LIVIVO - Search results -

Search results

Result 1 - 10 of total 28

Search options

Article ; Online: Role of Biofilm in Bacterial Infection and Antimicrobial Resistance.

Pokharel, Khilasa / Dawadi, Bishwa Raj / Shrestha, Lok Bahadur

JNMA; journal of the Nepal Medical Association

2022 Volume 60, Issue 253, Page(s) 836–840

Abstract: Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes ... ...

Abstract	Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes that provide them resistance to antimicrobial and host immune systems. Biofilms protect the invading bacteria against the immune system of the host via impaired activation of phagocytes and the complement system. Biofilm-producing isolates showed greater multidrug resistance than non-biofilm producers. Biofilm causes antibiotic resistance through processes like chromosomally encoded resistant genes, restriction of antibiotics, reduction of growth rate, and host immunity. Biofilm formation is responsible for the development of superbugs like methicillin-resistant Staphylococcus aureus, vancomycin-resistant Staphylococcus aureus, and metallo-beta-lactamase producing Pseudomonas aeruginosa. Regular monitoring of antimicrobial resistance and maintaining hygiene, especially in hospitalized patients are required to control biofilm-related infections in order to prevent antimicrobial resistance.
MeSH term(s)	Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Methicillin-Resistant Staphylococcus aureus/genetics ; Staphylococcus aureus/genetics ; Staphylococcal Infections/microbiology ; Drug Resistance, Bacterial ; Biofilms ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-09-01
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.7580
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Article ; Online: Standard Operating Procedure for Specimen Collection, Packaging and Transport for Diagnosis of SARS-COV-2.

Shrestha, Lok Bahadur / Pokharel, Khilasa

JNMA; journal of the Nepal Medical Association

2020 Volume 58, Issue 228, Page(s) 627–629

Abstract: Coronavirus disease-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARSCoV-2). Specimen quality, and proper transportation is vital for accurate diagnosis. This standard operating procedure is designed to educate the clinicians, nurses, ...

Abstract	Coronavirus disease-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARSCoV-2). Specimen quality, and proper transportation is vital for accurate diagnosis. This standard operating procedure is designed to educate the clinicians, nurses, paramedics, and laboratory personnel regarding proper methods of sample collection, packaging, and transportation. Nasopharyngeal swabs and/or oropharyngeal swabs should be collected for real-time quantitative polymerase chain reaction to detect SARS-CoV-2. The sample should be collected wearing proper personal protective equipment, packed in a triple packaging system, and transported maintaining cold chain.
MeSH term(s)	Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Humans ; Pandemics ; Pneumonia, Viral/diagnosis ; Real-Time Polymerase Chain Reaction ; SARS-CoV-2 ; Specimen Handling
Keywords	covid19
Language	English
Publishing date	2020-07-31
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.5260
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Metallo-β Lactamase Producing Non-Fermentative Gram-Negative Bacilli from Various Clinical Isolates in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Shrestha, Mahendra / Baral, Ratna / Shrestha, Lok Bahadur

JNMA; journal of the Nepal Medical Association

2021 Volume 59, Issue 241, Page(s) 875–880

Abstract: Introduction: Non-fermentative gram-negative bacilli are common causes of human infections especially nosocomial infections. These organisms are usually resistant to multiple antimicrobial agents including carbapenems. The study aimed to find out the ... ...

