Miracle-dz/UniFAR-FTUs huggingface dataset:
Marijuana Induced Gingival Enlargement

Different aetiologies with various clinical presentations are evident in cases of gingival enlargement. We report a case of 34-year-old male who presented with the chief complaint of gingival overgrowth in upper and lower front teeth region. Patient was systemically healthy and gave no history of common medications known to cause gingival enlargement. He had a history of marijuana consumption for two consecutive years following which gingival swelling increased in severity. Based on clinical and histopathologic findings, provisional diagnosis of combined inflammatory + marijuana induced gingival enlargement was made. Treatment consisted of scaling and root planing followed by sextant wise gingivectomy. Results were stable until three months follow-up. Signs of inflammation were evident when the patient reported after 1.5 years.
Analysis of Patients Diagnosed with Benign Paroxysmal Positional Vertigo and the Corresponding Incidence and Patterns of Electric Toothbrush Use

Objective To investigate whether mechanical vibrational energy from using an electric toothbrush may cause an increase in the incidence of benign paroxysmal positional vertigo (BPPV) and prevent successful treatment of BPPV with canalith repositioning procedure. Methods This was a retrospective study conducted at an otolaryngology private practice. A survey of 111 patients who were diagnosed with BPPV in an otolaryngology practice between May 2012 and January 2017 was conducted using a questionnaire that included questions regarding demographics, inner ear pathology, treatment method, and use of an electric toothbrush. The results were recorded and compared using a chi-square test of analysis or Fisher’s exact test. Results Overall, 47 (42.3%) of the 111 BPPV patients used an electric toothbrush, whereas 64 of the 111 (57.6%) patients did not. Six (12.7%) of the 47 patients experienced dizziness with electric toothbrush use. Of the 47 patients using an electric toothbrush, 33 (70.2%) had a resolution of symptoms after Epley treatment, whereas 14 (23.4%) of 47 patients did not. Of the 64 patients who did not use an electric toothbrush, 15 (23.4%) did not have resolution after Epley treatment. Of the 47 patients using an electric toothbrush, 6 (12.8%) had a recurrence of BPPV diagnosed in the office, whereas 41 (82.2%) did not. Seven (10.9%) of those who did not use an electric toothbrush had a recurrence of BPPV, whereas 57 (89.1%) of the 64 patients did not. These results were not statistically significant (p = 0.77). Conclusions This study suggests that the mechanical vibrations from electric toothbrush use do not have an association with recurrent BPPV. The results align with some publications demonstrating that vibrations in the head and neck area from the use of an electric toothbrush can initiate dizziness; however, it does not appear that this modality of vibration is significant for inducing recurrent BPPV.
A Descriptive study on the Clinical Profile of Benign Breast Diseases

Benign breast diseases (BBDs) are twelve times more common than the malignant conditions of the breast. By far BBDs have been a largely overlooked entity in our country despite the fact that these conditions place significant physical and psychological stresses on the affected women. With increasing awareness about breast cancers in the community in recent times there have been a significant increase in female patients presenting with complaints pertaining to the breast in our general surgery outpatient clinics. As we are in a unique position to evaluate such patients we have endeavoured to conduct a study on the clinical profile of Benign Breast Diseases in our tertiary care hospital. We hope to analyse the BBDs in terms of age, parity, side and quadrant wise distribution as well as the accuracy of clinical diagnosis versus histopathological diagnosis.
Loop versus Divided Colostomy in Patients with High and Intermediate Anorectal Malformations: Randomized Controlled Study

