the inclusion and exclusion criteria. Characteristic data of the study samples found that most of the study subjects were more than 35 years old, 27 patients (77%), 21 patients (60%) of cases with primigravida parity, 26 patients (76%) with the duration of second stage labour more than equal to 1 hour. Episiotomy was performed in 30 patients (86%), 34 patients (97%) had a newborn birthweight of less than 4000 grams. There was a significant association between the risk factors for parity in primigravida (p-value 0.02), second stage labour duration in primigravida (p-value 0.01), and episiotomy (p-value 0.01), with postpartum urinary retention in spontaneous labour. In contrast, age (p-value 0.19), and birthweight (p-value 0.10) were not significantly associated with postpartum urinary retention in spontaneous labour.Conclusions: There were significant associations between obstetric risk factors (parity, duration of second stage labour, and episiotomy) with postpartum urinary retention in spontaneous labour. Whereas age and birth weight were not significantly associated with postpartum urinary retention in spontaneous labour.Keywords: obstetric risk, postpartum retention, spontaneous delivery. Abstrak Tujuan: Mengetahui hubungan faktor risiko obstetrik dengan kejadian retensio urin postpartum pada persalinan spontan di RSUD Ulin Banjarmasin.Metode: Penelitian ini merupakan penelitian klinis dengan rancangan observasional analitik dengan pendekatan potong lintang. Populasi dari penelitian ini adalah ibu postpartum yang didiagnosis dengan retensio urin postpartum pada persalinan spontan di kamar bersalin dan di ruangan nifas RSUD Ulin Banjarmasin periode Januari 2018-Agustus 2020. Data dianalisis bivariat menggunakan uji Chi square dan analisis multivariate dengan menggunakan binary logistik.Hasil: Didapati 35 sampel yang didiagnosis retensio urin postpartum pada persalinan spontan dan memenuhi kriteria inkulusi dan eksklusi. Data karakteristik sampel penelitian ditemukan usia terbanyak subyek penelitian berusia lebih dari 35 tahun sebanyak 27 pasien (77,14%), kasus dengan paritas primigravida sebanyak 21 pasien (60%), lama kala dua primigravida lebih dari sama dengan 1 jam sebanyak 26 pasien (76%). Tindakan episiotomi sebanyak 30 pasien (86%), berat bayi lahir terbanyak pada berat kurang dari 4.000 gram yaitu sebnyak 34 pasien (97%). Terdapat hubungan yang bermakna pada faktor risiko paritas pada primigravida dengan p value 0,02, lama kala dua dengan p value 0,01, dan tindakan episotomi dengan p value 0.01 dengan kejadian retensio urin postpartum sedangkan didapatkan hasil yang tidak bermakna pada risiko obstetrik usia dengan p value 0.19 dan berat bayi lahir dengan p value 0.10 pada kejadian retensio urin postpartum.Kesimpulan: Terdapat hubungan signifikan antara faktor risiko obstetrik (paritas, lama kala dua dan tindakan episotomi) dengan retensio urin postpartum persalinan spontan. Sedangkan umur dan berat badan lahir tidak berhubungan dengan retensio urin postpartum pada persalinan spontanKata kunci: persalinan spontan, risiko obstetrik, retensio postpartum.

2020 ◽  
Vol 2 (1) ◽  
pp. 31-36
Author(s):  
Wa Ode Hajrah ◽  
Niken Purbowati ◽  
Novia Nuraini

erineal rupture needs attention because it can cause dysfunction of the female reproductive organs, as a source of bleeding, a source, or a way in and out of infection, then it can cause death due to bleeding or sepsis. About 85% of Women who delivery vaginally experience perineal rupture, in the age group 25-30 years 24%, while in maternal age 32-39 years by 62%. In Asia, perineal rupture is also a problem in society, 50 % of the world's occurrence is in Asia. The study aims to determine the relationship of maternal factors to the position of the second stage labor and perineal rupture occurrence. This research applied a descriptive-analytic method using a cross-sectional research design. The research sample was 102 respondents, accidental random sampling, which was all labor with perineal rupture in July to November 2018. Statistical tests used chi-square. The results of perineal rupture with maternal age was p-value 0.042 (p <0.05), perineal rupture with maternal parity was p-value 0.01 (p <0.05). Suggestions for various maternal positions in maternity and ANC classes to prevent perineal rupture.


