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Uwamahoro C, Jo JH, Jang SI, Jung EJ, Lee WJ, Bae JW, Kwon WS. Assessing the Risks of Pesticide Exposure: Implications for Endocrine Disruption and Male Fertility. Int J Mol Sci 2024; 25:6945. [PMID: 39000054 PMCID: PMC11241045 DOI: 10.3390/ijms25136945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
Pesticides serve as essential tools in agriculture and public health, aiding in pest control and disease management. However, their widespread use has prompted concerns regarding their adverse effects on humans and animals. This review offers a comprehensive examination of the toxicity profile of pesticides, focusing on their detrimental impacts on the nervous, hepatic, cardiac, and pulmonary systems, and their impact on reproductive functions. Additionally, it discusses how pesticides mimic hormones, thereby inducing dysfunction in the endocrine system. Pesticides disrupt the endocrine system, leading to neurological impairments, hepatocellular abnormalities, cardiac dysfunction, and respiratory issues. Furthermore, they also exert adverse effects on reproductive organs, disrupting hormone levels and causing reproductive dysfunction. Mechanistically, pesticides interfere with neurotransmitter function, enzyme activity, and hormone regulation. This review highlights the effects of pesticides on male reproduction, particularly sperm capacitation, the process wherein ejaculated sperm undergo physiological changes within the female reproductive tract, acquiring the ability to fertilize an oocyte. Pesticides have been reported to inhibit the morphological changes crucial for sperm capacitation, resulting in poor sperm capacitation and eventual male infertility. Understanding the toxic effects of pesticides is crucial for mitigating their impact on human and animal health, and in guiding future research endeavors.
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Affiliation(s)
- Claudine Uwamahoro
- Department of Animal Science and Biotechnology, Kyungpook National University, Sangju 37224, Republic of Korea; (C.U.); (J.-H.J.); (S.-I.J.); (E.-J.J.); (W.-J.L.); (J.-W.B.)
| | - Jae-Hwan Jo
- Department of Animal Science and Biotechnology, Kyungpook National University, Sangju 37224, Republic of Korea; (C.U.); (J.-H.J.); (S.-I.J.); (E.-J.J.); (W.-J.L.); (J.-W.B.)
| | - Seung-Ik Jang
- Department of Animal Science and Biotechnology, Kyungpook National University, Sangju 37224, Republic of Korea; (C.U.); (J.-H.J.); (S.-I.J.); (E.-J.J.); (W.-J.L.); (J.-W.B.)
| | - Eun-Ju Jung
- Department of Animal Science and Biotechnology, Kyungpook National University, Sangju 37224, Republic of Korea; (C.U.); (J.-H.J.); (S.-I.J.); (E.-J.J.); (W.-J.L.); (J.-W.B.)
| | - Woo-Jin Lee
- Department of Animal Science and Biotechnology, Kyungpook National University, Sangju 37224, Republic of Korea; (C.U.); (J.-H.J.); (S.-I.J.); (E.-J.J.); (W.-J.L.); (J.-W.B.)
| | - Jeong-Won Bae
- Department of Animal Science and Biotechnology, Kyungpook National University, Sangju 37224, Republic of Korea; (C.U.); (J.-H.J.); (S.-I.J.); (E.-J.J.); (W.-J.L.); (J.-W.B.)
| | - Woo-Sung Kwon
- Department of Animal Science and Biotechnology, Kyungpook National University, Sangju 37224, Republic of Korea; (C.U.); (J.-H.J.); (S.-I.J.); (E.-J.J.); (W.-J.L.); (J.-W.B.)
