Miracle-dz/UniFAR-FTUs huggingface dataset:
Use Of Complementary and Alternative Medicine in Children With Cancer: Effect on Survival

The objective of the present study was to determine the type, frequency, the reason why complementary and alternative medicine (CAM) treatments are used, the factors related with their use, and the effects of CAM usage on long-term survival. Families of a total of 120 children with cancer between 0–18 years of age, including 50 (41.7%) girls and 70 (58.3%) boys, participated in our study. The authors found that 88 patients (73.3%) used at least one CAM method, the most common (95.5%) of which was biologically based therapies. Most frequently used biologically based therapies were dietary supplements and herbal products. The most commonly used dietary supplement or herbal product was honey (43.2%) or stinging nettle (43.2%), respectively. We found that patients used such CAM methods as complementary to, but not instead of, conventional therapy. Sixty-nine out of 88 patient families (78.4%) shared the CAM method they used with their physicians. No statistically significant relation was found between socioeconomic, sociodemographic, or other factors or items and CAM use. The mean follow-up period of the CAM users and nonusers groups was 79.4 ± 36.7 (21.3–217.9) and 90.9 ± 50.3 (27.4–193.7) months, respectively. Five-year survival rates for CAM users and nonusers were found as 81.5% and 86.5%, respectively (P > .05). In conclusion, families of children with cancer use complementary and alternative treatment frequently. They do not attempt to replace conventional treatment with CAM. Higher rates of CAM use was found in families with higher educational level. CAM usage did not affect the long-term survival.
New Treatments for Diabetic Chronic Kidney Disease

Despite the availability of current therapies that target hyperglycemia, hypertension, dyslipidemia and blockade of the renin-angiotensin-aldosterone (RAA) system, many people with diabetic chronic kidney disease (CKD) still progress to end stage renal disease (ESRD). Hence, new therapies to slow the progression of this important diabetic complication are urgently needed. Disappointingly many promising interventions for diabetic CKD have not coming to fruition when tested in large clinical trials. A recent clinical trial has shown that estimated GFR increases with bardoxolone. However, this finding awaits confirmation that it reflects changes in true GFR and translation into a reduction in clinical events. Here we discuss studies that have evaluated the effects of novel approaches to inhibiting the pathways involved in the pathogenesis of diabetic CKD.
Outcome of Endophthalmitis Treatment in a Tertiary Referral Center in Southern Iran

Purpose: The purpose of this study was to investigate the causative organisms, the clinical characteristics, visual outcomes, and the incidence of acute endophthalmitis after cataract surgery. Materials and Methods: In this retrospective study, a chart review was performed for patients treated in a tertiary referral center for acute endophthalmitis after cataract surgery from January 2005 to December 2009. During the study period, 62 additional patients with acute postoperative endophthalmitis were referred to and treated in this center. Therefore the cohort comprised 70 patients (8 of whom underwent cataract surgery at our center, and 62 who were referred). Demographic, clinical, and laboratory data were analyzed. The primary outcome measure was final visual acuity. P<0.05 indicated statistical significance Results: During the study period, 7737 cataract surgeries were performed in this center. Eight (0.10%) of 7737 eyes developed acute postoperative endophthalmitis. Subgroup analysis indicated that extracapsular cataract extraction was associated with a fourfold higher risk of endophthalmitis compared with phacoemulsification. We found better initial visual acuity (VA) (≥ hand motion) (P<0.001) and negative cultures (P=0.021) were independently associated with a more favorable visual outcome. Patients with relative afferent papillary defect (RAPD) were associated with lower initial VA (P<0.001) and worse visual outcome (P=0.001). Positive microbial cultures were found for 33 (42.9%) cases. Staphylococcus aureus was the most common organism isolated. Positive cultures were more frequently found in patients with RAPD. The “gram-positive coagulase-negative” and “no growth” groups had the best visual outcome. Associated keratitis and avoiding intraocular steroids were associated with the risk of evisceration. Conclusion: The visual outcome after endophthalmitis was generally poor and only one eighth of the eyes achieved a final corrected visual acuity of ≥20/200. Therefore, better treatment strategies are warranted. Immediate treatment is essential and the role of primary vitrectomy requires further investigation. In addition, RAPD, as an objective test, may complement VA for predicting the prognosis and planning the course of treatment.
Pharmacotherapy of the third-generation AEDs: lacosamide, retigabine and eslicarbazepine acetate