Abstract	Introduction: Non-fermentative gram-negative bacilli are common causes of human infections especially nosocomial infections. These organisms are usually resistant to multiple antimicrobial agents including carbapenems. The study aimed to find out the prevalence of metallo-β-lactamase producing non-fermentative gram-negative bacilli among the samples which yielded growth of bacteria in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital from February 2017 to May 2017. Convenience sampling method was used. Bacterial identification, characterization and antimicrobial susceptibility testing were done by following standard microbiological guidelines. Metallo-β-lactamase production was detected by using combined disk diffusion test and double-disc synergy test. Data were analyzed by using Statistical Package of Social Science software version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 628 samples which yielded growth of bacteria, 118 (18.79%) at 95% Confidence Interval (15.74-21.84) were metallo-β-lactamase producing non-fermentative gram-negative bacilli. Among them, 54 (45.76%) were Pseudomonas aeruginosa and 64 (54.24%) were Acinetobacter baumannii. Conclusions: A high prevalence of metallo-β-lactamase production was observed among the nonfermentative gram-negative bacilli than the study done in similar settings. It is mandatory to perform routine monitoring of metallo-β-lactamase producing isolates in clinical laboratories in order to help the clinicians prescribe proper antibiotics.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Carbapenems ; Cross-Sectional Studies ; Gram-Negative Bacteria ; Humans ; Microbial Sensitivity Tests ; Tertiary Care Centers ; beta-Lactamases
Chemical Substances	Anti-Bacterial Agents ; Carbapenems ; beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2021-09-11
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.6408
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Broadly-Neutralizing Antibodies Against Emerging SARS-CoV-2 Variants.

Shrestha, Lok Bahadur / Tedla, Nicodemus / Bull, Rowena A

Frontiers in immunology

2021 Volume 12, Page(s) 752003

Abstract: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have become a major concern in the containment of current pandemic. The variants, including B.1.1.7 (Alpha), B.1.351 (Beta), P1 (Gamma) and B.1.617.2 (Delta) have ... ...

Abstract	The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have become a major concern in the containment of current pandemic. The variants, including B.1.1.7 (Alpha), B.1.351 (Beta), P1 (Gamma) and B.1.617.2 (Delta) have shown reduced sensitivity to monoclonal antibodies, plasma and/or sera obtained from convalescent patients and vaccinated individuals. Development of potent therapeutic monoclonal antibodies (mAbs) with broad neutralizing breadth have become a priority for alleviating the devastating effects of this pandemic. Here, we review some of the most promising broadly neutralizing antibodies obtained from plasma of patients that recovered from early variants of SARS-CoV-2 that may be effective against emerging new variants of the virus. This review summarizes several mAbs, that have been discovered to cross-neutralize across Sarbecoviruses and SARS-CoV-2 escape mutants. Understanding the characteristics that confer this broad and cross-neutralization functions of these mAbs would inform on the development of therapeutic antibodies and guide the discovery of second-generation vaccines.
MeSH term(s)	Animals ; Antibodies, Viral/blood ; Antibodies, Viral/immunology ; Antibody Specificity ; Binding Sites, Antibody ; Broadly Neutralizing Antibodies/blood ; Broadly Neutralizing Antibodies/immunology ; COVID-19/blood ; COVID-19/immunology ; COVID-19/virology ; Cross Reactions ; Host-Pathogen Interactions ; Humans ; Mutation ; SARS-CoV-2/genetics ; SARS-CoV-2/immunology ; SARS-CoV-2/pathogenicity
Chemical Substances	Antibodies, Viral ; Broadly Neutralizing Antibodies
Language	English
Publishing date	2021-09-27
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2021.752003
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: mRNA vaccines as a revolutionary approach to combat cancer.

Mainali, Nischal / Shrestha, Abhigan Babu / Shrestha, Shubham / Chapagain, Sanskriti / Khanal, Barsha / Shrestha, Lok Bahadur / Shrestha, Sajina / Jaiswal, Vikash

Postgraduate medical journal

2024 Volume 100, Issue 1183, Page(s) 279–282

MeSH term(s)	Humans ; Neoplasms/prevention & control ; mRNA Vaccines ; Cancer Vaccines/therapeutic use ; Vaccines, Synthetic
Chemical Substances	mRNA Vaccines ; Cancer Vaccines ; Vaccines, Synthetic
Language	English
Publishing date	2024-04-22
Publishing country	England
Document type	Editorial ; Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1093/postmj/qgad138
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Ua VI Zs.340: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Evolution of the SARS-CoV-2 omicron variants BA.1 to BA.5: Implications for immune escape and transmission.

