Miracle-dz/UniFAR-FTUs huggingface dataset:
The sensitivity and specificity of the conventional symptoms and signs in making a diagnosis of acute appendicitis

Introduction : Simple appendicitis can progress to perforation, which is associated with a much higher morbidity and mortality. So, surgeons have therefore been inclined to operate when the diagnosis is probable rather than wait until it is certain. Objective: This study is designed to evaluate the sensitivity and specificity of clinical examination in the diagnosis of acute appendicitis. Methods : The study included 866 patients of acute appendicitis who had undergone appendicectomy with preoperative diagnosis of acute appendicitis. They were analyzed retrospectively. The parameters evaluated were age/gender, clinical presentation (signs and symptoms) and total white blood cell counts. The operative findings were recorded and the inflammation of the appendix was graded into normal, acutely inflamed and gangrenous. Results : Clinical diagnosis was made correctly in 807 (93.2%) of the patients. White blood cells count ranged from 3.70 to 45.30 /mm3 (mean 17.5353 /mm3). It was Conclusions : Clinical assessment is the best criterion to reach a confident diagnosis. Investigations may supplement the diagnosis but are never a substitute for it. Key Words: Appendicitis; Symptoms; Signs; Sensitivity; Specificity
Students’ perception of the learning environment in a new medical college by means of the DREEM inventory

Background: The educational environment in a college is one of the most important factors in determining the success of the curriculum and the student. The DREEM inventory is a validated global instrument for measuring the educational environment in undergraduate medical education. A study was undertaken to assess the educational environment as perceived by the students of a new medical college established in India in 2008. Objectives: To compare the quality of the educational environment in preclinical years as perceived by the first two batches of students in a new medical college so that appropriate remedial measures could be taken, and also to identify gender differences, if any in the students’ perception. Methods: The DREEM questionnaire was administered to 156 students (2008 batch, n=56 and 2009 batch, n=100) on different occasions after a lecture class. Purpose of the study was explained to the students before administering the questionnaire. Confidentiality was maintained. Statistical analysis used: Cronbachs alpha for internal consistency and reliability. Unpaired t test was used for comparison. Results: The response rate was 100% (256 /256 students). The overall DREEM score was 126.3/200 indicating that perception of the educational environment of the medical school was more positive than negative. However, the study revealed some problem areas within the educational environment. Conclusion: A large number of diverse and hidden factors influence the way students perceive their educational environment. It should be a continuous process to monitor the feedbacks from the students to identify problem areas so that necessary remedial measures can be instituted at the earliest.
Hematological changes in neonatal diarrheic calves of different age groups

The study was conducted on 100 neonatal calves of different age groups suffering from diarrhoea to identify any changes in the hematology. Hemoglobin levels of the affected calves of every age group were significantly decreased (p<0.01) as compared to corresponding control group. PCV values of 22–30 and 31–60 days diseased age groups were significantly (p<0.01) decreased but were not significantly different from the respective controls in other age groups. Significant leukocytosis, neutrophilia and lymphopenia were observed in diseased groups.
Indications for Gynaecological Consultation by Women at a Rural Outreach Centre in North-Central Nigeria

