Miracle-dz/UniFAR-FTUs huggingface dataset:
Critical analysis of vector-borne infections in dogs: Babesia vogeli, Babesia gibsoni, Ehrlichia canis and Hepatozoon canis in Punjab, India

There are few published studies on various vector borne diseases of dogs in India and most depict clinical infection in dogs, diagnosed by observation of the haemopathogens in stained blood smears. This study provides the first report regarding molecular confirmation and ancestral relationship analysis of blood smears positive cases of assorted haemopathogens in Punjab province of India. On blood smear examination, haemopathogens were observed in 124 out of 778 (15.95%, 95% CI: 13.53–18.68) blood smears. Further polymerase chain reactions (PCR) was used on bloods smear positive cases to validate the results. Out of 778 blood samples, Babesia gibsoni was most common parasite infecting dogs (15.04%, 95% CI: 12.7–17.72), followed by Ehrlichia canis (0.39%, 95% CI: 0.0–1.13), infection of Babesia vogeli and Hepatozoon canis was same (0.26%, 95% CI: 0.0–0.9). Among various risk factors studied (age, sex, season), prevalence of infection was non-significantly higher in 1–2 year of age group (19.88%, 95% CI: 14.45–26.71), regarding sex same prevalence was recorded (15.94%), and chances of infection was highest in pre-monsoon i.e. summer (18.26%, 95% CI: 14.49–22.76). Phylogenetic analysis revealed ancestral background of Ludhiana isolates of B. vogeli, B. gibsoni, H. canis, and E. canis with the isolates of Philippines, Mongolia and Tunisia.
Neurocognitive impairment and psychosis in bipolar I disorder during early remission from an acute episode of mood disturbance.

OBJECTIVE Recent studies have reported greater neurocognitive impairment in euthymic bipolar disorder patients with a history of psychosis relative to patients without such a history. To further explore the relation between psychosis and cognitive dysfunction in bipolar disorder, the current study examined the cognitive functioning of patients during early remission from a discrete episode of mood disturbance. The study aimed to determine whether the presence of psychosis during inpatient hospitalization was associated with greater cognitive impairment at the time of hospital discharge. METHOD Fifty-nine inpatients who met DSM-IV criteria for bipolar disorder (24 admitted with psychosis, 35 admitted without psychosis), ages 18-59 years, completed a neuropsychological battery and mood measures 24-48 hours before discharge. The cognitive battery included standardized tests of IQ, attention and working memory, visual memory, verbal memory, and executive functioning. RESULTS A multivariate analysis of variance detected group differences on measures of verbal memory (P < .001) and executive functioning (P < .003), using mood measures and previous number of psychiatric admissions as covariates. Post hoc analysis of between-subjects effects revealed significantly poorer performance on the California Verbal Learning Test-Second Edition, logical memory subtest from Wechsler Memory Scale-Revised, Stroop Word/Color Interference test, and the Wisconsin Card Sorting Test for patients who were admitted to the hospital with psychosis. These results remained significant after matching the groups for past psychosis, with the exception of the logical memory subtest. CONCLUSIONS The results of this study indicate that patients with bipolar disorder who were admitted to the hospital due to psychosis exhibited significantly more severe cognitive impairment at the time of discharge than patients admitted for an acute mood disturbance without psychosis. These findings may be important for improving discharge planning and the development of more effective outpatient services.
Genetic characterisation of antimicrobial resistance and virulence genes in Staphylococcus aureus isolated from commercial broiler chickens in the Durban metropolitan area, South Africa

