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Article ; Online: Successful bilateral lung transplantation from a recent SARS-CoV-2 PCR positive donor.

Jyothula, Soma S S K / Patel, Jayeshkumar / Dhand, Abhay

Transplant infectious disease : an official journal of the Transplantation Society

2023 Volume 25, Issue 3, Page(s) e14031

MeSH term(s)	Humans ; SARS-CoV-2/genetics ; COVID-19/diagnosis ; Lung Transplantation/adverse effects ; Tissue Donors ; Polymerase Chain Reaction ; COVID-19 Testing
Language	English
Publishing date	2023-03-06
Publishing country	Denmark
Document type	Letter
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.14031
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Article ; Online: 1-Year Outcomes of Lung Transplantation for Coronavirus Disease 2019-Associated End-Stage Lung Disease in the United States.

Okumura, Kenji / Jyothula, Soma / Kaleekal, Thomas / Dhand, Abhay

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2023 Volume 76, Issue 12, Page(s) 2140–2147

Abstract: Background: Lung transplantation can provide quality of life and survival benefits for patients with coronavirus disease 2019 (COVID-19)-associated end-stage lung disease. Characteristics and outcomes of these lung transplant recipients are limited to ... ...

Abstract	Background: Lung transplantation can provide quality of life and survival benefits for patients with coronavirus disease 2019 (COVID-19)-associated end-stage lung disease. Characteristics and outcomes of these lung transplant recipients are limited to mostly single-center experiences or provide a short-term follow-up. Methods: Characteristics of deceased donors and adult lung transplant recipients for COVID-19-associated end-stage lung disease between August-2020 and June-2022 were analyzed using deidentified United Network for Organ Sharing database. Post-transplant patient survival of COVID-19 recipients was analyzed and compared with non-COVID-19 recipients. Secondary outcomes were length of hospitalization, post-transplant complications, and rates of organ rejection. Results: During the study period, 400 lung transplants for COVID-associated end-stage lung disease comprised 8.7% of all lung transplants performed in United States. In the COVID-19 group, Hispanic males received lung transplants at significantly higher rates. The COVID-19 group was younger and had greater need for intensive care unit stay, mechanical ventilation, hemodialysis, extracorporeal membrane oxygenation support, and receipt of antibiotics pre-lung transplant. They had higher lung allocation score, with a shorter wait-list time and received more double lung transplants compared with non-COVID-19 recipients. Post-transplant, the COVID-19 cohort had longer hospital stays, with similar 1-year patient survival (COVID, 86.6% vs non-COVID, 86.3%). Post-transplant, COVID-19-associated deaths were 9.2% of all deaths among lung transplant recipients. Conclusions: Lung transplantation offers a effective option for carefully selected patients with end-stage lung disease from prior COVID-19, with short-term and long-term outcomes similar to those for lung transplant recipients of non-COVID-19 etiology.
MeSH term(s)	Adult ; Male ; Humans ; United States/epidemiology ; Heart Transplantation ; Quality of Life ; Survival Rate ; COVID-19 ; Lung Transplantation ; Tissue Donors ; Lung Diseases ; Graft Survival ; Retrospective Studies
Language	English
Publishing date	2023-02-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciad072
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Article ; Online: Pulmonary manifestations of amyloidosis.

Khan, Nauman A / Bhandari, Bharat S / Jyothula, Soma / Ocazionez, Daniel / Buryanek, Jamie / Jani, Pushan P

Respiratory medicine

2023 Volume 219, Page(s) 107426

Abstract: Amyloidosis is caused by abnormal protein deposition in various tissues, including the lungs. Pulmonary manifestations of amyloidosis may be categorized by areas of involvement, such as parenchymal, large airway and pleural involvement. We describe four ... ...

