Miracle-dz/UniFAR-FTUs huggingface dataset:
Emergency Management of Traumatic Dental Injuries: Knowledge of Dubai School Nurses

Objective: To assess the knowledge of school nurses in Dubai, United Arab Emirates, about the emergency management of Traumatic Dental Injuries (TDIs) at schools. Material and Methods: A cross-sectional questionnaire survey was conducted amongst 68 school nurses (SN) prior to inviting them to an educational workshop on the emergency management of TDIs. The educational workshop covered all the topics in the questionnaire and provided basic necessary information to the SN regarding the emergency management of TDIs. Descriptive statistics were used to describe the characteristics of the sample; the Kolmogorov-Smirnov test was used to test normality for the score of knowledge and Mann-Whitney U test to correlate score of knowledge with different demographical variables (p<0.05). Results: An overall lack of knowledge about the emergency management of TDIs was observed. The overall average for the score of knowledge for all the participants was 10.75 out of a total of 16 correct answers. Female participants had significantly higher scores of knowledge compared to males (p=0.02). None of the other demographic variables were significantly associated with the score of knowledge. Conclusion: More training programs are essential for school nurses to improve their knowledge and awareness for better future handling of traumatic dental injuries.
Assessing the Adequacy of the Rate Based System of Enteral Nutrition Infusion in the ICU of a Community Hospital

iii LIST OF TABLES . vii LIST OF FIGURES . viii ACKNOWLEDGEMENTS . ix CHAPTER 1: INTRODUCTION . 1 Statement of the Problem . 2 Purpose . 3 Hypotheses . 4 Justification . 5 CHAPTER 2: REVIEW OF LITERATURE . 6 Prevalence of Malnutrition . 6 Nutrition Screening . 8 Implications of Malnutrition . 9 Obstacles in ICU Tube Fed Patients . 12 Gastric Residual Volume (GRV) . 13 Diarrhea . 13 Tube Feeding Protocols . 14 Rate Based Protocol . 14 Volume Based Protocol . 15 Permissive Underfeeding . 16 Summary . 17 CHAPTER 3: METHODS . 19 Research Design . 19 Subjects . 20 Instruments . 20 Data Collection Process . 21 Data Analysis . 22 CHAPTER 4: RESULTS . 23 Demographic Data . 23 Tube Feedings . 24 Tube Feeding Delivered . 25 Reasons for Stoppage Time . 25 CHAPTER 5: DISCUSSION AND CONCLUSIONS . 28 APPENDIX A . 37 A-1 Data Collection Instrument . 38
The effect of using a larger port on reducing the complications of laparoscopic cholecystectomy: A randomized trial

Osman Toktas1, Oztekin Cıkman1, Caghan Peksen1, Sadi Elasan2, Nurettin Yuzkat3 1Department of General Surgery, 2Department of Biostatistics, 3Department of Anesthesiology and Reanimation, Yuzuncu Yıl University, Faculty of Medicine, Van, Turkey Reducing the complications of laparoscopic cholecystectomy The effect of using a larger port on reducing the complications of laparoscopic cholecystectomy: A randomized trial
Left Lateral Cervical Mass with Draining Sinuses

The aim of the present study is to describe an uncommon case of tuberculous lymphadenitis (TL) in a symptomless 89-year-old male smoker patient, who presented at the emergency department of our hospital with left lateral cervical swelling with draining sinuses. No other clinical symptoms or physical findings were observed at admission. An elevated erythrocyte sedimentation rate (ESR) and a small calcified nodule in chest CT were the only abnormal findings. Pus samples from sinuses were examined and confirmed tuberculosis which was in agreement with surgical pathology of lymph nodes. A four- (4-) drug antituberculous regimen was administered. After an initial remission of his symptoms, the patient presented an exacerbation of the cervical swelling with draining sinuses necessitating addition of oral steroids. TL can be symptomless presenting a paradoxical reaction during treatment. The uniqueness of our case lies in the patient's advanced age, which is uncommon with cervical lymphadenopathy as a form of extrapulmonary tuberculosis, as well as in the administration of oral steroids to resolve the neck's clinical deterioration. The patient had a complete recovery and was free of disease after completion of his six-month antituberculous chemotherapy.
Innovative Drugs to Target Renal Inflammation in Sepsis: Alkaline Phosphatase

