Miracle-dz/UniFAR-FTUs huggingface dataset:
Caregivers’ satisfaction and supervision of primary health care services in Nnewi, Nigeria

Although major gains were made in the reduction of childhood health indicators in the previous decade, stagnations or reversals were seen in many countries since the 1990s. Despite presence of primary health centers (PHC) in Nigeria, there are still high levels of morbidity and mortality among children because the quality of child health services falls short of what it could be in the country. Supportive supervision of PHCs should also improve the quality of child health services. This study assessed the level of clients’ satisfaction with care received and the quality of supervision of child health services in selected PHC facilities of Nnewi, Nigeria. The study design was cross sectional. Four health facilities were selected by simple random sampling technique from a list of 12 public PHC facilities that provide at least three of the range of essential child health services. Using interviewer administered questionnaire, data were collected from 305 caregivers and analyzed accordingly. Also key informant interviews were used to elicit information facility supervision frequency and adequacy. The mean age of the mainly female caregivers was 31.9 ± 9.4 years. Majority of the caregivers attended health facilities closest to them but 18.5% of the 65 who do not, said they did not like the health workers. Although more than 80% of clients were satisfied with quality of child health services received, yet 41.3% of them felt that the number of service days were inadequate. None of the health facilities had a work plan, supervision schedule or supervision checklist. Increasing the number of service days and providing supervision schedules and checklists at the health facilities can improve caregiver satisfaction and hopefully enhance quality of child health services at the PHCs. Key words: Caregivers, satisfaction, supervision, PHC, Nnewi
Cold chain management: Knowledge and practices in primary health care facilities in Niassa, Mozambique

Background: To maintain vaccines perfectly conserved from its manufacture through administration requires an adequate could chain infrastructure. At the end of the chain, primary health care providers must have adequate knowledge to manage the cold chain. Objective: The study describes an observed audit of the Expanded Program on Immunization (EPI) in Niassa province of Mozambique. Methods: Data collection methods included questionnaires, observations and document analysis in 44 health facilities, 12 of which in district capitals, and the remaining 32 in peripheral health facilities in Niassa province. Findings: The results show that the principal explanatory variable for the inadequacies of the system was the location of the health facility as health workers in the peripheral health facilities were in general less educated, had less work experience and their knowledge of cold chain was not as per required levels to support effective cold chain management. Conclusions: The study strongly indicates the need to improve and integrate the knowledge and practices on cold chain management, especially to the peripheral level workers, by providing them with adequate training and supervision, and demonstrating how that can be effectively integrated with practice. The Ethiopian Journal of Health Development Vol. 21 (2) 2007: pp. 130-135
Assessment of the severity of aortic regurgitation with pulsed wave Doppler velocity profile in the descending aorta.

OBJECTIVE The quantitative parameters which are used to assess the severity of aortic regurgitation (AR) provide the most accurate information whereas these parameters are difficult and time-consuming. The aim of this study was to get a practical parameter to use in daily practice for assessing the severity of aortic regurgitation. METHODS The study was an observational cohort study on diagnostic accuracy of severity of aortic regurgitation. Thirty-seven patients with aortic regurgitation determined by quantitative parameters (18 patients with severe aortic regurgitation and 19 patients with moderate aortic regurgitation) were included in this study. Each patient's diastolic flow pattern in the descending aorta was examined by pulsed wave Doppler. Systolic and diastolic flow time-velocity integral (TVI), TVI time, systolic and diastolic TVI ratio in the descending aorta were evaluated. In addition to these parameters, dP/dt, peak acceleration time and end-diastolic flow velocity in the diastolic flow were determined. We investigated whether there a significant difference between two groups or not. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off values of echocardiographic parameters which were used to identify the severity of aortic regurgitation. RESULTS The study population was composed of 16 female and 21 male patients. Their mean age was 46.5 years. The mean diastolic flow TVI of patients who had moderate and severe aortic regurgitation was found 10.1 cm and 18.6 cm, respectively (p<0.001). In the ROC curve analysis, the values of diastolic flow TVI above 13.5 cm was found to have 83% sensitivity and 90% specifity to predict the severity of aortic regurgitation (AUC: 0.91, 95% CI 0.80-1.0, p<0.001). Also we investigated the other parameters like systolic flow TVI, the ratio of systolic and diastolic flow TVI, mean diastolic flow time, mean systolic flow time, the ratio of systolic and diastolic flow time, end-diastolic velocity, peak acceleration time, dP/dt values in evaluation of diastolic flow in the descending aorta. These parameters were found statistically significant in assessing the severity of aortic regurgitation but their statistical power was weak. CONCLUSION TVI of diastolic flow which is measured with pulsed wave Doppler in descending aorta could be a practical parameter in assessing the severity of aortic regurgitation.
Fixed-dose combination of losartan and hydrochlorothiazide significantly improves endothelial function in uncontrolled hypertension by low-dose amlodipine: a randomized study.