Abstract	Amyloidosis is caused by abnormal protein deposition in various tissues, including the lungs. Pulmonary manifestations of amyloidosis may be categorized by areas of involvement, such as parenchymal, large airway and pleural involvement. We describe four distinct manifestations of amyloidosis involving the lung and review their clinical, radiological and pathological features and summarize the evidence for treatment in each of these presentations. We describe alveolar-septal amyloidosis, cystic amyloid lung disease, endobronchial amyloidosis and pleural amyloidosis.
MeSH term(s)	Humans ; Lung/pathology ; Amyloidosis/complications ; Amyloidosis/diagnostic imaging ; Amyloidosis/metabolism ; Lung Diseases/diagnostic imaging ; Lung Diseases/etiology ; Amyloid/metabolism ; Pleura/pathology
Chemical Substances	Amyloid
Language	English
Publishing date	2023-10-13
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2023.107426
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Article: Clinical and functional recovery in a patient with pulmonary hypertension after bariatric surgery.

Karna, Rahul / Hussain, Rahat / Jyothula, Soma S K

Lung India : official organ of Indian Chest Society

2021 Volume 38, Issue 6, Page(s) 571–573

Abstract: Severe pulmonary hypertension (PH) in obese patients pose a challenge to treat despite advances in medical therapeutics. Current treatment options are limited for patients who are not responding to maximal medical therapy. Here, we present a case of ... ...

Abstract	Severe pulmonary hypertension (PH) in obese patients pose a challenge to treat despite advances in medical therapeutics. Current treatment options are limited for patients who are not responding to maximal medical therapy. Here, we present a case of multifactorial PH, not responsive to ambrisentan, tadalafil, and treprostinil, even after optimization of cardiac and pulmonary function and had a poor prognosis. She demonstrated weight loss after bariatric surgery, improving her restrictive lung disease, obstructive sleep apnea and PH, and overall functionality. Bariatric surgery may offer a potential therapeutic option, in patients with morbid obesity and PH resistant to maximal medical therapy.
Language	English
Publishing date	2021-11-08
Publishing country	India
Document type	Case Reports
ZDB-ID	2410801-7
ISSN	0974-598X ; 0970-2113
ISSN (online)	0974-598X
ISSN	0970-2113
DOI	10.4103/lungindia.lungindia_76_21
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Article ; Online: Seroprevalence of Measles, Mumps, Rubella, and Varicella-Zoster Virus and Seroresponse to the Vaccinations in Adult Solid Organ Transplant Candidates.

Javaid, Hana / Prasad, Pooja / De Golovine, Aleksandra / Hasbun, Rodrigo / Jyothula, Soma / Machicao, Victor / Bynon, John S / Ostrosky, Luis / Nigo, Masayuki

Transplantation

2023 Volume 107, Issue 10, Page(s) 2279–2284

Abstract: Background: Updating live vaccines such as measles, mumps, rubella, and varicella (MMRV) is an important step in preparing patients for solid organ transplant (SOT) to prevent morbidity from these preventable diseases. However, data for this approach ... ...

