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2019

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Outpatient Physical Therapy Management Of A Patient Following A Severe Left Middle Cerebral Artery Infarction: A Case Report, Ryan Parnell Dec 2019

Outpatient Physical Therapy Management Of A Patient Following A Severe Left Middle Cerebral Artery Infarction: A Case Report, Ryan Parnell

Case Report Posters

A cerebral vascular infarction (CVI) is a loss of blood flow to an area of the brain, which results in cell damage and/or death. The most common occluded artery is the middle cerebral artery (MCA). The incidence of falls within one year following a CVI can be as high as 42-60%. CVIs are a leading cause of long-term disability in the United States. CVIs account for 1 in every 19 deaths in the United States. Common impairments include: abnormal/slow gait, weakness, sensory loss, and decreased endurance. Common gait abnormalities include, genu recurvatum, foot drop,decreased stance phase, and foot slap on …


Oncologic And Orthopedic Rehabilitation For A Pancreatic Cancer Survivor Following Total Knee Arthroplasty Revision: A Case Report, Kelsey Dumond, Amy J. Litterini Dec 2019

Oncologic And Orthopedic Rehabilitation For A Pancreatic Cancer Survivor Following Total Knee Arthroplasty Revision: A Case Report, Kelsey Dumond, Amy J. Litterini

Case Report Posters

An estimated 80% of cancer survivors undergoing chemotherapy or radiation to manage their cancer will experience cancer-related fatigue (CRF). The majority of cancer survivors are elderly – a population frequently affected by osteoarthritis (OA). Physical activity is the most recommended and evidence-based non-pharmacologic intervention for CRF. Strong evidence exists for lower-extremity resistance and functional exercise following Total Knee Arthroplasty (TKA). Evidence suggests utilization of targeted exercise prior to extensive abdominal surgery, such as a pancreaticoduodenectomy, improves post-operative functional outcomes. The purpose of this case report is to describe physical therapy management for total knee arthroplasty revision and Whipple procedure prehabilitation …


Incline Treadmill Training For A Crush Ankle Injury With An Open Wound: A Case Report, Anna Prokity Dec 2019

Incline Treadmill Training For A Crush Ankle Injury With An Open Wound: A Case Report, Anna Prokity

Case Report Posters

Within the industrial workplace, soft tissue injuries to the ankle are common. The ankle is the second most commonly injured region in the body. Past research has shown that average time away from work was 2.5 weeks for a lateral ankle sprain, with 90% of individuals having full return to work at six weeks. Therapeutic activities are part of a comprehensive physical therapy (PT) plan of care that contribute to reintegration into a normal work-load. Treadmill training with an incline has been shown to reduce ankle stiffness and improve active range of motion. There is a paucity of research investigating …


Functional School-Based Physical Therapy Management For A Child With Pallister-Killian Syndrome: A Case Report, Cheryl R. Espinosa, Molly Collin Dec 2019

Functional School-Based Physical Therapy Management For A Child With Pallister-Killian Syndrome: A Case Report, Cheryl R. Espinosa, Molly Collin

Case Report Posters

Pallister-Killian Syndrome (PKS) is a rare genetic disorder caused by an additional short arm in chromosome 12. PKS affects multiple systems, which can impact a child’s development. Common clinical manifestations include: hypotonia, visual impairment, hearing loss, coarse facial features, intellectual disability, and congenital heart defects. Improvements in gross motor function have resulted from physical therapy (PT) and rehabilitation involving neurodevelopmental treatment (NDT). Research is limited on the effects of PT interventions to promote standing and ambulation for children with PKS. The purpose of this case report was to describe school-based PT interventions for a child with PKS, which involved standing …


Inpatient Rehabilitation For A Cancer Survivor Following A Lumbar Spinal Fusion Secondary To A Pathological Fracture: A Case Report, Nicole Marczak, Amy J. Litterini Dec 2019

Inpatient Rehabilitation For A Cancer Survivor Following A Lumbar Spinal Fusion Secondary To A Pathological Fracture: A Case Report, Nicole Marczak, Amy J. Litterini