- Research Institute for Innovative Animal Science, Kyungpook National University, Sangju 37224, Republic of Korea
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Xue C, Li G, Zheng Q, Gu X, Bao Z, Lu J, Li L. The functional roles of the circRNA/Wnt axis in cancer. Mol Cancer 2022; 21:108. [PMID: 35513849 PMCID: PMC9074313 DOI: 10.1186/s12943-022-01582-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/22/2022] [Indexed: 01/09/2023] Open
Abstract
CircRNAs, covalently closed noncoding RNAs, are widely expressed in a wide range of species ranging from viruses to plants to mammals. CircRNAs were enriched in the Wnt pathway. Aberrant Wnt pathway activation is involved in the development of various types of cancers. Accumulating evidence indicates that the circRNA/Wnt axis modulates the expression of cancer-associated genes and then regulates cancer progression. Wnt pathway-related circRNA expression is obviously associated with many clinical characteristics. CircRNAs could regulate cell biological functions by interacting with the Wnt pathway. Moreover, Wnt pathway-related circRNAs are promising potential biomarkers for cancer diagnosis, prognosis evaluation, and treatment. In our review, we summarized the recent research progress on the role and clinical application of Wnt pathway-related circRNAs in tumorigenesis and progression.
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Affiliation(s)
- Chen Xue
- grid.13402.340000 0004 1759 700XState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, National Clinical Research Center for Infectious Diseases, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, 310003 Hangzhou, China
| | - Ganglei Li
- grid.13402.340000 0004 1759 700XDepartment of Neurosurgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003 Hangzhou, China
| | - Qiuxian Zheng
- grid.13402.340000 0004 1759 700XState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, National Clinical Research Center for Infectious Diseases, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, 310003 Hangzhou, China
| | - Xinyu Gu
- grid.13402.340000 0004 1759 700XState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, National Clinical Research Center for Infectious Diseases, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, 310003 Hangzhou, China
| | - Zhengyi Bao
- grid.13402.340000 0004 1759 700XState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, National Clinical Research Center for Infectious Diseases, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, 310003 Hangzhou, China
| | - Juan Lu
- grid.13402.340000 0004 1759 700XState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, National Clinical Research Center for Infectious Diseases, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, 310003 Hangzhou, China
| | - Lanjuan Li
- grid.13402.340000 0004 1759 700XState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, National Clinical Research Center for Infectious Diseases, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, 310003 Hangzhou, China
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Kaur G, Verma R, Mukhopadhyay CS, Sethi R. Elevated pulmonary levels of Axin2 in mice exposed to herbicide 2,4-D with or without endotoxin. J Biochem Mol Toxicol 2021; 35:e22912. [PMID: 34463001 DOI: 10.1002/jbt.22912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 07/23/2021] [Accepted: 08/24/2021] [Indexed: 12/28/2022]
Abstract
2,4-Dichlorophenoxyacetic acid (2,4-D), a member of the phenoxy family of herbicides is commonly used in agriculture for controlling broadleaf weeds but its uncontrolled and incoherent use has been linked to incidences of lung toxicity. The present study aimed to understand the molecular mechanisms behind the 2,4-D alone or in combination with endotoxin (lipopolysaccharide [LPS]) induced pulmonary toxicity. Blood and lung samples were collected from Swiss albino mice (n = 48) following chronic exposure to high (37 mg/kg; 1/10th of LD50 ) and low (18.5 mg/kg; 1/20th of LD50 ) doses of 2,4-D alone or in combination with endotoxin (80 µg/animal). Transcriptome analysis revealed Wnt Canonical signaling as one of the top dysregulated pathways in mice lung following exposure to 2,4-D with and without endotoxin (LPS) co-exposure. Global view of differentially expressed genes showed increased messenger RNA expression of Axin2 by 0.26, 2.58, 3.14, 2.59, and 2.97 folds following exposure to LPS, high dose alone or in combination with LPS and low dose alone or in combination with LPS, respectively. The microarray data were validated using quantitative polymerase chain reaction and immunohistochemistry. Furthermore, the plasma concentration of Axin2 was elevated in the high dose group as revealed by Sandwich ELISA. The data taken together suggest a role of Axin2 to activate the Canonical Wnt signaling pathway in 2,4-D and or endotoxin-induced lung damage in mice.