Abstract	Background: Updating live vaccines such as measles, mumps, rubella, and varicella (MMRV) is an important step in preparing patients for solid organ transplant (SOT) to prevent morbidity from these preventable diseases. However, data for this approach are scarce. Thus, we aimed to describe the seroprevalence of MMRV and the efficacy of the vaccines in our transplant center. Methods: Pre-SOT candidates >18 y of age were retrospectively retrieved from SOT database in Memorial Hermann Hospital Texas Medical Center. MMRV serologies are routinely screened at the time of pretransplant evaluation. We divided patients into 2 groups: MMRV-positive group versus MMRV-negative group, patients with positive all MMRV serologies and with negative immunity to at least 1 dose of MMRV, respectively. Results: A total of 1213 patients were identified. Three hundred ninety-four patients (32.4%) did not have immunity to at least 1 dose of MMRV. Multivariate analysis was conducted. Older age (odds ratio [OR]: 1.04) and liver transplant candidates (OR: 1.71) were associated with seropositivity. Previous history of SOT (OR: 0.54) and pancreas/kidney transplant candidates (OR: 0.24) were associated with seronegativity. Among 394 MMRV seronegative patients, 60 patients received 1 dose of MMR vaccine and 14 patients received 1 dose of varicella-zoster virus vaccine without severe adverse events. A total of 35% (13/37) of patients who had follow-up serologies did not have a serological response. Conclusions: A significant number of pre-SOT candidates were not immune to at least 1 dose of MMRV. This highlights the importance of MMRV screening and vaccinations pre-SOT. Postvaccination serological confirmation should be performed to evaluate the necessity for a second dose.
MeSH term(s)	Humans ; Adult ; Infant ; Herpesvirus 3, Human ; Mumps/diagnosis ; Mumps/epidemiology ; Mumps/prevention & control ; Seroepidemiologic Studies ; Retrospective Studies ; Vaccines, Combined/adverse effects ; Measles/epidemiology ; Measles/prevention & control ; Rubella/epidemiology ; Rubella/prevention & control ; Rubella/chemically induced ; Chickenpox Vaccine ; Chickenpox/prevention & control ; Vaccination ; Organ Transplantation/adverse effects ; Antibodies, Viral
Chemical Substances	Vaccines, Combined ; Chickenpox Vaccine ; Antibodies, Viral
Language	English
Publishing date	2023-06-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000004681
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Post-Lung Transplantation Outcomes and Ex Vivo Histopathological Findings in Severe Post-Covid-19 Pulmonary Disease-A Single-Center Experience.

Javaid, Hana / Nigo, Masayuki / Zhao, Bihong / Trujillo, Daniel Ocazionez / Hasbun, Rodrigo / Ostrosky-Zeichner, Luis / Patel, Manish / Jyothula, Soma

Open forum infectious diseases

2022 Volume 9, Issue 9, Page(s) ofac425

Abstract: Background: A significant proportion of patients with severe and persistent coronavirus disease 2019 (COVID-19) require continuous ventilatory support and occasional extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome ( ... ...

Abstract	Background: A significant proportion of patients with severe and persistent coronavirus disease 2019 (COVID-19) require continuous ventilatory support and occasional extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). Lung transplantation is a treatment option for patients who develop severe ARDS. Methods: Our lung transplant database was retrospectively reviewed for patients who underwent lung transplantation for COVID-19 pulmonary disease at Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, from January 2020 to March 2022. We evaluated outcomes of patients who were followed in our clinic at least 6 months post-transplant. Pretransplant patient characteristics, COVID-19-related treatment, histopathology results, and postdischarge course were evaluated. Results: Among a total of 13 lung transplant recipients, 6 consecutive patients were identified who had a minimum of 6 months of follow-up post-lung transplantation. The average age of patients was 55 years, with a male predominance. The median time to transplantation was 111 days. All 6 patients had significant postinfectious complications due to COVID-19 before transplant. Histopathological findings from explanted lungs showed a predominance of fibrotic change. There were no reported cases of rejection or graft dysfunction. 5 patients had minimal to no post-transplant infectious complications. One patient died 218 days post-transplant from infectious complications. Conclusions: Five out of six lung transplant recipients at our institution have demonstrated excellent long-term outcomes after index hospitalization, for a mean follow-up of 13 months post-lung transplantation. Lung transplantation for lung fibrosis due to COVID-19 is an acceptable salvage treatment option. Larger studies are warranted to confirm these findings.
Language	English
Publishing date	2022-08-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac425
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Article ; Online: Granulomatous fungal and non-tuberculous mycobacterial infestation complicating chronic lung disease: Outcomes in patients undergoing lung transplantation.

Sadaf, Humaira / Zhao, Bihong / Lelenwa, Laura C / Patel, Manish K / Jyothula, Soma S / Gregoric, Igor D / Buja, L Maximilian

Annals of diagnostic pathology

2021 Volume 55, Page(s) 151832

Abstract: Introduction: Granulomatous infections are common in patients with chronic lung disease. We aim to study the incidence and clinicopathological features of granulomatous infections in a cohort of patients undergoing lung transplantation for end-stage ... ...

