Miracle-dz/UniFAR-FTUs huggingface dataset:
Non-ulcer dyspepsia: An endoscopic review

Background: Non-ulcer dyspepsia refers to dyspepsia with no organic cause. Upper gastrointestinal (GI) endoscopy provides superior diagnostic accuracy in detecting organic causes of dyspepsia than radiography. Objective: The objective of this study is to determine the prevalence of non-ulcer dyspepsia in the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Patients and Methods: A review of the upper GI endoscopy register of the endoscopy unit of the UBTH was undertaken to cover a 7 year period from February 2006 to January 2013. All consecutive adult patients who had dyspepsia as the indication for endoscopy were included in the study. The bio-data and findings from the procedure were obtained from the endoscopy register. Results: A total of 1075 patients had diagnostic upper GI endoscopy during the study period. Of these patients, 597 (55.5%) had dyspepsia as the indication for endoscopy and were studied. The ages ranged from 16 to 90 years with a mean age of 48.6 ± 15.7 years. Those in the 6 th decade of life constituted the largest cohort. Patients consisted of 201 (33.7%) males and 396 (66.3%) females giving a male to female ratio of 1:2. Non-ulcer dyspepsia constituted 15.4% (92/597) of the patients undergoing endoscopy for dyspepsia while the remaining 84.6% (505/597) was accounted for by organic dyspepsia. Conclusion: This study shows that the prevalence of non-ulcer dyspepsia in UBTH is low as compared with findings from other centers in the country. This finding needs to be explored further in alarger cohort study in Nigeria.
Sino‐Nasal outcome test‐22 outcomes after sinus surgery: A systematic review and meta‐analysis

The goal of the study was to perform a systematic review with meta‐analysis to determine the mean change in the 22‐item Sino‐Nasal Outcome Test (SNOT‐22) across patients who have had endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) in the literature.
THE UNTOWARD EFFECTS OF TREATMENT BY PHENYLHYDRAZINE HYDROCHLORIDE

Phenylhydrazine hydrochloride has come into general use as a therapeutic agent in the treatment of polycythemia vera. It was employed experimentally in animals in 1885 by Hoppe-Seyler. 1 Morawitz and Pratt 2 in 1908 used it for the purpose of producing experimental anemia in animals, and Eppinger and Kloss 3 in 1918 were the first to apply it clinically in cases of polycythemia vera. The reports that have appeared in the literature since that time concerning the treatment of polycythemia vera by means of phenylhydrazine have, in the main, been very favorable. Good results have been reported by Eppinger and Kloss,3 Taschenberg, 4 Levi, 5 Owen, 6 Brown and Giffin, 7 Altnow and Carey, 8 Stealy 9 and Cabot. 10 Bryan 11 alone called attention to possible serious unfavorable effects of phenylhydrazine. In the early cases an unnecessarily severe anemia was produced and the occurrence of thrombosis was noted. The
Back to the future: (re)turning from peer review to peer engagement

Key points Scholarly communication – with the exception of traditional (e.g. blind and double‐blind) peer review – prizes the open exchange of ideas. The aim of peer review should be engagement, not judgement. Reviews that improve the quality of a work and thus advance the field are not merely service to the community, but contributions to existing scholarship, and need to be rewarded accordingly; an open and transparent review process is the first step in enabling such reviews to be properly recognized.
Shaking Up the Debate: Ensuring the Ethical Use of DBS Intervention Criteria for Mid‐Stage Parkinson's Patients

Deep brain stimulation (DBS) is a well‐established treatment for the management of severe motor fluctuations in advanced Parkinson's disease (PD). Until recently, device regulation, medical, and insurance practices limited DBS to patients with advanced stages of PD. In February 2016 this changed, however, when the US Food and Drug Administration (FDA) granted formal approval for the use of brain stimulator in mid‐stage PD patients. In this article, we examine whether DBS in mid‐stage PD can be ethically justified beyond the FDA approval.
Hypertension on Target with TENORMIN (HOTT) Study-Evaluation of the Effectiveness and Safety of Atenolol in Indian Population

