IMSEAR Repository :: Browsing by Author "Tiwari, S"

Browsing by Author "Tiwari, S"

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Adverse Drug Reactions to Antifungals Used in the Management of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
(SAGE Publications, 2022-07) Tiwari, S; Vakil, Z.
Objectives: To determine the incidence and frequency of adverse drug reactions (ADRs) to find out factors, if any contributing to the same, while also exploring the use of amphotericin B deoxycholate as a cheaper and safe alternative to liposomal amphotericin B. Materials and Methods: It was a cross-sectional observational study, with a study population of 50 conducted over three months after ethics approval. All adult patients admitted to a tertiary care center, in a metropolitan city of Maharashtra, diagnosed with Rhino-orbito-cerebral mucormycosis, with a history of previous COVID-19 infection and receiving antifungals for the treatment of the same were included in the study. Central Drugs Standard Control Organization (CDSCO) ADR reporting forms were used to collect data. Results: Electrolyte disturbances mainly hypokalemia were the most frequently encountered ADR with both Amphotericin formulations (39/50; 20.31%) followed by pain at the injection site (33/50; 17.19%). Nephrotoxicity occurred slightly more frequently with Amphotericin B Deoxycholate (19/29; 65%), compared to Liposomal Amphotericin B (11/19; 57%), while Posaconazole was mainly associated with gastrointestinal (GI) disturbances and hepatotoxicity. Conclusion: Amphotericin B Deoxycholate was associated most with ADRs, hypokalemia, and pain at the injection site being the most frequent. However, concerning nephrotoxicity, both Amphotericin formulations showed only a modest difference. Posaconazole was associated with the least number of ADRs and had a favorable safety profile.
Anal leiomyosarcoma.
(1996-07-01) Porwal, K K; Tiwari, S; Pendse, A K
Anti-Saccharomyces cerevisiae antibody is not useful to differentiate between Crohn's disease and intestinal tuberculosis in India.
(2007-07-19) Ghoshal, U C; Ghoshal, U; Singh, H; Tiwari, S
CONTEXT: Clinical, endoscopic, radiological and histological parameters of intestinal tuberculosis (IT) and Crohn's disease (CD) are so similar that differentiation between these two diseases, which require different treatment, is difficult. Anti- Saccharomyces cerevisiae antibody (ASCA), which is often present in the sera of patients with CD, may be potentially useful to differentiate CD from IT. AIM: To evaluate the role of enzyme-linked immunosorbent assay test for ASCA in serum in differentiating CD from intestinal tuberculosis. SETTINGS AND DESIGN: Prospective case-control study. MATERIALS AND METHODS: Sixteen patients with IT, 16 CD, 36 UC diagnosed using standard parameters and 12 controls (11 healthy subjects and one with colonic carcinoma) were tested for IgG ASCA in serum. STATISTICAL ANALYSIS USED: Categorical variables were analyzed using Chi-square test with Yates' correction, as applicable. Continuous variables were analyzed using Mann-Whitney U test. RESULTS: Eight of 16 (50%) patients with IT, 10 of 16 with CD (62%), nine of 35 with UC (26%) and one of 12 controls tested positive for ASCA in serum. Though the frequency of ASCA in serum was comparable among patients with IT and CD (8/16 vs. 10/16, P = ns), IT and UC (8/16 vs. 9/35, P =ns), CD and UC (10/16 vs. 9/35, P =ns), its frequency in CD or IT but not in UC was higher than healthy controls (P Conclusions: Serum ASCA is unlikely to be useful to differentiate between CD and IT in India.
Artificial Intelligence-Powered Pediatric Dentistry: A Glimpse into the Future
(People's University, 2024-01) Taiwade, A; Tiwari, S; Mali, S; Suganya, M
The rapid digitalization of various aspects of life has significantly transformed dentistry, improving the quality of dental care through advanced technologies like artificial intelligence (AI). AI, which replicates human cognitive processes, has revolutionized dental practices by automating timeconsuming tasks and offering precise diagnostics and treatment plans. Despite being in early development stages, AI in dentistry signifies a disruptive technology poised to redesign clinical care. Innovations such as CAD/CAM systems, intraoral imaging, and digital radiography illustrate AI's applications in caries diagnosis, implant design, etc. Historical milestones, from conceptualization of AI to advancements in machine learning and neural networks, have paved the way for sophisticated AI models used in various dental specialties, including pediatric dentistry. AI's potential extends to patient education and practice management, promising a future where dentistry is increasingly efficient, accurate, and patient-centered. This review highlights role of AI in pediatric dentistry with special mention of review of literature.