Abstract	Introduction: Granulomatous infections are common in patients with chronic lung disease. We aim to study the incidence and clinicopathological features of granulomatous infections in a cohort of patients undergoing lung transplantation for end-stage chronic lung disease. Methods: Pathology reports of 50 explanted native lungs of patients who underwent lung transplantation since 2015 at our institution were reviewed. Four cases with granulomatous lesions were identified. Correlation was made with clinical findings in the 4 cases. Results: The granulomatous infections include non-necrotizing cryptococcal pneumonitis (case 1), necrotizing pneumonia due to Scedosporium sp. and Mycobacterium avium Complex (MAC) (Cases 2 and 3), and invasive Aspergillus pneumonia (Case 4). One patient received pre-transplant fungal prophylaxis (Case 4). Post-transplant infectious complications included invasive (Cases 2 and 4) and non-invasive (Case 1) fungal infections and bacterial pneumonia (Cases 1 and 2). Two patients (Cases 3 and 4) developed acute cellular rejection (ACR) in the first 30 days. The third patient (Case 1) was identified with ACR in the 9 months post-transplant and chronic lung allograft dysfunction at 29 months. In terms of mortality, 1 patient (Case 1) died at 30 months post-transplant from pseudomonal sepsis and chronic graft failure. Two patients with invasive fungal infections (Cases 2 and 4) are on secondary prophylaxis and doing well. One patient (Case 3) remains infection-free and on MAC prophylaxis. Conclusions: In our case series, patients with chronic lung diseases with superimposed granulomatous infestations frequently experienced post-transplant complications. These include invasive infections and repeat ACRs that predispose patients to chronic graft dysfunction. Pre- and post-transplant antifungal prophylaxis reduces fungal load and complication risk post-transplant.
MeSH term(s)	Aged ; Aspergillus fumigatus/isolation & purification ; Female ; Granuloma ; Humans ; Invasive Fungal Infections/diagnosis ; Invasive Fungal Infections/etiology ; Invasive Fungal Infections/pathology ; Lung Diseases/complications ; Lung Diseases/pathology ; Lung Transplantation/adverse effects ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous/diagnosis ; Mycobacterium Infections, Nontuberculous/etiology ; Mycobacterium Infections, Nontuberculous/pathology ; Nontuberculous Mycobacteria/isolation & purification ; Postoperative Complications ; Retrospective Studies ; Scedosporium/isolation & purification ; Treatment Outcome
Language	English
Publishing date	2021-09-30
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1440011-x
ISSN	1532-8198 ; 1092-9134
ISSN (online)	1532-8198
ISSN	1092-9134
DOI	10.1016/j.anndiagpath.2021.151832
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Article ; Online: Characterization of pulmonary vascular remodeling and MicroRNA-126-targets in COPD-pulmonary hypertension.

Goel, Khushboo / Egersdorf, Nicholas / Gill, Amar / Cao, Danting / Collum, Scott D / Jyothula, Soma S / Huang, Howard J / Sauler, Maor / Lee, Patty J / Majka, Susan / Karmouty-Quintana, Harry / Petrache, Irina

Respiratory research

2022 Volume 23, Issue 1, Page(s) 349

Abstract: Background: Despite causing increased morbidity and mortality, pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) patients (COPD-PH) lacks treatment, due to incomplete understanding of its pathogenesis. Hypertrophy of pulmonary ... ...

