scholarly journals Efficacy of topical Calcipotriol versus combination of topical Calcipotriol plus Betamethasone in the treatment of plaque type psoriasis

2015 ◽  
Vol 10 (1) ◽  
pp. 74-79
Author(s):  
Md Shirajul Islam Khan ◽  
Md Nasir Uddin ◽  
Md Abdul Latif Khan ◽  
Rowshan Ara ◽  
Lubna Khondker
Keyword(s):  
Combination Therapy ◽  
Plaque Psoriasis ◽  
Military Hospital ◽  
P Value ◽  
Base Line ◽  
Plaque Type ◽  
Pasi Score ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: The effectiveness of various topical agents for the treatment of plaque psoriasis is limited and the results are somewhat not satisfactory to some extent. Topical Calcipotriol can be used either monotherapy or combination therapy with betamethasone. This topical agent has “corticosteroid-sparing” benefit and reduction of side effects, duration of treatment and also relapse rates when used as combination therapy for the treatment of psoriasis. Objectives: The present study was conducted to compare the clinical efficacy between the topical Calcipotriol and combined formulation of topical Calcipotriol plus Betamethasone in the treatment of plaque type psoriasis. Materials and Methods: A clinical trial was carried out from January 2011 to Jan 2014 in outpatient department of Dermatology and Venereology, combined military hospital- Dhaka and Jessore Cantonment and Bangabandhu sheikh Mujib Medical University, Dhaka. Patients of plaque type psoriasis were the study population. Consequitive type of non-probability sampling method was followed in this study. Patients were divided into two groups.Group A was treated with topical Calcipotriol (0.005%) ointment and group B with combination of topical Calcipotriol plus Betamethasone ointment. Results: The mean percentage of Psoriasis Area and Severity Index (PASI) reduction after 4th week of treatment was 39.4 and 35.4 in group A and group B (p value >0.05) and after 8th week of 74 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 therapy was 59.6 in-group A and 60.7 in-group B respectively. The mean baseline PASI score was 6.7±4.5 and after 8th week it was 2.0 ±1.4 for group A and mean baseline PASI score was 5.5 ±4.2 and after 8th week it was 2.5±1.4 for group B. There was statistically significant reduction in PASI score from base line after 8th week of treatment in both treatment groups (p < 0.001). After 8th week of treatment moderate response was 22(73.3%) in group A and 18(60%) in group B. Very good response was 4 (13.3%) in group A and 8 (26.7%) in group B and minimal response of treatment occurs equally 4 (13.3%) in group A and group B. Conclusion: In the light of the findings of this study, topical Calcipotriol(0.005%) alone or combination with Betamethasone is individually effective for the treatment of plaque psoriasis but combination therapy is more effective than monotherapy. Therefore it may be recommended that monotherapy can be replaced by combination therapy in treating plaque psoriasis. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22929 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

scholarly journals Comparative Efficacy of Topical Calcipotriol (0.005%) Versus Topical Corticosteroid (Betamethasone 0.1%) in Treating Plaque Type Psoriasis

2015 ◽  
Vol 26 (2) ◽  
pp. 88-94
Author(s):  
Gulam Kazem Ali Ahmed ◽  
Lubna Khandker ◽  
Moriom Nessa ◽  
Mohd Nurul Alam ◽  
Anjana Chakraborty ◽  
...  
Keyword(s):  
Topical Corticosteroid ◽  
Base Line ◽  
Double Blind Study ◽  
Double Blind ◽  
Plaque Type ◽  
Pasi Score ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Medical University

A clinical trial was carried out to compare the efficacy of topical calcipotriol (0.005%) and topical corticosteroid (betamethasone 0.1%) in the treatment of plaque type psoriasis. The study was conducted from January 2012 to August 2012 and patients of plaque type psoriasis attending outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka were the study population. Patients were divided into two groups, group A was treated with topical calcipotriol (0.005%) ointment and group B with topical corticosteroid (betamethasone 0.1%) ointment. The mean baseline PASI score was 6.7 ±4.5 and after 8 weeks, the mean PASI score was 2.0 ±1.4 for group A and mean baseline PASI score was 5.5 ±4.2 and after 8 weeks, the mean PASI score was 2.5 ±1.4 for group B. There was statistically significant reduction in PASI score from base line after 8 weeks of treatment in both treatment groups (p < 0.001). After 8th week of treatment moderate response was 11(73.3%) in group A and 9(60%) in group B. Very good response was 4 (26.7%) in group B and 2 (13.3%) in group A and minimal response of treatment occurs equally 2 (13.3%) in group A and group B. In the light of the findings of the study we conclude that each of the treatment of calcipotriol(0.005%) and betamethasone (0.1%) is individually effective. Further multicenter, randomized, double-blind study should be conducted with large sample size.Medicine Today 2014 Vol.26(2): 88-94

scholarly journals INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

scholarly journals Transient Hypothyroxinaemia in Full Term Low Birth Weight Neonates

