Ritesh G Menezes1, Pradhum Ram2, Huda Fatima3, Brijesh Sathian4. 1. College of Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia. 2. Albert Einstein Medical Centre, Philadelphia, PA, United States of America. 3. Dow Medical College, Dow University of Health Sciences, Karachi,Pakistan. 4. Manipal College of Medical Sciences, Pokhara, Nepal.