Introduction: The search for new, more effective antiepileptic drugs (AEDs) continues. The three most recently approved drugs, the so-called third-generation AEDs, include lacosamide, retigabine and eslicarbazepine acetate and are licensed as adjunctive treatment of partial epilepsy in adults. Areas covered: For the above three AEDs, their mechanisms of action, pharmacokinetic characteristics, drug–drug interactions, pharmacotherapeutics, dose and administration and therapeutic drug monitoring are reviewed in this paper. Expert opinion: Lacosamide and retigabine act through novel mechanisms, while eslicarbazepine acetate, a pro-drug for eslicarbazepine, acts in a similar manner to several other AEDs. All three AEDs are associated with linear pharmacokinetic and rapid absorption and undergo metabolism. Their drug–drug interaction profile is low (lacosamide and retigabine) to modest (eslicarbazepine) in propensity. At the highest approved doses for the three AEDs, responder rates were similar. The most commonly observed adverse effects compared with placebo were dizziness, headache, diplopia and nausea for lacosamide; dizziness, somnolence and fatigue for retigabine and dizziness and somnolence for eslicarbazepine acetate. The precise role that these new AEDs will have in the treatment of epilepsy and whether they will make a significant impact on the prognosis of intractable epilepsy is not yet known and will have to await further clinical experience.
Quality of Life Assessment in Hematopoietic Stem Cell Transplantation Performed on Thalassemia Major Patients

Although successful hematopoietic stem cell transplantation (HSCT) can offer a cure in thalassemia major, there are only a few and noncomprehensive studies of its effect on the quality of life (QoL), as it is expected to increase the QoL by ending transfusion-related issues. Our objective was to compare the health-related quality of life (HRQoL) of transplanted and nontransplanted thalassemia major patients in a developing country. We have studied the QoL effect of HSCT in consecutively invited 50 nontransplanted and 49 transplanted patients who had received transplants from HLA matched related donors at least two years ago. PedsQL questionnaire was used for the patients under 18 years of age and World Health Organization's WHOQoL-BREF questionnaire for above 18 years of age. Higher QoL was determined in HSCT performed group surveyed in 5–18 years' age group. Detailed analysis marked the profound difference in 8–12 year subgroup, particularly in physical activity questionnaires. QoL scores in HSCT performed adult group are higher than the transfusion-dependent group, especially in physical activity domain. Transplanted adult patients rated their overall health significantly better than patients on conventional therapy. The patients who still have chronic graft versus host disease rated worse compared to those without it. In conclusion, thalassemia major patients who have undergone HSCT at least two years before assessment are not inferior to the transfusion-dependent group with regard to the QoL and have a better QoL than transfusion-dependent patients in some areas. The QoL score is better for school children and adolescents; therefore, we suggest HSCT before primary school. GVHD reduces the QoL significantly and it is obvious that GVHD prevention should be one of the primary goals of post-HSCT follow-up.
Quantifying the PBAC in a Pediatric and Adolescent Gynecology Population

Study objective: To determine the usefulness of the pictorial blood assessment chart (PBAC) for use as a valid screening tool for menorrhagia in adolescents. Study design: To conduct a prospective survey paired with retrospective chart review. Main outcome measures: To determine mean PBAC scores among adolescents presenting with menorrhagia versus normal or infrequent cycles. To determine the PBAC scores among adolescents self-identifying as having heavy, normal, or light menses. Results: Seventy-three subjects met criteria. Teens self-identified as having “light,” “medium,” or “heavy” cycles. Groups were then subdivided: Group 1 “heavy menses,” Group 2 “normal menses,” and Group 3 “light menses. ” The mean age of menarche was similar in all groups: 11.59 ± 1.56 years, 11.41 ± 1.51 years, 11.78 ± . 83 years in Groups 1, 2, and 3, respectively. The mean PBAC score for the cohort was 195, while the mean PBAC in Group 1 was 362, compared to 136 and 44 for Groups 2 and 3, respectively ( p < .002). Conclusions: This is the first study to address the use of the PBAC in an adolescent population. In addition, this study evaluates mean PBAC scores among teens who self-identify as having heavy, normal, or light periods. The incidence of bleeding disorders among those with menorrhagia was 20%, consistent with previously published studies.
Oxycodone for the treatment of postoperative pain

