Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical-Epidemiological Profile of Influenza A H1N1 Cases at a Tertiary Care Institute of India

Introduction: Influenza virus is a common human pathogen that has caused serious respiratory illness and death over the past century. In April 2009, a new strain of Influenza virus A H1N1, commonly referred to as “swine flu”, began to spread in several countries around the world, and India confirmed its first case on 16 May 16 2009. Aim: To study the clinical and epidemiological profile of Influenza A H1N1 cases at the Government Medical College and Hospital, Chandigarh. Materials and Methods: Clinical epidemiological characteristics of Influenza A H1N1 cases from May 2009 to April 2010 were retrospectively, descriptively analyzed using data from the Influenza A H1N1 screening center and isolation ward at the Government Medical College and Hospital, Chandigarh. Data were Analyzed using MS Excel software. Results: At GMCH, till April 2010, a total of 4379 patients were screened for Influenza A H1N1, of which 365 patients were tested. The most common symptoms were fever (87.6%), cough (49.77%), sore throat (27%) and breathlessness (23.9%). The most common presentation (42.30%) of Influenza A H1N1 cases was fever and cold-like features, not cough. 29.58% (108) of the tested patients were found to be positive for the disease. Maximum cases were detected in the month of December, and the patients less than 40 years of age accounted for 81.4% (44 cases) of the cases. Influenza A H1N1 resulted in death of 54.9% (28) of the admitted cases, of which 46% (12) deaths occurred within 48 h of admission. Conclusion: On the basis of these findings, it can be safely hypothesized that prevalence of Influenza A H1N1 is high in the younger population, and fever, cough and sore throat are the most common symptoms with which the patients usually present.
A comparison of positive youth development against depression and suicidal ideation in youth from Hong Kong and the Netherlands

Abstract Background This study tests the buffering effects of positive youth development (PYD) factors against depression and suicidal ideation across Hong Kong and Dutch students. Methods We collected data on depression, suicidal ideation, history of childhood maltreatment, and PYD from 565 Dutch and Hong Kong undergraduates. The three PYD factors, prosocial attributes, positive identity, and cognitive-behavioral competence, were examined for their moderating role in the relationship among childhood maltreatment, depression, and suicidal ideation in path analysis. Results Direct protective effects are found for all PYD factors in both cultures, except for cognitive-behavioral competence in the Dutch sample. A buffering effect of the PYD factors is observed in the maltreatment-depression relationship in Dutch, but not in Hong Kong students. Only behavioral competence buffers against suicidal ideation in Dutch students, while other PYD factors show no buffering effect in both groups of participants. Conclusion The differences in relationships between two samples highlights the need to consider cultural differences.
Prevalence and prognostic impact of comorbidity in soft tissue sarcoma: A population-based cohort study

Abstract Background. Comorbidity is an important prognostic factor for survival in other cancers, but the importance in soft tissue sarcoma has not yet been clarified. The aims of this study were to examine the prevalence of comorbidity in soft tissue sarcoma patients, and estimate the impact of comorbidity on overall and disease-specific mortality. Material and methods. Overall, 1210 adult patients with soft tissue sarcoma in the extremities or trunk wall were identified through the Aarhus Sarcoma Registry, a validated population-based database. Information on comorbidity was obtained through the National Patient Registry, and a Charlson's Comorbidity score was calculated for each patient. The prevalence of comorbidity was assessed overall, as well as according to age and year of diagnosis. Overall and disease-specific mortality rates according to level of comorbidity were computed. The prognostic value of comorbidity was estimated using crude and adjusted Cox proportional hazard models. Results. The overall prevalence of comorbidity was 25%. The prevalence increased with increasing age, and patients with comorbidity had a larger proportion of adverse prognostic factors when compared to patients without comorbidity. The five-year disease-specific mortality was 26% (95% CI 24–29) for patients without comorbidity, compared to 33% (95% CI 24–42), 41% (95% CI 32–50), and 44% (95% CI 33–55) for patients with mild, moderate, and severe comorbidity, respectively. After adjusting for age, sex, stage, tumor size, depth, grade, surgical margin, radiotherapy, and chemotherapy, comorbidity was independently associated with an increased overall and disease-specific mortality. Conclusion. Patients with comorbidity had significantly increased overall and disease-specific mortality compared to patients without comorbidity, even when adjusting for important prognostic factors including age.
Factors Associated with Morbidities Among Infants in Three Sub Centre Areas of Belgaum District of South India: A Longitudinal Study