Case Report Posters

Pathologic fractures are considered a skeletal-related event of bone metastasis. Bone metastases indicate a shorter prognosis with the survival rate varying from 6-53 months, depending on the primary type of cancer. Indications for surgery include spinal instability, vertebral collapse with or without neurologic deficit and intolerable pain that is not responsive to conservative treatment. Palliative physical therapy (PT) is provided to the patient and their family to offer education, optimize their functional independence and provide comfort and support. The purpose of this case report was to describe the plan of care for a man with advanced cancer to bone status-post …


Home Health Physical Therapy For A 90-Year-Old Patient Following Transient Ischemic Attack: A Case Report, Kendra Stephens Dec 2019

Home Health Physical Therapy For A 90-Year-Old Patient Following Transient Ischemic Attack: A Case Report, Kendra Stephens

Case Report Posters

Transient ischemic attack (TIA) is an episode of focal brain dysfunction that is temporary (<24 hrs.) and is due to a dysfunction of an arterial territory of the brain. Its most common symptoms include facial droop, arm weakness, and speech difficulty. An estimated 200,000 to 500,000 people per year experience a TIA in the U.S. After having TIA, 1/3 of them will have a stroke within a year. About 25% of people will die within a year after a TIA. While research for secondary prevention of stroke is clear for pharmacological and surgical interventions, there is limited research on non-pharmacological interventions. The purpose of this case report was to describe the immediate home health physical therapy (PT) management of an elderly community-dwelling patient following a TIA.


Restoring Functional Mobility Following A Ruptured Abdominal Aortic Aneurysm: A Case Report, Grace Laughlin Dec 2019

Restoring Functional Mobility Following A Ruptured Abdominal Aortic Aneurysm: A Case Report, Grace Laughlin

Case Report Posters

An abdominal aortic aneurysm (AAA) is a dilation of the abdominal aortic artery greater than three centimeters involving all layers of the vessel wall. There are two surgical options for treatment of AAA: open repair and endovascular aneurysm repair (EVAR). An endoleak is a complication following EVAR when blood leaks into the aneurysm sac. A type III endoleak occurs when there is a defect between parts of endografts causing an increase in the systemic pressure in the aneurysm sac. The purpose of this case report was to describe the physical therapy (PT) plan of care of an elderly patient following …


Physical Therapy Intervention For An Elderly Patient With Comorbidities Following Surgical Fixation Of A Femoral Neck Fracture: A Case Report, Yu-Min Chou Dec 2019

Physical Therapy Intervention For An Elderly Patient With Comorbidities Following Surgical Fixation Of A Femoral Neck Fracture: A Case Report, Yu-Min Chou

Case Report Posters

More than 300,000 elderly people over age 65 required hospitalization due to hip fracture in 2016. More than 95% of hip fractures are the result of falls. Strength training programs are suggested for geriatric patients with surgical fixation following hip fracture. Returning to prior level of function and quality of life is the primary goal of rehabilitation for geriatric patients recovering from a hip fracture. Complex comorbidities such as heart failure, diabetes, and extensive medical history will lead to a poor prognosis for recovery. Literature is limited on adverse responses or hardware failure in physical therapy patients following open reduction …


Physical Therapy Interventions To Increase Independence With Functional Mobility For An Older Individual With Spinal Stenosis: A Case Report, Eleni Bautz Dec 2019

Physical Therapy Interventions To Increase Independence With Functional Mobility For An Older Individual With Spinal Stenosis: A Case Report, Eleni Bautz

Case Report Posters

Spinal stenosis includes narrowing of the spinal canal which can affect nerves and other structures that pass through. Symptoms commonly associated with spinal stenosis are pain and paresthesia into the lower extremities. Spinal stenosis is diagnosed through patient history, clinical findings, and/or physical tests. Literature supports the use of physical therapy (PT) for conservative treatment in decreasing signs and symptoms of spinal stenosis The purpose of this case report was to describe a comprehensive physical therapy program with goals to decrease pain and improve functional mobility for a patient diagnosed with lumbar spinal stenosis living a sedentary lifestyle.