Antimicrobial resistance of Staphylococcus aureus in human and veterinary medicine is a serious worldwide problem. The aim of this study was to investigate the prevalence of S. aureus in commercial broiler chickens as well as to establish antimicrobial susceptibility and the distribution of genetic determinants conferring resistance and virulence. One hundred and ninety-four samples were aseptically collected from broiler chicken slaughterhouses and retail outlets around the Durban metropolitan area in South Africa. Microbiological and molecular methods were used to detect the presence of S. aureus as well as its resistance- and virulence-associated genes. Polymerase chain reaction (PCR) was used to confirm the presence of S. aureus by amplifying the nuc gene. Approximately 54% of 194 samples were positive for S. aureus. The disc diffusion technique was used to investigate antimicrobial susceptibility profiles of the S. aureus isolates to a battery of 10 antimicrobial agents, namely ampicillin, chloramphenicol, gentamicin, erythromycin, cefoxitin, kanamycin, streptomycin, tetracycline, vancomycin and trimethoprim. The results demonstrated that S. aureus isolates of abattoir origin had a high level (79.4%) of resistance to tetracycline, followed by ampicillin, vancomycin, cefoxitin, trimethoprim, erythromycin and streptomycin with resistance rates of 65.1%, 61.9%, 60.3%, 58.7%, 57.1% and 46.0%, respectively. Staphylococcus aureus isolates of retail origin exhibited higher antimicrobial resistance prevalence rates than those of abattoir origin. Tetracycline had the highest resistance rate (100%), followed by cefoxitin (91.7%), erythromycin (83.3%), streptomycin (83.3%) and kanamycin (66.7%). All isolates were resistant to two or more antimicrobial agents. Out of the four virulence genes that were screened, only two were detected (coagulase and protein A); however, their prevalence rates were very low. All antimicrobial resistance genes screened were detected (mecA, BlaZ and tetK), although their prevalence did not correspond with antimicrobial susceptibility testing.
Strategies for improving perinatal depression treatment in North American outpatient obstetric settings

Objective: To identify core barriers and facilitators to addressing perinatal depression and review clinical, programmatic, and system level interventions that may optimize perinatal depression treatment. Method: Eighty-four MEDLINE/PubMed searches were conducted using the terms perinatal depression, postpartum depression, antenatal depression, and prenatal depression in association with 21 other terms. Of 7768 papers yielded in the search, we identified 49 papers on barriers and facilitators, and 17 papers on interventions in obstetric settings aimed to engage women and/or providers in treatment. Results: Barriers include stigma, lack of obstetric provider training, lack of resources and limited access to mental health treatment. Facilitators include validating and empowering women during interactions with health care providers, obstetric provider and staff training, standardized screening and referral processes, and improved mental health resources. Conclusion: Specific clinical, program, and system level changes are recommended to help change the culture of obstetric care settings to optimize depression treatment.
Obstetrician-gynecologists’ knowledge, attitudes and practices regarding major depressive disorder

Abstract Background: Obstetrician-gynecologists (ob-gyns) provide depression screening and treatment, but these practices could be improved. This study investigated the use of depression screening tools and treatment of adolescents with depressive symptoms. Methods: Surveys were sent to 220 members of the American College of Obstetricians and Gynecologists (ACOG) who had responded to a survey on depression in the past two years. Response rate was 66% (n = 145). Questions included those related to standardized depression screening, antidepressant prescribing behavior, use of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) and knowledge of adolescent depression. Results: A total of 40% use standardized screening tools for depression with 46% using the Beck Depression Inventory-II and only 5% using the Patient Health Questionnaire-2 (PHQ-2). The majority (89%) of ob-gyns do not employ the DSM-IV to confirm a diagnosis of major depressive disorder. Of the ob-gyns indicating treating depression with antidepressants, 97% prescribe selective serotonin reuptake inhibitors. Only 19 respondents do not prescribe antidepressants, and instead refer depressed patients to mental health specialists. Most (79%) ob-gyns identified sexual problems as the primary side effect deterring prescribing of antidepressant medication. Ob-gyns were fairly accurate at estimating the prevalence of adolescent depression. Conclusion: Ob-gyns are not utilizing the recommended validated resources such as the DSM-IV or PHQ-2 for diagnosis of depression or prior to prescribing antidepressants.
Hepatitis B virus DNA level as predictor of response to therapy with interferon-alpha-2b (PDferon) in chronic hepatitis B infection

Background: To evaluate the strength of association and to determine the best prediction of response in terms of sensitivity and specificity among quantitative baseline HBV-DNA levels in blood serum in patients with chronic hepatitis B (CHB) infection who treated with interferon-alpha-2b. Patients and methods: Totally, 78 CHB patients with serum HBV-DNA>10 5 copies/mL were treated with interferonalpha-2b (PDferon: Pooyesh Darou, Tehran, Iran) for 52 weeks as 5 MU Sc. for 24 weeks in HBeAg(+) and 48 weeks for HBeAg(-) at baseline of study in Tehran, Iran. Serum HBV-DNA level using Cobas Amplicor HBV Monitor test and HBeAg status were assessed at baseline and end of 6-months follow-up. Sustained response (SR) (n=42, 56%) was defined by HBeAg seroconversion (n=12), or with a decrease in HBV-DNA >10
Effect of dexamethasone added to lidocaine in supraclavicular brachial plexus block: A prospective, randomised, double-blind study

Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomised, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of supraclavicular brachial plexus block as this is the most common type of brachial block performed in our institute. Methods: Sixty American Society of Anaesthesiologist's physical status I and II patients undergoing elective hand, forearm and elbow surgery under brachial plexus block were randomly allocated to receive either 1.5% lidocaine (7 mg/kg) with adrenaline (1:200,000) and 2 ml of normal saline (group C, n=30) or 1.5% lidocaine (7 mg/kg) with adrenaline (1:200,000) and 2 ml of dexamethasone (8 mg) (group D, n=30). The block was performed using a nerve stimulator. Onset and duration of sensory and motor blockade were assessed. The sensory and motor blockade of radial, median, ulnar and musculocutaneous nerves were evaluated and recorded at 5, 10, 20, 120 min, and at every 30 min thereafter. Results: Two patients were excluded from the study because of block failure. The onset of sensory and motor blockade (13.4±2.8 vs. 16.0±2.3 min and 16.0±2.7 vs. 18.7±2.8 min, respectively) were significantly more rapid in the dexamethasone group than in the control group (P=0.001). The duration of sensory and motor blockade (326±58.6 vs. 159±20.1 and 290.6±52.7 vs. 135.5±20.3 min, respectively) were significantly longer in the dexamethasone group than in the control group (P=0.001). Conclusion: Addition of dexamethasone to 1.5% lidocaine with adrenaline in supraclavicular brachial plexus block speeds the onset and prolongs the duration of sensory and motor blockade.
A simple method for evaluation of the uptake of isoflurane and its comparison with the square root of time model

Background: The square root of time (SqRT) model had been used to predict the uptake of volatile agents. Methods: We studied the rate of uptake of isoflurane in 10 patients using liquid isoflurane infusion through syringe pump into the closed circuit. The infusion rates were titrated to maintain a constant end tidal concentration of isoflurane of 1.5%. The predicted uptake values were also calculated from the square root principle and compared with the derived uptake. Results: The observed rate of uptake was higher than predicted from the Lowe and Ernst equation (P<0.001). There exists considerable inter-individual variability in uptake pharmacokinetics and it showed statistically significant correlation with ideal body weight, body weight (P<0.01), body surface area, and body weight¾ from 30 min of start of isoflurane infusion (P<0.05). Conclusion: SqRT model is inaccurate in predicting isoflurane uptake and underestimates it during closed circuit anaesthesia.
Continuous paravertebral infusion of ropivacaine with or without fentanyl for pain relief in unilateral multiple fractured ribs

Background: Continuous thoracic paravertebral block (TPVB) provides effective analgesia for unilateral multiple fractured ribs (MFR). However, prolonged infusion of local anaesthetic (LA) in high doses can predispose to risk of LA toxicity, which may be reduced by using safer drugs or drug combinations. This study was conducted to assess efficacy and safety of paravertebral infusion of ropivacaine and adrenaline with or without fentanyl to provide analgesia to patients with unilateral MFR. Methods: Thirty adults, having ≥3 unilateral MFR, with no significant trauma outside chest wall, were studied. All received bolus of 0.5% ropivacaine 0.3 ml/kg through paravertebral catheter, followed by either 0.1-0.2 ml/kg/hr infusion of ropivacaine 0.375% with adrenaline 5 μg/ml in group RA or ropivacaine 0.2% with adrenaline 5 μg/ml and fentanyl 2 μg/ml in group RAF. Rescue analgesia was provided by IV morphine. Results: Statistical analysis was performed using unpaired Student t-test, Chi-square test and repeated measures ANOVA. After TPVB, VAS scores, respiratory rate and PEFR improved in both groups with no significant inter-group differences. Duration of ropivacaine infusion, morphine requirements, length of ICU and hospital stay, incidence of pulmonary complications and opioid-related side-effects were similar in both groups. Ropivacaine requirement was higher in group RA than group RAF. No patient showed signs of LA toxicity. Conclusion: Continuous paravertebral infusion of ropivacaine 0.375% with adrenaline 5 μg/ml at 0.1-0.2 ml/kg/hr provided effective and safe analgesia to patients with unilateral MFR. Addition of fentanyl 2 μg/ml allowed reduction of ropivacaine concentration to 0.2% without decreasing efficacy or increasing opioid-related side-effects.
The Affect of Grip Width on Bench Press Performance and Risk of Injury