1970 ◽  
Vol 6 (1) ◽  
pp. 8-11
Author(s):  
Z Parveen ◽  
N Begum ◽  
MM Hossain
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Low Birthweight ◽  
Full Term ◽  
Military Hospital ◽  
Control Group ◽  
Base Line ◽  
Group A ◽  
The Mean ◽  
Group B

This prospective study was done in Combined Military Hospital, Dhaka from July 2002 to June 2003 todocument the postnatal changes of thyroid hormones in full term low birth weight (LBW) neonates. Theparameters were- serum TT4 (total thyroxin), TT3 (total triiodothyronine), FT4 (free thyroxin) and TSH(thyroid stimulating hormone). Twenty seven healthy full term neonates formed the control group (group A)who were studied on day 5 to observe the base line data. Study group (group B) consisted of 27 low birthweight (LBW) neonates. They were studied twice on day 5 (B1) and day 45 (B2). The mean ± SD gestational agewas 38.41±0.93 and 38.63±1.08 weeks in group A and B respectively. The mean ± SD birth weight were3.41±0.55 and 2.11±0.33 kg in group A and B respectively and the difference was statistically significant (p<0.0001). All neonates of group A had normal serum levels of TT4, TT3, FT4 and TSH on day 5 but in LBW fullterm neonates though FT4 level remained within normal range, 48% neonates of group B had significantlydecreased levels of TT4, TT3 and TSH (p<0.001) but on day 45 all of these hormone levels were significantlyincreased (p<0.001) and attained normal values. This study showed that 48% LBW neonates had transienthypothyroxinaemia on day 5 which was corrected spontaneously by day 45.Key words: Hypothyroxinaemia; Low birth weight (LBW).DOI: 10.3329/jafmc.v6i1.5984Journal of Armed Forces Medical College, Bangladesh Vol.6(1) 2010 p.8-11

scholarly journals EVALUATION OF DEXMEDETOMIDINE ON HEMODYNAMIC STRESS RESPONSE DURING LARYNGOSCOPY AND INTUBATION

2021 ◽  
Vol 71 (6) ◽  
pp. 2126-30
Author(s):  
Abdul Raafeh Jamal ◽  
Bilal Yaseen ◽  
Mohammad Saeed ◽  
Rao Ali Shan Khan ◽  
Syed Hamid Ali Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Systolic Blood Pressure ◽  
Military Hospital ◽  
P Value ◽  
Hemodynamic Stress ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Dexmedetomidine (Precedex) in addressing the mean haemodynamic stress response to laryngoscopy and endotracheal intubation (L&I). Study Design: Quasi-experimental study. Place and Duration of Study: Anesthesiology Department, Combined Military Hospital, Rawalpindi, from Jun 2019 Jun 2020. Methodology: The patients were divided into two groups. Group A was given Inj. Dexmedetomidine and group B (placebo). Operation theatre assistant randomly assigned the patients to either group A or group B each day. The second person administered the drug or placebo. The third person (researcher) recorded all the parameters mentioned in the proforma. Results: There were 100 patients with an age range of 18-60 years. The majority of the patients were ASA-I physical status. The main surgical procedure was laparoscopic cholecystectomy. Recording of heart rate and systolic blood pressure during laryngoscopy and intubation, after administration of drug or placebo, showed mean heart rate less than mean basal value in group-A and 22% above mean basal value in group-B, and it was statistically highly significant (p-value <0.001). Whereas mean systolic blood pressure in group-A was 122.42 ± 14.91 (less than the mean basal value) as compared to group B, 155.00 ± 18.32/min (20% above mean basal value). This change was also statistically highly significant (p-value <0.001). Conclusion: It is concluded that dexmedetomidine showed statistically significant stabilizing effects on the expected changes of the hemodynamic stress response.

scholarly journals Methotrexate plus narrow band ultraviolet B (NBUVB) versus methotrexate alone in the treatment of moderate to severe plaque psoriasis: A randomized clinical trial