Early Mobilization And Functional Mobility Training For A Patient With Triple Vessel Coronary Artery Bypass Grafting: A Case Report, Cody Hall Dec 2019

Early Mobilization And Functional Mobility Training For A Patient With Triple Vessel Coronary Artery Bypass Grafting: A Case Report, Cody Hall

Case Report Posters

Coronary artery bypass grafting (CABG) is a widely used procedure (200,000 annual cases in the US)1 in individuals with Coronary artery disease (CAD). CAD is a build-up of plaque in the blood vessels that supply the heart, which can result from diabetes, smoking, and a vast number of other conditions. The procedure involves harvesting blood vessels (usually autografts of the patient’s saphenous vein) and surgically attaching them to the aorta and the poorly perfused area of the heart, bypassing the damaged vessels. Early mobility is now the standard of care in physical therapy (PT) practice following CABG, however some clinicians …


Functional Mobility Interventions For A Bariatric Patient With Necrotizing Fasciitis: A Case Report, Jakub Cwalinski Dec 2019

Functional Mobility Interventions For A Bariatric Patient With Necrotizing Fasciitis: A Case Report, Jakub Cwalinski

Case Report Posters

Necrotizing Fasciitis is a life threatening soft tissue infection that is characterized by a rapid spreading infection of the subcutaneous tissue. Symptoms include red or purple skin in the affected area, severe pain, fever, and vomiting. Typically, the infection enters the body through a break in the skin such as a cut or burn. Surgical debridement is the mainstay of treatment for necrotizing fasciitis. Intravenous antibiotics are started immediately upon diagnosis. The purpose of this case report is to describe functional mobility interventions for a bariatric patient with necrotizing fasciitis.


Joint Stability And Proprioception Training To Reduce Chronic Pain For A Female Patient With Hypermobile Ehlers-Danlos Syndrome: A Case Report, Ashley Tullo Dec 2019

Joint Stability And Proprioception Training To Reduce Chronic Pain For A Female Patient With Hypermobile Ehlers-Danlos Syndrome: A Case Report, Ashley Tullo

Case Report Posters

Ehlers-Danlos Syndrome (EDS) is a heritable connective tissue disorder with many subtypes. Hypermobile EDS (hEDS), the most common subtype, is characterized by generalized joint hypermobility, musculoskeletal impairments, systemic involvement, and a familial history of EDS. Due to the many subtypes of EDS, and general hypermobility, a categorization of all terms was created called the Hypermobility Spectrum Disorder. Patients present with physical, psychological, and central nervous system impairments reducing their quality of life (QoL). The purpose of this case report was to describe the interventions utilized for a 28-year-old female with hEDS and chronic pain with the intention of reducing symptoms …


Physical Therapy Management Of A Patient With Unilateral Headache, Neck, And Shoulder Pain Who Presents With Undiagnosed Mastoiditis: A Case Report, Alexandr Kostenko Dec 2019

Physical Therapy Management Of A Patient With Unilateral Headache, Neck, And Shoulder Pain Who Presents With Undiagnosed Mastoiditis: A Case Report, Alexandr Kostenko

Case Report Posters

Mastoiditis is an infection and inflammation of the mastoid cells. If left untreated, mastoiditis can lead to intracranial complications and ultimately death. Diagnosis is confirmed with imaging such as computed tomography or magnetic resonance imaging. Common symptoms include earache, retroauricular pain, headache, mastoid tenderness, hearing loss, and discharge from the ear. Mastoiditis is typically managed with antibiotics, but may require mastoidectomy which is the surgical removal of the mastoid bone. The purpose of this case report is to illuminate the signs/symptoms of Mastoiditis as well as Cervicogenic Headaches and their commonalities which include overlapping site of cervicalgia.


Rehabilitation And Prosthetic Training For An Individual With Bilateral Lower Extremity Amputations Due To Peripheral Vascular Disease: A Case Report, Morgan Bessette Dec 2019

Rehabilitation And Prosthetic Training For An Individual With Bilateral Lower Extremity Amputations Due To Peripheral Vascular Disease: A Case Report, Morgan Bessette

Case Report Posters

Peripheral vascular disease (PVD) is a condition in which there is a disruption of blood flow to the extremities. Common causes of PVD include: hypertension (HTN), smoking, cardiac disease and/or diabetes. 12 to 20% of the population greater than 60 years old are affected by PVD. PVD can cause intermittent claudication or critical limb ischemia (CLI) and is therefore the most common cause of lower extremity amputation (LEA). Individuals with diabetes are at even greater risk of LEA. The purpose of this case report is to describe the physical therapy (PT) interventions and prosthetic training for a patient with bilateral …


Functional Mobility In A Patient With Antiphospholipid Antibody Syndrome Following A Femoral Neck Fracture Surgical Repair: A Case Report, Mckenna Young Dec 2019