summary Bodybuilders, athletes, and recreational lifters select a grip width during the bench press that they believe will produce a greater force output. Research has demonstrated that a wide grip (> 1.5 biacromial width) may increase the risk of shoulder injury, including anterior shoulder instability, atraumatic osteolysis of distal clavicle, and pectoralis major rupture. Reducing grip width to ≤1.5 biacromial width appears to reduce this risk and does not affect muscle recruitment patterns, only resulting in a ±5% difference in one repetition maximum.
Pharmacological beneficial effect and side effect of intrathecal analgesia, prospective, randomized control trial

Spinal anesthesia is sufficient to provide adequate motor blockage and also provides effective pain relief during the initial post-operatives period. In order to maximize post-operative analgesia, a number of adjutants have been added to local spinal anesthetics. The objective of this study is to compare the beneficial and side effects of intrathecal midazolam and ketamine in patients undergoing lower limb surgery. This prospective, open label, parallel assignment, randomized, single-center trial, included eighty patients, who were admitted for lower limb surgery with American Society of Anesthesiologists (ASA) grade I and II between the ages of 20 and 60 years to our hospital were studied for 6 months. From the onsets, intra-operative and post-operative vital signs, pain assessment by visual analogue scale, intra-operative and post operative adverse effects, and post-operative analgesia supplement time were recorded. A significantly higher Visual Analogue Scale (VAS) score were seen in intrathecal ketamine group (Group I) compare to intrathecal midazolam group (Group II). The difference in mean post-operative supplemental analgesic time (Group I: 482 ± 68.22 min, Group II: 645 ± 61.28 min) between the 2 groups was very highly significant (p < 0.001). Intrathecal midazolam with bupivacaine provides very good and prolonged post-operative analgesia compare to intrathecal ketamine with bupivacaine. The incidences of side effect are less in Group II compares to Group I.
Post-operative cognitive dysfunction in the elderly: A prospective clinical study

Background and Aims: Aging population is a major demographic trend worldwide. Globally, 50% of all the elderly individuals are estimated to undergo atleast one surgical procedure and post-operative cognitive dysfunction (POCD) is one of the most common and often poorly understood post-operative complications in this section of the population. This randomised prospective study was conducted to assess the post-operative cognitive status in the elderly undergoing non-cardiac surgery, evaluate the cognitive parameters affected, evaluate the potential risk factors and thereby analyse the potential for implementation of preventive strategies. Methods: This study was conducted on 200 patients aged 60 years or older scheduled for elective non-cardiac surgeries. The baseline cognitive status of the patients was assessed 2 days prior to the date of the surgery. The post-operative cognitive status was assessed on the 3 rd day, 7 th day and after 1 month. Statistical analysis was performed using SAS and SPSS. Results: The incidence of POCD showed a gradual decline from postoperative day 3 to 30. Females were found to be at significant risk in developing POCD. Advancing age and level of education emerged as dominant factors, while type of anaesthesia, duration of surgery, and presence of coexisting comorbidities had no influence on the incidence of cognitive dysfunction. Conclusion: POCD is a definite complication after surgery and anaesthesia in the elderly population. Gender emerged as a significant risk factor with increasing age as a dominating factor contributing to POCD.
Improved adherence to CPAP by telemetric support in newly diagnosed OSAS patients