Background: Colostomy is performed as a step of staged management of high-type anorectal malformations in pediatrics. Creating a colostomy, by itself, is a minor surgical procedure, but it has many complications. Aim: The aim of the study was to compare the outcome results of loop versus divided colostomies in patients with high and intermediate anorectal malformations. Methods and Material: This randomized prospective study was performed on 34 patients with imperforate anus. Patients were divided into 2 groups (17 patients each); group A were subjected to loop colostomy and group B were subjected to divided colostomy. Results: There was no significant difference between both groups as regards to demographic data (gestational age, sex and birth weight), age of first presentation, associated congenital anomalies and types of fistula. The mean operative time was 42.05 ±6.19 min in group A and 51.76 ±8.21 min in group B. The difference between both groups in this point was statistically significant (P value =0.04). The hospital stay and postoperative complications showed insignificant difference between both groups. Patients with loop stomas were significantly more likely to develop prolapse (P=0.033). Conclusions: Both techniques of colostomy are easy to perform and safe in the anorectal malformation (ARM) patients. Loop colostomy had a shorter operative time, but the complications rates, especially prolapse and urinary tract infection (in cloaca patients), are significantly higher in the loop colostomy when compared to the divided colostomy.
Factors affecting the maternal-foetal relationship.

Background Mother's attachment to her unborn child has a strong impact on a pregnant woman's attitude towards her health, postnatal attachment, and the child's physical and emotional growth. The purpose of our study was to identify the factors that impact the maternal-foetal relationship. Materials and methods The study was conducted at the Centre of Obstetrics and Gynaecology of the tertiary-level Vilnius University Hospital Santaros Klinikos in Vilnius, Lithuania. An original questionnaire of nine parts was developed that the questionnaire included information on demographical data, gynaecological and obstetrical history, a relationship assessment scale, the index of happiness, an antenatal depression risk questionnaire, and the Maternal-Antenatal Attachment Scale. Results The study included 388 pregnant women. It was found that the level of education, obstetrical issues during pregnancy, and the risk of postnatal depression negatively impacted the maternal-foetal relationship (p < 0.05). Mothers who were elder in family birth order, also those whose pregnancy was of a longer duration, who had a better-quality romantic relationship with partner, and whose socioeconomic fulfilment was higher were all found to have a better quality of maternal-foetal bonding (p < 0.05). Conclusions The early recognition of low attachment and right application of various means of psychologic intervention might improve the quality of pregnancy, maternity, and childhood.
A Prospective Cross-Sectional Analysis of Construct Validity for the PALMPASS, A Brief Patient-Reported Outcome Measure for Psoriasis

Background: While the Psoriasis Area and Severity Index (PASI) represents the most commonly used assessment tool for psoriasis severity, it has been criticized for its complexity in clinical practice. Objective: To validate a simplified 2-item patient-administered limited measure psoriasis area and severity score (PALMPASS) compared to standardized measure of psoriasis. Materials and Methods: This was a prospective observational survey of adult patients with psoriasis and psoriatic arthritis in Veterans Affairs Medical Center (VAMC) dermatology and rheumatology clinics participating in the Program to Understand the Longterm outcomes in SpondyloARthritis registry between January and June 2016 (n = 885). Patients at 7 US VAMCs (n = 363) completed a 2-item, 11-point PALMPASS questionnaire, assessing (1) how psoriasis affected the patient and (2) the degree of surface area involvement. Results from the PALMPASS were then compared to the PASI, the Psoriasis Symptom Inventory (PSI) and the Dermatology Life Quality Index (DLQI). Data were analyzed using Lin concordance, intraclass correlations, Spearman correlations, and linear regression. Results: Strong correlations existed between PALMPASS and PASI (Spearman ρ = 0.74, P < .001), PSI (Spearman ρ = 0.71, P = .001), and DLQI (Spearman ρ = 0.77, P < .001). Results were comparable in analyses based on intraclass correlations. Elevated C-reactive protein concentrations correlated with higher PALMPASS. Conclusion: The PALMPASS is a patient-reported instrument that demonstrates validity and serves as a reliable and simplified tool to guide evidence-based management.
Comparison of ACR 1990 and ACR 2010 classification criteria in fibromyalgia syndrome

