Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of Prescribing Practices in the Outpatient Departments of a Teaching Hospital

Irrational use of medicines is widespread throughout the world. Polypharmacy, injudicious use of antimicrobials and unnecessary use of vitamins are commonly observed. In an attempt to observe the prescribing practices in a Teaching Hospital outpatient departments and to sensitize the future prescribers about rational prescribing, 1200 prescriptions were collected and analyzed by 4th year MBBS students using some of the WHO/INRUD core drug prescribing indicators. The average number of drug per prescription was 3.24. Only 0 13% drugs prescribed under generic names. Around 36.83% of prescriptions were prescribed with antimicrobials and 7.08% prescriptions were contained injections. About 48.35 drugs were prescribed from essential list of drugs and vitamins were prescribed in 33.33% prescriptions. The result revealed that there are apparent lacks of prescribing habit among the prescribers even in a teaching hospital. It is suggested that the periodic evaluation of prescribing practices at a health facility would eventually help to promote rational prescribing. Furthermore, participation of 4th year MBBS students in such exercise may enhance the understanding and sensitize them about rational use of medicines in future. DOI: http://dx.doi. org/10.3329/bmj.v40i2. 18499 Bangladesh Medical Journal 2011 Vol.40(2): 19-22
Brivaracetam: a new drug in development for epilepsy and neuropathic pain

Background: Epilepsy is a neurological disorder with a worldwide prevalence estimated to be 0.5 – 1.0% of the population. Many potent antiepileptic drugs (AED) have been used for treatment but still about 30% of patients are resistant to current AEDs. Some AEDs are also used for the treatment of neuropathic pain. Objective: The aim of this report is to present preclinical and clinical studies of brivaracetam (UCB-34714), a new drug developed by UCB Pharma. Methods: Published results of preclinical studies in several animal models of epilepsy, neuropathic pain, essential tremor and results of Phase I and II evaluations of brivaracetam have been analysed. Results/conclusion: Brivaracetam represents a new mechanism of action being a ligand of synaptic vesicle protein 2A. It is undergoing Phase III evaluation after a successful Phase II programme in which was effective as an adjunctive treatment in partial-onset epilepsy (50 mg/day). It is well tolerated, without serious adverse side effects.
Associação dos polimorfismos dos genes TGF-beta1, CD14, IL-4, IL-4R e ADAM33 com a gravidade da asma em crianças e adolescentes

OBJETIVO: Verificar, em uma amostra de pacientes com asma atopica persistente leve, moderada e grave, a associacao entre os polimorfismos dos genes fator de crescimento transformante-b1 (TGF-b1) (C-509T e T869C), CD14 (C-159T), IL-4 (C-590T), IL-4R (ILe50Val) e ADAM33 (S_2) com a gravidade da asma. METODOS: Realizou-se um estudo clinico laboratorial prospectivo em pacientes com asma atopica persistente, comparados a um grupo controle no Hospital Universitario da Universidade Estadual de Campinas nos anos de 2006 e 2007. A analise do polimorfismo T869C do gene TGF-b1 foi realizada pela tecnica de reacao em cadeia da polimerase (PCR) + sistema de amplificacao refrataria de mutacao (ARMS). Os outros polimorfismos, C-509T do gene TGF-b1, C-159T do gene CD14, C-590T da IL-4, ILe50Val da IL-4Ra e S2 do gene ADAM33, foram detectados por PCR e enzima de restricao. RESULTADOS: Foram incluidos 88 pacientes com asma atopica persistente (27 leves, 23 moderados e 38 graves) e 202 individuos saudaveis, doadores de sangue. Em relacao ao polimorfismo T869C (TGF-b1), observou-se uma associacao entre o genotipo CC e os pacientes com asma grave. Nenhuma associacao foi encontrada com os polimorfismos C-509T (TGF-b1), C-590T (IL4) e S_2 (ADAM33). Quando se comparou a distribuicao da frequencia genotipica do polimorfismo C-159T (CD14) na asma grave com o grupo controle, foi observado um resultado significativo com o genotipo TT. Houve associacao significativa do genotipo Val/Val (IL-4R) com a asma leve. CONCLUSAO: Nossos resultados indicam que os polimorfismos T869C (TGF-b1), C-159T (CD14) e Val/Val (IL-4R) podem estar envolvidos na modulacao da gravidade da asma.
Travel characteristics and risk-taking attitudes in youths traveling to nonindustrialized countries.

