Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk factors for mortality among Human Immuno Virus infected children on antiretroviral therapy

Background: Children infected with HIV often reach the health care well after progression to severe immunosuppression which results in higher morbidity and mortality as compared to adults. They are vulnerable to faster disease progression compounded by susceptibility infections and social factors like attrition of caretakers. The present study delineates the factors for poor outcomes among HIV infected children.Methods: The records of HIV infected children from 1 to 15 years of age, started on HAART, registered at ART Centre at a tertiary hospital were reviewed in the Retrospective descriptive study. The demographic details, growth parameters, clinical features, WHO staging and investigations were assessed to study the risk factors for mortality in these children.Results: Amongst the 205 HIV infected children, enrolled in the study, the incidence of mortality was 27/205 (13.7%). The mean age of HIV infected children on ART in the no mortality and mortality group was 8.19 years and 8.25 years. The mean WHO stage of HIV infected children on ART in no mortality and mortality groups at the start of the study was 2.75 (SD=0.89) and 3.66 (SD=0.48), respectively. The mean CD4 count at start in the mortality group (195.85±105.57 cells/mm3) is significantly lower as compared to the no mortality group (306.2+355.66 cells/mm3). The mean grade of malnutrition in the no mortality and mortality groups was 1.84 and 2.88, respectively. Tuberculosis was present in 48.78% at start.Conclusions: Presence of advanced clinical stage, immunosuppression, poor nutritional state, and shorter duration of therapy are important factors deciding outcome of the children on HAART. The intense monitoring in period post starting of HAART will ensure better outcomes.
To study the effect of taurine on the effects of vital bones and regulate the level of glucose in type II diabetes

Taurine is sulfur containing semi-essential amino acid that has important roles in many biological processes, but its effect on glucose homeostasis, weight, growth and bone mineralization weren’t well defined. Objectives: the evaluation of oral Taurine effects has used for 3 months on bone mineralization biomarker, glycemic control and body weight in type ll diabetic patients. Methods: the interventional double-blind placebo-controlled study in which 80 patients with type 2 diabetes mellitus (age range 45-55) assigned in either control (n=40), or study group the (n=40) group. The last group has received a 1000mg capsule of Taurine once a day for three months. Parameters measured were serum calcium, 25(OH) vitamin D and osteocalcin, NTX-1 HbA1C% with fasting blood glucose before and after 3 months. Results: taurine led to significant (p<0.05) rise in osteocalcin, significant lowering in body weight, BMI and there were no significant changes in serum calcium, NTX-1, Vitamin D, HbA1C and fasting blood glucose, all as compared with the control value. Conclusions: the 3 months of oral Taurine are used in type II diabetic patients may modulate bone mineralization represented by elevation of osteocalcin and reduction of body weight, but has no significant effect on glycemic control and did not reduce HbA1C%.
COMPARING STUDENT SUCCESS AND UNDERSTANDING IN INTRODUCTORY STATISTICS UNDER CONSENSUS AND SIMULATION-BASED CURRICULA

This study examines the transferability of results from previous studies of simulation-based curriculum in introductory statistics using data from 3,500 students enrolled in an introductory statistics course at Montana State University from fall 2013 through spring 2016. During this time, four different curricula, a traditional curriculum and three simulation-based curricula, were used. Student success rates and understanding of six key statistical concepts are compared among these curricula using mixed logistic regression. Results indicate that after controlling for salient covariates, differences in student success rates are minimal while student understanding under the simulation-based curricula are similar to or better than student understanding under the traditional curriculum suggesting simulation-based curricula may help increase student understanding of several key statistical concepts. First published May 2018 at Statistics Education Research Journal Archives
Pattern of tuberculosis among tribal population of Central India with special reference to cartridge based nucleic acid amplification test as diagnostic tool: a descriptive study at tertiary care hospital

Background: Tuberculosis (TB) kills close to half a million Indians every year. Lack of reliable rapid diagnostic techniques for TB hampers timely diagnosis and leads to continued disease transmission, causing significant morbidity and mortality. The potential of newly recommended CBNAAT in TB and MDR-TB detection has been underutilized in our area due to lack of awareness regarding the same. Hence we utilized this rapid, logistically simplified test to study the pattern of tuberculosis among tribal population of Central India.Methods: Descriptive study of suspected TB patients in tertiary care centre from March 2016 to March 2019. Appropriate specimens from suspected TB patients were collected and subjected to CBNAAT and AFB smear to study the pattern of TB and Rifampicin- Resistant(RR) TB in our area.Results: CBNAAT detected overall 27% MTB cases; 27.72 % Pulmonary-TB cases as against smear positivity rate of 20.73% whereas 12.74% Extra-pulmonary-TB (EPTB) cases as against smear positivity rate of 1.59%. Overall 94.91% were RiF Sensitive( RS-TB) and 4.58% were RR-TB. Of the 57 (4.16%) HIV-TB coinfected cases; 96.49% were RS-TB and 5.26% were RR-TB. Co-infected patients have high incidence of EPTB(21.05%) involvement with RR-TB 3.50%. Among EPTB cases; lymph node aspirate and pus provided highest CBNAAT positive cases and almost 90.62% EPTB specimens were RS-TB . Conclusions: Availability of new diagnostic services has increased early identification of TB and RR-TB. Awareness among physicians regarding diagnostic utility of CBNAAT should be further increased as early identification of possible MDR cases is key to reducing community transmission and treatment initiation, particularly in high-burden, resource-limited settings.
A STUDY OF METABOLIC PARAMETERS IN NON DIABETIC PATIENTS WITH NON ALCOHOLIC FATTY LIVER DISEASE - IMPORTANCE OF DYSLIPIDEMIA.