Purpose of this study is to compare the American College of Rheumatology (ACR) 1990 and ACR 2010 classification criteria in fibromyalgia syndrome. Fifty-one patients with fibromyalgia syndrome (FMS) and 50 control patients were included in the study. Patients with FMS were diagnosed by a specialist, and ACR 1990 or ACR 2010 classification criteria were not considered as a necessity. Control group consisted of patients with non-inflammatory pain such as osteoarthritis, periarthritis, regional pain syndrome. Patients were evaluated for ACR 1990 and ACR 2010 criteria, and they were examined for algometry. While ACR 1990 classification criteria had a sensitivity of 0.74, a specificity of 0.88, accuracy of 0.81, ACR 2010 criteria had a sensitivity of 0.78, a specificity of 0.76, and an accuracy of 0.77. In our study, ACR 2010 classification criteria were found to be more sensitive than ACR 1990 classification criteria, but specificity was lower. Besides, the ACR 2010 classification criteria do not require a tender point examination and may be more advantageous in assessing physical and psychological symptoms. It is considered that the classification criteria of ACR 2010 may be more favorable for clinical diagnosis and monitoring of diagnosed disease.
Histopathological and Immunohistochemical Characteristics of Breast Carcinomas in Uyo, Subtropical Region of Africa

Background: There is a relative dearth of data for immunohistochemical characteristics of breast carcinomas in cancer registries of Nigeria and some parts of Africa. A descriptive hospital based study, done over a year, involving three hospitals in Uyo rendering breast cancer care. Objective: To determine the immunohistochemical-expression pattern of oestrogen receptor, progesterone receptor, and human epidermal receptor 2 and their relationship with histopathological features of invasive breast carcinomas in Uyo, Akwa Ibom State. Materials and methods: Each specimen with an accompanying completely filled coded proforma form containing clinical characteristics of patients with breast cancer was received at the Histopathology Department for subsequent histopathological and immunohistochemical analysis. Results: The age range for patients with breast carcinoma was 23 -70 years with a mean age at presentation of 43.07 ± 11.19 years. Invasive ductalcarcinoma was the commonest histological type accounting for 86.9 % of all breast cancer. Positivity for oestrogen receptors, progesterone receptors and Her-2 were seen in 18.0%, 14.8% and 32.8% of breast carcinomas respectively. Majority of breast carcinomas were triple negative phenotype (62.3%). Conclusion: Majority of the invasive breast carcinomas in our environment were triple negative phenotype (62.3%).
Developing a measure of L2 learners' productive knowledge of English collocations

Obtaining accurate measurements of L2 learners’ productive knowledge of collocations has proven difficult. The goal of the work reported in this thesis was to develop and test a means of eliciting from learners a reliable and representative sample of their productive knowledge of collocations. The two main methods typically used for this purpose are demonstrated to suffer from a number of drawbacks, yet one instrument is identified as having potential. This instrument, LexCombi, originally devised by Barfield (2009a), presents noun cues to learners and asks for three collocates in response to each cue, which are then evaluated as either canonical or not. In this thesis, LexCombi is taken forward and, through an iterative series of empirical studies, developed further. Specifically, after trialling LexCombi and exploring how learners interact with it, the format is adapted to more clearly guide respondents towards producing collocations; the scoring of learners’ responses is reviewed to gain a more complete picture of learners’ knowledge; and a new set of cue words is trialled and selected to resolve a number of issues identified with the original cues. After this development process, an empirical evaluation of the final form of the instrument, LexCombi 2, is conducted and its capacity to provide useful data on learners’ productive knowledge of collocations is evaluated. Following this, the empirical data is used to consider what can be learned about collocation knowledge using LexCombi 2. Explorations include the relationship between collocation knowledge and general L2 proficiency, the types of words that are used as responses to LexCombi 2, and how LexCombi 2 scores are affected by different conceptions of collocation. Finally, the thesis considers the overall significance of this work for our understanding of collocation knowledge more generally.
Use of nebulised N-acetylcysteine as a life-saving mucolytic in intensive care: A case report