Background: Health status of infants is a sensitive indicator of development and factors influencing it need to be better understood. Objectives: This study was conducted to search for factors associated with morbidity among infants and to find out their influence on weight gain during infancy. Materials and Methods: This longitudinal study was undertaken in south India from November 2004 till April 2006. A birth cohort of all children born during first 6 months of the study period were assessed at enrollment and followed up monthly till they attained 1 year of age. Results: Incidence of morbidity among infants was found to be least among those exclusively breast fed (EBF) for 6 months and most when EBF for less than 6 months (P = 0.045). It was also more when infants were weaned with a combination of animal milk, formula milk, semi-solids and solid diet and least when weaned only with semi-solids and solids (P = 0.018). Diarrheal episodes were more in infants who were bottle-fed (P < 0.001). Weight gain between 6th and 12th month of infancy was found to be significantly affected by various morbidities (P = 0.001). Incidence of morbidities was less among preterm babies and more among partially immunized (P < 0.001) babies with birth order ≥ 3 (P = 0.012), babies of mothers with low socio-economic and educational status. Delayed milestones during infancy was seen more in babies with history of birth asphyxia (P = 0.018). Conclusion: Several factors influenced incidence of morbidities and these morbidities had a negative effect on weight gain. Hence these factors need to be addressed to promote better child health.
A Study on the Role of Mobile Phone Communication in Tuberculosis DOTS Treatment

Background: Every year, a lot of Tuberculosis (TB) patients undergo Directly Observed Treatment Short-course (DOTS) in Salem city, one of the high TB districts in South India. Mobile phone usage among these patients and health workers is common. Mobile phone communication has a great potential in TB treatment. Objectives: To analyze the mobile phone usage and its effectiveness in TB DOTS treatment. Materials and Methods: A cross-sectional survey with 150 TB patients was followed by a focus group discussion with treatment supervisors, DOTS providers, and health workers. Results: Majority of patients use mobile phones to make calls to health workers to clarify their doubts on side effects, food, and symptoms of the disease. TB treatment supervisors effectively use mobile phones to counsel patients to adhere to the treatment regimen. Patients see mobile phones as a useful communication tool in TB treatment though they prefer direct interpersonal communication with health workers. Though the mobile ownership is 68% among the TB patients, many of them are not able to send text messages or read messages in English. Conclusion: Mobile phone possession and usage is high among the patients. Patients need to be trained to use mobile phone features such as alarm, voice mail, and interactive voice response. Incentives like free talk time and short message service (SMS) will encourage patients to communicate frequently with health workers, thereby, increasing the chances of better adherence to DOTS. SMS could be made available in the regional languages.
A treatment planning and delivery comparison of volumetric modulated arc therapy with or without flattening filter for gliomas, brain metastases, prostate, head/neck and early stage lung cancer