BACKGROUND Metabolic risk factors of non alcoholic fatty liver disease (NAFLD) in non diabetic teetotallers who constitute a definite group are not well defined. OBJECTIVE To identify the metabolic risk factors of NAFLD if any in non diabetic subjects who do not consume alcohol. METHODS In a cross sectional study the effect of metabolic parameters (BMI, individual lipid levels, hemoglobinA1c (HbA1c), HOMA IR and the metabolic syndrome components) of 150 consecutive non diabetic teetotallers (90 with normal glucose tolerance and 60 prediabetics) on their NFS (quantifiable severity parameter of NAFLD) was studied by linear regression analysis. Similar study was done in the normal glucose tolerance and prediabetes groups separately. These parameters were then compared with those of 75 matched diabetic teetotallers with NAFLD. To analyse further the difference between normal glucose tolerance, prediabetic and overt diabetic groups, binary logistic regression of the factors was carried out taking prediabetes and diabetes as outcome variable. RESULTS All the metabolic parameters were significantly higher in diabetics compared to non diabetics and in prediabetics compared to those with normal glucose tolerance except high-density lipoprotein cholesterol. Triglyceride, high-density lipoprotein cholesterol and BMI significantly predicted NFS in the overall (adjusted R2 68.7%, P=0.000) and normal glucose tolerance groups (adjusted R2 73.2%, P=0.000) whereas BMI, triglyceride, low-density lipoprotein cholesterol and HbA1c did in prediabetics (adjusted R2 89%, P=0.000). The metabolic syndrome was significantly associated with NFS in the overall and prediabetic groups. High triglyceride (odds ratio1.08), low-density lipoprotein cholesterol (odds ratio1.03) and HbA1c (odds ratio 11.54) were positively associated with prediabetes compared to normal glucose tolerance group. CONCLUSION In nondiabetic teetotallers dyslipidemias are the prime contributors to the development of NAFLD.
Radial head fractures

The shape and size of the radial head is highly variable but correlates to the contralateral side. The radial head is a secondary stabilizer to valgus stress and provides lateral stability. The modified Mason–Hotchkiss classification is the most commonly used and describes three types, depending on the number of fragments and their displacement. Type 1 fractures are typically treated conservatively. Surgical reduction and fixation are recommended for type 2 fractures, if there is a mechanical block to motion. This can be done arthroscopically or open. Controversy exists for two-part fractures with >2 mm and <5 mm displacement, without a mechanical bloc as good results have been published with conservative treatment. Type 3 fractures are often treated with radial head replacement. Although radial head resection is also an option as long-term results have been shown to be favourable. Radial head arthroplasty is recommended in type 3 fractures with ligamentous injury or proximal ulna fractures. Failure of primary radial head replacement may be due to several factors. Identification of the cause of failure is essential. Failed radial head arthroplasty can be treated by implant removal alone, interposition arthroplasty, revision radial head replacement either as a single stage or two-stage procedure.
Service Delivery Factors That Influence Utilization of HIV Integrated Primary Health Care Programme in Embu Referral Hospital, Kenya

Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served; they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.
A novel mutation in a common pathogenic gene (SETD5) associated with intellectual disability: A case report

Intellectual disability (ID) is a non-specific phenotype present in a genetically heterogeneous group of disorders. The genetic cause of ID remains elusive in the majority of patients due to this extreme heterogeneity. Whole exome sequencing technology has been applied to identify pathogenic gene variants responsible for ID. The present report described a 1.7-year-old female patient who had severe ID with the specific features of delayed motor development, language disorders and abnormal facial features. Exome analysis identified a novel pathogenic variant of the SETD5 gene [c. 2025_2026delAG (p.Gly676Valfs*2)]. The variant was a frameshift mutation, causing termination of the protein in advance. These findings indicated that this mutation of the SETD5 gene may be a genetic cause for ID. The present study aimed to provide a meaningful exploration of ID and the identification of clinical core genetic pedigrees.
Psychoactive substance use among outpatients with severe mental illness: A comparative study