Background: Atenolol is a widely used anti-hypertensive drug worldwide. Despite well-studied from other population, due to the paucity of data from Indians, this study was conducted. Materials and Methods: This was a prospective cohort study conducted in 566 tertiary care hospitals in India. Adult male or female naïve patients with Stage I 1 or Stage II 2 (Seventh Report of the Joint National Committee) essential hypertension or patients uncontrolled on current monotherapy or other combination therapy. Demographic details, blood pressure and heart rate readings (weeks 2, 8, and 12) and drug-related details of the study participants were collected and analyzed. Results: A total of 2657 participants were evaluated. The mean (standard deviation [SD]) baseline systolic and diastolic blood pressure of the study participants were 161.73 (15.13) and 99.21 (11.37), respectively. Mean (SD) of the baseline heart rate was 84.39 (10.17) beats/min. Statistically significant reductions (P < 0.05) were noted in both the blood pressures and heart rate at all the follow-up visits in comparison to baseline. Of the total 632 patients with Stage I hypertension, 153 (24.21%) achieved a reduction in blood pressure <120/80 mmHg, while 245 (38.77%) had their blood pressure between 121 and 140 mmHg systolic and/or 81-90 mmHg diastolic at 12 weeks of therapy. Global assessment of the efficacy and tolerability were found to be at least satisfactory in the majority of the study participants. Conclusion: To conclude, atenolol as an anti-hypertensive agent seems to be promising both in terms of effectiveness and safety profile in the Indian population.
Focal Hemodynamic Responses in the Stimulated Hemisphere During High‐Definition Transcranial Direct Current Stimulation

High‐definition transcranial direct current stimulation (HD‐tDCS) using a 4 × 1 electrode montage has been previously shown using modeling and physiological studies to constrain the electric field within the spatial extent of the electrodes. The aim of this proof‐of‐concept study was to determine if functional near‐infrared spectroscopy (fNIRS) neuroimaging can be used to determine a hemodynamic correlate of this 4 × 1 HD‐tDCS electric field on the brain.
A Qualitative Study on the Perspective and Teaching Practice of Novice Lecturers in a Paramedic Course

Objective: The study aimed to obtain the perspective and teaching practice of novice lecturers serving at the training institutions, Ministry of Health Malayisa (MOH). Method: A qualitative research was conducted on four novice lecturers at the Medical Assistant College, Seremban. Data were obtained from interview and observation on their teaching in the lecture rooms. The data analysis was performed by using Nvivio 9 software. Result: In the aspect of the teaching perspective, the finding showed that there were two main themes; teaching concept and the teaching method. As far as the teaching concept concerned, respondents perceived that lecturers were the source of knowledge and those who transfered the knowledge to the students. Meanwhile, the second perspective relateed to the teaching approach in which lecturers need to use their experiences, they need to be knowledgeable and creative in their teaching. The integration of the themes formed the main perspective, which was the lecturer-centered teaching. In turn, in the teaching practice, it was consistent with their perspective whereby the approach of teaching is lecturer-centered. Conclusion: This study showed that new lecturers would employ the lecturer-centered approach. Apart from that, they were also lacking of the skills in terms of class control and value inculcation. The deficiency in both these aspects needs to be overcome as it can affect the effectiveness of the teaching, also the quality of the graduates produced
Phosphorus Additives and Albuminuria in Early Stages of CKD: A Randomized Controlled Trial.