Assessment of age-based variations in physiological and anthropometric metrics in Kashmiri men
(Medip Academy, 2025-03) Haq, MAU; Tiwari, S; Tiwari, S.
Background: This study investigates age-related variations in physiological and anthropometric metrics among Kashmiri men aged 60-70 years, focusing on cardiovascular and body composition parameters across two age groups (60-65 and 66-70 years). Methods: Conducted under ethical approval from the university of Delhi, the study included 200 physically active participants, evenly divided into two age groups. Physiological metrics-systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate (RHR), body mass index (BMI), body fat percentage (BFP), waist-to-hip ratio (WHR), and basal metabolic rate (BMR)-were measured using validated tools. Data were analysed using descriptive statistics, independent t-tests, and Pearson’s correlation analysis, with significance set at p<0.05. Results: Significant differences were observed in RHR and BMR between the age groups. Participants aged 66-70 exhibited higher RHR (82.33±3.71 bm?¹) compared to those aged 60-65 (80.88±3.46 bm?¹, p=0.01). Conversely, the 60-65 group showed a higher BMR (1555.19±184.65 kcal/day) than the 66-70 group (1487.42±165.96 kcal/day, p=0.01). Non-significant differences were noted for SBP, DBP, BMI, BFP, and WHR, though BFP approached significance (p=0.06). Correlation analysis revealed strong interrelations among BMI, BFP, and BMR, with weaker associations between blood pressure metrics and WHR. Conclusions: Age-related changes in RHR and BMR highlight physiological adaptations among older Kashmiri men. These findings underscore the need for tailored health interventions addressing cardiovascular and metabolic risks in this demographic.
Assessment of Genetic Variability, Heritability and Genetic Advance for Seed Yield and Its Contributing Traits in Greengram [Vigna radiata (L.) Wilczek]
(Ms. M. B. Mondal, 2024-03) Jain, N; Sikarwar, RS; Tripathi, MK; Tiwari, S; Rahangdale, S; Barela, A.
Vigna radiata L. Wilczek, sometimes known as greengram or mungbean, is a popular pulse crop in India. Most of its cultivation takes place in India's subsistence farming systems. It is cultivated in three distinct seasons in India, despite the extremely low average productivity. Due to the crop's extensive growth in a variety of environmental circumstances, the local germplasm exhibits a high degree of genetic variation. In order to determine the genetic variability, heritability, and genetic advancement of 40 green gram genotypes, a study utilizing twelve quantitative variables was conducted. For every traits, significant variance was discovered using basic descriptive statistics. High Phenotypic Coefficients of Variation (PCV) and high Genotypic Coefficients of Variation (GCV) were identified for seed yield per plant, number of branches per plant, number of clusters per plant, biological yield per plant, number of pods per plant and 100 seed weight. Moderate PCV and GCV values observed for number of seeds per pod, plant height, harvest index, pod length and days to 50% flowering, whereas low PCV and GCV values were observed for days to maturity. Most of the characters studied in the current study had high estimates of heritability coupled with high to moderate genetic advance as a percentage of mean. This may be attributed to the preponderance of additive gene action and their high selective value, meaning that selection pressure can be applied profitably to these characters to improve them rationally.
Assessment of Maternal Predictors of Intrauterine Growth Retardation-A Case-Control Study
(Society for Scientific Research, 2024-09) Soni, U; Deodhar, P; Tiwari, S; Shirali, V
Background: Intrauterine growth restriction (IUGR) is a common disorder in which the birth weight is less than 10th percentile. This ongoing challenging fetal adverse condition leads to postnatal morbidities and fetal mortality. Methods: Forty postnatal women with newborns weighing less than the 10th percentile for gestational age (GA) were recruited as cases in this case-control research, and forty postnatal women whose neonatal weight was within the GA were recruited as controls. A thorough history of medical, obstetric, and maternal Sociodemographic factors was recorded and compared. Results: Most mothers (46.3%) were 21-30 with a mean±SD of 24.83±4.09 years. Most of them (78.8%) belonged to the lower middle class; there was significantly poor weight gain during pregnancy among cases (80%) as compared to among controls (60%). Anemia, hypertensive disorders of pregnancy, previous history of abortion, or IUGR were significantly associated with fetal growth retardation (p<0.05). Conclusion: Low socioeconomic level, low gestational weight gain, anemia, hypertensive disorders of pregnancy, and previous history of abortion are potent risk factors for IUGR. Therefore, proper screening of these risk factors is essential to improve neonatal health.