Sepsis-related mortality roughly doubles when acute kidney injury (AKI) occurs and end-stage renal disease is more common in sepsis-associated AKI survivors. So far, no licensed treatment for the prevention of AKI is available, however the data on alkaline phosphatase (AP) is promising and might change this. Sepsis-associated AKI is believed to be the result of inflammation and hypoxia combined. Systemic inflammation started by recognition of ‘pathogen-associated molecular patterns’ (PAMPs) such as lipopolysaccharide (LPS) which binds to Toll-like receptor 4 and leads to the production of inflammatory mediators. Due to this inflammatory process renal microcirculation gets impaired leading to hypoxia resulting in cell damage or cell death. In the process of cell damage so called ‘danger-associated molecular patterns’ (DAMPs) are released resulting in a sustained inflammatory effect. Apart from the systemic inflammation DAMPs and PAMPs also interact with receptors in the proximal tubule of the kidney causing a local inflammatory response leading to leukocyte infiltration and tubular lesions, combined with renal cell apoptosis and ultimately to AKI. In the longer-term, inflammation-mediated inadequate repair mechanism may lead to fibrosis and development of chronic kidney disease. AP is an endogenous enzyme that dephosphorylates and thereby detoxifies several compounds, including LPS. A small phase 2 clinical trial in sepsis patients showed that urinary excretion of tubular injury markers was attenuated and creatinine clearance improved in sepsis patients treated with AP. This renal protective effect was confirmed in a second small clinical phase 2 trial in sepsis patients with AKI. Subsequently, a large trial in sepsis patients with AKI was conducted using a human recombinant AP. In 301 patients no improvement of kidney function within 7 days after enrolment was observed, but kidney function was significantly better on day 21 and day 28 and all-cause 28-day mortality was significantly lower (14.4% in AP group versus 26.7% in the placebo group). Possible explanations of this lack of short-term kidney function improvement are discussed and potential effects of AP on renal repair mechanisms, including inflammation-mediated induction of fibrosis, that may explain the beneficial longer-term effects of AP are proposed.
Prevalence of Enterobacteriaceae Isolated from Childhood Diarrhoea in Mukuru Slums, Nairobi- Kenya

Diarrhoea in young children continues to be a major public health concern in developing countries, including Kenya. Poor sanitation among other factors can predispose a child to diarrhoea. Therefore, the present study sought to determine the prevalence of enterobacteriaceae isolated from childhood diarrhoea in Mukuru Slums, Nairobi. It employed a cross-sectional design targeting children below 5 years of age. Stool specimens were obtained aseptically and cultured on MacConkey agar and Salmonella-Shigella agar. Biochemical tests were used to identify the isolated bacteria to genus and species using biochemical characterization scheme and the Analytic Profile Index 20E. Drugs sensitivity Antimicrobial susceptibility tests (AST) were done using standard techniques. Escherichia coli ATCC 25922 was included as a control strain. Analysis of gender verses diarrhoea revealed that there was no statistical significant association between the gender (male and female) and area of residence in relation to diarrhoea in this study (p = 0.146 > 0.05). There was no statistical significant difference between the participant’s characteristics and their area of residence (p= 0.144). Age of the participants had significant association with the prevalence of diarrhoea (p=0.00). The E. coli bacteria showed the highest percentage of enteric pathogens isolated (35.2%) from female children at Mukuru kwa Njenga and 29.4% from male children, Salmonella spp being second (4.9%) from female at Mukruru kwa Reuben and the least was Shigella sonnei (3.2%) from female children at Sinai. Emphasis should therefore be placed on primary preventive measures such as ensuring good sewage management and safe supply of drinking water in the study area and Kenya at large especially in the slums.
Occupational stress coping strategies utilised by drugs and substance abuse rehabilitation counsellors in the selected counties in Kenya