Introduction : Acceptance of positive airway pressure therapy (PAP) within the first month is predictive for long term adherence. Telemedicine is a novel tool to supervise PAP use at patient's home. We report 30-day results of a pilot study, comparing PAP use in telemetrically supervised vs. conventionally treated patients (pts). Methods : Between 1/2012 and 12/2012, of 293 newly diagnosed OSAS pts, 170 started PAP with a telemetric 3G-device (ResTraxx OnlineTM, ResMed) and 123 conventionally. For telemedicine pts, hours of PAP use and leak flow were checked on a protected online data depository 3 d/week. Phone calls were triggered by 0.4L/s for 2 consecutive nights. After 30 days, PAP use/night and number of nights without PAP were compared. Results : At baseline, OSAS severity (ESS, AHI, ODI) was not different between groups, but telemedicine pts were younger and more often outpatients. View this table: Baseline characteristics of the study population Within the first 30 days telemedicine pts used PAP 48 minutes/night longer (5.2 [3.5-6.3] vs 4.6 [2.6-6.1] h/night, p=0.05) and for more nights (28 [23-30] vs 26 [18-30], p<0.001). After adjusting for age and proportion of outpatients, the telemedicine effect was stronger (p=0.02). Conclusion : In this non-randomised pilot study, a telemetric support for the first month of PAP was technically feasible and increased PAP adherence. To determine the direct effects of telemedicine on medium and long-term PAP use, a randomised prospective study is necessary.
Two New Cases of Metastatic Basal Cell Carcinoma from the Eyelids

Abstract Background: Basal cell carcinoma (BCC) is an extremely common malignancy. Unlike other skin cancers, it very rarely metastasises. Methods: We present two cases of advanced BCC on the eyelids that metastasized to the parotid region after local excision. Discussion: We include a review of patients with metastatic BCC originating from the eyelids. Conclusion: Metastatic BCC from the eyelids is rare, but appears to occur in an older age group with a shorter time before metastasis when compared to metastatic BCC as a whole.
Human Respiratory Syncytial Virus Infection and its Subgroups Among the Hospitalized Young Children With Acute Respiratory Infection

Background: Respiratory syncytial virus (RSV) can cause acute respiratory infection (ARI) in infants and young children. Objectives: This study was conducted to determine the incidence of RSV infection and its subgroups among children with ARI. Materials and Methods: A total of 100 throat samples were collected from hospitalized children with ARI in different hospitals across the Khuzestan province from June 2009 to April 2010. The samples were tested for RSV by the nested PCR. The product of positive RSV was sequenced to determine the RSV subgroup, followed by phylogenic tree. Results: Of total 100 patients, 29 (29%) including 16 (16%) male and 13 (13%) female were found positive for RSV infection. All the RSV positive patients were subgroup A dominant. High prevalence of RSV (8%) was found among the children under one year in contrast to 2% RSV incidence among the age group 6 years. Conclusions: This study revealed that RSV subgroup A is dominant among the young children especially in children less than one year of age.
Chemiluminescent Assay Versus Immunoblotting for Detection of Positive Reaction to Allergens

Background: The multiple allergen simultaneous test-chemiluminescent assay (MAST-CLA) has been widely used in South Korea to detect allergen-specific immunoglobulin E (IgE). However, MASTCLA frequently shows concurrent positivity for immune-system cells that fight multiple allergens. Objective: To compare the results of MASTCLA with those of the new MAST-immunoblot assay, a potential alternative method for concurrently testing for IgE and positivity for multiple allergens. Methods: A total of 55 patients with positive results in MAST-CLA were tested using the MAST-immunoblot system. A total of 133 allergens that displayed discrepancies in MAST-CLA and MAST-immunoblot results were examined with the ImmunoCAP test. Results: The positivity rates for 20 common allergens, as measured by MAST-CLA and MAST-immunoblot, were 53.4% and 19.5%, respectively. The agreement rate of MAST-CLA and ImmunoCAP (75.9%) results was higher than MAST-CLA and MAST-immunoblot (62.4%) results. The mean number of positive results for specific allergens per patient as measured by MASTimmunoblot and MAST-CLA were 5.6 and 15.9, respectively. Conclusions: The higher agreement rate between ImmunoCAP and MAST-CLA results compared with MAST-CLA and MASTimmunoblot results was caused by frequently occurring concurrent positive reactions to multiple allergens. The frequency of concurrent positive results and the number of allergens showing concurrent positive results was lower in MAST-immunoblot than in MAST-CLA. Therefore, MAST-immunoblot may be helpful in the diagnosis of allergic disease and will decrease any confusion arising from concurrent positivity for multiple allergens.