OBJECTIVE Flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) in the brachial artery are well-known indices for evaluating endothelial function (ECF). The blood pressure-lowering effects of the combination of losartan (ARB) and low-dose hydrochlorothiazide (H: ARB-H; ARB, 50 mg and H, 12.5 mg) are useful. The aim of the present study was to examine whether the combination of losartan and low-dose hydrochlorothiazide could improve ECF. METHODS To investigate the effect of ARB-H on ECF in patients with uncontrolled hypertension despite the use of amlodipine (2.5 mg daily), we performed a randomized controlled open-labeled study by using the envelope method and assigned 42 patients to either a control (CTRL) group or an ARB-H combination group, both of which received amlodipine 2.5 mg daily during the treatment period. In addition, both the CTRL (n=21, 69±7 years old) and ARB-H groups (n=21, 69±7 years old) received additional behavioral modification. Before and after 8 weeks of therapy, FMD and NMD were measured in both groups using novel FMD equipment (UNEXEF18G). RESULTS Although baseline FMD was not different between the two groups, post-therapy FMD increased in the ARB-H group (2.97±1.56 to 3.95±1.86%, p<0.05) but did not change significantly in the CTRL group (2.95±1.43 to 3.11±1.27%, NS). No significant change was seen in NMD when comparing baseline and post-therapy values in either group. No treatment complications were observed. CONCLUSION A fixed-dose combination of losartan and hydrochlorothiazide enhances ECF, suggesting that this combination might have both anti-hypertensive and anti-atherosclerotic effects in patients with hypertension.
Correlates of Goal Orientations among Young Athletes

Two major ways of judging one’s competence and defining subjective success in achievement situations are task (focus is on improvement) and ego (focus is on beating others) involvement (16). Specific to the athletic context, this study examined the relationship of young athletes’ proneness to task and ego involvement, or individual differences in the degree of task and ego orientation, respectively, to their (a) beliefs about the causes of success, (b) perceived ability, and (c) degree of satisfaction/enjoyment in the athletic domain. Subjects were 55 young athletes recruited from summer basketball camps. Congruent with previous research on older athletes and the classroom, a conceptually consistent relationship between goal orientations and views concerning the causes of success was revealed. Young athletes who were high in task and ego orientation tended to perceive themselves as more capable and report greater satisfaction/enjoyment. Implications concerning the motivational consequences of goal orienta.
Estimated nutrient intake of urban Indigenous participants enrolled in a lifestyle intervention program