Coping with occupational stress has become an important area for research in the last three decades. Coping strategies play a critical role in an individual’s physical, behavioural and physiological wellbeing. Coping is thus a critical point of entry for protecting mental and physical health from the harmful effects of occupational stress. This paper explores the coping strategies utilised by drugs and substance abuse rehabilitation counsellors in selected counties in Kenya. The sample included 112 rehabilitation counsellors and 13 administrators working in five counties. The theoretical concept was drawn from Seyle’ GAS, Person-Environment Fit and Transactional theories of stress. Descriptive survey research design was used in the study. Occupational stress survey questionnaire and an interview schedule was used as instruments to assess the coping strategies to combat occupational stress. Descriptive statistics (mean, standard deviation and percentages) were used to analyse the data. Results of the study revealed that Supervision, problemfocused, emotion-focused and social support were the most utilised coping strategies while escape avoidance was least utilised. The study further revealed that demographic and work characteristics influenced the way coping strategies were utilised.
Antimicrobial Profile and Asymptomatic Urinary Tract Infections among Pregnant Women Attending Antenatal Clinic in Bolgatanga Regional Hospital, Ghana

Background: Urinary tract infection (UTI) in pregnancy is associated with significant morbidity for both the mother and the baby. Proper investigation and prompt treatment are needed to prevent the serious life-threatening condition and morbidity associated with UTI in pregnant women. Aim: This study was designed to detect common uropathogens and their antibiotic susceptibility pattern among asymptomatic pregnant women attending antenatal care in the Bolgatanga Regional Hospital. Methodology: Mid-stream urine samples were collected from 200 individuals and inoculated onto cysteine lactose electrolyte deficient (CLED) agar media. Colony counts yielding bacterial growth of ≥ 105 CFU /ml was regarded as significant bacteriuria. Pure isolates of bacterial pathogens were characterized by colony morphology, Gram-stain and standard biochemical procedures. Kirby Bauer disc diffusion method was used for antimicrobial susceptibility testing of all identified isolates. Results: The overall prevalence of bacteria-associated asymptomatic UTI was 17.5%. Escherichia coli (42.9%) was the most isolated organism followed by Staphylococcus aureus (34.3%), Klebsiella pneumoniae (11.4%), Staphylococcus saprophyticoccus (5.7%) and Proteus mirabilis 2 (5.7%). Yeast cells and Schistosoma haematobium were also recorded in 2% of the women. Isolates showed significant sensitivity to commercially prepared antibiotic discs. However, higher level of resistance was recorded with tetracycline, nitrofurantoin and nalidixic acid. Conclusion: Early screening for UTI should be done for all pregnant women and those found to be infected need to be treated with appropriate antimicrobial agents to avoid complications.
Complications of endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections and their management

The development of endoscopic ultrasound (EUS)-guided drainage techniques and lumen-apposing metal stents (LAMS) has markedly reduced the complication rate of endoscopic transmural drainage of pancreatic collections and made these procedures safer and more effective. Despite its improved safety profile, various types of complications, some even life-threatening, can occur after EUS-guided drainage of pancreatic fluid collections. Stent maldeployment/migration, bleeding, gastrointestinal perforation, and air embolism are important complications of EUS-guided drainage of pancreatic collections. Delayed complications weeks after the procedure, such as bleeding and buried LAMS due to the presence of prolonged indwelling transmural stents, have also been described. Careful patient selection, with proper assessment of the size, solid necrotic content and location of the collection, as well as an in-depth understanding of various risk factors that predict complications, are important for a safer and more effective endoscopic transmural drainage. For a better clinical outcome, it is important for the endoscopist to know about various complications of EUS-guided drainage of pancreatic collections, as well as their appropriate management strategies.
Clinical profile and serum homocysteine level in young patients with stroke: a prospective, observational study