Background Despite several studies on the prevalence and pattern of substance use in Nigeria, there is little information on substance use in patients diagnosed with serious mental illness (SMI) such as schizophrenia and bipolar affective disorder (BD). Aim The aim of the study was to compare the pattern of psychoactive substance use among outpatients with BD and schizophrenia. Setting The study was conducted in a neuropsychiatric hospital in Nigeria. Methods Seventy five consecutive patients with a MINI-PLUS diagnosis of BD were compared with an equal number of patients obtained by systematic random sampling with a MINI-PLUS diagnosis of schizophrenia. Results The respondents with schizophrenia were aged 18–59 years (37.2 ± 9.99) and were predominantly young adult (49, 65.3%), men (46, 61.3%), who were never married (38, 50.7%). Overall, lifetime drug use prevalence was 52%, while for current use, overall prevalence was 21.3%. Participants with BD were aged 18–63 years (36.7 ± 10.29) and were predominantly young adult (53, 70.7%), women (44, 58.7%), who were married (32, 42.7%), with tertiary education (31, 41.3%). Overall, lifetime drug use prevalence was 46.7%, while current overall prevalence was 17.3%. These rates (lifetime and current) for both diagnostic groups are higher than what was reported by the World Health Organization in the global status report of 2014 (0% – 16%). The statistically significant difference between the two diagnostic groups was related to their sociodemographic and clinical variables and psychoactive substance use. Conclusion Psychoactive substance use remains a burden in the care of patients diagnosed with schizophrenia and BD. Future policies should incorporate routine screening for substance use at the outpatient department with a view to stemming the tide of this menace.
Opiate Withdrawal and Conditioned Withdrawal Enhance Consolidation of Object Memory in Male Sprague-Dawley Rats

OPIATE WITHDRAWAL AND CONDITIONED WITHDRAWAL ENHANCE CONSOLIDATION OF OBJECT MEMORY IN MALE SPRAGUE-DAWLEY RATS Nana Baidoo University of Guelph, 2019 Advisor: Dr. Francesco Leri The present study explored the effects of acute precipitated and conditioned withdrawal on object memory. Using the object recognition task, it was demonstrated that 3 mg/kg naltrexone enhanced memory in morphine-maintained (osmotic minipumps;10 mg/kg/day) rats when administered immediately but not 6 h post-sample. Importantly, post-sample naltrexone enhanced memory in the same animals in a drugfree state following removal of mini pumps 7 days later. To establish that conditioned withdrawal could also alter memory, morphine-maintained animals received naltrexone in a distinctive context (CS+) and vehicle in a separate context (CS) alternatively over 10 days. At the end of conditioning, confinement to this CS+ produced a conditioned locomotion suppression. More important, immediate but not delayed post-sample exposure to CS+ enhanced memory. These experiments indicate that both acute precipitated and conditioned withdrawal have significant facilitatory effects on memory consolidation and thus can play a role in the development of addictive behaviours.
Impact of a Mass Media Campaign on Adults’ Knowledge and Attitudes towards Antibiotic Use

Background & Objective(s): Self-medication with antibiotics is a worldwide problem and a major driver of the emergence of antimicrobial resistance. The objectives were to estimate the frequency, describe pattern and identify possible determinants of self-medication with antibiotics among adults in Misurata and to evaluate the impact of a mass media campaign on their knowledge and attitude regarding self-medication with antibiotics. Methods: In the 1st phase, a cross sectional design was used and 277 adults accompanying patients attending the outpatient clinics of Misurata Central Hospital were interviewed using a predesigned structured questionnaire. Data about pattern of antibiotic use, knowledge and attitude was collected. In the 2nd phase, an intervention design (one group pretest post-test design) was used. A two months mass media campaign in the form of a radio program (one episode/week for eight weeks), a TV episode and written articles in Misurata University magazine about the correct use of antibiotics was launched and its effect was assessed after three months. Results: Among adults using antibiotics, 39.5% used it as self-medication. Several defects in the pattern of antibiotic use was noticed including the duration of use, indication, and course completion. Almost two thirds had poor knowledge about antibiotics, while the majority had neutral or positive attitudes. The mean knowledge and attitude scores regarding antibiotics had significantly increased after the mass media campaign (from 9.03± 3.02 to 18.1± 4.21 and from 23.17± 5.11 to 25.81± 4.83,
Prevalence and Pattern of Antibiotic Self-Medication Practice in an Urban Population of Kerala, India: A Cross-sectional Study