Shrestha, Lok Bahadur / Foster, Charles / Rawlinson, William / Tedla, Nicodemus / Bull, Rowena A

Reviews in medical virology

2022 Volume 32, Issue 5, Page(s) e2381

Abstract: The first dominant SARS-CoV-2 Omicron variant BA.1 harbours 35 mutations in its Spike protein from the original SARS-CoV-2 variant that emerged late 2019. Soon after its discovery, BA.1 rapidly emerged to become the dominant variant worldwide and has ... ...

Abstract	The first dominant SARS-CoV-2 Omicron variant BA.1 harbours 35 mutations in its Spike protein from the original SARS-CoV-2 variant that emerged late 2019. Soon after its discovery, BA.1 rapidly emerged to become the dominant variant worldwide and has since evolved into several variants. Omicron is of major public health concern owing to its high infectivity and antibody evasion. This review article examines the theories that have been proposed on the evolution of Omicron including zoonotic spillage, infection in immunocompromised individuals and cryptic spread in the community without being diagnosed. Added to the complexity of Omicron's evolution are the multiple reports of recombination events occurring between co-circulating variants of Omicron with Delta and other variants such as XE. Current literature suggests that the combination of the novel mutations in Omicron has resulted in the variant having higher infectivity than the original Wuhan-Hu-1 and Delta variant. However, severity is believed to be less owing to the reduced syncytia formation and lower multiplication in the human lung tissue. Perhaps most challenging is that several studies indicate that the efficacy of the available vaccines have been reduced against Omicron variant (8-127 times reduction) as compared to the Wuhan-Hu-1 variant. The administration of booster vaccine, however, compensates with the reduction and improves the efficacy by 12-35 fold. Concerningly though, the broadly neutralising monoclonal antibodies, including those approved by FDA for therapeutic use against previous SARS-CoV-2 variants, are mostly ineffective against Omicron with the exception of Sotrovimab and recent reports suggest that the Omicron BA.2 is also resistant to Sotrovimab. Currently two new Omicron variants BA.4 and BA.5 are emerging and are reported to be more transmissible and resistant to immunity generated by previous variants including Omicron BA.1 and most monoclonal antibodies. As new variants of SARS-CoV-2 will likely continue to emerge it is important that the evolution, and biological consequences of new mutations, in existing variants be well understood.
MeSH term(s)	Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized ; Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 ; Humans ; SARS-CoV-2/genetics
Chemical Substances	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Antibodies, Neutralizing ; Antibodies, Viral ; sotrovimab (1MTK0BPN8V)
Language	English
Publishing date	2022-07-20
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1086043-5
ISSN	1099-1654 ; 1052-9276
ISSN (online)	1099-1654
ISSN	1052-9276
DOI	10.1002/rmv.2381
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 3308: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾

Article ; Online: Antimicrobial Susceptibility Pattern in Opportunistic Pathogens Isolated from Immunocompromised Patients.

Basnet, Ajaya / Chand, Arun Bahadur / Pokhrel, Nayanum / Acharya, Sadikchya / Gurung, Parbati / Khanal, Laxmi Kant / Shrestha, Kundu / Shrestha, Lok Bahadur / Raghubanshi, Bijendra Raj

Journal of Nepal Health Research Council

2023 Volume 20, Issue 3, Page(s) 664–671

Abstract: Background: Brought with the advancements in transplantation science and the development of immunosuppressive agents, immunocompromised patients characterized with defective immunity have increased throughout the world with increased risk for ... ...