BACKGROUND International travel to developing countries is increasing with rising levels of disposable income; this trend is seen in both adults and children. Risk-taking attitude is fundamental to research on the prevention of risky health behaviors, which can be an indicator of the likelihood of experiencing illness or injury during travel. The aim of this study is to investigate whether risk-taking attitudes of youths are associated with travel characteristics and likelihood of experiencing illness or injury while traveling to nonindustrialized countries. METHODS Data were analyzed from the 2008 YouthStyles survey, an annual mail survey gathering demographics and health knowledge, attitudes, and practices of individuals from 9 through 18 years of age. Travelers were defined as respondents who reported traveling in the last 12 months to a destination other than the United States, Canada, Europe, Japan, Australia, or New Zealand. Risk-taking attitude was measured by using a four-item Brief Sensation-Seeking Scale. All p values ≤ 0.05 were considered significant. RESULTS Of 1,704 respondents, 131 (7.7%) traveled in the last 12 months. Females and those with higher household income were more likely to travel (odds ratio = 1.6,1.1). Of those who traveled, 16.7% reported seeking pretravel medical care, with most visiting a family doctor for that care (84.0%). However, one-fifth of respondents reported illness and injury during travel; of these, 83.3% traveled with their parents. Males and older youths had higher mean sensation-seeking scores. Further, travelers had a higher mean sensation-seeking score than nontravelers. Those who did not seek pretravel medical care also had higher mean sensation-seeking scores (p = 0.1, not significant). CONCLUSIONS Our results show an association between risk-taking attitudes and youth travel behavior. However, adult supervision during travel and parental directives prior to travel should be taken into consideration. Communication messages should emphasize the importance of pretravel advice, target parents of children who are traveling, and be communicated through family doctors.
Level of concern and precaution taking among Australians regarding travel during pandemic (H1N1) 2009: results from the 2009 Queensland Social Survey.

BACKGROUND Global disease outbreaks, such as the recent Pandemic (H1N1) 2009 (the so-called Swine flu), may have an impact on travel, including raising the concerns of travelers. The objective of this study was to examine the level of concern of Australians regarding travel during Pandemic (H1N1) 2009 and how this impacted on their travel. METHODS Data were collected by interviews as part of the Queensland Social Survey (QSS) 2009. Specific questions were incorporated regarding travel and Pandemic (H1N1) 2009. Multivariate logistic regression was used to analyze associations between demographic variables and concern and likelihood of cancelling travel. RESULTS There were 1,292 respondents (41.5% response rate). The sample was nearly equally divided between males and females (50.2% vs 49.8%). Younger people (18-34 y) were under-represented in the sample; older people (> 55 y) were over-represented in the sample. About half (53.2%) of respondents indicated some level of concern about Pandemic (H1N1) 2009 when traveling and just over one-third (35.5%) indicated they would likely cancel their air travel if they had a cough and fever that lasted more than one day. When cross-tabulating these responses, people who expressed concern regarding Pandemic (H1N1) 2009 when they traveled were more likely than those without concern to cancel their air travel if they had a cough and fever lasting more than one day (44.7% vs 27.7%, χ² = 33.53, p < 0.001). People with higher levels of education [adjusted odds ratio (AOR): 0.651], people with higher incomes (AOR: 0.528) and people living outside of metropolitan Southeast Queensland (AOR: 0.589) were less likely to be concerned about Pandemic (H1N1) 2009 when traveling, and younger people (AOR: 0.469) were less likely than others to cancel travel if they had a cough and fever. CONCLUSIONS Pandemic (H1N1) 2009 was of some concern to more than half of Queensland travelers. None-the-less, the majority of Queenslanders would not have postponed their own travel, even if they exhibited symptoms consistent with Pandemic (H1N1) 2009.
A birth cohort study in South-West Ethiopia to identify factors associated with infant mortality that are amenable for intervention

