by Muna Shaaeli and Eman EL-Sawalhy
Case Report
Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset reduction of anterograde memory. Many etiologies were debated, such as migraine, focal ischemia, venous flow abnormalities, and epileptic phenomena. A large proportion of TGA cases are preceded by stressful events, which may be emotional or physical. Here we are reporting a case of TGA in a 60-year-old woman triggered by emotional stress.
American Journal of Medical Case Reports. 2021, 9(12), 754-755. DOI: 10.12691/ajmcr-9-12-23
Pub. Date: November 07, 2021
1946 Views3 Downloads
by Yi Zou, Xiao Yan, Yingzi Ling, Si Ouyang, Jun Deng, Qian Huang, Wo Li, Yalin Li, Changquan Fu, Lai Wei, Yongping Liu and Gaoyin Kong
Original Research
Endotracheal tube (ETT) frequently induces cough, hemodynamic response, postoperative sore throat, and hoarseness in patients with prolonged intubation. Intracuff alkalinized lidocaine (ICAL) is associated with reduced ETT related complications. This study investigated the effects of ICAL on obstructive sleep apnea (OSA) patients undergoing uvulopalatopharyngoplasty (UPPP) and prolonged intubation. In the in vitro study, we found that 5% sodium bicarbonate (NaHCO3) dramatically increased lidocaine diffusion from the ETT cuff in 24 h, and the diffusion rate of lidocaine was correlated with the dose of alkalinized lidocaine in the ETT cuff. In the in vivo pilot study, we recruited 7 OSA patients undergoing UPPP with intranasal intubation under general anesthesia, among these patients, 4 EET cuffs were filled with air, and 3 were filled with 2% lidocaine and 5% NaHCO3. All the patients were intubated overnight after surgery. We found that ICAL was ineffective to alleviate ETT induced agitation and cough at emergence from anesthesia. However, we found that ICAL significantly improved patients’ sleep quality and satisfaction in the postoperative intubation period. The hemodynamic response was also well suppressed in patients with ICAL compared to those with intracuff air. In addition, ICAL improved the attending nurses’ satisfaction that may reduce nurses’ workload in the postoperative period. No adverse effects occurred. According to our study, we recommend using ICAL in patients with prolonged intubation, and further study is warranted.
American Journal of Medical Case Reports. 2021, 9(12), 748-753. DOI: 10.12691/ajmcr-9-12-22
Pub. Date: November 04, 2021
2457 Views8 Downloads
by Leila Shafiq, Andrew J Shychuk and Joanna M Chaffin
Case Report
Non-Hodgkin’s lymphomas (NHL) manifest in a multitude of presentations dependent on the subtype, aggressiveness, and primary location of the lymphoma. Because of varied clinical presentations, NHL can oftentimes be difficult to diagnose. However, a high index of suspicion and timely diagnosis is critical, especially in the case of aggressive NHL, in order to initiate prompt treatment for the most optimal outcomes. Here we describe the case of a 62 year-old Caucasian male who presented to a new primary care provider for further evaluation of edema, at which time he was found to have evidence of progression to anasarca along with evidence of protein-losing enteropathy. This occurred after initial workup for symptoms had been terminated prematurely by the previous provider with a move toward symptomatic management without establishing a diagnosis due diagnostic challenges of his nonspecific symptoms. The disease course had an insidious onset. By the time adenopathy became apparent and was biopsied, a diagnosis of aggressive and advanced angioimmunoblastic T-cell lymphoma and secondary Epstein-Barr virus (+) B-cell lymphoma was eventually made. This case highlights an uncommon form of aggressive NHL (angioimmunoblastic T-cell lymphoma) presenting insidiously as edema most likely secondary to protein-losing enteropathy. Lymphatic invasion can obstruct drainage leading to intestinal lymphangiectasia, ulceration, and inflammatory exudation of protein causing anasarca. Additional mechanisms postulated in the presentation of edema in NHL include an increase in Tumor Necrosis Factor Alpha and vascular endothelial growth factor. Therefore, it is important to consider the diagnosis of NHL in patients with similar manifestations when workup is otherwise inconclusive. Additionally, this case brings to light the critical role that primary care providers can play in maintaining a high index of suspicion for cancer, continuing to work up patients not responsive to initial therapy in a prompt manner to mitigate any delays in diagnosis.