Abstract Background. Flattening filter-free (FFF) beams are an emerging technology that has not yet been widely implemented as standard practice in radiotherapy centers. To facilitate the clinical implementation of FFF, we attempted to elucidate the difference in plan quality and treatment delivery time compared to flattening filter beams (i.e. standard, STD) for several patient groups. We hypothesize that the treatment plan quality is comparable while the treatment delivery time of volumetric modulated arc therapy (VMAT) is considerably shorter using FFF beams, especially for stereotactic treatments. Methods. A total of 120 patients treated for head and neck (H&N) tumors, high-grade glioma, prostate cancer, early stage lung cancer and intra-cranial metastatic disease (both single and multiple metastases) were included in the study. For each cohort, 20 consecutive patients were selected. The plans were generated using STD- and FFF-VMAT for both 6 MV and 10 MV, and were compared with respect to plan quality, monitor units and delivery time using Wilcoxon signed rank tests. Results. For H&N and high-grade gliomas, there was a significant difference in homogeneity index in favor for STD-VMAT (p < 0.001). For the stereotactic sites there were no differences in plan conformity. Stereotactic FFF-VMAT plans required significantly shorter delivery time compared to STD-VMAT plans (p < 0.001) for higher dose per fraction, on average 54.5% for 6 MV and 71.4% for 10 MV. FFF-VMAT generally required a higher number of MU/Gy (p < 0.001), on average 7.0% for 6 MV and 8.4% for 10 MV. Conclusion. It was generally possible to produce FFF-VMAT plans with the same target dose coverage and doses to organs at risk as STD-VMAT plans. Target dose homogeneity tended to be somewhat inferior for FFF-VMAT for the larger targets investigated. For stereotactic radiotherapy, FFF-VMAT resulted in a considerable time gain while maintaining similar plan quality compared to STD beams.
Mendelian Randomization using Public Data from Genetic Consortia

Abstract Mendelian randomization (MR) is a technique that seeks to establish causation between an exposure and an outcome using observational data. It is an instrumental variable analysis in which genetic variants are used as the instruments. Many consortia have meta-analysed genome-wide associations between variants and specific traits and made their results publicly available. Using such data, it is possible to derive genetic risk scores for one trait and to deduce the association of that same risk score with a second trait. The properties of this approach are investigated by simulation and by evaluating the potentially causal effect of birth weight on adult glucose level. In such analyses, it is important to decide whether one is interested in the risk score based on a set of estimated regression coefficients or the score based on the true underlying coefficients. MR is primarily concerned with the latter. Methods designed for the former question will under-estimate the variance if used for MR. This variance can be corrected but it needs to be done with care to avoid introducing bias. MR based on public data sources is useful and easy to perform, but care must be taken to avoid false precision or bias.
Physical Hazards in Employment and Pregnancy Outcome

The past century has seen an enormous improvement in the political, social, and economic status of women, of which employment is an integral part. Women workers require special protection while pregnant because of the following reasons:(1) The developing embryo may be more susceptible to noxious agents than the exposed mother. Females may be less suited for some work tasks than males. Pregnancy may decrease the capacity to cope with many work factors. Women tend to feed themselves less substantially than men. The Physiology of Work During Pregnancy Physical exertion has often been suggested as a risk factor for adverse pregnancy outcomes,(2–21) which may occur due to various factors. (4,22–24) Work involves muscle action, causing an increase of sympathetic vasomotor activity in working muscles proportional to the severity of work. Hence, when cardiac output increases rapidly during muscular activity, most blood goes to the working muscles and proportionately less arrives in the other viscera, which during pregnancy, includes the placental bed. With hard work there is an increased release of catecholamines with resultant arteriolar constriction. With chronic hard work, lactate accumulates making any unloading of lactate from the fetus more difficult. Sweating reduces plasma volume, which is an important determinant of uteroplacental blood flow. Circulatory blood flow in the uterus and placenta decreases in the standing position. Pronounced physical exercise may lead to hormonal disturbances, hypothermia, and nutritional deficits. Shift work and irregular work schedules could lead to a change in the circadian rhythm, which affects regulation of the ovulatory cycle with resultant menstrual irregularities. Whether such shifts also influence pregnancy outcome is unknown. Heavy lifting increases intra-abdominal pressure and this may provoke uterine contractions. Heat stress causes dehydration resulting in the release of the anti-diuretic hormone and oxytocin, which stimulates the uterus to contract. Due to the combined effects of vasoconstriction, myometrial contraction, reduced plasma volume, and diversion of blood flow away from the placental bed, there is diminution of uteroplacental blood flow and resultant fetal hypoxia. This, along with possible hormonal imbalance, may have deleterious effects on the fetus.
Excitatory Amino Acids in Cerebrospinal Fluid of Patients with Acute Head Injuries