Association Between Asthma and Coronary Heart Disease: A Systematic Review and Meta-Analysis
(Society for Scientific Research, 2024-12) Tiwari, P; Rathore, RK; Tiwari, S; Dhakar, JM.
Background: Airway tightness is a clinical symptom of asthma. It is a diverse syndrome that presents with a range of characteristics. The arteries become inflamed and hardened due to coronary artery disease. Asthma also causes swelling of the airways. Coronary artery disorders are characterized by inflammation and lipid buildup. As a result, numerous writers have reported that asthmatics are more likely to develop cardiovascular diseases (CVD). Methods: Ten published articles about coronary artery disease and asthma that were released between May 2004 and April 2018 were chosen by the search technique. Results: The study's pooled analysis revealed a significant correlation between CHD and asthma overall [OR 2.26 (1.45, 3.52), p=0.0003]. The heterogeneity test yielded higher results (I2 = 99%, p<0.00001). Conclusion: According to this pooled analysis, individuals with asthma have a greater risk of coronary heart disease. Asthma and the incidence of coronary heart disease are positively correlated, according to several earlier research.
Bardet-Biedl syndrome with rheumatic aortic regurgitation.
(2008-09-18) Mukta, V; Tiwari, S; Kalirattiname, M
A case report of ruptured corpus luteal cyst with congenital bleeding disorder
(Medip Academy, 2025-05) Dohare, R; Tiwari, S; Roy, S.
Women of reproductive age with Von Willebrand disease (VWD) are at increased risk of haemorrhagic ovarian cysts due to excessive bleeding into the corpus luteum during ovulation. The rupture of these cysts can lead to life-threatening hematoperitoneum and other complications such as pelvic adhesions, fallopian tube blockages, and ovarian damage, which may impair fertility. Early diagnosis and management of VWD are critical to mitigating these risks. A 20-year-old unmarried woman presented to the emergency department with acute abdominal pain and vomiting. She was hemodynamically unstable and in shock, with severe pallor, abdominal distension, and guarding. Laboratory tests revealed a hemoglobin level of 3.9 g/dl. Imaging suggested a ruptured corpus luteal cyst with gross haemoperitoneum, and a negative urine pregnancy test ruled out ectopic pregnancy. Emergency laparotomy revealed a ruptured 4x2 cm corpus luteal cyst and approximately 2000 cc of haemoperitoneum, which was drained. Postoperatively, the patient experienced recurrent bleeding from the wound site, requiring multiple blood transfusions, resuturing, and a second exploratory laparotomy to drain a 500 cc subcutaneous hematoma. Further investigations confirmed a diagnosis of VWD. The patient was managed with transfusions of blood products and factor VIII and eventually discharged in stable condition. This case underscores the diagnostic and therapeutic challenges of managing VWD in reproductive-aged women with acute gynecological emergencies. Severe haemoperitoneum, recurrent bleeding, and impaired wound healing necessitate a high index of suspicion for bleeding disorders in similar presentations. Multidisciplinary care involving gynecologists, hematologists, and critical care specialists is essential for optimal outcomes.
Circadian rhythm of peak expiratory flow rate in healthy north Indian men.
(2008-01-04) Goyal, M; Goel, A; Kumar, P; Bajpai, M; Verma, N S; Kant, S; Tiwari, S
Peak expiratory flow rate (PEFR) variability follows a specific pattern in asthmatics as well as in healthy individuals. There is scarcity of data for Indian healthy subjects. The PEFR (L/min.) was measured with Wright's portable peak flow meter at 05:00, 8:00, 11:00, 14:00, 17:00, 20:00 and 23:00 hours in 42 healthy, non-smoking adults of age group between 18-26 years. The variability of PEFR revealed a circadian pattern. PEFR levels tend to increase from morning at 5:00 hours till evening at 17:00 hours, with peak PEFR in evening at 17:00 hours, after which there was a progressive fall in PEFR levels, till morning 5:00 hours. This study provides the preliminary reference data of circadian pattern of PEFR in healthy individuals.