Aims: To identify the reasons for consultations, the common clinical diagnosis and disease pattern at a rural gynaecologic outreach clinic. Study Design: Descriptive Retrospective Study. Place and Duration of Study: NKST Hospital Mkar-Gboko, Benue state, North-central Nigeria, in seven years (1 April 2005 to 31st July 2012). Methodology: Information from the case notes of patients who attended the outreach clinic over the study period were retrieved and analysed. Majority of the patients came by self-referral. Results: Of the 1,733 women that attended the clinic during the study period, 1,605 (92.6%) women made the inclusion criteria and formed the study population. The age Original Research Article International Journal of TROPICAL DISEASE & Health, 4(6): 696-712, 2014 697 range was 15 to 78 years; mean value of 33.6 +/9.5 year; 78% of the women were ages 21 – 40 years. The mean parity was 2.1 +/2.7and ranged between 0 to 13 children. 68% of the women were para 0 – 2 whilst 18% had parity of 5 and above. The women had 73 reasons and 2,390 presenting complaints, 49.6% of them had multiple presenting complaints (average 1.5 complaints per woman). Most common complaints were inability to conceive, lower abdominal pain and leaking of urine and /or faeces amongst 38%, 11% and 10% of the women respectively. There were 63 disease conditions with 1,793 clinical diagnoses. About 12% of the women had multiple clinical diagnoses. The three leading clinical diagnoses were infertility, genital fistulae and uterine myoma, in 46%, 12% and 10% of the women respectively; followed by sundry other gynaecological disorders (9%) and medical disease conditions (5%) in which hypertension, diabetes mellitus and retroviral diseases were more frequent in that order. Some women (n = 21; 1%) came for second opinion. Conclusion: Gynaecological diseases are diverse and common among women in rural central Nigeria. Inability to conceive, lower abdominal pain and incontinence of urine and or faeces were the three main reasons women sought consultation with the gynaecologist at Mkar. Infertility, genital fistulae, uterine myoma, non-communicable medical disorders and retroviral diseases were leading clinical diagnoses. Extending the services of Gynaecologist to the rural areas in the region may reduce the access gap to women’s health and enhance national development.
Prevalence of malaria among pregnant women in Owerri municipality, Imo State, Nigeria

A study was carried out on the prevalence of malaria among pregnant women in Owerri Municipal council area in Imo State, Nigeria between December 2001 and October 2002. Of 250 women examined, 200 women were pregnant. Of the 200 pregnant women examined, 22 (11.0%) had malaria parasitaemia. Prevalence of malaria was significantly higher in pregnant women than in non-pregnant women, in pregnant women from Owerri General Hospital than in Owerri Federal Medical Centre, in women within the second trimester (13.9%) than other gestational periods (P Keywords : keyword; keyword; keyword AJAZEB Vol. 6 2004: pp. 31-35
Local-global concurrent path planning and execution

Sensor-based discovery (i.e. dynamic) path planning is problematic because the path needs to be continually recomputed as new information is discovered. A process-based client-server approach is presented that permits concurrent sensor-based map and localization-correction updates as well as concurrent path computation and execution. A potential function is created by solving Laplace's equation (i.e. a harmonic function) using an iteration kernal convolved with an occupancy-grid representation of the current free space. The path produced (i.e. by steepest gradient descent on the harmonic function) is optimal in the sense of globally minimizing the distance to the goal as well as locally minimizing a hitting probability. This helps alleviate the influence of uncertainty on path planning. On a regular grid, the computation of the harmonic function is linear in the total number of grid elements, thus constraining this planner to be local. A global planner-provided that an a priori CAD map of the fixed objects exists-provides information to the local planner about the effects of a global goal. An algorithm for the three typical local scenarios found in indoor office-like environments is presented showing how a global goal is projected into the local context for each case. Since objects are sensed on-the-fly it is possible to discover that passage through a hallway or room may be blocked. A zero gradient vector in the local potential function is used to signal a blocked passage and subsequently initiate global replanning. The technique has been used to control a Nomadics 200 robot.
Cooperativity network of Trp‐cage miniproteins: probing salt‐bridges

Trp‐cage miniprotein was used to investigate the role of a salt‐bridge (Asp9–Arg16) in protein formation, by mutating residues at both sides, we mapped its contribution to overall stability and its role in folding mechanism. We found that both of the above side‐chains are also part of a dense interaction network composed of electrostatic, H‐bonding, hydrophobic, etc. components. To elucidate the fold stabilizing effects, we compared and contrasted electronic circular dichroism and NMR data of miniproteins equipped with a salt‐bridge with those of the salt‐bridge deleted mutants. Data were acquired both in neutral and in acidic aqueous solutions to decipher the pH dependency of both fully and partially charged partners. Our results indicate that the folding of Trp‐cage miniproteins is more complex than a simple two‐state process as we detected an intermediate state that differs significantly from the native fold. The intermediate formation is related to the salt‐bridge stabilization; in the miniprotein variants equipped with salt‐bridge the population of the intermediate state at acidic pH is significantly higher than it is for the salt‐bridge deleted mutants. In this molecular framework Arg16 stabilizes more than Asp9 does, because of its higher degree of 3D‐fold cooperation. In conclusion, the Xxx$^{9} \leftrightarrow$Yyy16 salt‐bridge is not an isolated entity of this fold; rather it is an integrated part of a complex interaction network. Copyright © 2011 European Peptide Society and John Wiley & Sons, Ltd.
Factors Influencing Early Dental Implant Failures

