Asian Journal of Medicine and Health https://journalajmah.com/index.php/AJMAH <p style="text-align: justify;"><strong>Asian Journal of Medicine and Health</strong>&nbsp;<strong>(ISSN: 2456-8414)</strong>&nbsp;aims to publish high quality papers (<a href="/index.php/AJMAH/general-guideline-for-authors">Click here for Types of paper</a>) in the areas of Medicine and Health Science. By not excluding papers based on novelty, this journal facilitates the research and wishes to publish papers as long as they are technically correct and scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled, OPEN peer-reviewed, open-access INTERNATIONAL journal.</p> SCIENCEDOMAIN international en-US Asian Journal of Medicine and Health 2456-8414 The Prevalence of Tuberculosis among BCG Vaccinated Individuals at the North West Region of Cameroon https://journalajmah.com/index.php/AJMAH/article/view/30521 <p><strong>Aims: </strong>This study focuses as it main objective to determine the effectiveness of early BCG vaccination in preventing tuberculosis.</p> <p><strong>Study Design: </strong>It was a cross sectional descriptive study. The study population being all early BCG vaccinated individuals.</p> <p><strong>Place and Duration of Study: </strong>This study was carried out from March to June 2017 at the Saint Elizabeth General Hospital Shisong, situated in Kumbo Town (Bui Division), North West region of Cameroon.</p> <p><strong>Methodology: </strong>It was based on the administration of a structured questionnaire to all early BCG vaccinated individuals. Biological data were obtained from sputum collected from participants. Sputum was analyzed using Xpert MTB/RIF assay which simultaneously detects MTB-complex and rifampin resistance strain by amplifying and identifying a MTB-complex specific sequence of the rpoB gene.</p> <p><strong>Results: </strong>This finding shows an overall prevalence of 13.08% on early BCG vaccinated individuals seeking medical care at the Saint Elizabeth General Hospital Shisong. The prevalence of TB in HIV positive subjects was 22.05%. The occurrence was high among HIV subjects not living on ART, 6 (33.33%) against 3 (13%) in HIV subject on ART. This study also showed that male patients 11 (15.94%) developed TB compared to female patients 3 (7.89%). The rate of infection, 9 (28.13%) occurring within the age range of &gt; 28 - 38 associated to the development of TB with no correlation. Drinking habit was found to be associated with the development of TB with weak correlation and the occurrence of TB do not seem to be associated drinking duration.</p> <p><strong>Conclusion: </strong>These results show the necessity of the application of a suitable measure to prevent TB in adults, especially those at high risk of developing the disease irrespective of early childhood BCG vaccination status.</p> Donfack Jean Hubert Dosi Samuel Kidia Atemkeng Tsatedem Faustin Wandji Kounougo Rene Ngueguim Tsofack Florence ##submission.copyrightStatement## 2022-08-20 2022-08-20 1 11 10.9734/ajmah/2022/v20i1130521 Utilization of Fresh Frozen Plasma and Cryoprecipitate in Factor VIII and Factor IX Deficient Hemophilia Patient https://journalajmah.com/index.php/AJMAH/article/view/30522 <p>Haemophilia is one of the most common causes of inherited bleeding disorder resulting from deficiency of coagulation factor VIII or factor IX. Ideally, replacement should be done with factor concentrate. Due to economic constraints associated with its procurement, bleeding episodes are regularly dealt with Fresh Frozen Plasma (FFP) or cryoprecipitate in low-resource countries. This study was carried out to compare the utilization profile and clinical characteristics of haemophilia patients receiving FFP and cryoprecipitate for replacing clotting factor deficiency. This cross-sectional comparative study was conducted in the day care unit of the Department of Transfusion Medicine of Bangabandhu Sheikh Mujib Medical University between 2 groups of haemophilia patients receiving either cryoprecipitate or FFP for treatment. Out of the total 100 haemophilia patients, 50 were treated with cryoprecipitate and 50 with FFP. In FFP group, the majority of patients (48% in cryoprecipitate group and 36% in FFP group) were in the age group of more than 5 to 10 years followed by 11 to 15 years age (24% versus 30%) with a mean SD of age in cryoprecipitate group and FFP group being 11.78±5.61 and 13.42±6.12 years, respectively. About 33 (66.0%) had a history of bleeding following trauma and 32 (64.0%) had a history of spontaneous bleeding among the patients in cryoprecipitate group as