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Affiliation(s)
- Gurvinder Kaur
- Department of Animal Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Ramneek Verma
- Department of Animal Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Chandra Shekhar Mukhopadhyay
- Department of Animal Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Ramsaran Sethi
- Department of Animal Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
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Kaur G, Kumar BVS, Singh B, Sethi RS. Exposures to 2,4-Dichlorophenoxyacetic acid with or without endotoxin upregulate small cell lung cancer pathway. J Occup Med Toxicol 2021; 16:14. [PMID: 33865415 PMCID: PMC8052721 DOI: 10.1186/s12995-021-00304-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 04/07/2021] [Indexed: 01/03/2023] Open
Abstract
Background Pesticide residues in food and environment along with airborne contaminants such as endotoxins pose health risk. Although herbicide 2,4-Dichlorophenoxyacetic acid (2,4-D) has been associated with increased risk of lung cancers such as small cell lung cancer (SCLC) among agricultural workers, there are no data on the SCLC signaling pathway upon 2,4-D exposure without LPS or in combination with endotoxin. Methods We exposed Swiss albino mice (N = 48) orally to high (9.58 mg kg− 1) and low (5.12 mg kg− 1) dosages of 2,4-D dissolved in corn oil for 90 days followed by E. coli lipopolysaccharide (LPS) or normal saline solution (80 μl/animal). Lung samples and broncho-alveolar fluid (BALF) were subjected to Total histological score (THS) and total leucocyte count (TLC) and differential leucocytes count (DLC) analyses, respectively. We used microarray and bioinformatics tools for transcriptomic analyses and differentially expressed genes were analyzed to predict the top canonical pathways followed by validation of selected genes by qRT-PCR and immunohistochemistry. Results Total histological score (THS) along with BALF analyses showed lung inflammation following long term dietary exposure to high or low doses of 2,4-D individually or in combination with LPS. Microarray analysis revealed exposure to high dose of 2,4-D without or with LPS upregulated 2178 and 2142 and downregulated 1965 and 1719 genes, respectively (p < 0.05; minimum cut off 1.5 log fold change). The low dose without or with LPS upregulated 2133 and 2054 and downregulated 1838 and 1625 genes, respectively. Bioinformatics analysis showed SCLC as topmost dysregulated pathway along with differential expression of Itgb1, NF-κB1, p53, Cdk6 and Apaf1. Immunohistological and quantitative real time PCR (qRT-PCR) analyses also supported the transcriptomic data. Conclusions Taken together, the data show exposures to high and low dose of 2,4-D with/without LPS induced lung inflammation and altered pulmonary transcriptome profile with the involvement of the SCLC pathway. The data from the study provide the insights of the potential damage on lungs caused by 2,4-D and help to better understand the mechanism of this complex relation. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-021-00304-4.
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Affiliation(s)
- Geetika Kaur
- Department of Animal Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, 141004, India
| | - B V Sunil Kumar
- Department of Microbial and Environmental Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, 141004, India
| | - Baljit Singh
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, S7N 5B4, Canada.
| | - R S Sethi
- Department of Animal Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, 141004, India.