The purpose of the present study was to assess the influence of local and systemic factors on the occurrence of dental implant failures up to the second-stage surgery (abutment connection). This retrospective study is based on 2,670 patients who received 10,096 implants and were consecutively treated with implant-supported prostheses between 1980 and 2014 at 1 specialist clinic. Several anatomic-, patient-, health-, and implant-related factors were collected. Descriptive statistics were used to describe the patients and implants. Univariate and multivariate logistic regression models were used at the patient level as well as the implant level to evaluate the effect of explanatory variables on the failure of implants up to abutment connection. A generalized estimating equation method was used for the implant-level analysis to account for the fact that repeated observations (several implants) were available for a single patient. Overall, 642 implants (6.36%) failed, of which 176 (1.74%) in 139 patients were lost up to second-stage surgery. The distribution of implants in sites of different bone quantities and qualities was quite similar between implants lost up to and after abutment connection. Smoking and the intake of antidepressants were the statistically significant predictors in the multivariate model (ClinicalTrials.gov NCT02369562).
Epidural Analgesia After Dural Puncture

1. Wilson JN, Grow JB, Demong CV, et al. Central venous pressure in optimal blood volume maintenance. Arch Surg 1962;85:563–78. 2. Fabian JA, Jesudian MCS, Rah KH. Double internal jugular vein cannulation in pediatric and adult cardiac surgery patients: an easy and convenient technique. Anesth Analg 1986;65:419–20. 3. Harte FA, Chalmers PC, Danker PR, Sheikh F. Double internal jugular vein cannulation in adult patients utilizing a single venipuncture. Anesth Analg 1987;66:370–1.
The Random Subspace Method for Constructing Decision Forests

Much of previous attention on decision trees focuses on the splitting criteria and optimization of tree sizes. The dilemma between overfitting and achieving maximum accuracy is seldom resolved. A method to construct a decision tree based classifier is proposed that maintains highest accuracy on training data and improves on generalization accuracy as it grows in complexity. The classifier consists of multiple trees constructed systematically by pseudorandomly selecting subsets of components of the feature vector, that is, trees constructed in randomly chosen subspaces. The subspace method is compared to single-tree classifiers and other forest construction methods by experiments on publicly available datasets, where the method's superiority is demonstrated. We also discuss independence between trees in a forest and relate that to the combined classification accuracy.
Association of Endodontic Lesions with Coronary Artery Disease

An endodontic lesion (EL) is a common manifestation of endodontic infection where Porphyromonas endodontalis is frequently encountered. EL may associate with increased risk for coronary artery disease (CAD) via similar pathways as marginal periodontitis. The aim of this cross-sectional study was to delineate the associations between EL and CAD. Subgingival P. endodontalis, its immune response, and serum lipopolysaccharide were examined as potential mediators between these 2 diseases. The Finnish Parogene study consists of 508 patients (mean age, 62 y) who underwent coronary angiography and extensive clinical and radiographic oral examination. The cardiovascular outcomes included no significant CAD (n = 123), stable CAD (n = 184), and acute coronary syndrome (ACS; n = 169). EL was determined from a panoramic tomography. We combined data of widened periapical spaces (WPSs) and apical rarefactions to a score of EL: 1, no EL (n = 210); 2, ≥1 WPS per 1 apical rarefaction (n = 222); 3, ≥2 apical rarefactions (n = 76). Subgingival P. endodontalis was defined by checkerboard DNA-DNA hybridization analysis, and corresponding serum antibodies were determined by ELISA. In our population, 50.4% had WPSs, and 22.8% apical rarefactions. A total of 51.2% of all teeth with apical rarefactions had received endodontic procedures. Subgingival P. endodontalis levels and serum immunoglobulin G were associated with a higher EL score. In the multiadjusted model (age, sex, smoking, diabetes, body mass index, alveolar bone loss, and number of teeth), having WPSs associated with stable CAD (odds ratio [OR] = 1.94, 95% confidence interval [95% CI] = 1.13 to 3.32, P = 0.016) and highest EL score were associated with ACS (OR = 2.46, 95% CI = 1.09 to 5.54, P = 0.030). This association was especially notable in subjects with untreated teeth with apical rarefactions (n = 59, OR = 2.72, 95% CI = 1.16 to 6.40, P = 0.022). Our findings support the hypothesis that ELs are independently associated with CAD and in particular with ACS. This is of high interest from a public health perspective, considering the high prevalence of ELs and CAD.
Thalidomide therapy for cutaneous lupus erythematosus: historical and practical considerations