BACKGROUND Little is known about the effects of phosphorus additives on patients with kidney disease. STUDY DESIGN Randomized, double-blind, crossover trial. SETTING & PARTICIPANTS 31 adults with early stages of presumed chronic kidney disease (estimated glomerular filtration rate ≥ 45mL/min/1.73m2; urine albumin-creatinine ratio sex-specific cutoff points: men ≥ 17mg/g, women ≥ 25mg/g). INTERVENTION Higher versus lower phosphorus intake for 3 weeks. Higher phosphorus intake was achieved by the addition of commercially available diet beverages and breakfast bars to diet. OUTCOMES Change in 24-hour urine albumin excretion and plasma fibroblast growth factor 23 level. MEASUREMENTS Two 24-hour urine collections and a single fasting blood draw at the end of each period. RESULTS Mean baseline values for phosphorus intake, 24-hour urine phosphorus excretion, and estimated glomerular filtration rate were 1,113±549 (SD) mg/d, 688±300mg/d, and 74.6±22.0mL/min/1.73m2. Median urine albumin excretion of 82.7 (IQR, 39.6-174.1) mg/d. Although phosphorus intake from study products increased by 993mg/d (P<0.001) during the higher compared to lower phosphorus additive period, background phosphorus intake decreased by 151mg/d (P=0.004). Higher phosphorus additive consumption increased 24-hour urine phosphorus excretion by 505 (95% CI, 381 to 629) mg/d (P<0.001), but did not significantly increase albuminuria (higher vs lower: 14.3%; 95% CI, -2.5% to 34.0%; P=0.1) or fibroblast growth factor 23 level (higher vs lower: 3.4%; 95% CI, -5.9% to 13.6%; P=0.4). LIMITATIONS Small sample size, short duration of intervention, changes in background diet during the intervention. CONCLUSIONS A 3-week consumption of higher phosphorus food additives did not significantly increase albuminuria. Further studies are needed to confirm these results.
Assessing Household Natural Disaster Preparedness in Shiraz, Iran, 2011: Results of a Knowledge, Attitude, and Practices Survey

Abstract Objective Public education and training that focus on appropriate knowledge, attitudes, and practices have had a crucial role in preparedness. The aim of this study was to assess knowledge, attitudes, and practices of households regarding natural disasters in Shiraz, Iran. Methods In this cross-sectional descriptive study, we used a stratified random sampling technique. The data collection tool was a self-administered questionnaire, which was completed in through face-to-face interviews. The data were analyzed with the SPSS statistical software package (version 16). Results The overall mean scores were 7.3±2.0 for knowledge, 26.3±6.5 for attitudes, and 5.2±2.2 for practices. Mean scores for all 3 factors were higher in women and married participants. In other comparisons, the differences were statistically significant only for the associations between gender and the score for practices. The mean knowledge score was lower in illiterate participants than in other categories of educational status. Conclusion Our findings showed that the knowledge of households regarding disaster preparedness was encouraging, but that of attitudes and practices might be improved through a greater focus on motivational educational programs and cooperation among the organizations involved in public awareness. (Disaster Med Public Health Preparedness. 2014;0:1–4)
Pattern of adipose tissue tumors in Ahmadu Bello Universty Teaching Hospital, Zaria, Nigeria

Background: Adipose tumors are the most common soft tissue tumors in humans. The reported incidence of lipoma is probably less than the actual incidence because of its insidious growth pattern and minimal associated symptoms. Objective: The objective of this study is to document the pattern of these tumors in a tertiary hospital in Northern Nigeria. Materials and Method: This is a retrospective study of all diagnosed adipose tissue tumor over a 10-year period (January 2002 to December 2011), in the Department of Pathology, Ahmadu Bello University Teaching Hospital. Tissue biopsies fixed in 10% formalin and stained routinely with hematoxylin and eosin were studied. Biodata and sites of involvement were retrieved from patients′ requisition cards. Results: Four hundred and three adipose tissue tumors were diagnosed during this period. Three hundred and ninety-five (98.0%) of the tumors were benign, while 8 (2.0%) were malignant. The male to female distribution was 197 and 206, respectively. Patients ages ranged from 3 months to 75 years with a peak age distribution in the fifth decade (23.6%). The most common site of involvement was the trunk (38.0%), followed by the head and neck region (21.3%) and lower limbs (17.4%). Conventional lipoma was the most common benign tumor, accounting for 328 cases (81.4%), while myxoid liposarcoma was the most common malignant tumor with 4 cases (1.0%). Conclusion: Adipose tissue tumors are not uncommon in our setting and accounted for 6.0% of all tumors seen within the study period. There is a slight female preponderance and the trunk is the most common site of involvement. Benign tumors formed the bulk of lesions recorded.
MRI findings in proven Mycobacterium tuberculosis (TB) spondylitis

The incidence of skeletal TB is increasing. A better understanding of the MRI features of proven TB spondylitis in our setting is needed. Materials and methods. Histologically proven cases of TB spondylitis, with MR imaging performed at Universitas Hospital on a 1.5T scanner, were reviewed. Results. Typical findings of vertebral column involvement were seen in all patients, namely multiple levels affected and paravertebral abscesses. The thoracic spine was involved more than the lumbar spine. In nearly all cases intervertebral disc involvement was noted. Posterior longitudinal ligaments were intact in all but 1 patient, even though there was some elevation in a number of patients. Abscess walls were also found to be thick instead of thin as expected. South African Journal of Radiology Vol. 10 (2) 2006: pp. 6-12
Effect of Coenzyme Q10 on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ10 Biomarker Trial.