A one year live birth cohort of all identified children born in Jimma, Keffa and Illubabor Zones of Southwest Ethiopia, was followed from birth to the end of the first year of life, or to an earlier death, to investigate factors associated with mortality. All identified live-born infants were visited as soon as they were born and then bimonthly to the age of one or early death or lost for follow-up. Information was collected on socio-economic, behavioral, biological, and environmental factors for infants, mothers, and family immediately after birth and in consecutive visits. Overall, infant mortality was 106.2/1000, with estimates of 97.0/1000 and 113.5/1000 for urban and rural areas, respectively. Based on the results of the final Cox Proportional Hazards Model, mortality was associated with mothers' education and with antenatal care follow-up: there was better survival with at least one antenatal care follow-up. It was not associated with the mother's age per se but with marital status. Birth weight was strongly associated with infant mortality, and boys were more likely to die than girls. Twins were much more likely to die than singletons, even after taking their birth weight into account. Once adjustment had been made for these variables, there was no independent effect of the mothers' ethnic group or religion, or of family income. Family size was found to be significantly associated with infant mortality and higher mortality rate to families with the 2-4 persons. The type of water supply to the home was not associated with mortality, but habit of use of soap by the mother in washing her hands was. These results suggest that improvements in survival could be brought about by attempts to improve maternal education, antenatal care attendance, and habit of soap use in washing her hands which are amenable for change with local resources. (Ethiopian Journal of Health Development, 2000, 14(2): 161-168)
Incidence and impact of travelers' diarrhea among foreign backpackers in Southeast Asia: a result from Khao San road, Bangkok.

BACKGROUND Travelers' diarrhea is the most common disease reported among travelers visiting developing countries, including Southeast Asia, a region visited by large numbers of backpackers each year. Currently, the knowledge of travelers' diarrhea among this group is limited. This study aimed to determine the incidence and impact of travelers' diarrhea in this group. METHOD Foreign backpackers in Khao San road, Bangkok, Thailand, were invited to fill out a study questionnaire, in which they were queried about their demographic background, travel characteristics, pretravel preparations and actual practices related to the risk of travelers' diarrhea. For backpackers who had experienced diarrhea, the details and impact of each diarrheal episode were also assessed. RESULTS In the period April to May 2009, 404 completed questionnaires were collected and analyzed. Sixty percent of participants were male; overall, the median age was 26 years. Nearly all backpackers (96.8%) came from developed countries. Their main reason for travel was tourism (88%). The median stay was 30 days. More than half of the backpackers (56%) carried some antidiarrheal medication. Antimotility drugs were the most common medications carried by backpackers, followed by oral rehydration salts (ORS), and antibiotics. Their practices were far from ideal; 93.9% had bought food from street vendors, 92.5% had drunk beverages with ice-cubes, and 33.8% had eaten leftover food from a previous meal. In this study, 30.7% (124/404) of backpackers had experienced diarrhea during their trip. Most diarrhea cases (88%) were mild and recovered spontaneously. However, 8.8% of cases required a visit to a doctor, and 3.2% needed hospitalization. Longer duration of stay and drinking beverages with ice-cubes were associated with higher risk of diarrhea. CONCLUSIONS About one third of the foreign backpackers in Southeast Asia had experienced diarrhea during their trip. Their current practices related to the risk of travelers' diarrhea were inadequate and should be improved.
Association Between the Retail Food Environment, Neighborhood Deprivation, and County-Level Dietary Outcomes Among Supplemental Nutrition Assistance Program–Education (SNAP-Ed) Recipients in Kentucky, 2010–2011