ABSTRACT: Connective tissue diseases are notoriously difficult to treat and the cutaneous manifestations of lupus erythematosus (LE) can be severe, leading to significant and progressive disfigurement. Fortunately several modalities exist for the treatment of this condition. However, oftentimes patients manifest severe disease and are refractory to conventional treatment. Second‐ and third‐line agents used to treat cutaneous LE (CLE) can also exhibit many intolerable side effects. Thalidomide, a drug with a notorious past, has been found to be efficacious in the treatment of most of these patients. Response can be dramatic and patients are often maintained on thalidomide as a monotherapy. We review thalidomide's past, with a focus on its use in the treatment of CLE. We also discuss the practical issues involved in safely administering this drug, using three case histories. In conclusion, thalidomide is very effective in the treatment of CLE, however, prolonged use is often needed to maintain long‐term remission. Properly used, thalidomide is very safe, with minimal and mild side effects. However, proper implementation and monitoring is imperative to guard against known serious side effects of teratogenicity and neuropathy.
Cytogenetic Study on Workmen Occupationally Exposed to Pesticides

Cytogenetic Study on Workmen Occupationally Exposed to Pesticides A cytogenetic study was performed on 40 workmen who were exposed to the pesticides malathion and chlorpyrifos and on 30 healthy males who had not been so exposed. The exposed workers had a consistent increase in chromosome abnormalities including chromatid gap, chromatid break, isochromatid break, dicentric and ring chromosomes, as determined by the standard chromosome aberration assay, when compared to the control group. The incidence was significantly higher in exposed smokers than that for exposed non smokers and than that for the unexposed controls as well. These findings provide further evidence for the intrinsic mutagenic activity of the pesticides studied.
Differential Expression and Roles of Secreted Frizzled-Related Protein 5 and the Wingless Homolog Wnt5a in Periodontitis

The Wingless/integrase-1 (Wnt) family of protein ligands and their functional antagonists, secreted frizzled-related proteins (sFRPs), regulate various biological processes ranging from embryonic development to immunity and inflammation. Wnt5a and sFRP5 comprise a typical ligand/antagonist pair, and the former molecule was recently detected at the messenger RNA (mRNA) level in human periodontitis. The main objective of this study was to investigate the interrelationship of expression of Wnt5a and sFRP5 in human periodontitis (as compared to health) and to determine their roles in inflammation and bone loss in an animal model. We detected both Wnt5a and sFRP5 mRNA in human gingiva, with Wnt5a dominating in diseased and sFRP5 in healthy tissue. Wnt5a and sFRP5 protein colocalized in the gingival epithelium, suggesting epithelial cell expression, which was confirmed in cultured human gingival epithelial cells (HGECs). The HGEC expression of Wnt5a and sFRP5 was differentially regulated by a proinflammatory stimulus (lipopolysaccharide [LPS] from Porphyromonas gingivalis) in a manner consistent with the clinical observations (i.e., LPS upregulated Wnt5a and downregulated sFRP5). In HGECs, exogenously added Wnt5a enhanced whereas sFRP5 inhibited LPS-induced inflammation, as monitored by interleukin 8 production. Consistent with this, local treatment with sFRP5 in mice subjected to ligature-induced periodontitis inhibited inflammation and bone loss, correlating with decreased numbers of osteoclasts in bone tissue sections. As in humans, mouse periodontitis was associated with high expression of Wnt5a and low expression of sFRP5, although this profile was reversed after treatment with sFRP5. In conclusion, we demonstrated a novel reciprocal relationship between sFRP5 and Wnt5a expression in periodontal health and disease, paving the way to clinical investigation of the possibility of using the Wnt5a/sFRP5 ratio as a periodontitis biomarker. Moreover, we showed that sFRP5 blocks experimental periodontal inflammation and bone loss, suggesting a promising platform for the development of a new host modulation therapy in periodontitis.
Impact of Obesity on Orthodontic Tooth Movement in Adolescents: A Prospective Clinical Cohort Study