BACKGROUND Oxidative stress is highly prevalent in patients with end-stage renal disease and is linked to excess cardiovascular risk. Identifying therapies that reduce oxidative stress has the potential to improve cardiovascular outcomes in patients undergoing maintenance dialysis. STUDY DESIGN Placebo-controlled, 3-arm, double-blind, randomized, clinical trial. SETTING & PARTICIPANTS 65 patients undergoing thrice-weekly maintenance hemodialysis. INTERVENTION Patients were randomly assigned in a 1:1:1 ratio to receive once-daily coenzyme Q10 (CoQ10; 600 or 1,200mg) or matching placebo for 4 months. OUTCOMES The primary outcome was plasma oxidative stress, defined as plasma concentration of F2-isoprotanes. Secondary outcomes included levels of plasma isofurans, levels of cardiac biomarkers, predialysis blood pressure, and safety/tolerability. MEASUREMENTS F2-isoprostanes and isofurans were measured as plasma markers of oxidative stress, and N-terminal pro-brain natriuretic peptide and troponin T were measured as cardiac biomarkers at baseline and 1, 2, and 4 months. RESULTS Of 80 randomly assigned patients, 15 were excluded due to not completing at least 1 postbaseline study visit and 65 were included in the primary intention-to-treat analysis. No treatment-related major adverse events occurred. Daily treatment with 1,200mg, but not 600mg, of CoQ10 significantly reduced plasma F2-isoprostanes concentrations at 4 months compared to placebo (adjusted mean changes of -10.7 [95% CI, -7.1 to -14.3] pg/mL [P<0.001] and -8.3 [95% CI, -5.5 to -11.0] pg/mL [P=0.1], respectively). There were no significant effects of CoQ10 treatment on levels of plasma isofurans, cardiac biomarkers, or predialysis blood pressures. LIMITATIONS Study not powered to detect small treatment effects; difference in baseline characteristics among randomized groups. CONCLUSIONS In patients undergoing maintenance hemodialysis, daily supplementation with 1,200mg of CoQ10 is safe and results in a reduction in plasma concentrations of F2-isoprostanes, a marker of oxidative stress. Future studies are needed to determine whether CoQ10 supplementation improves clinical outcomes for patients undergoing maintenance hemodialysis.
Estimating Post-Emergency Fertility Among Disaster-Affected Adolescents: Findings From a Case-Control Study in Aceh Province, Indonesia

Abstract Objective We aimed to retrospectively estimate adolescent fertility rates before and after a large-scale natural disaster. Methods A case-control study was conducted in Aceh Province, Indonesia, 2 years after the Indian Ocean tsunami in 2004. The age-specific fertility rates of 15–19-year-old-women (ASFR 15–19) was estimated each year from 2004 to 2006 by creating hypothetical age cohorts. The results were compared with data from the closest edition of the Indonesian Demographic Health Survey (IDHS). Results The pre-disaster ASFR 15–19 (4.4% in 2004) was not significantly different from the 2002–2003 IDHS data (P=0.49), whereas the post-disaster ASFR 15–19 (1.1% in 2005–2006) was significantly lower than the provincial estimation in the 2007 IDHS (P<0.01). ASFR 15–19 was reduced by 76% in the post-disaster period compared with the pre-disaster period (rate ratio: 0.24, P=0.02). Conclusions The creation of hypothetical age cohorts enabled valid and useful estimation of the ASFR in disaster-affected areas where reliable vital statistics are not available. For pre-disaster fertility estimation, however, we suggest excluding data from the 40-week period preceding the disaster, because the data may be biased by excess mortality in childbearing mothers and newborn babies in the disaster. (Disaster Med Public Health Preparedness. 2016;10:80–86)
Coping Behavior and Risk of Post-Traumatic Stress Disorder Among Federal Disaster Responders