Aim: The present study evaluates the reported nutrient intake of adult urban Aboriginal and Torres Strait Islander people who participated in a medically based lifestyle intervention program. Methods: The analysis was based on dietary records from all Indigenous participants (n = 100) enrolled in a 2003–2005 prospective lifestyle intervention study that followed a cohort of overweight (body mass index > 25) participants served by the Townsville Aboriginal and Islanders Health Service, Queensland, Australia. Standardised multiple-pass 24-hour dietary recalls were collected at baseline and 12-month program completion. Changes in pre- and post-program reported intake were evaluated using a paired-sample t-test. The Mann–Whitney test was used to compare baseline intake with an age and gender-matched sample created from 1995 National Nutrition Survey data. Results: The cohort was 88% female with a mean age of 44.4 ± 1.3 standard error of the mean. Dietary intake improved between baseline and program completion. At baseline, there was a high prevalence of reported intakes below the Estimated Average Requirement for vitamin A, thiamine, riboflavin, niacin, folate, vitamin C, magnesium, calcium, phosphorus, iron and zinc. Compared with the median Australian intake, the Indigenous intake was significantly higher in protein and cholesterol; however, vitamin A, vitamin C, niacin, potassium, magnesium, iron and fibre were lower. Conclusions: The present study found the intake in a cohort of Indigenous people was significantly different than the previously measured Australian nutrient intake. The nutrient patterns observed in the present study may be associated with the excess chronic disease burden experienced by Australian Indigenous populations.
Synthesis and anticonvulsant activity of new N-mannich bases derived from benzhydryl- and isopropyl-pyrrolidine-2,5-dione

Abstract Synthesis and anticonvulsant properties of 26 new N-Mannich bases of 3-benzhydryl-(5–17) and 3-isopropyl-pyrrolidine-2,5-diones (18–30) have been described. Initial anticonvulsant screening for these compounds was evaluated in mice after intraperitoneal administration in the maximal electroshock (MES) and subcutaneous pentylenetetrazole (scPTZ) seizures tests. The acute neurological toxicity was determined by applying the rotorod test. The in vivo results in mice showed that the majority of 3-benzhydryl-pyrrolidine-2,5-dione derivatives revealed effectiveness, while 3-isopropyl-pyrrolidine-2,5-dione derivatives were practically devoid of activity. The quantitative evaluation in both tests revealed that the most active were N-[{4-(3-chlorophenyl)-piperazin-1-yl}-methyl]-3-benzhydryl-pyrrolidine-2,5-dione (9) with ED5 0 value =42.71 mg/kg (MES), ED5 0 value >150 mg/kg (scPTZ), and N-[{4-(3-trifluoromethylphenyl)-piperazin-1-yl}-methyl]-3-benzhydryl-pyrrolidine-2,5-dione (13) with ED5 0 value =101.46 mg/kg (MES) and ED5 0 value =72.59 mg/kg (scPTZ). These molecules showed higher potency and lower neurotoxicity than the reference antiepileptic drugs (ethosuximide and valproic acid). To explain the probable mechanism of action of selected active derivatives (9 and 13), their influence on Nav1.2 and l-type calcium channel was evaluated in vitro.
The nomogram of intracranial translucency in the first trimester in singletons.

OBJECTIVE Measurement of intracranial translucency (IT), which is a recent earlier recognizable sonographic marker, has been suggested for detection of spina bifida. In this prospective study we aimed to determine normative values of IT in the population of Turkish singleton pregnant women during the first trimester of pregnancy. MATERIAL AND METHODS Between January 2011 and July 2011, all consecutive singleton pregnant women were screened for intracranial translucency. Pregnancies were followed until birth. Pregnancies with any detected/suspicious anatomical or genetic fetal anomalies, biochemical abnormalities, increased nuchal translucency measurements, pregnancies of artificial reproduction techniques and anomaly detected at birth were set to be excluded from the data analyses. Mean±standard deviation, median and percentile values of intracranial translucency were calculated. Linear regression analyses were done between the length of intracranial translucency and gestational week and CRL. RESULTS Data analyses included 201 fetuses. Median maternal age was 31 years. Median CRL was 62 mm. Median gestational week was 12.57 weeks. Median IT value for the first trimester was 1.7 mm (range 1.00-2.40). Calculated formulae are; IT (mm)=[0.237×Gestational Week)]-1.27, R(2)=0.302; p<0.001 and IT (mm)=[0.020×CRL (mm)]+0.44, R(2)=0.381; p<0.001). IT measurements increased with increasing CRL and advancing gestational weeks. During follow up none of the fetuses was found to have any anatomical abnormality or anomaly. CONCLUSION This study presents normative values of intracranial translucency in the first trimester screening of normal singleton pregnancies of the Turkish population. In accordance with previous reports, intracranial translucency increases linearly with advancing CRL.
Prenatal diagnosis of β‐thalassaemia and other haemoglobinopathies in India