a cause of swelling/bleeding and in FFP group, 23 (46.0%) had history of spontaneous bleeding followed by 23 (34.0%) with history of bleeding following trauma. Regarding the type of bleeding, oral bleeding was most common, followed by soft tissue bleeding in both group (40.0% versus 38.0%). Presence of ecchymosis in both groups was statistically significant. The difference in type of haemophilia between the two groups was statistically significant (p&lt;0.001) with a prevalence of haemophilia A of about 88%. The life expectancy of haemophilia patients is increasing dramatically day by day with successful and effective treatment with the appropriate plasma component. Cryoprecipitate is better than FFP as there is less chance of volume overload minimizing leucocyte induced non-haemolytic febrile transfusion reaction and rapid correction of coagulation factor.</p> Atiar Rahman Anika Mahmood Subarna Saha Farah Anjum Sonia Sheikh Saiful Islam Shaheen Kashfia Islam ##submission.copyrightStatement## 2022-08-23 2022-08-23 12 19 10.9734/ajmah/2022/v20i1130522 Exam Anxiety among Medical Students in Dhaka City and Its Associated Factors-A Cross-sectional Study https://journalajmah.com/index.php/AJMAH/article/view/30523 <p>Exam anxiety can be term as a mental disorder found in most students. It is a kind of fear and scaredness for which students choose to avoid the feared situations such as exams. A little bit of anxiety is common before and during the examination. Still, it can negatively impact their mental health and academic performances when it is more than the threshold level. The reasons might be expectations and pressure from parents and for competition with other peers. A cross-sectional study was conducted among medical students of Dhaka City in Bangladesh to see the status of examination phobia as they were usually going through lots of exam pressure than any other students. A structured questionnaire was used to conduct this study. WATS (West Side Test Anxiety Scale) was incorporated into the questionnaire to assess the phobia and anxiety levels of the students. Both descriptive and inferential statistics were performed for intensive analysis. Medical students must go through several different kinds of exams such as oral examination (viva), written, objective structured practical examination (OSPE), practical, short case, long case; all these things together play a contributing role in the induction of anxiety. More than 30% of students were suffering from moderate to severe examination anxiety, which compelled them to dropout or avoid the potential exams. The findings of this research can contribute significant impact on public health and mental health studies and the mental health professionals can provide policy guideline to the medical student to reduce exam anxiety. Further study needs to be done on a large scale to see a broad-spectrum scenario to assess the severity level of test anxiety and mental health status in the in the COVID-19 pandemic changing situation.</p> Atia Sharmin Bonna A. S. M. Sarwar Sarker Md. Nasrullah Khandaker Sabit Bin Razzak Sharmina Rahman Chowdhury Sabrina Rahman Shahed Rafi Pavel ##submission.copyrightStatement## 2022-08-23 2022-08-23 20 30 10.9734/ajmah/2022/v20i1130523 Prevalence of Urinary Tract Infections in Pregnant Women Attending Antenatal Consultations at the General Reference Hospital of Makiso in Kisangani, Democratic Republic of Congo https://journalajmah.com/index.php/AJMAH/article/view/30524 <p>Infections during pregnancy are a source of premature onset of labour, of ectopic pregnancy in women and of infections, especially of the eyes and lungs, in newborns. A third of women usually suffer from urinary tract infection before the age of 24. Bacteria are the cause of most urinary tract infections. Women are much more affected than men because their urethra is shorter and facilitates the entry of bacteria into the bladder. These infections rank 2nd (15%) among the contributing causes of maternal deaths worldwide. This descriptive-analytical study aims to determine the prevalence of urinary infection in pregnant women by the presence of white blood cells and epithelial cells in the urinary sediment. Of 215 pregnant women who came to the Makiso Reference General Hospital for Prenatal Consultation, Only 85 have agreed to give their urine for microscopic examination in the laboratory during the period from September 10 to December 10, 2021. This analysis shows that out of a total of 85 respondents, 56.5% of cases are positive compared to 43.5% of negative cases. High infection was observed in pregnant women from the Makiso commune (62.5%); the most affected age group was 32-41 years (37.5%); the age group 42 years and over had only one case (2%). 