Introduction: Pain is a likely outcome of any surgical procedure. In several countries the use of oxycodone has surpassed that of morphine in postoperative pain management. Areas covered: This review summarizes the recent pharmacological and clinical data on oxycodone use for postoperative pain management. The benefits and the impact oxycodone may have on outcome in different patient groups is addressed. As oxycodone is available on different pharmaceutical formulations and as a new combination product with naloxone, the different approaches that may be used with oxycodone in postoperative pain management are also reviewed. Expert opinion: The recent interest in oxycodone is based on its favorable pharmacokinetics and pharmacodynamics, especially in the central nervous system. Moreover, relatively high enteral bioavailability allows an easy switch from one drug formulation to another during the course of pain management. Oxycodone is highly effective and well tolerated in different types of surgical procedures and patient groups, from preterm to aged patients. In the future, the use of transmucosal administration and enteral oxycodone–naloxone controlled-release tablets is likely to increase, and an appropriate concurrent use of different enteral drug formulations will decrease the need for more complex administration techniques, such as intravenous patient-controlled analgesia.
Treatment strategies for myasthenia gravis: an update

Introduction: New treatments for immune mediated diseases have increased notably in the last 10 years. Monoclonal antibodies directed against different components of the immune system have appeared, along with new drugs from the haematology field. In the case of myasthenia gravis (MG), many of these new treatments have been used in experimental animal models and also in patients. Areas covered: This manuscript reviews the progress in the field of MG treatment achieved in the last 5 years. Firstly, our current treatment protocol is introduced. Secondly, new data from recent randomized trials and case series of patients treated with methotrexate, cyclophosphamide, rituximab or improved systems of apheresis is reported. Finally, all future treatments are discussed that are currently under evaluation in preclinical animal models of experimental autoimmune MG. Expert opinion: Evidence supporting the use of methotrexate and rituximab in MG has been published recently, in addition to conflicting randomized trials that were not successful, evaluating the use of tacrolimus as a steroid sparing agent. New promising treatments are currently under evaluation in clinical trials, such as belimumab and eculizumab.
Management of middle mesial canal in mandibular second molar

The primary objective of endodontic therapy is to achieve a three-dimensional obturation of the root canal space after adequate preparation of the canal space to remove the tissue debris, microorganisms, and their byproducts. Anatomical variations have frequently been encountered in endodontic practice and have to be adequately managed by the clinician. Missed roots and canals are a major reason for failure of therapy. Technological advances have given the clinician ample opportunity to identify and treat these aberrations successfully. The present report describes a left mandibular second permanent molar requiring root canal treatment, found to have three separate canals in the mesial root. This case demonstrates a rare anatomical configuration and emphasizes the need for the clinician to be aware of and look out for such variations and use adequate diagnostic methodologies prior to and during therapy to detect such variations. The possibility of additional canals, whenever in doubt, should be explored with the assistance of technologies such as those of magnification and illumination and various diagnostic aids. Operator experience has also shown to be a key factor in negotiation and management of these aberrant canal configurations.
Expanding Exposure: Can Increasing the Daily Duration of Head Start Reduce Childhood Obesity?