Functional Mobility In A Patient With Antiphospholipid Antibody Syndrome Following A Femoral Neck Fracture Surgical Repair: A Case Report, Mckenna Young

Case Report Papers

Background and Purpose: The main focus of chronic disease in healthcare has typically been about treatment of the disease itself, with little attention given to secondary injuries that result from the chronic disease process. As these individuals age, the risk of secondary injuries increases. This is costly and adds to the caregiver burden. The purpose of this case report was to investigate a comprehensive physical therapy (PT) program focused on rehabilitation for a female with chronic disease who sustained a femoral fracture following her most recent fall. Case Description: A 42-year-old female presented to outpatient PT following a right femoral …


Tissue Plasminogen Activator Effects On Stroke And Physical Therapy Outcomes In Acute Care: A Case Report, Lindsey Leboeuf Dec 2019

Tissue Plasminogen Activator Effects On Stroke And Physical Therapy Outcomes In Acute Care: A Case Report, Lindsey Leboeuf

Case Report Papers

Background and Purpose: An ischemic stroke occurs when blood flow to an area of the brain is restricted and can cause numbness or weakness on one side of the body, facial droop, trouble speaking, and trouble walking. Patients who seek medical attention for symptoms within three hours of their onset can be eligible to receive tissue plasminogen activator (tPA). These patients often have less resultant disability than their counterparts who did not receive the drug. The purpose of this case reports is to display the positive effects of tPA and physical rehabilitation following a stroke in the acute care setting. …


Combining A Comprehensive Physical Therapy Program And Electrocorpeal Shockwave Therapy For Plantar Fasciitis: A Case Report, Kathryn Piersiak Dec 2019

Combining A Comprehensive Physical Therapy Program And Electrocorpeal Shockwave Therapy For Plantar Fasciitis: A Case Report, Kathryn Piersiak

Case Report Papers

Background and Purpose: Plantar fasciitis (PF) is present in 2 million Americans a year, and in 10% of the population over a lifetime. Conventional physical therapy (PT) for PF has included strengthening of foot and hip musculature, and lower extremity stretching. Extracorporeal shockwave therapy (ECSW) has also been utilized with success in treatment of PF. While these two treatments have been used individually, their combined effect has not been studied. The purpose of this case report investigated a combined plan of care utilizing conventional PT, targeted hip strengthening, and ECSW. Case Description: The patient was a 48-year-old female who presented …


Treatment Of A Work-Related Superior Glenoid Labral Repair: A Case Report, Alexandra Touri Dec 2019

Treatment Of A Work-Related Superior Glenoid Labral Repair: A Case Report, Alexandra Touri

Case Report Papers

Background and Purpose: A superior glenoid labrum tear anterior to posterior (SLAP) is a common injury in the shoulder although they are less commonly seen in the workplace. There are many resources for SLAP lesions concerning overhead throwing athletes, however, there are not specific details on return to work rehabilitation activities for the workers’ compensation population. The purpose of this case report is to explore the post-operative physical therapy management of a workers’ compensation patient with a superior glenoid labrum lesion. Case Description: This patient was a 45-year-old Hispanic female diagnosed with a superior glenoid labrum lesion of the left …


A Hip Strengthening Protocol For A Patient Following Achilles Repair: A Case Report, Matthew Morris Dec 2019

A Hip Strengthening Protocol For A Patient Following Achilles Repair: A Case Report, Matthew Morris

Case Report Papers

Background and Purpose: The Achilles tendon is the strongest, yet most frequently ruptured, tendon in the body. Hip strength has been associated with various lower extremity (LE) conditions. However, there is a lack of literature regarding hip strengthening and its impact on Achilles injuries. Therefore, the purpose of this case report was to describe the rehabilitation of a patient following a left Achilles tendon repair utilizing a comprehensive hip strengthening protocol. Case Description: The patient was a 32-year-old female who ruptured her Achilles playing tennis. She underwent surgical repair three weeks later and was immobilized and non-weightbearing for a total …


Restoring Functional Mobility For A Geriatric Patient Following Open Repair Of A Ruptured Abdominal Aortic Aneurysm: A Case Report, Grace Laughlin Dec 2019

Restoring Functional Mobility For A Geriatric Patient Following Open Repair Of A Ruptured Abdominal Aortic Aneurysm: A Case Report, Grace Laughlin

Case Report Papers

Background and Purpose: Each year 200,000 people are diagnosed with an abdominal aortic aneurysm (AAA) in the United States and the mortality rate for ruptured AAA is estimated to be 80%. There are two surgical options to treat ruptured AAA, an open repair and an endovascular aneurysm repair (EVAR). The incidence of rupture following an EVAR is 0.9%. The purpose of this case report was to describe the physical therapy (PT) plan of care of an elderly patient following an open repair of a ruptured AAA with a history of EVAR. Case Description: The patient was an 86-year-old female admitted …


Physical Therapy Management Of Low Back Pain In A Young Female With Ankylosing Spondylitis Associated With Hla-B27 Antigen: A Case Report, Jake Adkins Dec 2019

Physical Therapy Management Of Low Back Pain In A Young Female With Ankylosing Spondylitis Associated With Hla-B27 Antigen: A Case Report, Jake Adkins

Case Report Papers

Background and Purpose: Ankylosing spondylitis (AS) is a form of arthritis characterized by chronic inflammation of the axial skeletal system that causes back pain and loss of mobility with strong potential for slow, eventual spinal fusion. The condition affects 0.2-0.5% of the United States population. There is no known cure for AS and the cause is unknown. The purpose of this case report is to describe a comprehensive approach for physical therapy (PT) management of AS in order to assist clinical reasoning and clinical decision-making and enhance care management in this patient population. Case description: A 27-year old female referred …


Gait, Strength, And Balance Training For A 43-Year-Old Male Following An Acute Right Middle Cerebral Artery Stroke: A Case Report, Victoria Dwyer Dec 2019

Gait, Strength, And Balance Training For A 43-Year-Old Male Following An Acute Right Middle Cerebral Artery Stroke: A Case Report, Victoria Dwyer

Case Report Papers

Background and Purpose: Although many patients who have had a stroke receive inpatient rehabilitation treatment, there is limited literature that investigates the interventions utilized to treat this population. The purpose of this case study was to describe the inpatient rehabilitation treatment interventions including body weight supported treadmill training (BWSTT), functional electrical stimulation (FES), balance, and lower extremity (LE) strengthening on a patient with a sub-acute right middle cerebral artery (R MCA) stroke. Case description: The patient was a 43-year-old male who recently had a R MCA stroke. He presented with significant expressive aphasia, left-sided hemiparesis, balance and transfer deficits, and …


Functional School-Based Physical Therapy Management For A Child With Pallister-Killian Syndrome: A Case Report, Cheryl R. Espinosa Dec 2019

Functional School-Based Physical Therapy Management For A Child With Pallister-Killian Syndrome: A Case Report, Cheryl R. Espinosa

Case Report Papers

Background and Purpose: Pallister-Killian Syndrome (PKS) is a rare genetic disorder resulting from an additional short arm in chromosome 12. This condition leads to varying levels of multi-system impairments that impact a child’s development in gross motor skills yielding functional limitations. Pediatric physical therapy (PT) management is crucial for these children to facilitate improvements in sitting, standing, and ambulation. The purpose of this case report was to describe functional school-based PT management for a child with PKS. Case Description: The child was a seven-year-old male diagnosed with PKS at 20 weeks’ gestation. The child was seen for PT five times …


Alpha-Skew Generalized Normal Distribution And Its Applications, Eisa Mahmoudi, Hamideh Jafari, Rahmat S. Meshkat Dec 2019

Alpha-Skew Generalized Normal Distribution And Its Applications, Eisa Mahmoudi, Hamideh Jafari, Rahmat S. Meshkat

Applications and Applied Mathematics: An International Journal (AAM)

The main object of this paper is to introduce a new family of distributions, which is quite flexible to fit both unimodal and bimodal shapes. This new family is entitled alpha-skew generalized normal (ASGN), that skews the symmetric distributions, especially generalized normal distribution through this paper. Here, some properties of this new distribution including cumulative distribution function, survival function, hazard rate function and moments are derived. To estimate the model parameters, the maximum likelihood estimators and the asymptotic distribution of the estimators are discussed. The observed information matrix is derived. Finally, the flexibility of the new distribution, as well as …


Stability Of A Regular Black Holes Thin-Shell Wormhole In Reissner-Nordstrom - De Sitter Space-Time, A. Eid Dec 2019

Stability Of A Regular Black Holes Thin-Shell Wormhole In Reissner-Nordstrom - De Sitter Space-Time, A. Eid

Applications and Applied Mathematics: An International Journal (AAM)

The dynamics regular black holes thin shell wormhole with a phantom energy equation of state in Reissner-Nordstrom - De sitter space-time is studied using the Darmois-Israel formalism. A mechanical stability analysis is carried out by using the standard perturbation method. The stable and unstable static solution depends on the suitable value of parameters.