32.9% of infected pregnant women have no level of study; This study provides more information on urinary tract infection in pregnant women who came for Prenatal Consultation.</p> Briston Mongita Esol’e Emakanya Ghislain Nsilulu Basilwa Flavien Mongita Etisomba Likoke Bernard Bolungwa Lofeta Jacques Baitoasola Mosongolia ##submission.copyrightStatement## 2022-08-26 2022-08-26 31 37 10.9734/ajmah/2022/v20i1130524 Effect of Hours of Exposure to Cement Dust on Cancers Markers on Cement Workers in Port Harcourt https://journalajmah.com/index.php/AJMAH/article/view/30525 <p>The study was aimed at evaluating the effect of cement dust exposure on cement loaders in Port Harcourt. The study was a cross sectional study which used convenient sampling size of 100 healthy male cement workers recruited in one cement depot and eight cement loading sites in Port Harcourt using simple random technique. Subjects were classified into three groups based on daily hour cement exposure; group 1 (1-5 hrs), group 2 (6-10 hrs) and group 3 (&gt;10 hrs). Group 1 had 27 subjects, group 2 had 62 subjects and group 3 had 11 subjects. 4 ml of the venous blood was drawn into plain vacutainer bottles for the evaluation of Neuron specific Enolase, Vascular Endothelial Growth Factor A, and Total Antioxidant Status. ELISA method was used for the laboratory determination of VEGF-A and NSE while a colorimetric method was used for TAS estimation. Results showed TAS level among the classes was not significantly different (p=0.3304) and has the mean value of 2.02±0.40; 2.16±0.41 and 2.1 ±0.41 in groups 1, 2 and 3 respectively. VEGF-A level among the classes was not significantly different (p=0.7123) with mean value of 406.00 ±234.80; 439.60 ±369.40 and 361.00 ±171.00 in groups 1, 2 and 3 respectively. The mean value for NSE level among the groups (1, 2, and 3) were 3.78±1.49; 4.17±2.91 and 3.42±0.98 but there was no significantly difference (p=0.5551). This has shown that hourly exposure to cement dust among healthy cement workers does not have significant impact on cancer markers (VEGF-A, NSE and TAS). A higher timeframe assessment may provide a better picture of the effect of cement dust exposure since many diseases associated with cement dust exposure are chronic.</p> Jonathan Nyebuchi Mieiwari Ibifubara Jumbo Collins Ohwonigho Adjekuko Adams Matthew Okur Arit Okechukwu Nwogu ##submission.copyrightStatement## 2022-08-31 2022-08-31 38 45 10.9734/ajmah/2022/v20i1130525 Outcome of Pterygium Excision with Conjunctival Autograft in a Tertiary Hospital in Southern Nigeria https://journalajmah.com/index.php/AJMAH/article/view/30526 <p><strong>Aim:</strong> To report the outcome of pterygium surgery with conjunctival autograft at a tertiary hospital in Southern Nigeria.</p> <p><strong>Methods:</strong> This is a retrospective non comparative study of post operative outcomes in which the medical records of all patients who had pterygium excision with conjunctival autograft from July 2016 to June 2021 at Nigerian Navy Reference Hospital Calabar, Nigeria were reviewed. All the patients were followed up for a minimum of 6 months. Data collected were sex, age, grade of pterygium, indication for pterygium surgery, post operative complications and recurrent pterygium growth.</p> <p><strong>Results:</strong> Forty – three eyes of 38 patients were operated on. There were 23 males and 15 females (M:F = 1.5:1). Age range was 28 to 61 years (mean 40.9 ± 8.4). Age range with the highest surgery was 31 to 40 years. Grade two pterygium accounted for most of the cases (88.4%) followed by grade three (9.3%) and grade one (2.3%). The most common indication for pterygium surgery was cosmetic (55.8%) followed by recurrent inflammation (34.9%) and the least indication was blurring of vision (9.3%).</p> <p>Of the 43 eyes operated, one had recurrence giving a recurrence rate of 2.3%. One patient each developed granuloma and conjunctival cyst while three patients had subgraft hemorrhage.</p> <p><strong>Conclusion:</strong> Primary pterygium excision with conjunctival autograft has a low recurrence rate consistent with previously published reports.