Background: According to the WHO, stroke is the second most important cause of death in elderly people with age >60 years and fifth leading cause in the age group of 15 to 59 years. Hyperhomocysteinemia has been linked to increased incidence of ischemic strokes. Thus, the aim of the present study was to assess serum homocysteine levels as an individual risk factor of stroke in young patients.Methods: This was a prospective, cross-sectional, single center study performed in 50 patients admitted in the Department of Medicine, Thanjavur Medical College and Hospital, Thanjavur, over a period of 7 months (i.e., from December 2013 to June 2014). Young patients, aged 1545 years, and diagnosed with stroke were included in the study. Serum homocysteine was measured by fluorescein polarization immunoassay (FPIA). Significant difference between the patients with normal and elevated mean serum homocysteine levels was identified by using unpaired t-test. P value ≤0.05 was considered as statistically significant.Results: Majority of the stroke patients were male (78%). Similarly, male patients dominated the total number of patients with elevated serum homocysteine levels (75%). Thirty-two (64%) patients had an elevated serum homocysteine level. There was a significant difference between the patients with increased homocysteine levels as compared to patients with normal homocysteine levels (p value <0.05). Out of 32 patients with hyperhomocysteinemia, 27 (84.38%) patients had ischemic stroke, 4 (12.50%) had cortical vein thrombosis and 1 (3.12%) had hemorrhagic stroke.Conclusions: Findings of the present study confirm that hyperhomocysteinemia is associated with an increased incidence of stroke in young patients. As healthcare providers, we must stress on prevention of stroke, especially by identifying treatable risk factors.
The Nutrition Education Initiative Resource Guide: Examining Effectiveness with Middle School Students and Perceptions of Science Teachers

Background and Purpose: With obesity in children and youth continuing to be a major health problem in the U.S., schools are considered an important setting to implement programs to address the issue but few have focused on middle school students. The purposes of this study were to: 1) determine the effectiveness of a school-based nutrition education program, the Nutrition Education Initiative (NEI) Resource Guide, in improving school lunch eating behaviors of middle school students, and 2) identify science teachers’ perceptions of the materials. Implementation: The project was implemented by 16 middle school science teachers and 309 seventh grade students in a medium-sized north Florida community. The NEI Guide included three conceptual areas (Build a Healthy Base, Choose Sensibly and Aim for Fitness), major concepts, objectives, narrative information, and teaching strategies. Evaluation: Using a pre-/post without control group design, the study involved collecting data via food recall surveys with students, and surveys and interviews with teachers. Data were analyzed using descriptive statistics and paired t-tests. Results: During lunch time, a higher proportion of students met the recommended dietary servings for dairy, meat, vegetables, fruit, juice and grains from pre-test to post-test. Students also significantly increased dietary intake of meat (p< .01), fruit (p< .01) and fruit/juice combined (p< .05); and significantly decreased intake of fried vegetables (p< .001), with decreased fat intake approaching significance (p< .06). Differences in dietary patterns were noted between the two schools studied. Science teachers perceived the NEI Guide as effective; yet they also identified challenges including lack of adequate training, lack of time to implement the materials, and lack of collaboration with the project team. Conclusion: The project outcomes suggest that middle school science teachers can positively impact school lunch eating behaviors of middle school students in selected schools by incorporating nutrition education in their curricula. © 2014 Californian Journal of Health Promotion. All rights reserved.
Validation of the Adolescent Pediatric Pain Tool for the Multidimensional Measurement of Pain in Children and Adolescents Diagnosed with Osteogenesis Imperfecta

ABSTRACT Background The Adolescent Pediatric Pain Tool (APPT) is a self-reported, multidimensional assessment of pain location, intensity, and quality in children and adolescents. Yet, it has not been validated for use in children and adolescents with osteogenesis imperfecta (OI). Aims This study aimed to validate and evaluate the feasibility of the APPT for pain assessment in children and adolescents with OI. Methods A prospective observational study was conducted at a university-affiliated pediatric hospital in Canada. Thirty-three children and adolescents with OI participated by completing the APPT pre-bisphosphonate intravenous infusion and 1 week post-bisphosphonate intravenous infusion. Main outcomes were internal consistency, convergent and discriminative validity, and feasibility. Results The Kuder-Richardson test of internal consistency was 0.863, 0.661, and 0.729 for the Sensory, Affective, and Evaluative subscales, respectively. For the entire pain quality scale, the Cronbach’s alpha was 0.835. Regarding convergent validity, a moderate correlation was observed between the ratings on the pain intensity scale and the Faces Pain Scale–Revised (Spearman’s rho = 0.711). Patients for whom pain was a problem reported higher pain intensity (Mann Whitney U = 41.50, P = 0.032) and more pain quality descriptors (Mann Whitney U = 45.50, P = 0.020) and painful body areas (Mann-Whitney U = 25.50, P = 0.001) than those for whom it was not (Mann-Whitney U, P < 0.05). In terms of feasibility, completing the tool may require a considerable time commitment and assistance from a clinician or parent, especially if the patient is experiencing pain and provides detailed pain location and quality information by completing the APPT. Conclusions This study suggests that the APPT is valid for the multidimensional assessment of pain in children and adolescents with OI, but feasibility needs to be enhanced.
Relationship between Occlusal Factors, Oral Parafunctions and Temporomandibular Disorders: A Case Control Study