2020 ◽  
Vol 47 (2) ◽  
pp. 68-73
Author(s):  
A.A. Akinbodewa ◽  
O.A. Adejumo ◽  
A. Ogunleye ◽  
T.T. Oluwafemi ◽  
O.A. Lamidi

Background: New evidences reveal significant association of cardiovascular risk factors to development of chronic kidney disease among children and adolescents but there is paucity of data from Africa. Objectives: We examined the association of cardiovascular risk factors to renal dysfunction among Nigerian pediatric subjects. Materials and method: This was a prospective, cross-sectional study of pediatrics aged 2 to 17 years. Blood pressure, body mass index, serum lipids and creatinine were determined. Their glomerular filtration rate was calculated using the revised Schwartz equation. Data was analyzed with SPSS 20. Test of association was by Chi square at P <0.05. Results: We studied 114 children and adolescents. There were 55 (48.2%) males and 59 (51.8%) females with mean age of 8.99±4.26 years. There were 68 (53.5%) children and 53 adolescents (46.5%). Four (3.5%) subjects had proteinuria ≥1+. Renal dysfunction (eGFR <60ml/ min/1.73m2) was found among 9 (7.9%) participants. Renal dysfunction was higher among children than adolescents (13.1% v 1.9%) (p = 0.027). The presence and clustering of risk factors were higher among subjects with renal dysfunction (p value 0.466, 95% CI 0.19-28.3). Low HDL-c (44.4%), prehypertension(22.2%) and overweight (22.2%) were the most prevalent risk factors among those with renal dysfunction. Only age demonstrated relationship to renal dysfunction in terms of mean difference (p value 0.007, 95% CI, 1.125-6.818). Conclusions: The prevalence and clustering of cardiovascular risk factors is higher among children with renal dysfunction. Age showed association  to renal dysfunction. Dyslipidemia and high body mass have propensity to influence the development of pediatric CKD. Keywords: Cardiovascular risk factors, renal dysfunction, association, pediatrics, Nigeria, Africa.


2021 ◽  
Vol 5 (2) ◽  
pp. 112
Author(s):  
Kristiani Sianturi ◽  
Rini Handayani ◽  
Putri Handayani ◽  
Cut Alia Keumala Muda

Background: Firefighters.are often under pressure and get complaints from the public when extinguishing fires. They are often having heavy workloads and time targets to extinguish fires. It makes them have work stress. The initial survey showed of 80% firefighters having moderate-heavy work stress. Purpose: The aim was to know the risk factors of work stress in Firefighters in West Jakarta in 2019. Method: The research design used a cross-sectional design study. The population and samples are 105 Firefighters in West Jakarta (total sampling). The analysis was done in bivariate which was used the chi-square test. Result: The proportion of moderate-heavy work stress in Firefighters is 60.9%. Bivariate analysis show that there are relation of age (p-value < 0.001) interpersonal relationship (p-value = 0.014), and mental workload (p-value = 0.004) with work stress on Firefighters. It also show that there are no relation between level of education (p-value = 0.163), marital status (p-value = 0.071) and years of service (p-value = 0.351) with work stress on firefighter. Conclusion: The risk factors of work stress in firefighters are age, interpersonal relationships, and mental workloads.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ahmed Kh. Mohammed Almaawi