American Journal of Medical Case Reports. 2021, 9(12), 743-747. DOI: 10.12691/ajmcr-9-12-21
Pub. Date: October 22, 2021
2930 Views19 Downloads
by Stella Onyi, Chukwuemeka A. Umeh and Frederick White
Original Research
Stroke is a leading cause of disability and death, and the use of tissue plasminogen activator (tPA) has been shown to improve outcomes in ischemic stroke. However, despite the favorable outcome from the use of tPA, it has been associated with complications, including intracranial hemorrhage, major systemic hemorrhage, and angioedema. Though there are few reports of intracerebral hemorrhage complicating tPA use, pontine hemorrhage, a sub-set of intracerebral hemorrhage, is rarely reported. We report a case of pontine hemorrhage in an ischemic stroke patient after tPA and discussed the management of this rare complication of tPA.
American Journal of Medical Case Reports. 2021, 9(12), 739-742. DOI: 10.12691/ajmcr-9-12-20
Pub. Date: October 18, 2021
2249 Views5 Downloads
by Dieuwertje Horsten, Lore Noben, Laura van Dommelen and Carolien A.M. Koks
Case Report
Chorionic villus sampling (CVS) is a procedure in which biopsies of placental tissue are obtained for prenatal genetic diagnosis. Risk of infection after CVS is low and only sporadic cases of postprocedural sepsis have been reported. Clostridium perfrigens and Escherichia coli are the most commonly described pathogens in cases of sepsis after prenatal invasive diagnostic procedures. However, this report describes a case of sepsis with fetal loss after CVS caused by Atopobium vaginae.
American Journal of Medical Case Reports. 2021, 9(12), 734-738. DOI: 10.12691/ajmcr-9-12-19
Pub. Date: October 18, 2021
2059 Views2 Downloads
by Kami Whitney PA-C
Case Report
Mucus hypersecretion is a debilitating feature of COPD that is often overlooked and under treated by clinicians despite its contribution to declining lung function and quality of life. This case study explores the use of the COPD Assessment Test in the evaluation of mucus hypersecretion and improvements in quality of life related to this symptom after the addition of guaifenesin as part of a comprehensive COPD care plan.
American Journal of Medical Case Reports. 2021, 9(12), 730-733. DOI: 10.12691/ajmcr-9-12-18
Pub. Date: October 13, 2021
2169 Views4 Downloads
by Nida Saleem, Saima Bashir, Syed Nayer Mahmud and Muhammad Haneef
Case Report
We report a case of an elderly male patient, who presented with acute kidney injury on background of diabetic nephropathy, secondary to dapagliflozin induced acute tubulo-interstitial nephritis requiring hemodialysis sessions. Histopathological findings are consistent with moderate tubulo-interstitial inflammation with mixed lymphocytic and eosinophilic inflammatory deposits. The patient responded well to cessation of causative medication and upon initiation of high dose steroids. The direct cause and effect relationship between dapagliflozin initiation and development of acute tubulo-interstitial nephritis is indicative of dapagliflozin being responsible for marked renal deterioration, as seen in this patient.
American Journal of Medical Case Reports. 2021, 9(12), 725-729. DOI: 10.12691/ajmcr-9-12-17
Pub. Date: October 09, 2021
2448 Views7 Downloads
by Hiroyuki Ueno and Youichi Yanagawa
Case Report
An 82-year-old woman was admitted due to disturbance of consciousness. Six months previously, she had been diagnosed with nested variant of urothelial carcinoma. Magnetic resonance imaging showed multiple bilateral small acute cerebral infarctions, corresponding to Trousseau’s syndrome. Best supportive care was chosen and she finally died. This is the sixth case of Trousseau’s syndrome induced by bladder carcinoma and the first case of Trousseau’s syndrome in a patient with nested variant of urothelial carcinoma. This unique case adds one more cause to the list of documented etiologies of Trousseau’s syndrome.