Abstract Background Our knowledge about the impact of coping behavior styles in people exposed to stressful disaster events is limited. Effective coping behavior has been shown to be a psychosocial stress modifier in both occupational and nonoccupational settings. Methods Data were collected by using a web-based survey that administered the Post-Traumatic Stress Disorder (PTSD) Checklist–Civilian, General Coping Questionnaire-30, and a supplementary questionnaire assessing various risk factors. Logistic regression models were used to test for the association of the 3 coping styles with probable PTSD following disaster exposure among federal disaster responders. Results In this sample of 549 study subjects, avoidant coping behavior was most associated with probable PTSD. In tested regression models, the odds ratios ranged from 1.19 to 1.26 and 95% confidence intervals ranged from 1.08 to 1.35. With control for various predictors, emotion-based coping behavior was also found to be associated with probable PTSD (odds ratio=1.11; 95% confidence interval: 1.01-1.22). Conclusion This study found that in disaster responders exposed to traumatic disaster events, the likelihood of probable PTSD can be influenced by individual coping behavior style and other covariates. The continued probability of disasters underscores the critical importance of these findings both in terms of guiding mental health practitioners in treating exposed disaster responders and in stimulating future research. (Disaster Med Public Health Preparedness. 2016;10:108–117)
Neuroaxonal dystrophy in PLA2G6 knockout mice

The PLA2G6 gene encodes group VIA calcium‐independent phospholipase A2 (iPLA2β), which belongs to the PLA2 superfamily that hydrolyses the sn‐2 ester bond in phospholipids. In the nervous system, iPLA2β is essential for remodeling membrane phospholipids in axons and synapses. Mutated PLA2G6 causes PLA2G6‐associated neurodegeneration (PLAN) including infantile neuroaxonal dystrophy (INAD) and adult‐onset dystonia‐parkinsonism (PARK14), which have unique clinical phenotypes. In the PLA2G6 knockout (KO) mouse, which is an excellent PLAN model, specific membrane degeneration takes place in neurons and their axons, and this is followed by axonal spheroid formation. These pathological findings are similar to those in PLAN. This review details the evidence that membrane degeneration of mitochondria and axon terminals is a precursor to spheroid formation in this disease model. From a young age before the onset, many mitochondria with damaged inner membranes appear in PLA2G6 KO mouse neurons. These injured mitochondria move anterogradely within the axons, increasing in the distal axons. As membrane degeneration progresses, the collapse of the double membrane of mitochondria accompanies axonal injury near impaired mitochondria. At the axon terminals, the membranes of the presynapses expand irregularly from a young age. Over time, the presynaptic membrane ruptures, causing axon terminal degeneration. Although these processes occur in different degenerating membranes, both contain tubulovesicular structures, which are a specific ultrastructural marker of INAD. This indicates that two unique types of membrane degeneration underlie PLAN pathology. We have shown a new pathological mechanism whereby axons degenerate due to defective maintenance and rupture of both the inner mitochondrial and presynaptic membranes. This degeneration mechanism could possibly clarify the pathologies of PLAN, Parkinson disease and neurodegeneration with iron accumulation (NBIA), which are assumed to be due to the primary degeneration of axons.
Recurrent Hepatitis C in Liver Allografts: Early Histologic Indicators

Our purpose was to establish the earliest histologic parameters of acute hepatitis that correlated with recurrent hepatitis C virus (HCV) infection in liver allografts. Histologic reviews of posttransplant liver biopsies from eight patients with pretransplant chronic HCV (group I) and eight with pretransplant non-HCV liver disease (group II) were performed and correlated with concurrent or subsequent presence or absence of HCV-RNA by polymerase chain reaction (PCR). Six of eight group I patients developed HCV-RNA positivity in liver and serum. Of the histologic parameters studied, the presence of Kupffer cell hyperplasia, spotty hepatocellular necrosis (acidophil bodies), or both, correlated the most with the earliest diagnosis of acute recurrent hepatitis. The postoperative time period for the earliest diagnosis of recurrent HCV was variable (34 to 123 days). These early indicators and the time of their appearance were not predictive of the course of the disease process or the final outcome of the patient. The recurrence rate of HCV infection in liver allografts is high. The presence of Kupffer cell hyperplasia and diffusely scattered acidophil bodies are reliable, early histologic indicators of an acute hepatitic process.