Background: The excitatory amino acids (EAAs) glutamate (Glu) and aspartate (Asp) play a role in the pathogenesis of postischemic and posttraumatic brain insult. The changes of EAAs in cerebrospinal fluid (CSF) of patients with traumatic brain injury are incompletely understood. Methods: We used reversed-phase HPLC with precolumn derivatization with o -phthalaldehyde and fluorescence detection to measure Glu and Asp in CSF of 42 patients with acute head injury and 9 control adults without neurologic diseases. We assessed the Glasgow Coma Scale (GCS) on admission, the main lesion patterns on computed tomography (CT) scan within 24 h post trauma, and the Glasgow Outcome Scale (GOS) 3 months post injury. Results: The mean concentrations of Glu and Asp in CSF in the brain-injured group were significantly higher than those of the control group (Glu, P <0.001; Asp, P <0.05). In patients admitted within 24 h after severe injury (n = 13), peak Glu values appeared within 48 h in 11 patients (85%), and the mean value remained higher than control values at day 7 ( P <0.02). The concentrations of EAAs were higher in patients with severe injuries (GCS ≤8) than in those with milder injuries (Glu, P <0.001; Asp, P <0.05). GCS and peak EAAs correlated negatively (Glu, r s = −0.5706, P <0.001; Asp, r s = −0.5503, P <0.001). The patients with focal brain contusion on initial CT scan (n = 8) had a significantly lower peak Glu value than the patients with other patterns (n = 8–15; P <0.02 to 0.001). The peak value of EAAs in the poor-outcome group (including severe disability, vegetative state, and death) was significantly higher than in the good-outcome group (good recovery and moderate disability; Glu, P <0.001; Asp, P <0.01); GOS was closely correlated to the EAA values (Glu, r s = 0.5737, P <0.001; Asp, r s = 0.5470, P <0.001). Conclusions: The EAA concentrations in CSF increase after acute head injury and remain higher for at least 1 week post injury in severely injured patients. The more severe the trauma, the more obvious the excitotoxicity induced by EAAs and the worse the outcome.
Cervical cancer screening in the Faroe Islands

Abstract Background. The Faroe Islands have had nationally organised cervical cancer screening since 1995. Women aged 25–60 years are invited every third year. Participation is free of charge. Although several European overviews on cervical screening are available, none have included the Faroe Islands. Our aim was to provide the first description of cervical cancer screening, and to determine the screening history of women diagnosed with cervical cancer in the Faroe Islands. Material and methods. Screening data from 1996 to 2012 were obtained from the Diagnostic Centre at the National Hospital of the Faroe Islands. They included information on cytology and HPV testing whereas information on histology was not registered consistently. Process indicators were calculated, including coverage rate, excess smears, proportion of abnormal cytological samples, and frequency of HPV testing. Data on cervical cancer cases were obtained from the Faroese Ministry of Health Affairs. The analysis of the screening history was undertaken for cases diagnosed in 2000–2010. Results. A total of 52 457 samples were taken in 1996–2012. Coverage varied between 67% and 81% and was 71% in 2012. Excess smears decreased after 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76–95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. Conclusion. Despite the difficult geographical setting, the organised cervical cancer screening programme in the Faroe Islands has achieved a relatively high coverage rate. Nevertheless, challenges, e.g. consistent histology registration and sending reminders, still exist.
Surveillance of Injuries in a Tertiary Care Hospital