Coinciding with the work requirements of welfare reform in the mid-1990s, the early childhood education program, Head Start, significantly expanded to increase the availability of full-day classes. Using unique administrative data, we examine the effect of full-day compared to half-day attendance on childhood obesity. This effect is identified from changes in obesity over time and from the elimination of a state-provided full-day expansion grant that decreased the supply of full-day classes. Our results suggest that full-day Head Start attendance significantly reduces the proportion of obese children at the end of the academic year.
Smoking: Making the Risky Decision

This is a book on smoking that uses rigorous empirical data to explore in detail the character of the tradeoffs that people make in choosing whether to smoke or not to smoke. It is, therefore, not strictly about the hazards of smoking but about how people's perceptions of the risk of smoking affects their smoking behaviour. Some of the interesting and potentially controversial conclusions include: 1) People overestimate the risk of lung cancer compared to the actual incidence of the disease; 2) if people had an accurate perception of the risk of lung cancer national smoking rates would rise by 8%; 3) excise taxes on cigarettes increase people's risk perceptions and decrease smoking rates; 4) people who smoke are more likely to accept work in hazardous professions, and require less extra compensation for hazardous work than non-smokers; 5) young people, who are making the decision whether to smoke have a higher perception of the risks of smoking than older people.
Study of effect of exercise on PEFR in pregnant women

Background: Many physiological adaptations occur during pregnancy. One such is changes in the respiratory functions and response to exercise. Many studies have been conducted on changes in peak expiratory flow rate (PEFR) in pregnancy, but there are only few studies reporting the effect of exercise on PEFR in pregnant women. Aims and Objectives: To study the effect of exercise on PEFR in pregnant women. Materials and Methods: PEFR was measured in 50 pregnant women in their second trimester of pregnancy in comparison with nonpregnant women (controls). PEFR was measured twice. The first reading was taken at rest and the second after moderate exercise, in the form of walking on a treadmill for 6 min at 12% slope. It was measured using RMS Medspiror. Results: The mean age of the pregnant women was 23.1 ± 2.7 years and that of the controls was 24.3 ± 2.4 years. The mean height was 1.51 ± 0.05 m in pregnant women and 1.51 ± 0.04 m in controls. In pregnant women, PEFR at rest was lower than that in nonpregnant women. The difference was found to be statistically significant. After exercise, the PEFR decreased in both pregnant and nonpregnant women. The percentage of decrease did not change significantly between the two groups. Conclusion: We conclude that although resting PEFR in pregnant women is less, there is not much difference in the response to exercise between the two groups. Thus, pregnant women can be encouraged to exercise regularly.
Function and Size of the Residual Kidney After Treatment of Wilms Tumor

Long-term damage to the residual kidney is of concern in the survivors of Wilms tumor. Our objective was to evaluate the long-term glomerular function and size of the residual kidney in these patients. Twenty-nine survivors of Wilms tumor diagnosed between July 1999 and June 2004 were enrolled. The glomerular function was assessed by creatinine clearance, 99mTc DTPA radionuclide scintigraphy and 24-hour urinary protein. Renal size was evaluated by ultrasonography. Median age at diagnosis and at enrollment were 2.87 ± 1.8 (range: 0.5–7.5) and 7.9 ± 3.8 years (range: 2.5–18). Median duration of follow-up was 4.78 ± 2.6 years (range: 1–8.8). Evidence of renal dysfunction in the form of either function or size was identified in eight (27.6%) children. Six children had subnormal glomerular filtration rate and one had proteinuria. Subnormal size of the residual kidney was observed in one child. Age at diagnosis, stage, and duration elapsed after nephrectomy had no association with renal dysfunction (P >.05). Long-term follow up is crucial to identify clinical nephrotoxicity among survivors of Wilms tumor.
In vitro antioxidant and H+, K+-ATPase inhibition activities of Acalypha wilkesiana foliage extract