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Hachim MY, Elemam NM, Ramakrishnan RK, Bajbouj K, Olivenstein R, Hachim IY, Al Heialy S, Hamid Q, Busch H, Hamoudi R. Wnt Signaling Is Deranged in Asthmatic Bronchial Epithelium and Fibroblasts. Front Cell Dev Biol 2021; 9:641404. [PMID: 33791298 PMCID: PMC8006921 DOI: 10.3389/fcell.2021.641404] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/01/2021] [Indexed: 12/16/2022] Open
Abstract
Both canonical and non-canonical Wnt signaling pathway alterations have been documented in pulmonary disease pathogenesis and progression; therefore, they can be an attractive target for pharmaceutical management of severe asthma. Wnt/β-catenin signaling was shown to link early embryonic lung development impairment to later in life asthmatic airway remodeling. Here we explored the changes in Wnt signaling associated with asthma initiation and progression in epithelial and fibroblasts using a comprehensive approach based on in silico analysis and followed by in vitro validation. In summary, the in silico analysis showed that the bronchial epithelium of severe asthmatic patients showed a deranged balance between Wnt enhancer and Wnt inhibitors. A Th2-high phenotype is associated with upregulated Wnt-negative regulators, while inflammatory and neutrophilic severe asthmatics showed higher canonical Wnt signaling member enrichment. Most of these genes are regulators of healthy lung development early in life and, if disturbed, can make people susceptible to developing asthma early in life and prone to developing a severe phenotype. Most of the Wnt members are secreted, and their effect can be in an autocrine fashion on the bronchial epithelium, paracrine on nearby adjacent structural cells like fibroblasts and smooth muscles, or systemic in blood. Our results showed that canonical Wnt signaling is needed for the proper response of cells to proliferative stimuli, which puts cells under stress. Cells in response to this proliferative stress will activate the senescence mechanism, which is also dependent on Wnt signaling. Inhibition of Wnt signaling using FH535 inhibits both proliferation and senescence markers in bronchial fibroblasts compared to DMSO-treated cells. In fibroblasts from asthmatic patients, inhibition of Wnt signaling did not show that effect as the Wnt signaling is deranged besides other pathways that might be non-functional.
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Affiliation(s)
- Mahmood Yaseen Hachim
- College of Medicine, Mohammed bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Noha Mousaad Elemam
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rakhee K Ramakrishnan
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Khuloud Bajbouj
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Ibrahim Yaseen Hachim
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Saba Al Heialy
- College of Medicine, Mohammed bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Meakins-Christie Laboratories, McGill University, Montreal, QC, Canada
| | - Qutayba Hamid
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Meakins-Christie Laboratories, McGill University, Montreal, QC, Canada
| | - Hauke Busch
- Medical Systems Biology Group, Institute for Experimental Dermatology, Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany
| | - Rifat Hamoudi
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Division of Surgery and Interventional Science, University College London, London, United Kingdom
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Verma G, Sethi RS. Study of ethion and lipopolysaccharide interaction on lung in a mouse model. Lab Anim Res 2020; 36:22. [PMID: 32742976 PMCID: PMC7390112 DOI: 10.1186/s42826-020-00055-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022] Open
Abstract
Ethion is an organophosphate used commonly in India despite being banned in many other countries. The present study was designed to study the interaction of ethion and lipopolysaccharide (LPS) together on lung after single low dose ethion exposure. Mice (n = 20) were alienated into control and treatment groups (n = 10 each). The treatment group was orally fed ethion (8 mg/kg/animal/day) dissolved in corn oil. The animals (n = 5 each) from both the groups were challenged with 80 μg Escherichia coli lipopolysaccharide (LPS) intranasally and the remaining animals (n = 5 each) were administered normal saline solution after 24 h. Ethion along with LPS induced lung inflammation as indicated by increased neutrophils and total leukocyte count (TLC) in broncheoalveolar lavage fluid. Ethion induced histomorphological alterations in lung as shown by increased pulmonary inflammation score in histopathology. Real time PCR analysis showed that ethion followed by LPS resulted significant (p < 0.05) increase in pulmonary Toll-like receptor (TLR)-4 (48.53 fold), interleukin (IL)-1β (7.05 fold) and tumor necrosis factor (TNF)-α (5.74 fold) mRNA expression. LPS co-exposure suggested synergistic effect on TLR4 and TNF-α mRNA expression. Ethion alone or in combination with LPS resulted genotoxicity in blood cells as detected by comet assay. The data suggested single dietary ethion exposure alone or in conjunction with LPS causes lung inflammation and genotoxicity in blood cells.
