Miracle-dz/UniFAR-FTUs huggingface dataset:
Thyroid Cancer and Acromegaly

Acromegaly results from oversecretion of growth hormone and subsequent insulin growth factor-I. Some studies have described an association between acromegaly and increased risk of some cancers, including thyroid cancer, the most common endocrine malignancy. It is well known that follicular thyroid cells express IGF-I receptor and that GH and IGF-I have both proliferative and anti-apoptotic effects and their hypersecretion may theoretically induce tumor development and stimulate its growth, despite the fact that research data is conflicting and population-based data on thyroid cancer and acromegaly is rare. Some molecular alterations, including point mutations in BRAF and RAS genes and RET/PTC gene rearrangements, have been associated with oncogenesis of PTC. However, the implications of these genetic markers in the development of PTC in patients with acromegaly are not yet well known. In this chapter, we discuss epidemiology, pathogenesis, molecular biology aspects, and how to screen and to manage acromegalic patients with nodular thyroid disease and thyroid cancer.
A comparative study of functional outcome of treatment of intra-articular fractures of distal end radius fixed with external fixator vs. volar plate

Background: Distal end radius fractures constitute 75% of all forearm fractures. Maintenance of the articular congruity is an ardent prerequisite for successful recovery, following distal end radius fractures. The available options include immobilization with plaster, external fixation, prefabricated splintage using ligamentotaxis, K-wire fixation, and open reduction internal fixation with various plates. The aim of the study was to analyze and compare the functional outcome and possible complications associated with fixation of two different surgical modalities: External fixator and Volar Plate in the treatment of intra-articular fractures of distal end radius.Methods: A prospective comparative study was conducted in 26 patients who were admitted and operated between September 2017 to September 2018 and had fulfilled the inclusion /exclusion criteria. They were allocated into 2 groups-group A and B, 13 patients each for external fixator and open reduction and internal fixation with volar T plate, respectively.Results: The results were assessed using the modified Green O’ Brien Scoring. In Group-A of patients treated with External fixator we had 6 excellent, 3 good, 3 fair results and 1 poor results. Whereas in Group-B of ORIF with Volar plating we had 7 excellent, 3 good, 2 fair results and 1 poor results.Conclusions: In our study, volar plate fixation showed superiority as it provides better long term functional outcome owing to more adequate restoration of radio-ulnar variance and distal end radius parameters.
Detection of Enteroviruses in Children with Acute Diarrhea

Background: Diarrhea is one of the most significant diseases in children, causing morbidity and mortality worldwide. Diarrhea is caused by viruses, bacteria, and parasites. There are several viruses that can cause diarrhea, including some groups of enteroviruses that have a significant role in acute diarrhea in children. Objectives: This study was conducted to evaluate the presence of enteroviruses in the stool of children with diarrhea. Methods: We collected 85 stool samples including 50 (58.82%) from males and 35 (41.17%) from females with acute diarrhea. All the stool samples proved negative for bacterial and parasitic pathogens. The RNA was extracted from the stool samples and cDNA was prepared. The semi-nested PCR was carried out for the detection of the 5’-UTR region of enteroviruses. To determine the enterovirus serotypes, the sequences of semi-nested PCR product was performed using conserved primers for the 5’-UTR region. Results: Overall, 21/85 (24.7%) patients including 12/50 (24%) males and 9/35 (25.71%) females showed positive results for enteroviruses (P = 0.3). Based on the results of sequencing, one of the isolated serotypes was identified as coxsackievirus A6 and the other isolated serotype was echovirus 9. Conclusions: Overall, 21/85 (24.7%) children with acute diarrhea were infected with enteroviruses. The distribution of enteroviruses was not significantly different between male and female patients. The results of sequencing indicated that one of the isolated serotypes was coxsackievirus A6 and the other isolated serotype was echovirus 9. The remaining 64/85(75.29%) isolates were negative for enteroviruses. The role of other viral gastroenteritis agents including rotaviruses, noroviruses, calicivirus, astrovirus, and adenoviruses was not explored that needs further investigation.
Determinants of Smoking Among Adolescents (14 -19 Years) in UC Maingri District Narowal