American Journal of Medical Case Reports. 2021, 9(12), 722-724. DOI: 10.12691/ajmcr-9-12-16
Pub. Date: September 27, 2021
2245 Views4 Downloads
by Kara L Heuvelhorst, Tyler Diener, Hana Manzoor, Maher Khadra, Faisal Musa and Syed K Jafri
Case Report
Objective: Here we present one of the first cases of Janssen (Johnson & Johnson Ad26.COV2.S vaccine-associated cerebral venous sinus thrombosis (CVST) in a male patient, and the presumed first case without associated thrombotic thrombocytopenic syndrome (TTS). Method: Patient was identified as a vaccine-related adverse effect due to the unusual presentation of CVST in a male following COVID-19 vaccination, though without thrombocytopenia. Results: Patient presented with left-sided weakness and transient dysarthria. Imaging revealed extensive CVST. Thorough coagulopathy work-up was negative and platelet levels remained within the normal range. Patient improved with non-heparin anticoagulation. Discussion: As more people worldwide continue to be vaccinated against COVID-19, the incidence of vaccine-related complications can be expected to rise. Multiple cases of CVST have been reported in patients following COVID-19 vaccination with associated TTS, nearly all in women. However, this is not the only presentation. Cerebral venous sinus thrombosis should be a consideration in patients who present with headache or altered mental status after COVID vaccination, despite normal platelet levels.
American Journal of Medical Case Reports. 2021, 9(12), 719-721. DOI: 10.12691/ajmcr-9-12-15
Pub. Date: September 25, 2021
2763 Views20 Downloads
by Ken-ichi Muramatsu, Youichi Yanagawa, Kei Jitsuiki, Hiroki Nagasawa and Kazuhiko Omori
Case Report
The patient was a 77-year-old man whose head and back impacted the ground after falling from a stepladder. On arrival, plain roentgenography and whole body computed tomography failed to depict a responsible spinal lesion. As he could walk, his wound was sutured and he was discharged to home. However, on the following day, he was unable to stand due to severe back pain. Urgent magnetic resonance image (MRI) revealed a high-intensity signal in the 12th thoracic vertebral body without compressive deformity. Follow-up roentgenography at 10 days showed compressive change at the 12th thoracic vertebral body; thus, a corset was applied at the thoracolumbar position. Final lumbar roentgenography at 6 months revealed compression of the thoracic vertebral body. In the present case an elderly patient, who initially showed a bone bruise, showed delayed compressive changes in the thoracic vertebral body. In our super-aging society, further studies are required to investigate the natural history of vertebral body bruises in elderly individuals.
American Journal of Medical Case Reports. 2021, 9(12), 717-718. DOI: 10.12691/ajmcr-9-12-14
Pub. Date: September 24, 2021
2129 Views4 Downloads
by Jake Corman, Eric Mulkey, Gregory Stewart and Sandeep Malhotra
Case Report
Gastric pneumatosis, air within the gastric wall, is a rare finding on imaging. Gastric pneumatosis is seen in both benign and life-threatening conditions. Emphysematous gastritis is a rare, and potentially life-threatening, form of gastritis. Early and effective non-operative management with bowel rest, nutritional support, intravenous hydration, and intravenous broad-spectrum antibiotics is a reasonable option for management of emphysematous gastritis. There is still no consensus and strict guidelines in management of emphysematous gastritis, but as this and a handful of other case reports show, immediate surgical intervention may not always be the answer.
American Journal of Medical Case Reports. 2021, 9(12), 714-716. DOI: 10.12691/ajmcr-9-12-13
Pub. Date: September 14, 2021
2427 Views1 Downloads
by Angel Goenawan, Frank Kussaga, Kenneth Schwartz and Seema D’Souza
Case Report
Myocarditis and pericarditis are known adverse effects from mRNA Covid-19 vaccines and are seen in young men usually after the second dose of vaccine. We report a case of recurrent pericarditis in a 67 year old man with history of diabetes and chronic kidney disease that occured with both vaccine doses, with the second episode associated with interval development of small pericardial effusion and moderate pleural effusion. Patient did not seem to have concomitant myocarditis as he did not have any troponin leak. He was managed with colchicine and prednisone with resultant improvement of his inflammatory markers on follow up.