Aims: The purpose of this study was to assess the multifactorial etiology of temporomandibular disorders (TMD). To this end, prevalence of occlusal factors and parafunctional habits was investigated and correlated in two groups: patients with TMD (case group) and patients without TMD (control group). Methods: Prevalence of 7 static and 4 dynamic malocclusion features, and some parafunctional activities (nail biting, teeth grinding, teeth clenching, lips and cheeks biting, pens chewing, mandibular jaw moves habit.) were recorded in the two groups. Case group consisted of 30 patients with a diagnosis of myofascial pain, with or without limited opening, and/or disk displacement with or without reduction. Control group consisted of 30 patients without TMD. Univariate and multivariate analysis were used to identify the significant associations between occlusal variables, oral parafunctions and temporomandibular disorders. Results: All patients in case group, and 93.3% in control group had at least one malocclusion, and a statistically significant association between TMD and three malocclusions (two dynamic malocclusion features: mediotrusive interferences, laterotrusive interferences, and one static malocclusion: overbite >4 mm) was shown. Regarding parafunctional activities, all patients in case group, and 93,3% in control group had at least one parafunction, and the mean number of parafunctions per patient was significantly higher in case group than in control group. Besides, an association between TMD and some parafunctions was shown. Conclusion: Given the multifactorial nature of TMD, a behavioral reeducation to reduce parafunctional activities could be the first phase of the care for TMD patients and could prevent TMD development. Besides, special attention should be given to normocclusion criteria. These criteria must be fulfilled for any dental care.
The Effectiveness of Hybrid Problem-Based Learning versus Manual-Based Learning in the Microbiology Laboratory

Promising results from the use of problem-based learning (PBL) as a teaching method in medical programs have encouraged many institutions to incorporate PBL into their curricula. This study investigates how applying hybrid-PBL (H-PBL) in a microbiology laboratory impacts students' higher-order thinking as compared to applying a lecture-based pedagogy. The experimental design compared the learning outcomes of two groups of students: the control group and the H-PBL group, for whom PBL cases comprised 30% of the curriculum. Both groups were taught basic skills for the microbiology lab by the same instructor. Using the traditional teaching style for the control group, the instructor offered each student what they needed for their experiments. The H-PBL group practiced experimental design, data analysis, theory proposal, and created research questions by using six study cases that were closely linked to the area of study. The outcome was measured using a pre- and post- assessment consisting of 24 questions that was designed by following Bloom's taxonomy of learning levels. A one-way ANOVA was used to analyze the data. The results showed that for the first three levels of Bloom's taxonomy— knowledge, comprehension, and application—there were no statistically significant differences between the H-PBL and control group gain scores as determined by a one-way ANOVA. For the knowledge level, f (1, 78) = . 232, and p = . 632; for the comprehension level, f (1, 78) = . 004, and p = . 951; and for the application level f (1, 78) =. 028, and p =. 863. On the other hand, the gain scores for the three higher levels—analysis, evaluation, and creativity—improved for the H-PBL group. The analysis level showed statistically significant differences, with f (1, 78) = 4.012, and p = . 049. Also, there were statistically significant differences in students' performance at the evaluation level, with f (1, 78) = 11.495, and p = . 001, and the creativity level, with f (1,78 ) = 23.432, and p = . 000. In conclusion, the study results supported the value of incorporating hybrid problem-based learning (H-PBL) into the traditional microbiology laboratory curriculum.