Comparison of internal sphincterotomy with topical diltiazem for post-hemorrhoidectomy pain relief: a prospective randomized trial.
(2009-01-27) Chauhan, A; Tiwari, S; Mishra, V K; Bhatia, P K
AIM: To assess the efficacy of internal sphincterotomy compared with application of topical 2% Diltiazem ointment after hemorrhoidectomy for pain relief. SETTINGS AND DESIGN: Prospective randomized study. MATERIALS AND METHODS: In an 18-month period, 108 subjects with uncomplicated Grade 3/ 4 hemorrhoids were enrolled in the study and were randomized into two equal groups: Subjects in Group A underwent internal sphincterotomy at time of primary surgery while those in Group B received 1 g of 2% Diltiazem ointment locally, thrice daily for seven days. Postoperative pain perception was measured using visual analog score (VAS) and on the basis of number of analgesic tablets (Tab tramadol 50 mg) required in each group. Time to discharge, time to return to work and incidence of complications measured and compared. STATISTICAL ANALYSIS USED: Statistical techniques applied were Student T test, Chi-square and Fisher's Exact Test. RESULTS: There were 102 analyzable subjects (Group A: 50 and Group B: 52). The mean VAS score was significantly less in the internal sphincterotomy group from the fourth postoperative day onwards compared to topical Diltiazem (2.23 vs. 3.72; P =0.031). Similarly, the mean requirement of analgesic tablets [10.54 vs. 15.40; P =0.01] was much lower in Group A. There was no significant difference in terms of time to discharge and time to return to work between the two groups. The incidence of complications was more with the internal sphincterotomy group (11.5% vs. 3 %; P =0.488). CONCLUSIONS: In patients undergoing hemorrhoidectomy, addition of surgical internal sphincterotomy results in lesser pain in the postoperative period as compared to those receiving topical application of Diltiazem.
Compulsory Yoga Protocol for MBBS Students- Students’ Perspective
(Society for Scientific Research, 2025-06) Tiwari, S; Kadarkar, K; Awasthi, S
Background: The National Medical Commission (NMC) introduced a compulsory Yoga module in the foundation course of MBBS students as part of Competency-Based Medical Education (CBME). Yoga is well known for its mental and physical benefits, including stress reduction and improved focus. This study aimed to explore students’ perspectives on the compulsory Yoga protocol. Methods: A cross-sectional study was conducted among 417 MBBS students (batches 2018–2022) from two medical colleges in Madhya Pradesh and Maharashtra. Data were collected using a pre-tested, semi-structured questionnaire and analyzed using SPSS v.24. Results: Most participants were from First MBBS and aged 21–25 years. Academic stress (70%), time mismanagement (33%), and internet distractions (14%) were cited as major hurdles. A majority (95%) agreed on the necessity of Yoga in the MBBS curriculum, citing benefits like improved mental health, relaxation, and stress relief. About 70% did not associate Yogasanas with religion, and 84% expressed willingness to continue Yoga. Most reported satisfaction with Yoga arrangements, especially the involvement of certified trainers. Around 93% felt more energetic and focused post-session and 83% reported regular involvement in physical activities like walking and running. Conclusion: The compulsory Yoga protocol was well-received by MBBS students and found effective in alleviating stress and enhancing focus. Regular integration of Yoga in medical education could promote long-term wellness and improve the quality of life for medical students
Effect of oophorectomy on expression of calcium sensing receptor mRNA in rat duodenal mucosa.
(2003-01-23) Mehrotra, M; Gupta, S K; Tiwari, S; Agarwal, A; Kumar, K; Awasthi, P K; Godbole, M M
Calcium sensing receptor (CaR) in duodenal mucosa may be involved in active calcium absorption. Estrogen deficiency results in decreased intestinal calcium absorption. Effects of bilateral oophorectomy (OVX) have been studied on calcium homeostasis, bone mineral density (BMD) and CaR mRNA levels in duodenal mucosa at 4 weeks in adult female Sprague Dawley rats and compared with those in sham-operated and control group. There was no significant change in serum corrected calcium, inorganic phosphorous, calcidiol and intact parathyroid hormone in all the three groups. OVX rats had a significant decline in serum estrogen (E2) levels and alkaline phosphatase. They also had a significant decrease in BMD (DXA) at lumbar spine in vivo, and proximal and distal tibia in vitro while there was no significant change in serum E2 and BMD parameters in sham-operated and control rats. Northern blot analysis revealed no significant change in the CaR mRNA expression in duodenal mucosa in all three groups. The results suggests that CaR mRNA expression in duodenal mucosa is not affected by physiological circulating concentrations of estradiol in rats.