American Journal of Medical Case Reports. 2021, 9(12), 709-713. DOI: 10.12691/ajmcr-9-12-12
Pub. Date: September 13, 2021
2471 Views4 Downloads
by Matteo Pezzoli, Sebastiano Bucolo, Federico Griva and Alessandro Pagliassotto
Case Report
Hypertrophic anterior osteophytes of the vertebrae affecting the anterior longitudinal ligament of the spine are typical of diffuse idiopathic skeletal hyperostosis (DISH), a spinal disorder of the elderly also known as Forestier Disease, from the name of the first author who reported it in 1950. Usually, patients are asymptomatic or have mild dysphagia, due to compression of the digestive tract but less commonly can have acute dyspnea requiring to secure the airway has been rarely reported. Diagnosis is usually obtained with radiologic exams that reveal a bony mass. In some cases, fibrosis and inflammation due to the constant movement of the cricoid lamina over a projecting osteophyte are also seen with the CT Scan. In this paper, we describe a distinct entity of a giant lesion of the cervical spine that appeared as a pseudotumor of cervical soft tissue and caused acute upper airway obstruction requiring emergency tracheostomy. Details of his clinical examination, radiologic imaging, and surgical management are provided and discussed.
American Journal of Medical Case Reports. 2021, 9(12), 705-708. DOI: 10.12691/ajmcr-9-12-11
Pub. Date: September 13, 2021
2210 Views3 Downloads
by Sharif Al Qadhi, Neeraj Salhotra, Bashar Al Tunbi, C. Livingston, Fahad Al Kheder, Mohammad Hashim and Kauthar Al Zakwani
Original Research
Sprengel's Deformity is a congenital condition characterized by a small and undescended scapula often associated with scapular winging and scapular hypoplasia. Diagnosis is made clinically with a high-riding, medially rotated, triangular-shaped scapula, with associated limitations in shoulder abduction and flexion. Treatment is observation in the absence of shoulder dysfunction. Operative management is indicated in the presence of severe cosmetic concerns or functional deformities (abduction < 110-120 degrees). We herewith present a case of this deformity seen in our center in patient of cervical stenosis with myelopathy.
American Journal of Medical Case Reports. 2021, 9(12), 702-704. DOI: 10.12691/ajmcr-9-12-10
Pub. Date: September 12, 2021
2467 Views2 Downloads
by Amritpal Sandhu, Randy Aviado, Kevin Dales and Hanadi Abou Dargham
Case Report
Acute renal failure is rarely associated with the usual presentations of sarcoidosis. Sarcoidosis is associated with hypercalcemia and presents with granulomas within other organs, usually the lungs [1]. We present a case of acute renal failure with hypercalcemia in an African American female patient who was eventually diagnosed with sarcoidosis.
American Journal of Medical Case Reports. 2021, 9(12), 698-701. DOI: 10.12691/ajmcr-9-12-9
Pub. Date: September 09, 2021
2278 Views5 Downloads
by Humaira Nasir, Nida Saleem, Fatima Anwar, Rabia Saleem and Syed Nayer Mahmud
Case Study
Karyomegalic interstitial nephritis (KIN) is a rare cause of hereditary interstitial nephritis, described 45 years ago. Only about 50 cases have been described in English literature so far and none from Pakistan. This disease has an escalated course with a worsened outcome. There are a few potential mimickers of this disease both clinically and histologically, which might lead to a missed diagnosis and hence poor management. We have described here a series of 05 cases of KIN that were diagnosed at our institute for better understanding of this disease entity.
American Journal of Medical Case Reports. 2021, 9(12), 693-697. DOI: 10.12691/ajmcr-9-12-8
Pub. Date: September 09, 2021
2112 Views1 Downloads
by Mehdi Seyedmoradi, Niloufar Mohamadian and Mazaher Ramezani
Case Report
Lymphocyte-predominant Hodgkin’s lymphoma (LPHL) that involving the breast and axillary tissue is very rare. We report a case of this subtype of Hodgkin’s lymphoma (HL) in right breast mass of a 48-year-old man, who presented with a 20 years history of this breast painless mass; but over the past year there has been an increase in the size of the mass, with pain but no discharge. Pathology report after immunohistochemistry (IHC) confirmed the LPHL.
American Journal of Medical Case Reports. 2021, 9(12), 690-692. DOI: 10.12691/ajmcr-9-12-7
Pub. Date: September 05, 2021
2293 Views2 Downloads
by Mada Hamwi, Sufyan Abdul Mujeeb and Abdallah Hamdallah
Case Report
Guillain-Barre syndrome (GBS) is a rare inflammatory disorder that most commonly occurs as a response to a preceding infection. Although GBS is most commonly associated with Campylobacter jejuni infection, several reports have indicated a relationship between the novel coronavirus disease-2019 (COVID-19) and GBS. Here, we present a case of a 72-year-old female diagnosed with COVID-19 who developed progressive lower and upper extremity weakness one month following her COVID-19 diagnosis. Magnetic resonance imaging (MRI) of the spine confirmed the diagnosis of GBS and her hospital course was further complicated by posterior reversible encephalopathy syndrome (PRES). She responded well to intravenous immunoglobulin (IVIG) and subacute inpatient rehabilitation.