The term obesity paradox was coined to describe potential associations between Supplemental Nutrition Assistance Program (SNAP) participation, food insecurity, and obesity. The study aimed to examine associations between (1) the retail food environment and macronutrients and (2) neighborhood deprivation and macronutrients. During 2010–2011, 57 Kentucky counties participated in the Supplemental Nutrition Assistance Program for Education (SNAP-Ed; n = 1585 total individuals aggregated at the county level) through the University of Kentucky Cooperative Extension. Dietary data were used to create county-level aggregate mean intake on calories, fat, protein, and carbohydrates. The retail food environment was determined by collecting food venue data from InfoUSA 2011, local health departments, and the Kentucky Department of Agriculture. There was a higher mean aggregate consumption of calories (206.23; 95% confidence interval [CI]: 173.93, 418.25) and fat grams (6.50; 95% CI: 3.04, 10.81) among SNAP-Ed participants in counties with 3 or more gas stations with food marts compared to SNAP-Ed participants in counties with less than 3 gas stations with food marts. County-level availability of certain food venues was associated with county-level aggregate dietary intake among SNAP-Ed participants.
Women’s Perceptions of Their Lifestyle and Quality of Life Several Years After a Diagnosis of Endometrial Cancer

Background: Few studies have examined the long-term changes experienced by women treated for endometrial cancer. Objective: The objectives of this study were to describe what women perceived important to their lifestyle and quality of life in the years following their diagnosis and to provide new insights that might inform healthcare practice. Methods: This was a thematic analysis of 237 open-ended comments from Australian women diagnosed with endometrial cancer 3 to 5 years previously. Results: We identified 3 main themes: (1) personal change, in which women spoke about cancer as permanently altering their lives in mostly negative but sometimes positive ways; (2) continuity of former life, which described both the minimal impact of cancer on women’s lives and identities and the difficulties negotiating this within the dominant “cancer survivorship” culture; (3) social support, where women wrote about how the quality of their relationships shaped their cancer trajectory. Conclusions: While typical “survivorship” issues exist for many women with endometrial cancer (eg, physical, emotional, sexual health changes), a proportion of women will not be focused on their cancer and can be encouraged to form lives and identities that are not situated within the “cancer survivorship” culture. Implications for Practice: A network of support, sensitive to women’s responses to having cancer, may benefit women’s long-term adjustment. Regular standardized assessment of women’s needs may facilitate appropriate support for those with concerns, whereas those without concerns could be reassured by health professionals that their experience is normal and shared by other people with cancer. This may encourage women to form lives that are personally meaningful.
Cystathionine β‐synthase as a carbon monoxide–sensitive regulator of bile excretion

Carbon monoxide (CO) is a stress‐inducible gas generated by heme oxygenase (HO) eliciting adaptive responses against toxicants; however, mechanisms for its reception remain unknown. Serendipitous observation in metabolome analysis in CO‐overproducing livers suggested roles of cystathionine β‐synthase (CBS) that rate‐limits transsulfuration pathway and H2S generation, for the gas‐responsive receptor. Studies using recombinant CBS indicated that CO binds to the prosthetic heme, stabilizing 6‐coordinated CO‐Fe(II)‐histidine complex to block the activity, whereas nitric oxide (NO) forms 5‐coordinated structure without inhibiting it. The CO‐overproducing livers down‐regulated H2S to stimulate HCO3−‐dependent choleresis: these responses were attenuated by blocking HO or by donating H2S. Livers of heterozygous CBS knockout mice neither down‐regulated H2S nor exhibited the choleresis while overproducing CO. In the mouse model of estradiol‐induced cholestasis, CO overproduction by inducing HO‐1 significantly improved the bile output through stimulating HCO3− excretion; such a choleretic response did not occur in the knockout mice. Conclusion: Results collected from metabolome analyses suggested that CBS serves as a CO‐sensitive modulator of H2S to support biliary excretion, shedding light on a putative role of the enzyme for stress‐elicited adaptive response against bile‐dependent detoxification processes. (HEPATOLOGY 2009;49:141‐150.)
Experiences of Ethical Issues When Caring for Children With Cancer