This paper reports prenatal diagnosis of 787 fetuses of β‐thalassaemia and other haemoglobinopathies in Indian high‐risk communities. DNA based diagnosis was offered in the first, as well as the second trimester, in 489 pregnancies (with five twins) on fetal tissues such as chorionic villus (CV) and amniocytes using the amplification refractory mutation system (ARMS) and restriction fragment length polymorphism (RFLP) techniques. Two hundred and ninety‐two women (with one twin), who either presented late in the second trimester or whose DNA diagnosis was not informative, were offered prenatal diagnosis using globin chain synthesis (GCS) on fetal blood cells. Maternal contamination of fetal DNA was ruled out by variable number tandem repeat (VNTR) analysis using sites in four different genes (Apo‐B, D1S‐80, Ig‐JH and Ha‐ras), while contamination of fetal blood was checked by a particle size distribution channelyzer. Using both techniques we were able to offer complete diagnosis in 99.8% cases. Out of 494 fetuses tested by DNA analysis, 135 were found to be normal, 201 were carriers, whereas 146 were affected. Out of 293 fetuses analysed by GCS, 215 were unaffected and 71 were affected. In this study, both fetuses were tested in twin pregnancies, of which three required selective termination of one fetus. Because of social, religious taboos and family influences, genetic counselling was found to be an important guideline for couples selecting options for prenatal diagnosis. Our experience suggests that because of late presentation by many couples to the diagnostic centres, in developing countries like India, both the techniques of DNA analysis and GCS should be made available at major referral centres for maximum benefit to couples. Copyright © 2000 John Wiley & Sons, Ltd.
Adolescents’ experiences of familial involvement in their peer relations and school attendance

This study investigated adolescent experiences of familial involvement in adolescent peer relations and school attendance. The data were gathered through semi-structured interviews with Finnish adolescents (n = 19; aged 12–16 years). The data were analysed by qualitative content analysis. Positive familial involvement was described as enablement, continual conversations about adolescent activities, actual support and taking an active role in adolescent activities. Negative involvement included negligence, criticism, restrictiveness or coercion. The findings are discussed with reference to previous research, and implications for adolescent and family health promotion are noted.
Cinical Significance of Androgen Receptor, CK-5/6, KI-67 and Molecular Subtypes in Breast Cancer.

OBJECTIVE To detect the relationship between molecular subtypes of breast cancer with expressions of androgen receptor, cytokeratin 5/6 (CK5/6)and Ki-67. MATERIALS AND METHODS Expressions of androgen receptor, CK-5/6 and Ki-67 were determined by immunohistochemistry in paraffin-embedded sections obtained from 86 invasive breast cancer cases of stages I/IIa/IIb in 4 molecular subtypes. Patients treated for recurrent disease and locally advanced disease were excluded. RESULTS Forty one luminal A cases, ie. positive estrogen receptor(ER) and/or progesteron receptor (PR) with negative epidermal growth factor receptor (HER2), 14 luminal B, ie. positive ER and/or PR and positive HER2, 14 HER2-enriched (HER2+), ie. negative ER and PR with positive HER2, and 17 triple negative (negative ER and PR and HER2) invasive breast cancers were included. Mean follow-up was 17.46±11.70 mo. Androgen receptor-negativity and CK5/6-positivity were significantly more common in HER2+ and triple negative groups. Ki-67 and histological grade were higher in HER2+ group, significantly. Two deaths were triple negative (P=0.04). Androgen receptor-negativity, CK5/6 and Ki-67 status did not affect survival or systemic metastases, significantly. All groups had local recurrences. Local recurrence was significantly associated with androgen receptor-negativity in luminal A and high Ki-67 value in HER2+ groups. Systemic metastases were significantly more common in triple negative and HER2+ groups. CONCLUSION Molecular subtypes of breast cancer are prognostic and predictive. Androgen receptor is expressed more commonly in luminal subtypes with better prognosis and androgen receptor negativity is associated with development of local recurrence in luminal A cancers.
Evaluation of mesotherapeutic injections of three different combinations of lipolytic agents for body contouring