Objective: To assess CKD prevalence and risk factors including socio-demography among diabetics by estimating GFR rather than serum creatinine (sCr). Methods: A cross-sectional study was conducted in Dec. 15 2019 through Aug. 15 2020, among 800 diabetics attending tertiary diabetes centers, Baghdad. Data was collected by self-administered questionnaire. SPSS was used for data analysis by (mean, standard deviation and T-test) for quantitative variables and (frequency, percentage, Chi-square test and Kappa index) for qualitative variables. P-Value less than 0.05 was considered significant.  Results: 800 diabetics for last 5-40 years, 95.6% with type2. Aged 52.1±13.2 years, with male: female ratio 1.03:1, 63.6% were with no income, sCr level was 0.86±0.3 mg/dl, and eGFR by Cockcroft Gault (CG) and CKD-EPI equations was 100.4±36.5 & 92.2±25.5 ml/min/1.73m2 respectively. CKD prevalence based on sCr, and eGFR assessed by above equations was 13.3%, 20% and 15.9% respectively (p<0.001). Those with CKD were hypertensive, females, and living in peripheries. Conclusions: Diabetic patients, mainly those with risk factors are more likely to develop CKD. It is better to detect CKD intially by estimating the GFR, rather than serum creatinine level alone. Furthermore, using CKD-EPI equation might be better than the CG formula to estimate the GFR.


2020 ◽  
Vol 13 (4) ◽  
pp. 333-339
Author(s):  
Riska Wandini ◽  
Yuniati Yuniati

Caries prevalence and risk factors among children aged 4 to 6 years old in Bandar Lampung-IndonesiaBackground: Dental caries are still a matter of oral health in large industrialized countries , which affects 60-90% of the school children and most adults.Dental caries can be experienced by everyone and can arise on one or more dental surfaces.For example, from email to dentin or to Pulpa. Caries are due to various reasons, including are carbohydrates, microorganisms and saliva, tooth shape surfaces. Based on data by interviewed at the time were conducted on 20 Students at kindergarten Kuntum Mekar and Setia  Bandar Lampung obtained of 14 (70%) They have a cariogenic food intake during the day and had the poorest teeth brushing habits, characterized by dental caries of 7 (30%).Purpose: Knowing caries prevalence and risk factors among children aged 4 to 6 years old in Bandar Lampung-IndonesiaMethods: A quantitative research type (analytic), with cross sectional approach and population was all children at Kuntum Mekar and Setia kindergarten in Bandar Lampung. By formula Slovin got sample number of 80 students. Data analysis Used the chi-square statistical test.Result: Finding the frequency of consumption of high cariogenic foods As many as of 72 respondents (86%), had a poorest tooth brushing habits,  of 60 respondents (75%), and had a dental caries as many as of 63 respondents (83.8%), with the p-value = 0.022 and 0.002; OR: 5,357 and OR: 7,333.Conclusion: There is a correlation the factors cariogenic food intake during the day and had the poorest tooth brushing habits with dental caries occurance.Suggestions: To be pay attention for parent and teachers to remember that children reduce the consumption of cariogenic food and improving in brushing teeth habitKeywords: Cariogenic food intake; Brushing teeth habit; Dental caries.Pendahuluan: Karies gigi masih menjadi masalah kesehatan mulut di negara-negara industri besar, yang mempengaruhi 60-90% dari anak-anak sekolah dan sebagian besar orang dewasa. Karies gigi dapat dialami oleh semua orang dan dapat timbul di satu permukaan gigi atau lebih. Misalnya dari email ke dentin ataupun ke pulpa. Karies dikarenakan berbagai sebab, diantaranya adalah karbohidrat, mikroorganisme dan air ludah, permukaan bentuk gigi.Berdasarkan hasil prasurvei yang dilakukan pada siswa yang juga diwawancarai pada saat itu dilakukan pada 20 siswa di TK Kuntum Mekar dan TK Setia Bandar Lampung didapatkan data 14 siswa (70%) diantaranya mengkonsumsi makanan kariogenik dan memiliki kebiasaan menggosok gigi yang kurang baik ditandai dengan karies gigi dan 7 siswa (30%) diantaranya mengatakan jarang mengkonsumsi makanan kariogenik dan memiliki kebiasaan menggosok gigi cukup baik atau minimal dua kali sehari saat pagi sesudah makan dan malam sebelum tidur.Tujuan: Diketahui hubungan antara konsumsi makanan kariogenik dan kebiasaan menggosok gigi umur 4-6 tahun dengan kejadian karies gigi pada anak-anak di Bandar Lampung Indonesia.Metode: Penelitian kuantitatif (analitik), dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah anak-anak TK Kuntum Mekar dan TK Setia di Bandar Lampung, dengan jumlah sampel 80 murid.Pengambilan sampel menggunakan rumus Slovin.Analisis data menggunakan uji statistik chi-square.Hasil: Menunjukkan distribusi frekuensi konsumsi makanan kariogenik yang sering sebanyak 72 responden (86%), kebiasaan menggosok gigi yang buruk sebanyak 60 responden (75%). Karies gigi pada anak-anak dengan karies sebanyak 63 responden (83,8%). Ada hubungan antara konsumsi makanan kariogenik dengan kejadian karies gigi pada anak dengan nilai p-value = 0,022 (p-value<0,05), serta diperoleh nilai OR : 5.357. Ada hubungan anatara menggosok gigi dengan kejadian karies gigi pada anak dengan nilai p-value = 0,002 (p-value<0,05), serta diperoleh nilai OR : 7.333.Simpulan: Ada hubungan antara konsumsi makanan kariogenik dan kebiasaan menggosok gigi dengan kejadian karies gigi pada anak TK Kuntum Mekar dan TK Setia di Bandar Lampung Tahun 2019. Saran dalam penelitian ini diharapkan anak-anak mengurangi konsumsi makanan kariogenik dan mengetahui kebiasaan menggosok gigi yang benar.