Abstract	Background: Brought with the advancements in transplantation science and the development of immunosuppressive agents, immunocompromised patients characterized with defective immunity have increased throughout the world with increased risk for opportunistic infections. This study provides an overview of the antimicrobial susceptibility pattern among opportunistic pathogens isolated from immunocompromised patients. Methods: Clinical and laboratory records of immunocompromised patients [patients with chronic kidney disease neutropenia, diabetes, rheumatic heart disease acquired immune deficiency syndrome hepatitis B, hepatitis C, who were subjected to microbiological culture analysis in the Department of Clinical Microbiology, KIST Medical College and Teaching Hospital, for 2 years (January 2019 and December 2020) were analyzed. Results: Out of 8,402 immunocompromised patients, 954 (11.4%) patients were subjected to microbiological culture analysis. Among 954 patients, 253 (26.5%) patients [median(interquartile range) age: 52(31-67) years; male 138 (54.5%)] were infected. A total of 295 pathogens were isolated from 1,331 cultured samples. Infections due to Escherichia coli (n=71, 24.1%), Klebsiella spp. (n=55, 18.6%), Acinetobacter calcoaceticus-baumannii complex (n=35, 11.9%), Candida albicans (n=30, 10.2%), and Staphylococcus aureus (n=28, 9.5%) were frequently observed. Among the bacterial isolates (n=239), 81.6% (n=195) of bacteria were β-lactamase producers, 51.0% (n=122) were multi-drug resistant, 9.2% (n=195) were extensively-drug resistant, 0.8% (n=195) were pan-drug resistant, and 35.7% (n=10) of S. aureus were methicillin-resistant Staphylococcus aureus. Conclusions: The majority of infection in immunocompromised patients is caused by Gram-negative bacteria, and is often associated with a higher number of β-lactamase producers and multi-drug resistant organisms. Prescriptions of antibiotics on the grounds of antimicrobial stewardship might help to reduce the burden of antimicrobial resistance.
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Methicillin-Resistant Staphylococcus aureus ; Staphylococcus aureus ; Drug Resistance, Bacterial ; Microbial Sensitivity Tests ; Nepal ; Gram-Negative Bacteria ; beta-Lactamases ; Anti-Bacterial Agents/pharmacology
Chemical Substances	beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-03-09
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2551251-1
ISSN	1999-6217 ; 1999-6217
ISSN (online)	1999-6217
ISSN	1999-6217
DOI	10.33314/jnhrc.v20i3.4047
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Assessment of four in vitro phenotypic biofilm detection methods in relation to antimicrobial resistance in aerobic clinical bacterial isolates.

Basnet, Ajaya / Tamang, Basanta / Shrestha, Mahendra Raj / Shrestha, Lok Bahadur / Rai, Junu Richhinbung / Maharjan, Rajendra / Dahal, Sushila / Shrestha, Pradip / Rai, Shiba Kumar

PloS one

2023 Volume 18, Issue 11, Page(s) e0294646

Abstract: Introduction: The lack of standardized methods for detecting biofilms continues to pose a challenge to microbiological diagnostics since biofilm-mediated infections induce persistent and recurrent infections in humans that often defy treatment with ... ...

Abstract	Introduction: The lack of standardized methods for detecting biofilms continues to pose a challenge to microbiological diagnostics since biofilm-mediated infections induce persistent and recurrent infections in humans that often defy treatment with common antibiotics. This study aimed to evaluate diagnostic parameters of four in vitro phenotypic biofilm detection assays in relation to antimicrobial resistance in aerobic clinical bacterial isolates. Methods: In this cross-sectional study, bacterial strains from clinical samples were isolated and identified following the standard microbiological guidelines. The antibiotic resistance profile was assessed through the Kirby-Bauer disc diffusion method. Biofilm formation was detected by gold standard tissue culture plate method (TCPM), tube method (TM), Congo red agar (CRA), and modified Congo red agar (MCRA). Statistical analyses were performed using SPSS version 17.0, with a significant association considered at p<0.05. Result: Among the total isolates (n = 226), TCPM detected 140 (61.95%) biofilm producers, with CoNS (9/9) (p<0.001) as the predominant biofilm former. When compared to TCPM, TM (n = 119) (p<0.001) showed 90.8% sensitivity and 70.1% specificity, CRA (n = 88) (p = 0.123) showed 68.2% sensitivity and 42% specificity, and MCRA (n = 86) (p = 0.442) showed 65.1% sensitivity and 40% specificity. Juxtaposed to CRA, colonies formed on MCRA developed more intense black pigmentation from 24 to 96 hours. There were 77 multi-drug-resistant (MDR)-biofilm formers and 39 extensively drug-resistant (XDR)-biofilm formers, with 100% resistance to ampicillin and ceftazidime, respectively. Conclusion: It is suggested that TM be used for biofilm detection, after TCPM. Unlike MCRA, black pigmentation in colonies formed on CRA declined with time. MDR- and XDR-biofilm formers were frequent among the clinical isolates.
MeSH term(s)	Humans ; Anti-Bacterial Agents/pharmacology ; Agar ; Congo Red ; Cross-Sectional Studies ; Drug Resistance, Bacterial ; Biofilms
Chemical Substances	Anti-Bacterial Agents ; Agar (9002-18-0) ; Congo Red (3U05FHG59S)
Language	English
Publishing date	2023-11-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0294646
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Comparative study of antimicrobial resistance and biofilm formation among Gram-positive uropathogens isolated from community-acquired urinary tract infections and catheter-associated urinary tract infections.