Abstract Background: There has been significant interest recently in the technique of mesotherapy as a method of ‘melting fat’ for body contouring. Objective: The aim of this study was to evaluate the safety, efficacy and lipolytic potential of several compounds commonly used in cosmetic mesotherapy. Methods: A total of 75 women (mean age: 33 years) were separated randomly into three mesotherapy groups. Injections were performed for 15 treatments once a week. The main component of each cocktail was phosphatidylcholine/deoxycholic acid for group 1, caffeine for group 2, and Conjonctyl® for group 3. Outcome was evaluated by weight, body fat percentage (BFP), circumference measurements, and patient questionnaires. Results: Seventy-two of all the patients (96%) showed a circumference loss. An average circumference reduction of 4.41 cm per site for group 1, 2.99 cm for group 2, and 2.10 cm for group 3 was achieved. Mean body circumference loss was statistically significant, with p < 0.00. Weight loss was 5.33 ± 1.09 kg for group 1, 3.74 ± 1.51 kg for group 2, and 2.82 ± 1.43 kg for group 3. Seventy-four subjects (98.7%) showed a BFP decrease. A questionnaire indicated high patient satisfaction (63%). No patient showed irregularities, dimples or any serious side effects after treatment. Conclusion: Mesotherapy is a well-tolerated and effective alternative treatment modality for reducing the diameter of body circumference.
Effect of the 595-nm pulsed dye laser and ablative 2940-nm Er:YAG fractional laser on fresh surgical scars: An uncontrolled pilot study

A scar is a mark that remains after the healing of a wound or other morbid processes. In the past, treatment was mainly focused on severe scarring, such as the hypertrophic and burn scars. However, scars from relatively minor wounds can also be stressful. In a recent survey, patients were found to be highly concerned about scars that follow routine surgical procedures, with many expressing their strong desire for scar prevention (1). Despite the wide interest in surgical scar prevention, there is as yet no universal consensus on optimal treatment. In this pilot study, we examined the effect of the 595-nm pulsed dye laser (PDL) and ablative 2940-nm Er:YAG fractional laser (EYFL)
Assessment of safety and efficacy of a bipolar fractionated radiofrequency device in the treatment of photodamaged skin

Abstract Background: A number of devices are available for skin rejuvenation and conventional devices include both ablative and non-ablative lasers. More recently, bipolar fractionated radiofrequency (RF) devices have been introduced. Objective: To evaluate the safety and efficacy of a novel 144 pin high density tip bipolar fractionated radiofrequency (RF) device for skin rejuvenation in Fitzpatrick skin types I-IV. Methods and materials: This single-center, prospective, study enrolled 25 female between the ages of 35–60 years, with mild to moderate wrinkling based on the Fitzpatrick Wrinkle Scale. The subjects were of Fitzpatrick skin types I-IV. Each subject underwent 3 full-face treatments with a 144 pin fractional bipolar RF device at 30-day intervals. All subjects underwent clinical evaluations during the study period to evaluate for any adverse events. Subsequently, all subjects were evaluated for improvement in rhytides, dyschromias and skin texture based on photographic evaluation by blinded investigators at 6 months following the final RF treatment. Results: A statistically significant improvement in rhytides, dyschromias and texture was noted. Adverse events were limited to mild erythema and swelling. Post-inflammatory pigmentary changes were not observed in any subjects. Conclusion: The novel 144 pin high density tip bipolar fractionated RF device is both safe and effective for facial skin rejuvenation in Fitzpatrick skin types I-IV.