2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Martina Wulandari ◽  
Dwi Setyawan ◽  
Alfan Zubaidi

Abstract : Risk factors, Low Back Pain, Prosthetics and Orthotics Students of Health Polytechnic of Surakarta. Low Back Pain (LBP) or lower back pain is a common health problem that found in many people, not only in older people but also in younger nowadays. Low Back Pain associated with many kind of conditions and also risk factors. The etiology of LBP is widely accepted to be multi-factorial. The objectives of this study were to determine the risk factors causing LBP on Prosthetics and Orthotics students of Health Polytechnic of Surakarta. The study is cross sectional design used a questionnaire instrument to all Prosthetics and Orthotics students. Data analysis was performed by Chi square. The results showed that the prevalence of LBP after being Prosthetics and Orthotics students of Health Polytechnic of Surakarta is 32,2%. Risk factors associated with Low Back Pain were exercise (p value 0,033), daily time spend standing (p value 0,046), lifting (p value 0,027) and perceived stress (p value 0,008). Gender, body mass index and daily time spend sitting were not associate with Low Back Pain.


2016 ◽  
Vol 16 (2) ◽  
Author(s):  
Novita Nuraini ◽  
Rossalina Adi Wijayanti

Scabies masih menjadi masalah kesehatan terutama di lingkungan padat penghuni seperti pondok pesantren. Karakteristik santri merupakan salah satu penyebab kejadian Scabies. Penelitian ini bertujuan untuk mengetahui hubungan jenis kelamin dan tingkat pendidikan dengan kejadian Skabies di Pondok Pesantren Nurul Islam Jember. Penelitian ini menggunakan metode observasional analitik dengan desain cross-sectional. Sampel yang diambil dalam penelitian ini adalah seluruh populasi dengan metode proportional sampling berjumlah 56 santri dan pengambilan sampel dilakukan pada bulan Juli 2017. Variabel dalam penelitian ini terdiri dari jenis kelamin, tingkat pengetahuan dan kejadian Skabies. Diagnosis Skabies berdasarkan anamnesis dan pemeriksaan dermatologi untuk menegakkan diagnosis skabies oleh dokter peneliti. Data yang diperoleh diolah dengan software pengolahan data dan dianalisis menggunakan uji chi square. Hasil penelitian menunjukkan santri pondok pesantren nurul islam sebagian besar berjenis kelamin perempuan (56,3%). Tingkat pengetahuan santri terkait PHBS mayoritas tergolong dalam pengetahuan kurang yaitu 73,2%. Status kesehatan para santri mayoritas menderita penyakit scabies yaitu 60,3%. Terdapat hubungan yang signifikan antara jenis kelamin terhadap angka kejadian skabies dengan Nilai P value= 0,021. Terdapat hubungan yang signifikan antara tingkat pengetahuan terhadap angka kejadian skabies dengan Nilai P value= 0. Pencegahan Scabies lebih penting dari pengobatan salah satunya dengan penyuluhan. Agar penyuluhan kesehatan memberikan hasil yang baik, penyuluhan harus disesuaikan dengan karakteristik demografi santri antara lain jenis kelamin dan tingkat pengetahuan.