</p> Sunday Nnamdi Okonkwo Dominica Ibhaduwede Adebayo Ikenna Kizito Ogbonna ##submission.copyrightStatement## 2022-09-01 2022-09-01 46 51 10.9734/ajmah/2022/v20i1130526 Community Healthcare Worker’s Social Demographic Factors and Roles Influencing Uptake of Maternal Health Services in Musanze District, Northern Province, Rwanda https://journalajmah.com/index.php/AJMAH/article/view/30527 <p><strong>Background:</strong> Community health workers integrate individuals of their communities to provide preventive, habitual, and emergency maternity healthcare requirements. The aim of this study was to assess Community Health Workers social demographic factors and roles influencing uptake of Maternal Health services in Musanze District, Northern Province, Rwanda.</p> <p><strong>Methods:</strong> The study design used was analytical cross-sectional study design utilizing both quantitative and qualitative methods. In this study, a simple random sample approach was employed to choose 208 CHWs and 16 CHW’s supervisors were interviewed for qualitative data (KII). The statistical tool for social sciences (SPSS) Version 26, was utilized to examine the data. Bivariate analysis with Chi-square test of independence was used to check the relationship between the dependent and independent variables. Ordinal logistic regression was used as the most suitable inferential statistic because the predictor variables and the dependent were ordinal variables. Qualitative data were analyzed by INVIVO version 10. Community health workers 208 participated in the study and all were female.</p> <p><strong>Results</strong>: This study found that the uptake of maternal health services was regarded as very high. Among those services, deliveries at the Health Facility were at 73.6%, Antenatal care at 65.9%, Family planning at 54.3%, and the rate of Postnatal care was at 45.7%.This study assessed the influence of social demographic factors on uptake of maternal health services, level of education with<em> p*</em> &lt;.001, and working experience <em>p*</em> = .005 were associated with uptake of maternal health services. The study recommends improvement of maternal health services through family planning, health care during pregnancy, post-partum care, with particularly scaling up key motherly health services, regular training and supervision for CHWs. This will help to achieve third goal of SDG 2030 as Good Health and well-being for all People and end up reducing mortality rates in the community unit. The findings of the study will be helpful to Ministry of Health (at District and national level) in taking strategic steps towards reducing mortality rates in the unit and country at large.</p> Niyongabo Livingstone Eric Odongo Alfred Owino Dominic Mogere ##submission.copyrightStatement## 2022-09-03 2022-09-03 52 73 10.9734/ajmah/2022/v20i1130527 A Combined Treatment Effect of Cilostazol and Pentoxifylline in the Treatment of Peripheral Vascular Disease https://journalajmah.com/index.php/AJMAH/article/view/30528 <p><strong>Background:&nbsp;</strong>In past comparative studies in peripheral vascular disease (PVD) showed Cilostazol was efficient in relieving intermittent claudication as compared to Pentoxifylline.</p> <p><strong>Objectives:</strong> The present study was planned to assess the effect the combination of cilostazol (50 mg BD) and pentoxifylline (400 mg TDS) therapy in patients with PVD. Additionally, the adverse effects and economic burden of the combination was taken in to account.</p> <p><strong>Methodology:</strong> An Observational antegrade study was done among 100 patients. A Patient with PVD visited to OPD of the vascular department was enrolled in the study. Data was collected as per the Case Record Form.</p> <p><strong>Results: </strong>The mean age was found to be 58.4 ± 11.3 years of total 100 patients. An improvement in a Doppler testing (follow-up at the time interval after 1 month, 3 months and 6 months) and increased in peak systolic velocity in distal vessels as well as collaterals were observed in all patients. The PVD was prevalent in 50 to 60 years of age groups and hypertension and smoking were the most common risk factors present in PVD patients. There was more than 70% increase in walking distance after 24 weeks of treatment. Headache 24 (36.4%) and Dizziness 9 (13.6%) were observed as common side effect of therapy. The total cost of the combination therapy was affordable with improved quality of life.</p> <p><strong>Conclusion:</strong> The combination treatment showed symptomatic improvement in peripheral vascular disease in the study. The peak systolic velocity gradually increased in the distal vessel and the combination was found to be cost-effective.