Shrestha, Lok Bahadur / Baral, Ratna / Khanal, Basudha

Infection and drug resistance

2019 Volume 12, Page(s) 957–963

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2019-04-23
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494856-1
ISSN	1178-6973
ISSN	1178-6973
DOI	10.2147/IDR.S200988
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Bacteriological Profile and Antimicrobial Susceptibility Pattern among Isolates Obtained From Body Fluids.

Shrestha, Lok Bahadur / Bhattarai, Narayan Raj / Khanal, Basudha

Journal of Nepal Health Research Council

2019 Volume 17, Issue 2, Page(s) 173–177

Abstract: Background: Infections of the sterile body sites, when occurs typically have greater clinical urgency and these infections could be life threatening. For the appropriate management of patient, early detection and identification of organism is crucial. ... ...

Abstract	Background: Infections of the sterile body sites, when occurs typically have greater clinical urgency and these infections could be life threatening. For the appropriate management of patient, early detection and identification of organism is crucial. Hence, the present study was designed to evaluate the prevalence, organism profile and antimicrobial susceptibility pattern of isolates obtained from infection of body fluids. Methods: Laboratory and clinical records of all the sterile body fluid except blood and cerebrospinal fluid submitted to the Department of Microbiology, B. P. Koirala Institute of Health Sciences during the period of 5 years (January 2012 to December 2016) were analyzed. Results: Among 1835 samples, 196 fluids samples showed growth of organisms with an isolation rate of 10.68%. Escherichia coli (E. coli) was the most common organism followed by Staphylococcus aureus (S. aureus) and Acinetobacter calcoaceticus-baumannii complex. Antimicrobial susceptibility testing showed variable degree of resistance. Thirty percentage of organisms were multi-drug resistant, 10% were extensively-drug resistant, none was pan-drug resistant, 35% of E. coli and K. pneumoniae were extended spectrum ?-lactamase producer and 30% of S. aureus were methicillin-resistant S. aureus. The study showed increasing trends of multi-drug resistant, extensively-drug resistant, methicillin-resistant S. aureus and extended spectrum ?-lactamase over the years. Conclusions: The study showed infection rate of 10% among normally sterile body fluids. E.coli, S. aureus and Acinetobacter calcoaceticus-baumannii complex are the common organisms. The infections are associated with multi drug resistant organisms. Routine surveillance of multi-drug resistant in infection of body fluids is necessary to guide treatment.
MeSH term(s)	Adolescent ; Adult ; Aged ; Bacteria/drug effects ; Bacteria/isolation & purification ; Body Fluids/microbiology ; Child ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Nepal ; Retrospective Studies
Language	English
Publishing date	2019-08-04
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2551251-1
ISSN	1999-6217 ; 1727-5482
ISSN (online)	1999-6217
ISSN	1727-5482
DOI	10.33314/jnhrc.v0i0.1656
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

To top

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito