Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Case report
Year : 2021 | Month : August | Volume : 15 | Issue : 8 | Page : YD01 - YD02 Full Version

Post-COVID-19 Physiotherapy Rehabilitation: A Case Report

Published: August 1, 2021 | DOI:
Reema Joshi, Manisha Rathi, Jidnyasa Thakur

1. Associate Professor, Department of Community Physiotherapy, Dr D Y Patil College of Physiotherapy, Pune, Maharashtra, India. 2. Professor, Department of Community Physiotherapy, Dr D Y Patil College of Physiotherapy, Pune, Maharashtra, India. 3. Postgraduate Student, Department of Community Physiotherapy, Dr D Y Patil College of Physiotherapy, Pune, Maharashtra, India.

Correspondence Address :
Dr. Reema Joshi,
Green Valley, C/1003, Kaspate Vasti, Wakad, Pune-411057, Maharashtra, India.


Coronavirus Disease 2019 (COVID-19) is a severe disease mostly affecting the respiratory system. Even after the acute symptoms of COVID-19 subside, there are many post acute symptoms that are still present in the COVID-19 survivors. Post-COVID-19 fatigue is seen to affect people of all age groups. This case report emphasises on the Physiotherapy view point. There are very few studies showing the benefits of Physiotherapy exercises in Post-COVID-19 manifestations. A 21-year-old female presented to physiotherapy department. An 8-week Physiotherapy protocol was given and outcomes were assessed before and after the treatment protocol. The presented symptoms were found to be relieved, thus, showing the effectiveness of Physiotherapy in Post-COVID-19 phase.


Breathlessness, Coronavirus, Exercise, Fatigue, Fitness

Case Report

A 21-year-old female, student by profession presented with the complaints of breathlessness, generalised weakness, lower back pain and weight gain. Height and weight were 157 cm and 71 kg, respectively. The Body Mass Index (BMI) was found to be 28.8 kg/cm2 which was categorised as overweight according to the Asian classification of BMI.

In the month of September 2020, she was tested positive for COVID-19 on rapid antigen test as her father had a travel history during that period. The symptoms were loss of appetite, dizziness, weakness and headache. Medications were given and home quarantine of 14 days was advised. Drugs prescribed were- Vitamin B complex, vitamin C and paracetamol. After completion of the medications for 14 days, investigations were done and she was tested negative for COVID-19. After a week, she started suffering from persistent headache for which she visited the Medicine Department of the hospital and found it to be due to sinusitis. Medications like paracetamol, antibiotics and nimesulide were given.

A month later, she visited for Physiotherapy and presented with breathlessness after walking for a few miles, generalised weakness, lower back pain, weight gain and menstrual irregularities on 31st December 2020. She had started with Ayurvedic medications for the irregular menstrual cycle. Physiotherapy assessment was done which included all the components of fitness and special tests for back. Body composition, endurance, cardio-respiratory fitness, flexibility and strength were assessed. The special tests done for back pain was Faber test, Straight leg raise test and Gillet’s test. Faber test was found to be positive which indicated Sacroiliac joint involvement.

Treatment procedure was informed and written consent was obtained from the participant and overall study protocol was explained. The tests and scales used for each of the fitness component is shown in (Table/Fig 1)(1),(2),(3).

Physiotherapy session: The Physiotherapy session began on 2nd January 2021. Treatment was given for five days a week for 40-45 minutes daily for eight weeks. Treatment protocol included aerobic exercises along with strengthening according to the World Health Organisation (WHO) guidelines (4). The procedure was followed as:

Warm up: Stretching of upper limb and lower limb (30 seconds hold for 3 repetitions), Spot marching (30 seconds, 2 sets).

Aerobic exercises: Step up and step down (2 minutes, 3 sets), mild intensity aerobics of 32 count beats for 20 minutes. Given for three times a week. Weekly progression by increasing the intensity from mild to moderate.

Strengthening exercises: Initially, low resistance band (Red colour TheraBand) was used for strengthening upper limb and lower limb muscles (15 repetitions, 3 sets). Given for two times a week. Progression was given by increasing the repetitions of the exercise and later the resistance to Green colour TheraBand.

Cool down: Relaxation, Deep breathing exercise, Thoracic expansion exercise to improve lung capacity.

Exercises for low back pain: Pelvic bridging, bird-dog position. (Weekly progression with increase in repetitions and hold was given).

Rehabilitation protocol in the post-COVID-19 phase, found a significant effect on the fitness components like strength, endurance, and cardio-respiratory fitness that were assessed and the patient had relief in the presented complaints. The results of outcomes assessed before and after the treatment are given in (Table/Fig 2).


Coronavirus disease is an infectious disease which is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and has affected more than 15 million people around the world. The most commonly affected organ is the respiratory system. The virus binds to the Angiotensin Converting Enzyme 2 (ACE2) receptors which are present in the lungs, heart, kidneys, pharynx, liver and other tissues of the body (5). With progressive researches on COVID-19, it is highly evident that these patients experience long term effects like fatigue. This post-COVID-19 fatigue is the reduction in physical and mental ability which are the effects of changes in central, peripheral or psychological factors associated with COVID-19 disease (6).

Also, COVID-19 might have the ability to affect a variety of tissues, which also includes the skeletal muscles. The most common COVID-19 symptoms are muscle weakness and pain. Therefore, COVID-19 may directly affect the skeletal muscles and cause fatigue (6). This fatigue is becoming a major issue and affecting the quality of life. Thus, it is important to restore the functional status with proper rehabilitation (7).

The present study showed the effect of a rehabilitation protocol in the post-COVID-19 phase, found a significant effect on the fitness components like strength, endurance, and cardio-respiratory fitness that were assessed and the patient had relief from the presented complaints.

Physical activity is thought to be one of the chief components of healthy living and therefore is primary constituent of healthy living medicine. It has steadily shown significant reduction in the risk of developing systemic inflammation, excessive body mass and building immunity. This immune response to physical activity is due to increase in the immunosurveillance (8).

Physical activity also improves muscle strength, flexibility and endurance, thereby improving overall functional status (9).

In a case series of seven Post-COVID-19 patients, rehabilitation program for 1-2 sessions/day for 30 minutes, each for 6 days/week was done. The protocol followed showed improvement in functional outcomes (10).

A study has shown the correlation between obesity/ overweight and severity of COVID-19. The factors linked are reduced lung capacities and reduction in cardiovascular function along with reduction in immune response in obese/ overweight individuals (11). Obesity/overweight has shown to weaken immunity, and an overall negative impact on the efficiency of pathogen defenses. It is linked to a reduction in the diversity of T-cell receptors and also shown to cause a reduction in lymph node size, inhibition of the number of T- cells in the lymph nodes, and reduced ability of the immune system to recognise and effectively deal with foreign antigens. Obesity is known to cause chronic inflammation and an increase in circulatory, pro-inflammatory cytokines, which may play a role in the worsening of COVID-19 outcomes. Thus, the physiological outcomes of obesity/overweight, such as inflammation, contribute to COVID-19 severity in people with high BMI (11). Another study focused on the pulmonary rehabilitation in Post-COVID phase showing improvements in anxiety and dyspnoea (12).


Post-COVID-19 phase needs to be addressed with a tailor made rehabilitation protocol. The treatment given in this case was found to be useful in relieving the symptoms presented.


American College of Sports Medicine. ACSM’s Health-Related Physical Fitness Assessment Manual. 4th ed. Lippincott Williams and Wilkins, 2004. [crossref]
Radu LE, Fagaras SP, Vanvu G. Physical activity index of female university students. Procedia-Social and Behavioral Sciences. 2015;191:1763-66. [crossref]
Klok FA, Boon GJAM, Barco S, Endres M, Geelhoed JJM, Knauss S, et, al. The Post-COVID-19 Functional Status scale: A tool to measure functional status over time after COVID-19. Eur Respir J. 2020;56(1):2001494. [crossref] [PubMed]
Support for Rehabilitation: Self-Management after COVID-19 related illness by WHO Available from:
Woods JA, Hutchinson NT, Powers S, Roberts W, Gomez-Cabrera M, Radak Z, et, al. The COVID-19 pandemic and physical activity. SMHS. 2020;2:55-64. [crossref] [PubMed]
Rudroff T, Fietsam AC, Deters JR, Bryant AD, Kamholz J. Post-COVID-19 fatigue: Potential contributing factors. Brain Sci. 2020;10(12):1012. [crossref] [PubMed]
Swaminathan N, Jiandani M, Surendran PJ, Jacob P, Bhise A, Baxi G, et, al. Beyond COVID-19: Evidence-based consensus statement on the Role of physiotherapy in pulmonary rehabilitation in the Indian context. J Assoc Physicians India. 2020;68(12):82-89.
Laddu DR, Lavie CJ, Phillips SA, Arena R. Physical activity for immunity protection: Inoculating populations with healthy living medicine in preparation for the next pandemic. Prog Cardiovasc Dis. 2021;64:102-104. [crossref] [PubMed]
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et, al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. BJSM. 2020;54(24):1451-62. [crossref] [PubMed]
Ferraro F, Calafiore D, Dambruoso F, Guidarini S, de Sire A. COVID-19 related fatigue: Which role for rehabilitation in post-COVID-19 patients? A case series. J Med Virol. 2021;93(4):1896-99. [crossref] [PubMed]
Caci G, Albini A, Malerba M, Noonan DM, Pochetti P, Polosa R. COVID-19 and obesity: Dangerous Liaisons. J Clin Med. 2020;9(8):2511. [crossref] [PubMed]
Kunoor A, Ashok A, Moni M, Mehta A, Thomas E, Viswan V, et, al. A case series on post-COVID pulmonary rehabilitation: Early experiences from Kerala, South India. Indian J Case Reports. 2020;6(12):672-75. [crossref]

DOI and Others


Date of Submission: Apr 26, 2021
Date of Peer Review: May 27, 2021
Date of Acceptance: June 16, 2021
Date of Publishing: Aug 01, 2021

• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: Apr 28, 2021
• Manual Googling: June 10, 2021
• iThenticate Software: Jun 16, 2021 (12%)

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