2016 ◽  
Vol 13 (1) ◽  
pp. 12-23 ◽  
Author(s):  
Dhan Keshar Khadka ◽  
S Agrawal ◽  
T K Dhali
Keyword(s):  
Plaque Psoriasis ◽  
Negative Impact ◽  
Ultraviolet B ◽  
Plaque Type ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life. Efficacy of combination of methotrexate/narrowband ultraviolet B (NBUVB) phototherapy in the treatment of psoriasis has been rarely assessed. Objectives: To compare the therapeutic efficacy of methotrexate plus NBUVB phototherapy combination vs.  methotrexate  in  the  treatment  of  moderate  to  severe  chronic  plaque  psoriasis. Material and methods: Seventy-nine patients with chronic plaque-type psoriasis (body surface area involvement >2%) were randomized to receive either methotrexate/NBUVB phototherapy (group A) or methotrexate (group B). End point of treatment was 75% reduction in Psoriasis Area and Severity Index (PASI75) Score or up to 12weeks, whichever was earlier. Patients were then followed up for a period of 12 weeks for assessment of adverse effect, DLQI and relapse.Results: Of 79 patients, 69 completed the treatment period and follow-up. PASI 75 was achieved in 35/39(89%) patients in group A and 34/40(85%) patients in group B (P=0.052). The mean number of weeks (P = 0.031), the mean cumulative dose of NBUVB (8.2±3.5J/cm2)) and the mean number of phototherapy sessions (12±3)) required to achieve PASI 75 were less in group A compared with group B. There was no significant difference in the number of patients who relapsed during the follow- up period (P = 0.68). Conclusion: Combination of methotrexate and NBUVB phototherapy provides more rapid clinical improvement compared with methotrexate monotherapy in the treatment for chronic plaque-type psoriasis.NJDVL Vol. 13, No. 1, 2015 Page: 12-23

scholarly journals The Effect of Oral Zinc Therapy in Psoriasis Patients with Serum Zinc Deficiency: A Prospective Observational Study

2021 ◽  
Author(s):  
Majid Rostami Mogaddam ◽  
Nastaran safavi Ardabili ◽  
Nasrollah Maleki
Keyword(s):  
Zinc Deficiency ◽  
Thyroid Dysfunction ◽  
Serum Zinc ◽  
Treated Group ◽  
Zinc Level ◽  
P Value ◽  
Pasi Score ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Introduction: Some studies have reported an association between serum zinc levels and psoriasis. This study aimed to assess the serum zinc level and thyroid dysfunction between psoriasis patients and healthy controls. Also, we evaluated the effect of oral zinc therapy in psoriasis patients with serum zinc deficiency. Materials and Methods: A total of 100 psoriasis patients and 100 healthy age- and sex-matched volunteers were enrolled in this prospective cross-sectional study. Finally, 52 psoriasis patients with serum zinc deficiency were randomly divided into two groups: one in which clobetasol cream alone was treated (group A), and one in which clobetasol cream plus oral zinc sulfate was treated (group B). The treatment response was assessed with Psoriasis Area and Severity Index (PASI) score. Results: The mean serum zinc level in psoriasis patients and controls was 62.3 ± 14.3 μg/dL and 87.7 ± 35.2 μg/dL, respectively (P-value= .001). Serum zinc deficiency was found in 52% and 26% of psoriasis patients and control subjects, respectively. Thyroid dysfunction was found in 8% of patients with psoriasis compared with 7% in control subjects (P-value=.361). At the end of the 12th week of treatment, the mean value of % reduction from baseline values of PASI Score in group A was 23.8 ± 18.2%, whereas this was 21.31 ± 17.8% in group B (P-value=.486). Conclusion: Although the prevalence of serum zinc deficiency is higher in psoriasis patients compared with healthy subjects, oral zinc supplementation does not appear to have therapeutic benefits in these patients. Also, we could not find any relationship between thyroid dysfunction and psoriasis.

scholarly journals A prospective randomized single blind study to compare the safety and efficacy of propronolol and topiramate in migraine prophylaxis

2021 ◽  
Vol 10 (4) ◽  
pp. 425
Author(s):  
Keelu Rajkumar ◽  
Pothuru Anil Kumar
Keyword(s):  
Blind Study ◽  
P Value ◽  
Base Line ◽  
Safety And Efficacy ◽  
Treatment Groups ◽  
Migraine Headaches ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Single Blind