Author(s):  
Pipit Novita Sandra ◽  
Istika Dwi Kusumaningrum

Background: PTM is a disease that is not caused by bacterial infection including degenerative chronic disease. Integrated Guidance Post (Posbindu) is one of the empowerment program that aims to increase community participation in controlling risk factors for non-communicable diseases. Based on data obtained in Dusun Tegalsari, Donotirto village, Posbindu PTM activity was attended by 30 participants from 478 people aged > 15 years and still low in its utilization and participation. Objective: The purpose of this research is to know the correlation of knowledge, attitude and family support with the utilization of Posbindu PTM in Degotary Tegalsari Donotirto Village Kretek District, Bantul Regency. Method: This research type is descriptive quantitative research with cross-sectional research design. The population in this study as many as 30 people in which researchers took from the population of Degotary Tegalsari village Donotirto > 15 years old and actively participate in the activities posbindu PTM. Sampling using samples saturated as many as 30 people.Instrument in this research is questionnaire by using Chi Square test. Result: The result of Chi Square test shows that there is no correlation between knowledge with the utilization of Posbindu PTM with the result of significant value (P value) the correlation between knowledge with PTM Posbindu utilization is 0.778 (P value >a ). The existence of correlationbetween attitude with utilization of Posbindu PTM with result of significant value (Pvalue) equal to 0,003 (Pvalue <a). The existence of correlationbetween family support with utilization of posbindu PTM with result of significant value (P value) equal to 0,001 (P value <a). Conclusion: There is not significant correlation between knowledge with the utilization of Posbindu PTM, the correlation between attitude with the utilization of Posbindu PTM and family support with utilization of posbindu PTM.


2020 ◽  
Vol 5 (2) ◽  
pp. 7
Author(s):  
Aldi Febrian Wieminaty, SST., M.Kes

Jember Regency is the 2nd (second) highest place in the Maternal Mortality Rate at East Java. There was an increase number of maternal deaths from 2014 to 2017 at Jember Regency. The trias ocauses maternal of death included bleeding (28%), preeclampsia / eclampsia (24%), and infection (11%). Obesity triggers the incidence of preeclampsia through several mechanisms, namely superimposed preeclampsia, or through metabolite triggers and other micro molecules. The purpose of this study was to analyze the relationship between pregnant women who obesity with the incidence of preeclampsia. This type of research is descriptive with quantitative analysis and the research uses a cross-sectional approach. The population of this study were 182 pregnant women in the Kaliwates district, Jember in May-August. above 34 weeks pregnant mom, and the exclusion criteria were mothers who were not willing to be respondents. The results obtained were 66 pregnant women, this study used the Chi-Square test. The results of this study can be concluded that there is a relationship between pregnant women and obesity to the incidence of preeclampsia, namely as much as 70.0%, and pregnant women with obesity who do not experience preeclampsia as much as 30.0%. From the statistical test, the results of the null hypothesis are rejected with a P value of 0.000 <0.05, which means that there is a relationship or there is a relationship between pregnant women and obesity with the incidence of preeclampsia. Keywords: pregnant woman, obesity, preeclampsia


2020 ◽  
Vol 6 (3) ◽  
pp. 310-315
Author(s):  
Juniar Eka Budiyani ◽  
Susilawati Susilawati ◽  
Ledy Octaviani Iqmy