Background: Smokingis an important public healthproblem of the present time. It is responsible for high disease burden and mortality among all age groups. Adolescents are rapidly growing and developing young children into adults and get easily indulge into smoking. Many factors contribute to start smoking in adolescent period. Aims O to identify the factors responsible for smoking; and to find out association between smoking and various factors among adolescents. Methodology: Study Design: Cross-sectional survey. Study Setting: Union Council Maingri, Tehsil Shakargarh, District Narowal. Study Duration:- One month. Study Population: All the adolescents living in the union council Maingri. Sample Size: 300 adolescents aged 14-19 years were selected as study participant by simple random method. Results: Three-hundred adolescents were selected as study participants.Their mean age and SD was 16.63 ± 1.80years. 27.0% adolescents were smokers. Among 22 adolescents who were not attending school, 21 (95.5%) were smokers. Among 72 adolescents who were working, 58 (80.6%) were smokers. Among 135 adolescents whose fathers were smokers, 67 (49.6%) were smokers. Among 37 adolescents whose brothers were smokers, 28 (75.7%) were smokers. Among 62 adolescents whose friends were smokers, 59 (95.2%) were also smokers.Results showed significant association between adolescents smoking behavior and their schooling, working outside homes, parental and family smoking, smoking of friends and number of friends. Conclusion:Smoking of family members and friends had great influence on adolescents. Parents and teachers should play their significant roles in preventing adolescents from smoking through health education.
Etiology of isolated terminal ileal ulcers in symptomatic patients

Introduction: Isolated terminal ileal ulcers (ITIUs) are being frequently encountered by the clinicians with the increasing numbers of ileal intubation during colonoscopies. This study was aimed at finding the etiologies of these ulcers in symptomatic patients and their association with various clinical features. Methods: This was a hospital based prospective, observational, descriptive study performed on all consecutive patients who underwent ileocolonoscopy for various gastrointestinal symptoms between 1 July 2018 and 30 June 2019. Clinical, endoscopic and histopathological findings were analyzed to determine the etiology of ITIUs in symptomatic patients. Statistical analysis was done by SPSS 20. Results: Among 60 (7.67%) of 782 symptomatic patients who had ITIUs on ileocolonoscopy, specific etiologies were established in 28 (46.67%) of them. Intestinal TB was the most common specific diagnosis, which was seen in 18 (30%) patients. Chronic abdominal pain with or without chronic diarrhea was the most common indication for ileocolonoscopy. Conclusions: Specific etiologies like tuberculosis, Crohn’s disease, NSAID-induced ulcer and intestinal spirochetosis were seen in 28 (46.67%) of patients with isolated terminal ileal ulcers. The most common clinical features were chronic abdominal pain (65%) and abdominal pain with diarrhea (16.7%). No clinical presentation was significantly associated with any specific etiology, thus emphasizing the need for routine ileal intubation and tissue sampling for histopathological examination in all symptomatic patients undergoing colonoscopy.
Risk Factors of Coronary Artery Abnormality in Children With Kawasaki Disease: A Systematic Review and Meta-Analysis

While coronary artery abnormality (CAA) has been established as the most serious complication of Kawasaki disease (KD), there have been no detailed systematic reviews of the risk factors associated with this condition. We searched six databases and performed a systematic review and meta-analysis. Study-specific odds ratios (ORs) for each factor were pooled using a random effects model. We identified four risk factors for CAA children with KD: gender (OR, 1.75; 95% confidence interval [CI], 1.59–1.92), intravenous immunoglobulin (IVIG) resistance (OR, 3.43; 95% CI, 2.07–5.67), IVIG treatment beyond 10 days of onset of symptoms (OR, 3.65; 95% CI, 2.23–5.97), and increased C-reactive protein levels (OR, 1.02; 95% CI, 1.01–1.02). More number of the five typical symptoms of KD was identified as a protective factor against CAA (OR, 0.47; 95% CI, 0.33–0.66). Pediatric patients with IVIG resistant were more likely to develop CAA within 1 month of the onset of KD than the general population, even in patients with other risk factors for CAA. Thus, there is a potential risk of CAA misdiagnosis if echocardiography is not carried out frequently. In summary, we report four risk factors for CAA and a protective factor against CAA in children with KD. We recommend that pediatricians consider these factors much more closely. With accurate prediction and early preventive treatment in high-risk patients, we can expect a reduction in CAA rates. Further research is now required to investigate the associations between CAA and other factors including the interval between KD onset and IVIG administration, platelet count, and the duration of fever. We also need to confirm whether the frequency of echocardiography within a month of KD onset should be increased in IVIG-resistant patients.
A study of comparison of efficacy and side effects of intravenous paracetamol and intravenous diclofenac as a postoperative analgesic