Effects of rotating night shift and exposure of light at night on circadian pattern of salivary cortisol and urinary melatonin levels.
(2014-02) Anjum, B; Verma, N S; Tiwari, S; Fatima, G; Bhardwaj, S; Naz, Q; Singh, P; Mishra, S; Singh, R; Mahdi, A A
Objectives: The objective of the present study was to investigate the effects of rotating night shift and light exposure at night on circadian pattern of salivary cortisol and urinary melatonin levels. Methods: 62 healthy nursing professionals of both genders performing day and night shifts (continuous 9 days night shift with alternate day shifts) were recruited. Each month scheduled to continuous 9 days night shift (12 hours in regular 9 nights, from 20:00 to 08:00); after 9 days night shift they perform remaining duties in day shift and 4 days off. Saliva and Urine samples were collected at around 8 hours interval while they were performing night duties and repeated when they were assigned day duties. Saliva and Urine samples were analyzed by the ELISA method. Results: Significant difference was found in night cortisol among night (4.34 ± 3.37) vs day shift (2.70 ± 2.32), (p<0.001). Alteration in morning cortisol was also found between night (3.73 ± 2.47) vs day shift (5.00 ± 2.73). Night melatonin level was decreased as compared to morning melatonin. Significant deference were observed when compared night melatonin between night (16.71 ± 11.98) vs day shift (22.71 ± 13.25) (p<0.001), morning melatonin between night (20.07 ± 14.13) vs day shifts (28.26 ± 14.14) (p<0.001). The circadian pattern of cortisol and melatonin was altered by rotating night shift particularly at night and in the morning time. Conclusion: The present study concluded that the desynchronization was appeared during night shift and entrainment of circadian rhythm in the day shift.
Evaluation of Different Varieties and Genotypes of Aonla (Emblica officinalis Gaertn.) under Sodic Soil Condition of Eastern Uttar Pradesh, India
(Ms. M. B. Mondal, 2024-02) Maurya, AK; Pratap, B; Sonkar, A; Tiwari, S; Yadav, G; Pratap, R; Patel, B; Kumar, P.
The purpose of this study was to assess the aonla (Emblica officinalis Gaertn.) varieties and genotypes for their growth and development of fruits (flowering and fruiting), physical attributes and yield under the sodic soil condition of Eastern Uttar Pradesh. The evaluated varieties and genotypes had a significant variation for the recorded parameters. The maximum flowering duration among the varieties was recorded in BSR-1 (27 days) whereas, the minimum duration of flowering was observed in NA-6 (23 days) and Chakaiya (23 days). Among the selected varieties and genotypes, fruit weight, fruit length, and diameter were recorded maximum in genotype NA-25, and the maximum fruit drop at the maturity stage was found in BSR-1 (80.60%). The maximum yield (kg/plant) was recorded in NA-26 (80.35 kg/plant). The maximum fruit volume was recorded in NA-25 (54.2) with the maximum pulp weight (55.02g) and the pulp: stone ratio was recorded highest in NA-25 (28.10). The maximum specific gravity was recorded in Anand-1 (1.07).