ABSTRACT  Background Pre eclampsia is hypertension that occurs after 20 weeks of pregnancy accompanied by proteinuria. Based on Mangunang Kotaagung's Regional General Hospital, Mangunang Kota Agung itself obtained data from 1 January 2017 to 30 April 2019, there were 84 cases of preeclampsia from 677 cases who entered the Midwifery Hospital in Batin Mangunang, Agung City.  The Purpose of the study was the relationship between the risk factors of pregnant women and the incidence of preeclampsia and eclampsia in the Batin Mangunang Hospital in the Great City of Tanggamus Regency in 2019.  MethodsThis type of research is quantitative analytical research with a cross sectional approach. This population is all pregnant women who experienced preeclampsia as many as 54 cases for cases and 54 samples for control because this study uses a comparison of cases 1: 1. the sampling technique used is total sampling. Data collection using observation sheet and data analysis used is univariate and bivariate using the chi-square test.  The results showed that the frequency distribution of non-risk age was 66 people (61.1%), non-risky parity as many as 60 people (55.6%), respondents with a history of non-risky diseases as many as 81 people (75.0%), risky education (SD, SMP) as many as 54 people (50.0%), risk antenatal care as many as 55 people (50.9%), the incidence of preeclampsia cases as many as 54 people (50%), while respondents with preeclampsia control as many as 54 people (50%),  CoclusionThere is a relationship between risk factors for pregnant women based on age pvalue = 0.001, parity pvalue = 0.012 and antenatal service pvalue = 0.007 with the incidence of pre eclampsia, there is no relationship between risk factors for pregnant women based on maternal education p value = 0.847 and history of chronic disease 182, with the incidence of pre-eclampsia. Suggestion Can be used as knowledge, information, and references in subsequent studies related to factors related to the incidence of preeclampsia in labor by adding different variables and adding the number of samples with primary data.  Keywords: risk factors for preeclamptic events  ABSTRAK   Latar Belakang Pre eklampsia adalah hipertensi yang timbul setelah 20 minggu kehamilan disertai dengan proteinuria. Data Rumah Sakit Umum Daerah Batin Mangunang Kota Agung Periode 1 Januari 2017 sampai dengan 30 April 2019 terdapat  84 pasien dengan kasus preeklampsia dari 677 kasus yang masuk ke Ruang Kebidanan RSUD Batin Mangunang Kota Agung.  Tujuan penelitian untuk mengetahui  hubungan Antara Faktor Resiko Ibu Hamil dengan kejadian preeklamsi dan eklamsia Di RSUD Batin Mangunang  Kota Agung Kabupaten Tanggamus Tahun 2019.  Metode Jenis penelitian ini merupakan penelitian analitik kuantitatif dengan pendekatan cross sectional. Populasi ini adalah semua ibu hamil yang mengalami preeklampsi sebanyak 54 kasus untuk kasus dan 54 sampel untuk kontrol karena penelitian ini menggunakan perbandingan kasus 1:1.teknik sampling yang digunakan total sampling. Pengumpulan data dengan menggunakan lembar observasi dan analisa data yang digunakan adalah univariat dan bivariat dengan menggunakan uji chi-square. Hasil penelitian didapatkan bahwa Distribusi frekuensi usia tidak berisiko sebanyak 66 orang (61,1%), paritas yang tidak berisiko sebanyak 60 orang (55.6%), responden dengan riwayat penyakit yang tidak berisiko sebanyak 81 orang (75,0%), pendidikan berisisiko (SD, SMP) sebanyak 54 orang (50.0%), pelayanan antenatal berisiko sebanyak 55 orang (50,9%), kejadian preeklampsia kasus sebanyak 54 orang (50%), sedangkan responden dengan preeklampsia kontrol sebanyak 54 orang (50%),  Kesimpulan Ada hubungan antara Faktor resiko ibu hamil berdasarkan umur pvalue = 0,001, paritas pvalue = 0,012 dan pelayanan antenatal pvalue= 0,007 dengan Kejadian pre eklamsia, tidak ada hubungan antara Faktor resiko ibu hamil berdasarkan pendidikan ibu pvalue = 0,847 dan riwayat Penyakit kronik pada ibu  pvalue = 182, dengan Kejadian pre eklamsia.  Saran Dapat dijadikan sebagai pengetahuan, informasi, dan referensi dalam penelitian selanjutnya terkait faktor-faktor yang berhubungan dengan kejadian preeklampsia pada persalinan dengan menambahkan varibel yang berbeda dan menambahkan jumlah sampel dengan data primer.  Kata Kunci : Faktor Risiko kejadian preeklampsi  


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