American Journal of Medical Case Reports. 2021, 9(12), 686-689. DOI: 10.12691/ajmcr-9-12-6
Pub. Date: September 05, 2021
2212 Views6 Downloads
by Mazaher Ramezani, Sepehr Sadafi, Farhad Amirian and Masume Bayat
Case Report
Gall bladder adenocarcinoma is a rare malignancy with female predominance. Main patients are in the fifth to seventh decades. Clinical findings of gall bladder adenocarcinoma can be non-specific and the same as cholecystitis .The imaging is also non-specific with considerable overlap between benign and malignant lesions. Gall bladder adenocarcinoma may be overdiagnosed in histopathology by considering Rokitansky-Aschoff sinuses as malignant. It may be underdiagnosed in the cases of well-differentiated minimally invasive carcinoma. Incidental tumors are mainly in fundus and body of gall bladder. The first case was 80-year-old female with right upper quadrant pain, nausea and vomiting. Ultrasound was in favor of emphysematous cholecystitis. Postoperative diagnosis was acute gangrenous cholecystitis with tumor lesion suspicious for malignancy. Pathologist reported, moderately differentiated gall bladder adenocarcinoma extended to serosa in the neck of gall bladder. The second case was 58-year-old female with right upper quadrant severe pain, odynophagia, dysphagia, nausea and vomiting. Ultrasound examination showed gall bladder mass in the fundus and suggested gall bladder cancer. Pathologist reported, Poorly differentiated adenocarcinoma of gall bladder extended full wall thickness. Precise macroscopic evaluation is very important for finding of cases of gall bladder carcinoma even without clinical suspicion. For detection of malignancy, microscopic evaluation of all cholecystectomy samples is recommended. We suggest careful examination of cholecystectomy specimens especially in females more than forty with careful sampling of body and fundus.
American Journal of Medical Case Reports. 2021, 9(12), 683-685. DOI: 10.12691/ajmcr-9-12-5
Pub. Date: September 03, 2021
2428 Views3 Downloads
by Yongping Liu, Siyou Tan, Wenyan Chen and Lai Wei
Case Report
Anesthesia management for patients undergoing liver transplantation is challenging due to significant hemodynamic fluctuations and potential intraoperative awareness risk. Quadratus lumborum (QL) block is often used for anesthesia and postoperative analgesia in the patient’s abdominal surgery. In this case-series report, we present our experience with 4 patients in whom liver transplantation and early extubation were performed successfully under ultrasound-guided QL block. Four patients were scheduled for allograft orthotopic liver transplantation (AOLT), all of them were diagnosed with severe hepatitis B cirrhosis. After due deliberation and with the consent of patients and their family, a bilateral ultrasound-guided anterior QL block was performed with the patient in the lateral position. Fifteen to 20mL of 0.5% ropivacaine was injected at the front edge of the QL, bilaterally. Sensory loss to pinprick from T6 to L2 was achieved in all four patients 20 min after administration of blocks. The operation went smoothly for all the patients. All four patients experienced quiet recovery and early extubation, and none of them complained of discomfort in the surgical side in the first 12h after surgery. Here we present 4 cases of ultrasound-guided anterior QL block that may be an attractive option for anesthetic management of AOLT in clinical practice.
American Journal of Medical Case Reports. 2021, 9(12), 678-682. DOI: 10.12691/ajmcr-9-12-4
Pub. Date: August 30, 2021
2197 Views10 Downloads
by Houcine Mrad, Wided Besleï, Warda Mahdhaoui and Salem Bouomrani
Case Report
Cardiac complications of brucellosis are extremely rare with an overall frequency estimated at less than 1%. They are dominated by endocarditis and myocarditis, while pericarditis remains exceptional and unusual with only few sporadic cases in the world literature. Brucella pericarditis is exceptionally isolated. It is often associated with the involvement of other cardiac tunics (endocarditis and/or myocarditis) or is part of a complex cardiac involvement (brucella pancarditis). This clinical presentation of brucellosis is a real diagnostic challenge for clinicians. We report an original case of acute pericarditis as the first and only manifestation revealing septicemic brucellosis in 27-year-old Tunisian woman.