Background: Self-medication involves the use of medicinal products by a consumer to treat self-recognized disorders or symptoms or intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms. Practicing self-medication for antibiotics is a major factor fueling the emergence of drug resistance. This study would help health-care providers in creating public awareness on the dangers of antibiotic abuse. Objectives: The aim of the study was to assess the prevalence and pattern of antibiotic self-medication in an urban population of Kerala. Materials and Methods: A community-based cross-sectional study was carried out in Thrippunithura municipality, Kerala. Data were collected from 755 adults by face-to-face interview using a questionnaire after obtaining consent. Data were entered in Excel and were analyzed using SPSS. Results: The percentage of respondents who practiced antibiotic self-medication was 3.31%. Males (4.1%), graduates (3.8%), and skilled workers (8.5%) were found to practice antibiotic self-medication. Majority took self-medication for sore throat (25%). Azithromycin (39%) was the major antibiotic used. Among the respondents, 36% used doctor's previous prescription to get antibiotics. The reason for antibiotic self-medication reported by majority was convenience (41%). Conclusion: Health education must be given to graduates and professionals, highlighting the problems due to antibiotic self-medication. With danger of antibiotic resistance developing, this is a major threat that has to be addressed urgently.
Prevalence of Antibiotic Resistance of Haemophilus Influenzae in Iran- A Meta-Analysis

Introduction: Based on the World Health Organization reports, infections caused by ampicillin-resistant Haemophilus influenzae strains are a major threat to public health and need urgent therapy with new antibiotics. Given the lack of a previous comprehensive study on the prevalence of the antibiotic resistance of H. influenzae in Iran, this systematic review and meta-analysis was performed to increase the knowledge about antibiotic resistance status of this pathogenic agent. Materials and Methods: For the purpose of the study, the articles related to the subject of interest and published up to August 2018 were searched in several English and Persian databases, including PubMed, Scopus, Web of Science, Scientific Information Database, and Magiran. The search process was accomplished using the following keywords: “Antibiotic resistance”, “H. influenzae”, and “Iran”. The data were pooled from 13 eligible studies reporting the prevalence of antibiotic resistance of H. influenzae in Iran. Results: The prevalence of H. influenzae resistance to various antibiotics in Iran, including ampicillin, amoxicillin, cephalexin, cefixime, ceftazidime, cefotaxime, and ceftizoxime, were obtained as 54.8%, 66.6%, 28.6%, 62%, 21.3%, 22.3%, 23.2%, respectively. These rates were reported as 27.7%, 46.7%, 53%, 82.6%, 40.3%, 30.8% for chloramphenicol, tetracycline, trimethoprim/sulfamethoxazole, penicillin, erythromycin, and ciprofloxacin, respectively. Additionally, ceftriaxone, gentamicin, amikacin, kanamycin, rifampin, azithromycin, and clindamycin had the H. influenzae resistance rates of 33.1%, 40.2%, 45.8%, 44.4%, 18.5%, 17.4%, and 71.3%, respectively. Conclusion: The majority of the antibiotics tested in Iran showed a high rate of resistance to H. influenzae. This may cause serious problems in the treatment of infections in the future. Therefore, precautionary measures, such as monitoring antibiotic prescription and resistance and using the new classes of antibiotics, are necessary.
Anxiety and depressive disorders among infertile women attending clinic in a Nigeria Teaching Hospital

Children are highly valued, and childlessness is culturally not acceptable in any typical sub-Saharan African community. Involuntary infertility is associated with significant distress and psychological disturbances, and different psychiatric disorders have been reported among women undergoing fertility treatment. This study aimed to determine prevalence of anxiety and depressive disorders and factors that were predictive of these disorders among women with infertility problem that were attending clinic at a Northeastern Nigerian Teaching Hospital. The study was a cross-sectional, questionnaire-based survey of two hundred and seven adult women on treatment for infertility. Their sociodemographic variables were obtained by the use of pro formal questionnaire and clinical parameters were obtained from their case notes. Hospital anxiety and depression scale was used to determine the presence of anxiety and/or depression using cut-off point of 11. Eighty-five respondents had anxiety and/or depressive disorders which constituted 41.1% of the studied population. Fifty-seven respondents (27.5%) had anxiety disorders while fifty-three (25.6%) had depression and thirty-seven-people (17.9%) had co-morbidity for both disorders. The factors that were predictive of depression were: previous marriage, lack of support, stigmatizing behaviours, tuba-uterine factor as the cause of infertility and surgical method of treatment. Similarly, factors that were predictive of anxiety disorder were: stigmatizing behaviours and lack of supports. Others were long duration of infertility treatment and surgical treatment for infertility as against medical treatment. This study found high prevalence of depression and anxiety disorders among women on treatment for infertility and recommend that more attention be paid to their mental health. Keywords: infertility, anxiety disorder, depression, Nigeria Afr. J. Biomed. Res . Vol. 22 (May, 2019); 157- 165