Background: The treatment for pediatric cancer is often physically, socially, and psychologically demanding and often gives rise to ethical issues. Objective: The purpose of this study was to describe healthcare professionals’ experiences of ethical issues and ways to deal with these when caring for children with cancer. Methods: A study-specific questionnaire was given to healthcare professionals at a pediatric hospital in Sweden. Qualitative content analysis was used to analyze answers to open-ended questions. The data were sorted into 2 domains based on the objective of the study. In the next step, the data in each domain were inductively coded, generating categories and subcategories. Results: The main ethical issues included concerns of (1) infringing on autonomy, (2) deciding on treatment levels, and (3) conflicting perspectives that constituted a challenge to collaboration. Professionals desired teamwork and reflection to deal with ethical concerns, and they needed resources for dealing with ethics. Implications for Practice: Interprofessional consideration needs to be improved. Forums and time for ethics reflections need to be offered to deal with ethical concerns in childhood cancer care. Conclusions: Experiences of ethical concerns and dealing with these in caring for children with cancer evoked strong feelings and moral perplexity among nursing staff. The study raises a challenging question: How can conflicting perspectives, lack of interprofessional consideration, and obstacles related to parents’ involvement be “turned around,” that is, contribute to a holistic perspective of ethics in cancer care of children?
Patients’ Experiences of Performing Self-care of Stomas in the Initial Postoperative Period

Background: With the loss of an important bodily function and the distortion in body image, a stoma patient experiences physical, psychological, and social changes. With limited current studies exploring experiences of patients in the management of their stoma, there is a need to explore their experiences, their needs, and factors that influence their self-management. Objective: The aim of this study was to investigate patients’ experiences of performing self-care of stomas in the initial postoperative period. Methods: This study adopted a descriptive qualitative approach from the interpretive paradigm. Semistructured interviews were conducted with 12 patients 1 month postoperatively in a colorectal ward in a hospital in Singapore. Thematic analysis was applied to the interview data. Results: Five themes were identified: process of acceptance and self-management of stoma, physical limitations, psychological reactions, social support, and need for timely and sufficient stoma preparation and education. Conclusions: This study highlights the importance of health professionals’ role in helping patients adjust preoperatively and postoperatively and accept the presence of a stoma. Health professionals need to be aware of the physical, psychological, and social impact of stoma on patients in the initial 30-day postoperative period. Implications for Practice: Research findings informed the type and level of assistance and support to be offered to patients by nurses and the importance of encouraging patients to be involved in stoma care at an early stage, which will ultimately contribute to effective and independent self-management. Patients can be prepared preoperatively to reduce the psychological and social impact of stoma after creation of their stoma.
Association between Plasma Homocysteine Level and Ischemic Stroke

Background: Epidemiologic studies have identified hyperhomocysteinemia as a possible risk factor for atherosclerosis. The aim of my study was based on evaluation of relationship between homocysteinemia with ischemic stroke patients. Methods and materials: It was a prospective observational study conducted in the Department of Neurology, Sir Salimullah Medical College & Mitford hospital, Dhaka. Thirty six consecutive patients with ischemic stroke were analyzed by serum total homocysteine, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride and Equal number of controls same ages were compared with the case group. Result: Mean Fasting blood sugar, serum fasting total cholesterol (TC), serum fasting Low density lipoprotein (LDL) were significantly higher in case group (p=0.001). Serum TC and LDL had a positive correlation with serum homocystine a (p=0.001). Serum High density lipoprotein (HDL) had a negative correlation (p=0.718) and serum triglyceride (TG) had a negative correlation (p = 0.182). Total plasma fasting homocysteine level in case group was 21.89 ± 9.38 imol/l and control group was 12.31 ± 3.27 imol/l, (p=0.001). Elevated fasting homocystein level was found in 75.0% of ischemic stroke patient and in 16.67% of healthy controls (p=0.001). The incidence of hyperhomocysteinemia is higher in ischaemic stroke cases than that in age-sex matched healthy controls. Conclusion: Hyperhomocysteinemia is strongly associated ischaemic stroke patients. Hence it seems to be an important vascular risk factor in this study. DOI: http://dx.doi. org/10.3329/jbcps.v31i3. 20978 J Bangladesh Coll Phys Surg 2013; 31: 128-133