</p> Jalpa Suthar Birju Shah Ritu Ranjan ##submission.copyrightStatement## 2022-09-03 2022-09-03 74 80 10.9734/ajmah/2022/v20i1130528 Comparison of Illness Behavior between Japanese and Chinese Patients with Somatoform Disorders https://journalajmah.com/index.php/AJMAH/article/view/30529 <p><strong>Aims: </strong>To clarify the differences between Japan and China regarding illness behavior of outpatients with somatoform disorders.</p> <p><strong>Study Design:</strong> Cross-sectional study.</p> <p><strong>Place and Duration of Study:</strong> A survey on psychiatric and psychological outpatients with somatoform disorders between Japan and China. Duration of this study was three months between April 1, 2011, and June 30, 2011.</p> <p><strong>Methodology:</strong> The subjects of this research included 43 Japanese outpatients (49.7±10.5 yr., M/F:13/30) in psychiatry clinic at Saga Medical School Hospital, Saga 845-8502, Japan. It also included 38 Chinese outpatients (40.7±8.2 yr., M/F: 14/24) in psychiatry and psychology outpatient clinic in Dalian Medical University Hospital, Liaoning province, China. All psychiatric patients were diagnosed as the somatoform disorders according to the DSM-IV. To investigate the difference of psychological status and illness behavior, we examined them using two psychological instruments: Illness Behavior Questionnaire (IBQ) and General Health Questionnaire-30 (GHQ-30).</p> <p><strong>Results</strong><strong>:</strong> It can be found that there were the remarkable statistical differences between the Japanese and Chinese patients with somatoform disorders of each of the subscales of the GHQ-30. All GHQ-30 items were scored significantly higher by the Chinese than by the Japanese. Regarding the IBQ<strong>, </strong>the statistical differences of five subscales of IBQ between the two groups: General Hypochondriasis, Disease Conviction, Affective Inhibition, Affective Disturbance, and Irritability can be found. No obvious difference was found between the two groups of the subscale of Psychological versus somatic focusing (P/S) and Denial (D), however.</p> <p><strong>Conclusion:</strong> The GHQ-30 and the other five subscales of IBQ (except for P/S and D) for Chinese was higher than for Japanese. This finding may be attribute to the socio-cultural and economic factors. P/S and D scores on the IBQ were not significantly different, suggesting the possibility of an essential symptom of somatoform disorders.</p> Tomoko Takegishi Noriko Yamamoto Naoki Hirabayashi Suguru Hasuzawa Masahide Koda Zhengguo Huang Na Li Hisae Matsuo Takeshi Sato ##submission.copyrightStatement## 2022-09-03 2022-09-03 81 86 10.9734/ajmah/2022/v20i1130529 Prevalence of Malaria and Associated Factors among Pregnant Women Attending Uniosun Teaching Hospital Osogbo Osun State, Nigeria https://journalajmah.com/index.php/AJMAH/article/view/30530 <p>Pregnancy-related malaria is still a public health issue, as it contributes to a high infant mortality rate, low birth weight, and maternal mortality. Over 80% of the world's malaria cases were found in sub-Saharan Africa and India. More than 500,000 cases were reported in Nigeria, Madagascar, and the Democratic Republic of Congo. Pregnant women in sub-Saharan Africa, particularly in Nigeria, are most at risk of malaria infection each year, with about 50 million pregnancies at risk. Therefore, the objective of this study was to determine malaria prevalence and associated risk factors among pregnant women in Osun State, Nigeria.</p> <p>The study was retrospective of five years between January 2017- December 2021. The medical records of 277 pregnant women who tested positive for malaria were retrieved to examine the contributing factors and malaria-related complications. Data were analyzed using the SPSS statistical software package, version 23. The Chi-square test was used to determine statistical significance. Data were presented in their simplest form and P - value &lt; 0.05 was statistical significance.</p> <p>The prevalence of malaria reported among pregnant women was found to be 98.9% caused by <em>Plasmodium falciparum</em>. While most pregnant women who tested positive for malaria parasite had no complications, low birth weight was the most common complication among pregnant women who were infected with malaria, Proportion of malaria in pregnant women during the gestational period was found, according to the findings - 1st Trimester 33.2%, 2nd Trimester 47.3%, and 3rd Trimester 19.5%. There was no significant association between the prevalence of malaria and Genotypes (P=0.498).</p> <p>It was discovered that the prevalence of malaria among pregnant women was high with <em>P. falciparum</em> being the most common malaria parasite found in the stud. Prenatal care was found to be a major factor in the early detection of signs and symptoms associated with pregnancy.