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Affiliation(s)
- Geetika Verma
- College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab India
| | - R S Sethi
- College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab India
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GEETIKA GEETIKA, SODHI SS, MUKHOPADHYAY CS, RAMNEEK RAMNEEK, SETHI RS. Pulmonary expression of MYCN mRNA following exposure to 2,4-D with or without endotoxin challenge. THE INDIAN JOURNAL OF ANIMAL SCIENCES 2019. [DOI: 10.56093/ijans.v89i11.95863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The present study aimed to observe the expression of MYCN in lungs of mice following chronic exposure of 2,4-D with or without lipopolysaccharide (LPS). 2,4-D was administered orally dissolved in corn oil at high and low dose (1/10th and 1/20th of LD50) for 90 days. After 90 days of exposure, animals from each group were challenged with LPS/normal saline solution at 80 μg/animal. The lung tissues were processed for microarray and real time studies. LPS resulted decrease (–0.173 fold) in m-RNA expression level of MYCN as compared to control, while High dose of 2,4-D alone and in combination with LPS resulted 0.949-fold change and 1.656-fold change increase in expression of MYCN m-RNA, respectively, as compared to control. Similarly, Low dose of 2,4-D alone or in combination with LPS also altered MYCN expression. The microarray data when validated by Real Time PCR was found to be in concordance with the Real Time PCR data. The data taken together suggest that, high and low exposure of 2,4-D alone or in combination with LPS alters expression of MYCN at m-RNA level.
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Kaur G, Sethi RS. Multiple exposures to poultry barn air and lipopolysaccharide synergistically increase the pulmonary expression of TLR-4 and IL-1β. J Occup Health 2019; 62:e12094. [PMID: 31657105 PMCID: PMC6970387 DOI: 10.1002/1348-9585.12094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/05/2019] [Accepted: 10/05/2019] [Indexed: 12/14/2022] Open
Abstract
Objective Poultry farm workers are exposed to barn air and suffer from various respiratory disorders. Due to frequent prevalence of endotoxin in the farm settings workers can get co‐exposed to barn air and endotoxin. The study was aimed to explore the pulmonary damage following long‐term multiple exposures to poultry barn air with or without endotoxin. Methods We studied the pulmonary expression of Toll‐like receptor 4 (TLR4) and Interleukin‐1β (IL‐1β) by exposing Swiss albino mice to poultry barn air for 6 days (Monday‐Saturday) in a week for 5 and 10 weeks. At the end of exposure, animals were challenged with lipopolysaccharide (LPS) or normal saline solution @80 μg/mouse intranasally. Histopathology, bronchoalveolar lavage (BAL) fluid and blood analysis were used to characterize lung damage. mRNA and protein expression of TLR4 and IL‐1β were evaluated using quantitative polymerase chain reaction (qPCR) and immunohistochemistry, respectively. Results Histopathology along with TLC and DLC of blood and BAL fluid revealed lung damage following multiple exposures and damage was severe in combination with LPS. Exposures altered mRNA and protein expression of TLR‐4 and IL‐1β and the expression was more marked following 30 days of exposure. Further LPS co‐challenge showed a synergistic effect on the expression of TLR4 and IL‐1β. Conclusions The data suggest that long‐term exposures with or without LPS caused lung damage and altered the pulmonary expression of TLR4 and IL‐1β.
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Affiliation(s)
- Gaganpreet Kaur
- College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Ram Saran Sethi
- Department of Animal Biotechnology, College of Animal Biotechnology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
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Iyadurai R, Gutta S, Prasad J, Gunasekaran K. Hepatotoxicity and neurotoxicity of Fipronil poisoning in human: A case report. J Family Med Prim Care 2019; 8:3437-3439. [PMID: 31742187 PMCID: PMC6857411 DOI: 10.4103/jfmpc.jfmpc_486_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/22/2019] [Accepted: 09/03/2019] [Indexed: 11/04/2022] Open
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