BBackground: A postoperative patient suffers from pain the best relief of which is a clinician’s duty. Till date very few studies have been conducted for comparison of paracetamol and diclofenac as analgesics. As a result a comparative study between Paracetamol and Diclofenac was carried out. The aim of the study was to compare the efficacy and side effects of intravenous Paracetamol and intravenous Diclofenac in patients undergoing major abdominal open surgeries in obstetrics and gynaecology. The study was conducted to assess the postoperative visual analogue pain scores (VAS) and total analgesic requirement in the first 24 hours and also to study the total requirement of additional analgesics despite administration of either Paracetamol or Diclofenac in postoperative period.Methods: 100 patients satisfying the inclusion/exclusion criteria were recruited for the study. They were divided into two groups of 50 each. Group A was given IV Paracetamol 6 hourly for 48 hours starting 2 hours after surgery. Group B was given IV Diclofenac 8 hourly for 48 hours starting 2 hours after surgery. Patients were assessed for pain relief by visual analogue scale (VAS) of zero to ten after 6 hours, 12 hours, 24 hours and 48 hours of surgery by asking the patient to point the position on the 100 mm scale.Results: The results revealed that when we compared the VAS scores between the 2 Groups at different time intervals, it showed that at 24 hours and 48 hours VAS score in the Diclofenac Group was significantly less than the Paracetamol Group. The main side effects were nausea and vomiting in both the groups. There was more nausea and vomiting in Diclofenac group compared to Paracetamol group.Conclusions: It was concluded that at 24 hour and 48 hour pain reduction was more in the Diclofenac group as compared to Paracetamol group, but the side effects were more in the Diclofenac group compared to Paracetamol group.
Operative versus Conservative Treatment of Clavicular and Scapular Fractures

4 Introduction . 5 Normal Function of the Clavicle . 6 Clavicle Fractures and Their Effects on Glenohumeral Joint Kinematics . 6 Classification of Clavicular Fractures . 7 Conservative Treatment for Clavicular Fractures . 8 Operative Treatment for Clavicular Fractures . 9 Operative versus Conservative Treatment of Clavicular Fractures . 11 Effects on Shoulder Function . 11 Effects on Pain . 16 Risk of Nonunion. 17 Normal Function of the Scapula . 20 Changes in Glenohumeral Joint Mechanics Following Scapular Fracture . 20 Comorbid Injuries Occurring with Scapular Fractures . 21 Classification of Scapular Fractures . 22 Conservative Treatment for Scapular Fractures . 22 Operative Treatment for Scapular Fractures . 23 Indications for Surgical Intervention and Surgical Techniques. 23 Effects on Range of Motion . 26 Clavicular and Scapular Fracture Treatment 3 Effects on Muscular Strength . 28 Effects on Shoulder Function . 29 Operative versus Conservative Treatment of Scapular Fractures. 30 Effect on Function and Range of Motion of the Shoulder . 30 Methods . 32 Discussion. 33 Conclusion . 39 References . 40 Appendices . 44 Clavicular and Scapular Fracture Treatment 4
A Role for Neuronal Nicotinic Acetylcholine Receptors in Dopamine-Mediated Behaviors and the Hypnotic Response to Anesthetics: A Dissertation