American Journal of Medical Case Reports. 2021, 9(12), 675-677. DOI: 10.12691/ajmcr-9-12-3
Pub. Date: August 26, 2021
2358 Views9 Downloads
by Peter Flores, Sabina Kumar, Umeh Chukwuemeka, Jose Penaherrera, Pranav Barve and Shivang Shah
Original Research
Since the 1960s, benzodiazepines have been a clinical mainstay, utilized for sedation, anxiety, and withdrawal states. Between 1996 and 2013 alone, benzodiazepine prescriptions increased annually by 2.5%. Rather than risk symptoms of withdrawal such as muscle pain and severe cardiomyopathy, patients must be properly informed about how to taper their medications. A 75-year-old female with a history of anxiety, hypertension, lupus, and degenerative disc disease presented with palpitations, mid-sternal chest pain, diaphoresis, and progressive shortness of breath. The patient was found to have elevated troponins (peak troponin of 1.45) and EKG showed sinus rhythm and ST segment abnormalities. The patient stated that her chest pain started 24 hours ago, 48 hours after she had stopped taking lorazepam which she had been taking for the past 50 years for anxiety. Her PCP gave her a plan to taper down the dose of lorazepam safely, but the patient opted to stop “cold turkey.” Due to the patient’s typical chest pain and elevating troponin level, ACS protocol was initiated. Initial echocardiogram showed an ejection fraction of 35-40% with hypokinesis of the anterioseptal wall with impaired left ventricular diastolic filling. The cardiology team performed a catheterization which showed minimal coronary artery disease and no significant stenosis in the left anterior descending artery. Within the next few days, the patient’s chest pain resolved and her troponins were negative. The medical team concluded that the physical stress from withdrawing from benzodiazepine caused the patient to go into Takotsubo Cardiomyopathy. This case illustrates the risks involved with benzodiazepine in an era of polypharmacy. More importantly, this case illustrates the strong need to taper benzodiazepines properly. Because this patient had taken a benzodiazepine for 50 years, the tapering should have been as slow as possible. The result was Takotsubo cardiomyopathy.
American Journal of Medical Case Reports. 2021, 9(12), 672-674. DOI: 10.12691/ajmcr-9-12-2
Pub. Date: August 25, 2021
2138 Views7 Downloads
by Simin Laiq, Maimuna Al Saadi, Zahra Al Hajri, Shadhiya Al Khan, Khalid Al Amri and Nasser Al Rahbi
Case Report
Myeloid sarcoma is a malignant neoplasm, in which a tumor mass consisting of myeloid blasts with or without maturation occur at an anatomical site other than the bone marrow. Myeloid sarcoma is frequently, but not always, associated with acute myeloid leukemia, chronic myeloid leukemia, and other myelodysplastic disorders. Myeloid sarcomas involving the appendix are uncommon and myeloid sarcoma of the appendix presenting as acute appendicitis is rare. A 64-year-old Omani female presented to the emergency department with 1-day history of acute right lower abdominal pain. She was noted to have leukocytosis and thrombocytopenia in her pre-operative blood investigation, which prompted a 2-week prior history of a single episode of minor nosebleed. Abdominal imaging demonstrated findings suggestive of an acute appendicitis, with differential of mesenteric adenitis and/or focal fat infarction, for which she underwent laparoscopic appendectomy. Surgical pathology of the appendix showed myeloid sarcoma involving the entire appendix including the base. On further investigation, a peripheral blood smear revealed many circulating blasts. Patient was later diagnosed to have acute myeloid leukemia with inv (16) (p13.1 q22) genetic abnormality in a tertiary hospital. Acute appendicitis with leukemic infiltration in form of myeloid sarcoma as the initial manifestation of acute myeloid leukemia has been described in very few cases in the literature, and our case is the first case to be reported in Oman.
American Journal of Medical Case Reports. 2021, 9(12), 669-671. DOI: 10.12691/ajmcr-9-12-1
Pub. Date: August 25, 2021
2115 Views3 Downloads