Q-Sumudu Transforms Pertaining To The Product Of Family Of Q-Polynomials And Generalized Basic Hypergeometric Functions, V. K. Vyas, Ali A. Al –Jarrah, S. D. Purohit Dec 2019

Q-Sumudu Transforms Pertaining To The Product Of Family Of Q-Polynomials And Generalized Basic Hypergeometric Functions, V. K. Vyas, Ali A. Al –Jarrah, S. D. Purohit

Applications and Applied Mathematics: An International Journal (AAM)

The prime objective of commenced article is to determine q-Sumudu transforms of a product of unified family of q-polynomials with basic (or q-) analog of Fox’s H-function and q-analog of I-functions. Specialized cases of the leading outcome are further evaluated as q-Sumudu transform of general class of q-polynomials and q-Sumudu transforms of the basic analogs of Fox’s H-function and I-functions.


Jones Polynomial For Graphs Of Twist Knots, Abdulgani Şahin, Bünyamin Şahin Dec 2019

Jones Polynomial For Graphs Of Twist Knots, Abdulgani Şahin, Bünyamin Şahin

Applications and Applied Mathematics: An International Journal (AAM)

We frequently encounter knots in the flow of our daily life. Either we knot a tie or we tie a knot on our shoes. We can even see a fisherman knotting the rope of his boat. Of course, the knot as a mathematical model is not that simple. These are the reflections of knots embedded in threedimensional space in our daily lives. In fact, the studies on knots are meant to create a complete classification of them. This has been achieved for a large number of knots today. But we cannot say that it has been terminated yet. There are …


Underreporting Of Patient-Reported Outcomes In Myeloproliferative Neoplasms Clinical Trials, Anthony Messina, Quentin O'Brien Dec 2019

Underreporting Of Patient-Reported Outcomes In Myeloproliferative Neoplasms Clinical Trials, Anthony Messina, Quentin O'Brien

Clinical Research and Leadership Faculty Posters and Presentations

Introduction

Improvements in overall survival (OS) and quality of life (QoL) are clinically relevant outcomes that should guide clinical decision-making. Patients with MPNs can live with their disease for a long period of time, which increases the importance of understanding the impact of treatment in regards to a patients’ Health-Related QoL. Therefore, including PROs in clinical trials has become paramount in facilitating informed treatment decisions made by health care providers and patients. Furthermore, the FDA encourages the implementation of patient-centric measures in clinical trials.

Objective

We aimed to evaluate the frequency at which PRO measures are utilized as study endpoints …


Effectiveness Of E-Surveillance By The Infection Control Competent Nurses (Iccn) In Selected Hospitals Of Udupi And Dk Dist. Karnataka, Soumya Christabel Dec 2019

Effectiveness Of E-Surveillance By The Infection Control Competent Nurses (Iccn) In Selected Hospitals Of Udupi And Dk Dist. Karnataka, Soumya Christabel

Manipal College of Nursing, Manipal Theses and Dissertations

No abstract provided.


Efficacy Of Acupressure On Contributing Factors Of Fatigue, Severity Of Fatigue, Oxidative Stress Markers (Osm) And Other Blood Parameters Of Patients With End-Stage Renal Disease (Esrd) On Maintenance Hemodialysis (Mhd) In A Selected Tertiary Hospital Of Udupi Dist. Karnataka, Daisy Josphine Lobo Dec 2019

Efficacy Of Acupressure On Contributing Factors Of Fatigue, Severity Of Fatigue, Oxidative Stress Markers (Osm) And Other Blood Parameters Of Patients With End-Stage Renal Disease (Esrd) On Maintenance Hemodialysis (Mhd) In A Selected Tertiary Hospital Of Udupi Dist. Karnataka, Daisy Josphine Lobo

Manipal College of Nursing, Manipal Theses and Dissertations

No abstract provided.