Neuronal nicotinic acetylcholine receptors (nAChRs) are ligand-gated cation channels that most notably influence dopamine (DA) release. In this thesis, I examine the role of nAChRs in mediating DA-related behaviors such as movement and drug dependence. To accomplish this, I utilized a “gain-offunction” knock-in mouse (the Leu9’Ala line) containing agonist-hypersensitive α4* nAChRs (* indicates other nAChR subunits in addition to α4 are within the receptor complex) that renders receptors 50-fold more sensitive to nicotine and acetylcholine than wild-type (WT) receptors. I found that DHβE, a selective antagonist for α4β2* nAChRs, induced reversible and robust motor dysfunction characterized by hypolocomotion, akinesia, catalepsy, tremor, and clasping in Leu9’Ala but not WT mice. Reversal of the phenotype was achieved by targeting dopamine signaling. Blockade of mutant α4* nAChRs elicited activation of brain regions in the basal ganglia including dorsal striatum and substantia nigra pars reticulata indicated by c-Fos immunoreactivity. These data indicate that blocking α4* nAChRs in Leu9’Ala mice activates the indirect motor pathway resulting in a motor deficit. We also determined that α4* nAChRs involved in motor behaviors did not contain the α6 subunit, a nAChR subunit highly expressed in DAergic neurons suggesting that different nAChR subtypes modulating striatal DA release have separate functions in motor output. Conditioned place aversion and hypolocomotion, behaviors elicited during nicotine withdrawal, were also induced by DHβE in nicotine-naïve Leu9’Ala but not WT mice. Together these data suggest that DHβE globally reduces DA release in the CNS. In a separate project, I determined that α4* and α6* nAChRs modulate drug-induced hypnosis. Activation of nAChRs increased sensitivity to ketamine-induced hypnosis; whereas antagonizing nAChRs had the opposite effect. Additionally, α4 knockout (KO) mice were less sensitive to the hypnotic effects of ketamine, but α6 KO were more sensitive. High doses of ethanol induce an anesthesia-like state characterized by immobility, analgesia, and hypnosis. Testing the effects of ethanol hypnosis in α4 KO revealed that α4* nAChR do not play a large role in the acute effects of ethanol-induced hypnosis, but are involved in tolerance to this ethanol-induced behavior. The mechanisms of anesthetic-induced hypnosis are still largely unclear, despite the wide use of anesthesia. Future work on these receptors and their involvement in the anesthetic response will help to define a mechanism for hypnosis and improve the use of anesthetic drugs.
A Sex Comparison of Reasons for Attrition of Non-Journeyman FAA Air Traffic Controllers,

Abstract : Recent ATC attrition rates showed no sex differences in the proportion of trainees who completed FAA Academy training; however, the percentage of females who subsequently left ATC work was over twice that of male trainees. In the present study, the 56 females who entered the Academy between December 1968 and November 1970, and who were no longer with the FAA as of June 1972, were matched on several variables with male attritions who had entered the Academy at the same time. Reasons for attrition were obtained from job-exit forms, telephone interviews, and a questionnaire. (Modified author abstract)
The Impact of Prenatal and Early Postnatal Nutrition on Child Development: Comments on Lumey and Susser, Innis and Atkinson

The Lumey and Susser article discusses the research on the long-term impacts of prenatal and postnatal nutrition with a focus on the psychosocial and behavioural consequences in adulthood. This is an important health and well-being issue for the general population. Inadequate nutrition in the first months of life, during pregnancy or shortly after birth, can affect the development of the brain in ways that leave traces into adulthood.
When Technological Advance Meets Physician Learning in Drug Prescribing

The support for scientific investigation in biomedicine depends in part on the adoption of new knowledge into medical practice. We investigate how a technological advance, in the form of a large and influential 2010 randomized controlled study, changed physician practice in statin (a medication used to manage high cholesterol levels) prescribing. We analyze data representative of the Italian population for the period 2003-2014. Our analysis accounts for possible non-random sorting of patients into treatment. We show that both doctors and patients responded promptly to this technological shock, changing the mix of patients who received therapy, drug dosing, and frequency of testing for side effects, as well as patient adherence to therapy. The results show that investments in scientific knowledge can rapidly diffuse into practice in professions where continuing education is the norm.
Anomalous Origin and Course of Coronary Artery—Presentation of Three Cases

Anomalous origin of coronary arteries may be encountered coincidentally in the presence of unrelated pathology or when these are affected directly. This may directly be responsible for affecting the procedure or outcome. Various types of anomalies of origin, as well as course of coronary arteries, have been classified in the past. Here we report 3 cases of anomalous origin of coronary arteries in different scenarios. First case had anomalous coronary with bicuspid aortic valve with dilated ascending aorta for which Bentall’s procedure was done, while the second and third cases were anomalous coronaries with coronary artery disease for which coronary artery bypass grafting was done.
Computed tomography analysis of concomitance of concha bullosa, septal deviation and maxillary sinusitis