Obesity is a widespread chronic inflammatory disorder characterized by an increased overall disease burden and significant association with periodontitis. The aim of this prospective clinical cohort study was to investigate the effect of obesity on orthodontic tooth movement. Fifty-five adolescent patients (27 males, 28 females) with a mean (SD) age of 15.1 (1.7) years and mean (SD) body mass index (BMI) of 30.2 (3.5) kg/m2 in obese and 19.4 (2.2) kg/m2 in normal-weight groups were followed from start of treatment to completion of tooth alignment with fixed orthodontic appliances. Primary outcome was time taken to complete tooth alignment, while secondary outcomes included rate of tooth movement and change in clinical parameters (plaque/gingival indices, unstimulated whole-mouth salivary flow rate, gingival crevicular fluid biomarkers). Data collection took place at baseline (start of treatment: appliance placement), 1 h and 1 wk following appliance placement, and completion of alignment. Results were analyzed by descriptive statistics followed by generalized estimating equation regression modeling. There were no significant differences between groups in time taken to achieve tooth alignment (mean [SD] 158.7 [75.3] d; P = 0.486). However, at 1 wk, initial tooth displacement was significantly increased in the obese group (P < 0.001), and after adjusting for confounders, obese patients had a significantly higher rate of tooth movement compared with normal-weight patients (+0.017 mm/d; 95% confidence interval, 0.008–0.025; P < 0.001) over the period of alignment. Explorative analyses indicated that levels of the adipokines leptin and resistin, the inflammatory marker myeloperoxidase (MPO), and the cytokine receptor for nuclear factor kappa-B ligand (RANKL) were significantly different between obese- and normal-weight patients and associated with observed rates of tooth movement. This represents the first prospective data demonstrating a different response in obese patients compared with normal-weight patients during early orthodontic treatment. These differences in the response of periodontal tissues to orthodontic force in the presence of obesity have potential short- and long-term clinical implications.
Sclerostin Deficiency Promotes Reparative Dentinogenesis

In humans, the SOST gene encodes sclerostin, an inhibitor of bone growth and remodeling, which also negatively regulates the bone repair process. Sclerostin has also been implicated in tooth formation, but its potential role in pulp healing remains unknown. The aim of this study was to explore the role of sclerostin in reparative dentinogenesis using Sost knockout mice (Sost–/–). The pulps of the first maxillary molars were mechanically exposed in 3-mo-old Sost–/– and wild-type (WT) mice (n = 14 mice per group), capped with mineral trioxide aggregate cement, and the cavities were filled with a bonded composite resin. Reparative dentinogenesis was dynamically followed up by micro–computed tomography and characterized by histological analyses. Presurgical analysis revealed a significantly lower pulp volume in Sost–/– mice compared with WT. At 30 and 49 d postsurgery, a large-forming reparative mineralized bridge, associated with osteopontin-positive mineralization foci, was observed in the Sost–/– pulps, whereas a much smaller bridge was detected in WT. At the longer time points, the bridge, which was associated with dentin sialoprotein–positive cells, had expanded in both groups but remained significantly larger in Sost–/– pulps. Sclerostin expression in the healing WT pulps was detected in the cells neighboring the forming dentin bridge. In vitro, mineralization induced by Sost–/– dental pulp cells (DPCs) was also dramatically enhanced when compared with WT DPCs. These observations were associated with an increased Sost expression in WT cells. Taken together, our data show that sclerostin deficiency hastened reparative dentinogenesis after pulp injury, suggesting that the inhibition of sclerostin may constitute a promising therapeutic strategy for improving the healing of damaged pulps.