Abstract	Background: Despite causing increased morbidity and mortality, pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) patients (COPD-PH) lacks treatment, due to incomplete understanding of its pathogenesis. Hypertrophy of pulmonary arterial walls and pruning of the microvasculature with loss of capillary beds are known features of pulmonary vascular remodeling in COPD. The remodeling features of pulmonary medium- and smaller vessels in COPD-PH lungs are less well described and may be linked to maladaptation of endothelial cells to chronic cigarette smoking (CS). MicroRNA-126 (miR126), a master regulator of endothelial cell fate, has divergent functions that are vessel-size specific, supporting the survival of large vessel endothelial cells and inhibiting the proliferation of microvascular endothelial cells. Since CS decreases miR126 in microvascular lung endothelial cells, we set out to characterize the remodeling by pulmonary vascular size in COPD-PH and its relationship with miR126 in COPD and COPD-PH lungs. Methods: Deidentified lung tissue was obtained from individuals with COPD with and without PH and from non-diseased non-smokers and smokers. Pulmonary artery remodeling was assessed by ⍺-smooth muscle actin (SMA) abundance via immunohistochemistry and analyzed by pulmonary artery size. miR126 and miR126-target abundance were quantified by qPCR. The expression levels of ceramide, ADAM9, and endothelial cell marker CD31 were assessed by immunofluorescence. Results: Pulmonary arteries from COPD and COPD-PH lungs had significantly increased SMA abundance compared to non-COPD lungs, especially in small pulmonary arteries and the lung microvasculature. This was accompanied by significantly fewer endothelial cell markers and increased pro-apoptotic ceramide abundance. miR126 expression was significantly decreased in lungs of COPD individuals. Of the targets tested (SPRED1, VEGF, LAT1, ADAM9), lung miR126 most significantly inversely correlated with ADAM9 expression. Compared to controls, ADAM9 was significantly increased in COPD and COPD-PH lungs, predominantly in small pulmonary arteries and lung microvasculature. Conclusion: Both COPD and COPD-PH lungs exhibited significant remodeling of the pulmonary vascular bed of small and microvascular size, suggesting these changes may occur before or independent of the clinical development of PH. Decreased miR126 expression with reciprocal increase in ADAM9 may regulate endothelial cell survival and vascular remodeling in small pulmonary arteries and lung microvasculature in COPD and COPD-PH.
MeSH term(s)	Humans ; Hypertension, Pulmonary/pathology ; Vascular Remodeling ; Endothelial Cells/metabolism ; Pulmonary Disease, Chronic Obstructive/metabolism ; Pulmonary Artery/metabolism ; Lung/metabolism ; Ceramides/metabolism ; MicroRNAs/genetics ; MicroRNAs/metabolism ; Membrane Proteins/metabolism ; ADAM Proteins/metabolism
Chemical Substances	Ceramides ; MicroRNAs ; ADAM9 protein, human (EC 3.4.24.-) ; Membrane Proteins ; ADAM Proteins (EC 3.4.24.-) ; MIRN126 microRNA, human
Language	English
Publishing date	2022-12-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-022-02267-4
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Article: Esomeprazole attenuates inflammatory and fibrotic response in lung cells through the MAPK/Nrf2/HO1 pathway.

Ebrahimpour, Afshin / Wang, Min / Li, Li / Jegga, Anil G / Bonnen, Mark D / Eissa, N Tony / Raghu, Ganesh / Jyothula, Soma / Kheradmand, Farrah / Hanania, Nicola A / Rosas, Ivan O / Ghebre, Yohannes T

Journal of inflammation (London, England)

2021 Volume 18, Issue 1, Page(s) 17

Abstract: Introduction: Idiopathic pulmonary fibrosis (IPF) is an orphan disease characterized by progressive loss of lung function resulting in shortness of breath and often death within 3-4 years of diagnosis. Repetitive lung injury in susceptible individuals ... ...