Amaç: Bu çalışmada paranazal sinüs bilgisayarlı tomografi (BT) kullanılarak konka bülloza (KB), nazal septum deviasyonu (NSD) ve maksiller sinüzitin ilişkisi araştırıldı. Hastalar ve Yöntemler: Radyoloji bölümüne sevk edilen 205 hastanın (86 erkek, 119 kadın; ort. yaş 38.2±14.7 yıl; dağılım, 10-85 yıl) paranazal sinüs BT bulguları retrospektif olarak incelendi. Sinonazal bölgeyle ilgili olası yakınması olan hastalara BT uygulandı. Nazal ve/veya paranazal cerrahi öyküsü olan hastalar çalışma dışı bırakıldı. Koronal BT kesitleri KB, NSD, maksiller sinüsteki mukozal kalınlaşma (MK) ve maksiller sinüs ostiumu açısından incelendi. Bulgular: Tek taraflı KB ve kontralateral NSD arasında güçlü ilişki vardı (p=0.02). Mukozal kalınlaşma ve NSD arasında istatistiksel olarak anlamlı ilişki yoktu (p=0.18). Mukozal kalınlaşma, KB ve NSD arasında tarafları açısından anlamlı ilişki yoktu. Mukozal kalınlaşma ve maksiller sinüs ostium genişliği arasında ilişki yoktu. Sonuç: Çalışma bulgularımız KB’nin kontralateral NSD ile ilişkili olduğunu gösterdi. Buna bağlı olarak, NSD’si olan hastalarda nazal septum cerrahisi öncesi KB varlığını araştırmak için paranazal BT gerekli olabilir.
miR-1267 Induces Tumorigenicity and Contributes to Risk of Clear Cell Renal Cell Carcinoma

Objective: Dysregulated microRNA signatures in different cancer types are being uncovered continually implying their significance in cancer pathogenesis. miR-1267 was not previously associated with RCC. In this study, it is aimed to obtain the expression profile of miR-1267 in patients with ccRCC and its correlation with patient parameters. Methods: Kidney Cancer cDNA Array consisting of cDNA samples obtained from healthy kidney tissues of 4 healthy individuals and tumoral kidney tissues of 5 Stage I, 5 Stage II, 3 Stage III and 2 Stage IV ccRCC patients was used. Hsa-miR-1267 and SNORD48 (as housekeeping gene) expressions were analyzed. miR-1267 expression was statistically correlated with the clinical parameters of patients. miRGator 3.0 database was used to compare miR-1267 expression patterns of different urological cancer types. Results: The expression of miR-1267 was significantly higher in male than female (p=0.027). Also, there were statistically significant increase in miR-1267 expression in stage IV when compared to stage I (p 0.05). Conclusion: miR-1267 could have oncogenic function, have predictive value for RCC development and be predictive about aggressiveness in ccRCC.
Evaluation of general dentists’ knowledge regarding management of dental trauma

patient’s physical and psychological health. Immediate intervention for damaged teeth can elevate the success rate of treatment in TDI. Thus, general dentists’ knowledge and their effective intervention in TDI are important factors in prognosis of traumatized teeth. The objective of this study was to assess the general dentists’ knowledge and awareness regarding the diagnosis and management of traumatic dental injuries. Materials and Methods: In this cross-sectional study, the questionnaire data were collected from 130 general dentists, including the demographic data and general dentists’ knowledge about TDIs. The data were analyzed using the Student t-test and Analysis of Variance (ANOVA), Spearman’s and Pearson’s correlation coefficient. Results: The mean score of general dentists’ knowledge was 8.5±1.5 (total score:10) and it was the same between both males and females (P=0.083). Dentists’ work place does not have any influence in their knowledge (P=0.133). Also, there was no statically significant relationship between the age, job experience and dentists’ knowledge (P=0.805). The relationship between the frequency of TDI managed cases and dentists’ knowledge was not significant (P=0.507). Conclusion: Considering that the overall knowledge of general dentists regarding the management of TDI was sufficient, it could be a good opportunity in treating these injuries. As TDI is a developing science, it is important to motivate general dentists being up to date regarding this