We present a case of critical airway obstruction secondary to a solid tracheal mucus plug in a patient with pneumonia. Following failed conventional mucolysis therapy, nebulised N-acetylcysteine acted as a life-saving mucolytic, and prevented imminent cardiorespiratory arrest. Use of oral N-acetylcysteine as a mucolytic has been long established within respiratory medicine in managing chronic airway disease, but is rarely utilised in critically ill or mechanically ventilated patients due to the lack of comparative studies in literature. A 28-year-old female presented to the emergency department with shortness of breath and a productive cough. She was six weeks post-partum with no past medical history. Initial management for a community acquired pneumonia with type 1 respiratory failure included intensive care admission, antibiotics, fluid therapy and bronchodilators. The patient acutely deteriorated 48 h after admission becoming unresponsive and severely hypoxaemic. Intubation did not achieve ventilation, and subsequent direct bronchoscopy revealed a thick, solid, obstructing tracheal mucus plug, superior to the carina. It was resistant to aspiration despite the use of saline flushes, chest physiotherapy and bronchodilators and the bronchoscope could not pass it. N-acetylcysteine, administered via the bronchoscopic port, caused sufficient mucolysis to enable removal of the thick mucus cast, enabling ventilation and gas exchange. Such resistant mucus plugging is a rare cause of failed ventilation, with limited therapeutic options. Here, the unlicensed and rarely reported use of nebulised N-acetylcysteine was a life-saving mucolytic, allowing removal of the obstructing plug and re-establishing ventilation.
Association between C reactive protein and obesity: a study in a tertiary care hospital

Background: Obesity and dyslipidemia, especially in children and adolescents coupled with impaired blood glucose metabolism and elevated blood pressure may result in atherosclerosis in the older ages. This study was conducted to assess the association between high levels of CRP with obesity.Methods: Details including height and weight for BMI and serum for C reactive protein estimation was collected for all 134 patients.Results: 60.4% were females and 49.6% were males. Among the obese patients, clinically raised CRP levels was observed in 29.2% and elevated CRP levels in 45.8% levels, while in overweight patients, 21.4% had clinically raised CRP and 46.4% has elevated CRP levels. In normal BMI patients, elevated CRP was seen in 22% and clinically raised in 1.9%. Conclusion: Detection of CRP levels in overweight and obese patients is imperative in the early stages itself to prevent cardiovascular diseases.
A maritime targets detection method based on hierarchical and multi-scale deep convolutional neural network

The mainstream detection methods Faster R-CNN and SSD are mainly designed for general dataset, but do not emphasize the detection effect of small targets and can not to achieve higher average detection accuracy on general dataset. In order to overcome the problem, we present a target detection method based on hierarchical and multi-scale convolutional neural network aiming at the detection task of maritime targets in complex scenario. To enhance the detection capability of small targets, we extract proposals of different scales in the multi-resolution convolution feature map in the region proposal network. To further improve the detection accuracy, we add an object detection network. The convolution feature maps with high-resolution are used to extract the targets, then an upsampling layer is added to enhance the resolution of the feature maps. The region proposal network and object detection network are then combined to realize the accurate detection of the target. The experiment results demonstrate that the proposed method achieves good detection results in maritime targets dataset, and the accuracy of target detection outperforms those of the mainstream detection methods.
Quantified Magnetic Resonance Spectroscopy in the Diagnosis of Burning Mouth Syndrome

Purpose: To investigate potential pathological differences in major brain metabolites in burning mouth syndrome (BMS). Materials and Methods: We prospectively evaluated eight patients and six healthy controls with single voxel magnetic resonance (MR) spectroscopy throughout 2017 using 3-Tesla MR unit. Metabolite levels measured from the left posterior paracingulate white matter. Raw images were processed with Tarquin version 4.3. 10 and area under curve values were automatically calculated for GABA (γ-Aminobutyric acid), Ins (myo-inositole), tNAA (N-Acetylaspartate), tCho (total choline), tCr (total creatine) and GLx (glutamine + Glutamat). Major metabolite levels and all metabolites ratio to tCr calculated and compared between two groups using Mann-Whitney U test. Results: GABA/tCR value of the patients (0.589 ± 0.194, median = 0.515) was significantly higher than control group (0.230 ± 0.067, median = 0.220) (P = 0.002). tNAA/tCR value of the patients (1.106 ± 0.218, median: 1.205), was significantly lower than the control group (1.538 ± 0.401, median: 1.705) (P = 0.028). No significant difference was observed between two groups in terms of all other metabolites (P > 0.05). Conclusion: We demonstrated increased GABA and decreased NAA in the left posterior paracingulate region in BMS patients. We suggest that these metabolite alterations in central nervous system might play a key role in the etiology of the disease by inhibiting the suppression of burning sensation.
Comparison between Steiner cephalometric and modified Andrews photometric method for assessing antero-posterior position of the maxillary central incisors.