Field testing & evaluation of the efficacy & duration of effectiveness of a biolarvicide, Bactivec® SC (Bacillus thuringiensis var. israelensis SH-14) in Bengaluru, India
(Indian Council of Medical Research, 2018-03) Uragayala, S; Kamaraju, R; Tiwari, S; Ghosh, SK; Valecha, N
Background & objectives: Different formulations of Bacillus thuringiensis var. israelensis (Bti) have been tested against different mosquito vectors and other insects for their residual activity. In the present study, the efficacy and residual activity of a new formulation of Bti (Bactivec Suspension Concentrate) were evaluated against immature stages of Anopheles stephensi Liston (Diptera: Culicidae), Aedes aegypti Linnaeus (Diptera: Culicidae) and Culex quinquefasciatus Say (Diptera: Culicidae), in natural habitats in Phase II and Phase III in Bengaluru, India. Methods: Preferential breeding habitats of the mosquito species were selected and four dosages (0.25, 0.5, 1 and 2 ml/50 l) were tested in Phase II trial. Two most effective dosages, 0.5 and 1 ml/50 l were selected for Phase III trial. The evaluation was carried out essentially following the guidelines of the World Health Organization Pesticide Evaluation Scheme. Pre-treatment and post-treatment densities were recorded at regular intervals, and >80 per cent reduction in pupae was taken as the duration of effectiveness. Results: Bactivec SC treated at the dosage of 1 ml/50 l could produce 10-17 days efficacy (>80% reduction in pupae) in clean water habitats tested, whereas 0.5 ml/50 l dosage showed residual activity from 7 to 14 days against Ae. aegypti and An. stephensi in Phase III studies. In polluted water habitats, 4-7 days efficacy could be recorded against Cx. quinquefasciatus in Phase III. Interpretation & conclusions: The Bactivec SC formulation was operationally feasible and easy to handle. For the control of Anopheles and Aedes mosquitoes in freshwater habitats, 1 ml/50 l dosage was found effective, whereas in polluted water habitats against Cx. quinquefasciatus 5 ml/m2 was found effective.
Groundwater Quality Assessment for Drinking and Agricultural Use in Motipur Block, Muzaffarpur District, Bihar, India
(Ms. M. B. Mondal, Ph.D., 2025-05) Singh, SK; Kantawa, M; Kumar, A; Kumari, S; Singh, KK; Tiwari, S; Singh, P; Singh, A.
Groundwater is a critical resource for drinking and irrigation, yet its quality in rural areas such as Motipur block, Muzaffarpur (Bihar), remains poorly characterized. This study evaluated groundwater suitability by analyzing 40 samples from hand pumps and tube wells for key parameters, including pH, electrical conductivity (EC), bicarbonate (HCO??), chloride (Cl?), and total dissolved solids (TDS). Results revealed slightly alkaline conditions (pH 7.50–8.34, avg. 7.95), within WHO/BIS permissible limits. However, EC exceeded the BIS threshold (500 µS/cm), and 23 samples surpassed WHO bicarbonate standards (350 mg/L). Although most TDS values (300–1150 mg/L) complied with BIS limits (500 mg/L), chloride concentrations (355–1136 mg/L) consistently exceeded safe thresholds (250 mg/L). These findings underscore localized contamination risks, emphasizing the need for targeted interventions to ensure sustainable groundwater management in the region.
Isolation, Purification of Scopulariopsis fimicola and Effect of Cropping Period on Calocybe indica
(Ms. M. B. Mondal, 2024-03) Kumar, A; Singh, S; Singh, GA; Tiwari, S; Shiwangi; Singh, GP; Pundir, SK.
The Calocybe indica (Milky Mushroom) affected by large number of biotic and abiotic factors during cultivation. Among them, white plaster mould caused by Scopulariopsis fimicola encounter the compost and casing soil during cultivation and adversely affect the spawn run, growth and yield of C. indica. The present research work on various aspects of milky mushroom cultivation was conducted during 2019-21. June and August months (29.20- 35.80C temperature and 73.00- 85%relative humidity) are most suitable for milky mushroom cultivation. The associated mycoflora was isolated from infected casing soil, collected from farmers cultivating milky mushroom house/field. Eleven associated mycoflora viz., Aspergillus niger, A. flavus, A. flavus parasiticus, Penicillium citreonigrum, Acremonium sp., Alternaria alternata, Curvularia Iunata, Fusarium oxysporum, F. solani, Rhizopus stolonifera and Scopulariopsis fimicola were isolated and identified. The cropping period during April 2020 to October 2020 the moisture content, temperature and relative humidity varied from 74 to 75%, 26.9 to 36.6 °C and 73 to 88%and the spawn run during the rest of the month varied from 19 to 21 days. The maximum time of spawn run was recorded at 21 days in the month of October 2020 and minimum time of spawn run was recorded at 20 days in the month of July and August 2020.
Legal aspects in medical practice.
(2000-09-19) Tiwari, S

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