</p> Oluwanifemi Odesanmi Adeola Oshineye James Atolagbe ##submission.copyrightStatement## 2022-09-07 2022-09-07 87 96 10.9734/ajmah/2022/v20i1130530 The Study of Sectional Anatomy of Sheep and Human Brain by Various Staining Methods https://journalajmah.com/index.php/AJMAH/article/view/30531 <p>Five different staining methods were done on the sheep brain compared and the best method was employed to stain the human brain, Alstons&nbsp; staining method is found to be&nbsp; the best among the five staining method, which shows excellent differentiation of grey and white matter. Alston’s method has low shrinkage percentage and the time taken for this procedure is around 8 hrs 30 min. When compared with the unstained section with the stained section show pronounced grey matter. Learning neuroanatomy with wet brain section is difficult in unstained brain specimens, with the induction of staining method in the nueroanatomical structures will be helpful in differentiating the grey and white matter of brain. With the coronal and axial sections in this study various macroscopic neuroanatomical structures can be studied easily.</p> Mukilan Ramadoss S. Angelie Jessica M. Kavimani K. Prabhu P. Ramesh ##submission.copyrightStatement## 2022-09-14 2022-09-14 97 104 10.9734/ajmah/2022/v20i1130531 Attenuation of Potassium Bromate-induced Infertility by African Locust Bean (Parkia biglobosa) Seed https://journalajmah.com/index.php/AJMAH/article/view/30533 <p><strong>Background:</strong> <em>Parkia biglobosa </em>seed has been reported to enhance sperm quality. Thus, this study sought to assess its ability in attenuating KBrO<sub>3</sub>-induced sperm abnormalities.</p> <p><strong>Methodology:</strong> <em>P. biglobosa </em>was extracted with soxhlet extractor with 95% ethanol as the solvent. Twenty-four adult male Wistar rats were acclimatized under laboratory conditions and were randomly grouped into A, B, C and D. Group A was given distilled water orally. Animals in groups B, C and D were administered 100 mg/kg body weight of potassium bromate, but groups C and D were also treated with 100 and 200 mg/kg body weight of <em>P. biglobosa</em> respectively. Both potassium bromate and <em>P. biglobosa</em> were freshly prepared on daily basis and administered to rats by oral gavage. After 28 days of treatment, the animals were sacrificed under mild diethyl ether anaesthetization 24 hours after cessation of the last treatment. The cauda epididymis were separated from both testes and tinged with 2 mL of normal saline then teased. The suspension was mixed through a metallic net to avoid any other tissue contamination. This suspension was used for the determination of the sperm parameters.</p> <p><strong>Results:</strong> Exposure of animals to 100 mg/kg body weight of KBrO<sub>3</sub> significantly reduced sperm count, sperm motility, sperm viability and seminal pH but elevated sperm morphology when compared with animals in the control group at p&lt;0.05. These perturbations were attenuated by 100 and 200 mg/kg body weight of <em>P. biglobosa</em> seed extract in a dose-dependent manner.</p> <p><strong>Conclusion:</strong> The result of this study showed that potassium bromate induced abnormalities in sperm cells of treated animals, and seed extract of <em>P. biglobosa</em> attenuated these abnormalities in a dose-dependent manner. This pharmacological study is a useful tool for further drug development from the natural plant products.</p> E. O. Ezirim C. A. Onyeaghala S. F. Orji C. N. Ugwu C. Igwenyi C. L. Uche I. O. Abali O. I. N. Onyekachi M. U. Nwobodo F. U. Agu C. E. Iwuoha N. M. Chika-Igwenyi A. I. Airaodion ##submission.copyrightStatement## 2022-09-30 2022-09-30 112 123 10.9734/ajmah/2022/v20i1130533 Cardiac vs. Non Cardiac Chest Pain: Prospect of Different Pathological and Physiological Etiologies and Managements https://journalajmah.com/index.php/AJMAH/article/view/30532 <p>Chest pain with/without etiologies are common phenomenon in day to day life .Like indigestion, dyspepsia and heartburn, people of third world country frequently suffer from these symptoms. Though it is not uncommon, lack of precautions and awareness it would be life threatening situation unless treatment module is activated. Different medical roles along with life style modification helpful in this regard for managing chest pain with different clinical features.</p> Chowdhury Md. Navim Kabir ##submission.copyrightStatement## 2022-09-20 2022-09-20 105 111 10.9734/ajmah/2022/v20i1130532