Aims: The aim of this study was to evaluate the antioxidant activty and anti-acid property of Acalypha wilkesiana foliage extract. Materials and Methods: Hot and cold aqueous extracts were prepared from healthy leaves of A. wilkesiana. Free radical scavenging activity and H+, K+-ATPase inhibition activities of aqueous foliage extracts was screened by in vitro models. Statistical Analysis Used: All experiments were performed in triplicate and results are expressed as mean ± SEM. Results: A. wilkesiana hot aqueous extract (AWHE) showed significant antioxidants and free radical scavenging activity. Further, AWHE has shown a potent H+, K+-ATPase inhibitory activity (IC50: 51.5 ± 0.28 μg/ml) when compare to standard proton pump inhibitor omeprazole (56.2 ± 0.64 μg/ml); however, latter activity is equal to A. wilkesiana cold aqueous extract (AWCE). Quantitative analysis of AWHE has revealed more content of phenols and flavonoids; this is found to be the reason for good antioxidant activity over AWCE. Molecular docking was carried out against H+, K+-ATPase enzyme crystal structure to validate the anti-acid activity of A. wilkesiana major phytochemicals. Conclusions: The present study indicates that the constituents of AWHE and AWCE have good antacid and free radical scavenging activity.
Cytochrome P450 2C9 gene polymorphism in phenytoin induced gingival enlargement: A case report

Gingival enlargement comprises any clinical condition in which an increase in the size of the gingiva is observed. Among the drugs that induce gingival enlargement, the antiepileptic agent phenytoin has been widely related to this condition. The Cytochrome P450(CYP) superfamily is the most commonly involved enzymes in metabolism of drugs. Common coding region CYP variants that affects drug elimination and response has been studied in great detail. Pharmacogenetic influences on drug metabolism have been widely reviewed and gene polymorphism of cytochrome P450 2C9 appeared to be responsible for much of the interindividual variability on drug elimination. Genetic variation in the CYP2C9 gene can affect metabolism, leading to altered phenotypes. Individuals with poor metaboliser alleles of CYP2C9 gene were shown to have a reduced metabolism of phenytoin compared with wild-type alleles. Thus identification of patients genotype prior to anti-epileptic drug administration could potentially prevent higher serum drug concentrations leading to adverse side effects such as gingival enlargement. This case report addresses the influence of CYP2C9 genetic polymorphism on Phenytoin drug metabolism thereby causing gingival enlargement.
A polymerase chain reaction and enzyme linked immunosorbent assay based approach for diagnosis and differentiation between vaccinated and infected cattle with Mycobacterium bovis

Background: In most African and Arabic countries tuberculosis (TB) causes great economic losses in bovine species and constitutes serious zoonotic problem. As the traditional diagnostic method delay the research because of low sensitivity and specificity, a rapid method of diagnosis is of outmost importance. Aim: The study was designed to evaluate the two rapid diagnostic methods of TB in cattle, further to differentiate between infected and bacillus Calmette-Guerin (BCG) vaccinated animals. Materials and Methods: Intradermal tuberculin test was applied to 300 cattle. Of these cattle, 15 cattle were vaccinated from cattle negative to tuberculin test with BCG. Blood samples were taken for lymphocyte separation to apply polymerase chain reaction (PCR) upon and for serum preparation for the enzyme-linked immunosorbent assay (ELISA) application, this blood collected from 65 cattle classified into three groups, viz. positive tuberculin test (35 animals), negative tuberculin test (15 animals), and vaccinated cow with BCG (15 animals). From blood samples lymphocytes were separated and the isolated lymphocytes were subjected to PCR and serum for ELISA application. Blood samples, specimens from lymph nodes and specific tissues were taken for PCR and for cultivation and isolation of Mycobacterium bovis. Results and Conclusions: The results of this study revealed that PCR can be used as rapid efficient and accurate diagnostic test in detection of ruminant TB. Moreover, cattle's ELISA reading showed higher sensitivity in positive tuberculin animals. However, the differentiations between vaccinated and infected animals not clear by using a single antigen only.
Silenced stakeholders: Responding to mothers' experiences of the child protection system

While there has been a plethora of international and Australian research and inquiries into child protection and, to a lesser extent, foster care, there is a paucity of Australian research undertaken with the parents of children in care. While these parents are stakeholders in a system that has had a profound effect on their lives, their views are not generally canvassed. This paper discusses key findings of a community welfare Honours study which explored the experiences of six women whose children had been removed into foster care. The paper focuses on two core themes: firstly, the mothers' sense of betrayal when their pleas for help ultimately led to them losing their children, and, secondly, despite the resultant loss, grief and anger, their compulsion to do whatever it takes to have contact with, and to be reunited with, their children. The paper concludes with key messages and recommendations for practice.