Introduction/Objective. Maxillary incisors, when exposed during smile, are one of the most important facial features. In an attempt to overcome limitations of standard cephalometric methods, Andrews described an approach to determine ideal anteroposterior (AP) position of maxillary central incisors in smiling profile in relation to the forehead. We compared traditional Steiner cephalometric method, using surrounding skeletal landmarks, to the method proposed by Andrews, with the aim of determining whether distant but very noticeable craniofacial structures can affect our impression of tooth position. Methods. The study comprised 90 randomly selected lateral cephalograms, divided into three groups according to maxillary central incisors AP position according to Steiner cephalometric norms. The AP relationship of the maxillary central incisors was measured as a perpendicular distance from facial axis point to the nasion A line and to the vertical line through forehead facial axis point respectively. Student? s t-test and Pearson? s correlation were used to compare tested variables. Results. There was statistically significant difference between two methods (p = 0.01108). According to the Steiner method 46.67% subjects had retrusive incisors and 53.33% subjects had protrusion. Andrews? s method showed different results; 35.56% subjects had retrusion, while 64.4% had protrusion. Conclusion. The method proposed by Andrews showed consistently more protrusion than the traditional cephalometric method according to Steiner. Slightly retruded position of maxillary central incisors according to Steiner analysis does not always imply poor facial esthetics, if they have favorable position to the forehead. Low levels of correlation indicate that we should never rely on just one set of parameters.
Predictors of benefits from frontline chemoimmunotherapy in stage IV non-small-cell lung cancer: a meta-analysis

ABSTRACT Background: Immune checkpoint inhibitors (ICIs) have dramatically expanded the therapeutic landscape of non-small-cell lung cancer (NSCLC). In a previous study, gender, smoking history, and PD-L1 status were found to influence the efficacy of single-agent ICI in NSCLC. This meta-analysis evaluated the clinical and molecular factors that could predict a benefit from adding ICIs to first-line chemotherapy in metastatic NSCLC. Patients and Methods: The pooled hazard ratio (HR) of progression-free survival (PFS) and overall survival (OS) among the selected subgroups were analyzed using the random effects model. The correlation between PD-L1 expression and outcome was analyzed by meta-regression. Results: Seven phase III randomized controlled trials comparing chemo-immunotherapy (CIT) with chemotherapy in untreated stage 4 NSCLC were included. CIT evenly improved PFS irrespective of age, gender, histology, smoking history, and performance status. Among patients with baseline hepatic metastasis treated with Atezolizumab-containing CIT, PFS improvement was only detected with the addition of Bevacizumab. Whereas patients with EGFR/ALK-driven cancer exhibited greater PFS with the addition of ICI to a Bevacizumab (BEV)-based regimen, the derived benefit was no longer statistically significant among those treated with non-BEV-based regimens. Although the superior PFS conferred by CIT was noticeable across all PD-L1 expression subgroups, this benefit correlated with PD-L1 level and was more pronounced in the “PD-L1 high” cohort. Except for patients harboring EGFR/ALK aberrations or squamous histology, CIT consistently improved OS across the other selected subgroups. Conclusions: The survival advantage associated with first-line CIT in metastatic NSCLC was observed in different patient populations, including those for which single-agent ICI has marginal therapeutic benefit. Our findings support the role of chemotherapy with or without VEGF blockade as enhancers of ICI activity in NSCLC.