Injuries are increasingly recognized as a global public health epidemic. Injuries represent 12% of the global burden of disease and third most important cause of overall mortality. Deaths from road traffic injuries account for around 25% of total injury deaths. (1) A recent national review in India has estimated that a million injury deaths and 30 million hospitalizations occur every year at an average of 10.1 per lakh population. Southern Indian states reported higher number of deaths. 15.4 per lakh injuries occur in Karnataka with Bengaluru city reported 5660 injury deaths with suicides (2429) outscoring RTIs as the leading cause. (2) Largely as a consequence of epidemiological and demographic transitions in recent years, injuries have become a leading cause for morbidity and mortality. The problem is hidden and unrecognized due to the absence of good quality information within the health and related sectors. Systematic efforts need to be developed urgently in India to address the problem. Information that is relevant, complete, appropriate, timely, and representative is very vital to formulate injury prevention programs. There is a need to collect data beyond just number of deaths and causes of injuries. Data regarding the host attributes, environmental attributes, characteristics, and manner of injuries are essential for planning and operationalizing a comprehensive injury prevention program. M S Ramaiah Medical College hospital has been an active participant in injury surveillance program in Bangalore and this study was conducted in the hospital to study the pattern of injuries in M S R Hospitals since past 1 year. This information will be utilized to improve the quality of health care and conceptualize an injury prevention capsule so as to make the care comprehensive.
Awareness and Attitude of the General Public Toward HIV/AIDS in Coastal Karnataka

Objective: To assess the awareness and attitude of the general public toward people living with HIV/AIDS (PLWHA) in Mangalore, a city in Coastal Karnataka. Design: Community-based cross-sectional study. Materials and Methods: The study population included 630 individuals aged 18 years and above. The information was collected using a semi structured pre-tested questionnaire. The questionnaire consisted of 24 questions regarding awareness of the modes of transmission of HIV/AIDS (nine questions) and questions to assess the attitude toward People Living With HIV/AIDS (PLWHA) (15 questions). Statistical package SPSS version 11.5 was used, Chi-square test was conducted and P < 0.05 was considered as statistically significant. Results: About one-third of the study population thought that one could get infected by merely touching an HIV positive individual. Approximately 45% stated that they would dismiss their maid on finding out her HIV positive status. About 54% were willing to undergo the HIV test. The respondents with less than secondary school education had a discriminatory attitude toward HIV positive people, with regard to them deserving to suffer, dismissing a HIV positive maid, hesitating to sit next to a HIV positive person in the bus, divorcing the infected spouse, and willingness to get tested for HIV, which was found to be statistically significant. Conclusion: Stigma among the general public was mostly due to fear of contracting the illness. Stigma does exist to significant degrees among the educated people, which was suggested by about 45% of the participants being willing to undergo the HIV test. There is a need for greater attempts toward making information regarding HIV/AIDS available to every individual of the society.
Combined T2w volumetry, DW-MRI and DCE-MRI for response assessment after neo-adjuvant chemoradiation in locally advanced rectal cancer

Background. To assess the value of combined T2-weighted magnetic resonance imaging (MRI) (T2w) volumetry, diffusion-weighted (DW)-MRI and dynamic contrast enhanced (DCE)-MRI for pathological response prediction after neo-adjuvant chemoradiation (CRT) in locally advanced rectal cancer (LARC). Material and methods. MRI with DW-MRI and DCE-MRI sequences was performed before start of CRT and before surgery. After surgery, the tumor regression grade (TRG) was obtained based on the score by Mandard et al. Pathological complete responders (pCR, TRG 1), and pathological good responders (GR, TRG 1 + 2) were compared to non-pCR and non-GR patients, respectively. Results. In total 55 patients were analyzed, six had a pCR (10.9%) and 10 a GR (18.2%). Favorable responders had a larger decrease in tumor volume and Ktrans and a larger increase in apparent diffusion coefficient (ADC) values compared to non-responders. ADC change showed the best diagnostic accuracy for pCR. For GR, the model including ADC change and volume change showed the best diagnostic performance. However, this performance was not statistically better compared to the model with ADC change alone. Inclusion of Ktrans change did not increase the diagnostic accuracy for pathological favorable response. Conclusions. This explorative study showed that ADC change is a promising diagnostic tool for pCR and GR. Volume decrease showed potential limited additional diagnostic value for GR while Ktrans change showed no additional diagnostic value for pCR and GR.