Background: The aim of the study was to compare the Safety and efficacy of propranolol and topiramate in migraine prophylaxis.Methods: This was a prospective, randomized, single blind study which was conducted for six months in 100 patients of outpatient department of Neurology Government General Hospital, Guntur.Results: Among the hundred patients fifty were allotted to group A – propranolol 40 mg bd and fifty were allotted to group B- topiramate 25 mg bd. statistically there is no significant differences were found between the treatment groups of Propranolol and topiramate for the reduction in mean duration and severity of migraine headaches. Both Propranolol and topiramate have p value<0.001. This shows that both propranolol and topiramate have significantly decreased in the mean duration and severity of migraine attacks. However, in the present study topiramate is slightly more efficacious in reducing the symptoms of migraine frequency per month (days), duration and severity (visual analogue scale- VAS score) from baseline at the end of six months. The decrease in frequency of migraine attacks from 10.44±4.38 to 3.18±4.48 i.e., 70.2% from baseline is seen with topiramate.Conclusions: This study demonstrated that both propranolol and topiramate could significantly reduce migraine headache frequency, duration and intensity. However, compared with propranolol topiramate showed better results. topiramate 25 mg reduced the symptoms like frequency, duration and severity of migraine attacks from base line at the end of six months but more number of adverse effects were seen in topiramate group.

scholarly journals AB0393 EFFICACY OF HYDROXYCHLOROQUINE FOR LUPUS NEPHRITIS IN MAINTENANCE PHASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1496.2-1496
Author(s):  
M. Watanabe ◽  
Y. Haji ◽  
M. Kato ◽  
T. Ito ◽  
Y. Banno ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Therapeutic Option ◽  
Maintenance Phase ◽  
Base Line ◽  
Prednisolone Dose ◽  
Daily Urine ◽  
Group A ◽  
The Mean ◽  
Group B

Background:Hydroxychloroquine (HCQ) is an essential drug for systemic lupus erythematosus. But in Japan, chloroquine and HCQ remain unavailable until mid 2015 because of a series of lawsuits about its retinal toxicity in the 1970s. There is insufficient knowledge regarding renal protective effect of HCQ.Objectives:We aimed to investigate its efficacy of adding HCQ for Lupus nephritis (LN) as a maintenance-phase therapy.Methods:We conducted an observational retrospective cohort study included patients with LN (n=42) in maintenance-phase in Japan. We reviewed medical records of LN patients aged > 18 years who were initiated HCQ from May 2015 to May 2018. Maintenance phase was defined as stabilization in serum creatinine and urinary segment after induction therapy and who achieved complete or partial remission. The annual change of proteinuria was compared between patients on HCQ who have proteinuria (>0.5g/gCr) or not. Other outcome measures were disease flare, dose of steroids, renal and immunologic features.Results:A total of 42 patients were analyzed and allocated to two groups based on their amount of daily urine protein level: HCQ with proteinuria as group A (>0.5g/gCr, n=14) and HCQ without proteinuria as group B(≦0.5g/gCr, n=28). Both groups were comparable, with mean (SD) age of 36.1 (12.9) years and 37.5 (13.8), female 78.6% and 92.9% in each group, mean (SD) disease duration until HCQ of 3.5 (3.25) and 3.3 (2.9) years in group A and group B, with prednisolone dose at base line of 10.3 (7.1) mg and 7.9 (4.4) mg, respectively. The mean (SD) proteinuria at base line was 1.38 (1.11) g/gCr in group A and 0.20 (0.09) g/gCr in group B and after 12 months, proteinuria decreased in group A (-1.34 g/gCr in group A vs +0.03 g/gCr in group B; p<.001;95% CI,0.305-0.736). No relapse was experienced in group A during the study period.Conclusion:In patients with clinically stable LN but with proteinuria, hydroxychloroquine is a good therapeutic option for achievement of complete remission.Disclosure of Interests:None declared

scholarly journals TO DETERMINE EFFICACY OF GRANISETRON VERSUS PLACEBO FOR REDUCING SHIVERING IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

2021 ◽  
Vol 71 (2) ◽  
pp. 530-34
Author(s):  
Sana Abbas ◽  
Bilal Yasin ◽  
Basit Mehmood Khan ◽  
Umer Hayat ◽  
Beenish Abbas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Patient Comfort ◽  
Military Hospital ◽  
P Value ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Group A ◽  
Group B

Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia. Study Design: Comparative cross - sectional study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019. Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minutes and 60 minutes, average surgery time recorded to be 60 minutes. Results: None of the patients in group A (drug group) exhibited appreciable post spinal shivering whereas 25 (29%) in group B (placebo) had clinically significant shivering necessitated administration of other established pharmacological agents to abort shivering in order to ensure patient comfort and satisfaction with statistically significant p-value of <0.05. Conclusion: Prophylactic injection granisetron was efficacious against post spinal shivering, moreover provides worth while relief of nausea and vomiting which is dilemma with most of the drugs employed for control of post spinal shivering.

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Epidemiological Data ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

Sign in / Sign up

Export Citation Format

Share Document