Abstract	Introduction: Idiopathic pulmonary fibrosis (IPF) is an orphan disease characterized by progressive loss of lung function resulting in shortness of breath and often death within 3-4 years of diagnosis. Repetitive lung injury in susceptible individuals is believed to promote chronic oxidative stress, inflammation, and uncontrolled collagen deposition. Several preclinical and retrospective clinical studies in IPF have reported beneficial outcomes associated with the use of proton pump inhibitors (PPIs) such as esomeprazole. Accordingly, we sought to investigate molecular mechanism(s) by which PPIs favorably regulate the disease process. Methods: We stimulated oxidative stress, pro-inflammatory and profibrotic phenotypes in primary human lung epithelial cells and fibroblasts upon treatment with bleomycin or transforming growth factor β (TGFβ) and assessed the effect of a prototype PPI, esomeprazole, in regulating these processes. Results: Our study shows that esomeprazole controls pro-inflammatory and profibrotic molecules through nuclear translocation of the transcription factor nuclear factor-like 2 (Nrf2) and induction of the cytoprotective molecule heme oxygenase 1 (HO1). Genetic deletion of Nrf2 or pharmacological inhibition of HO1 impaired esomeprazole-mediated regulation of proinflammatory and profibrotic molecules. Additional studies indicate that activation of Mitogen Activated Protein Kinase (MAPK) pathway is involved in the process. Our experimental data was corroborated by bioinformatics studies of an NIH chemical library which hosts gene expression profiles of IPF lung fibroblasts treated with over 20,000 compounds including esomeprazole. Intriguingly, we found 45 genes that are upregulated in IPF but downregulated by esomeprazole. Pathway analysis showed that these genes are enriched for profibrotic processes. Unbiased high throughput RNA-seq study supported antifibrotic effect of esomeprazole and revealed several novel targets. Conclusions: Taken together, PPIs may play antifibrotic role in IPF through direct regulation of the MAPK/Nrf2/HO1 pathway to favorably influence the disease process in IPF.
Language	English
Publishing date	2021-05-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2164385-4
ISSN	1476-9255
ISSN	1476-9255
DOI	10.1186/s12950-021-00284-6
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Article: Overweight-mortality paradox and impact of six-minute walk distance in lung transplantation.

Chaikriangkrai, Kongkiat / Jhun, Hye Yeon / Graviss, Edward A / Jyothula, Soma

Annals of thoracic medicine

2015 Volume 10, Issue 3, Page(s) 169–175

Abstract: Unlabelled: Overweight-mortality paradox and impact of six-minute walk distance (SMWD) in lung transplantation.: Background: The objective of this study was to examine combined prognostic influence of body mass index (BMI) and SMWD on mortality in ... ...

Abstract	Unlabelled: Overweight-mortality paradox and impact of six-minute walk distance (SMWD) in lung transplantation. Background: The objective of this study was to examine combined prognostic influence of body mass index (BMI) and SMWD on mortality in lung transplant recipients. Methods: Consecutive isolated lung transplant recipients were identified. Preoperative BMI and SMWD data were collected. The cohort was followed for all-cause mortality. Results: The study included 324 lung transplant recipients with mean age of 57 ± 13 years and 58% were male (27% obstructive, 3% vascular, 6% cystic fibrosis, and 64% with restrictive lung diseases). In the total cohort; 37% had normal BMI, 10% were underweight, 33% were overweight, and 20% were obese. The median SMWD was 700 feet. The lower SMWDgroup was defined as the patients who had SMWD <237 feet as determined by receiver operating characteristic (ROC). Based on this definition, 66 patients (20%) had lower SMWD. There were 71 deaths during a median follow-up of 2.3 years. In multivariate analysis, both BMI and SMWD were independently associated with death. Being overweight was associated with reduced mortality risk (hazard ratio (HR) 0.50, P = 0.042) compared to the normal BMI group, and this was primarily driven by early mortality posttransplant. This paradoxical overweight-mortality relationship remained significant in the lower SMWD group (HR 0.075, P = 0.018), but not in the higher SMWD group (P = 0.552). Conclusion: In lung transplant recipients under lung allocation score (LAS) era, pretransplant BMI and SMWD were independent predictors for mortality after the transplant. The lowest mortality risk was noted in a group of transplant recipients identified as overweight; whereas, being underweight or obese was associated with increased mortality.
Language	English
Publishing date	2015-07-25
Publishing country	India
Document type	Journal Article
ZDB-ID	2241287-6
ISSN	1998-3557 ; 1817-1737
ISSN (online)	1998-3557
ISSN	1817-1737
DOI	10.4103/1817-1737.160835
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