Miracle-dz/UniFAR-FTUs huggingface dataset:
MATERNAL NEAR-MISS MORBIDITY AND MORTALITY –– A CONTINUUM

Objective: To determine the frequency and nature of maternal near-miss cases and to comparatively analyse near miss morbidities and maternal deaths in pregnant women.Material and Methods: This descriptive study was conducted in Gynae A Unit, Khyber Teaching Hospital Peshawar from January 2012 to December 2013. Cases of maternal near miss morbidities were identified from records of women presenting with potentially life threatening complications in pregnancy. Maternal mortality during the same period was also analysed.Results: A total of 71 women were identified as cases of maternal near-miss (MNM) with a frequency of 1.05%. Maternaldeaths were 20 with MMR (Maternal Mortality Ratio) of 283/100,000 live births and MNM to MMR ratio of 3.5:1.Causes were obstetrical haemorrhage in 23(32.39%), Hypertensive disorders of pregnancy in 21 (29.58%), Dystocia in 13(18.315), sepsis and Cardiac diseases in 7(9.86%) and 4(5.63%) cases of near miss while severe aneamia unrelatedto haemorrhage in 3(4.23%)cases of MNM. Of the 20 maternal deaths 8(40%) were due to haemorrhage, 4(20%) hypertension, 1(5%) dystocia, 4(20%) Sepsis, 2(10%) cardiac diseases in pregnancy. Mortality index (MI) for sepsis and cardiac disease were highest, 36.36% and 33.33% respectively. MI for haemorrhage was 25.81% and hypertension 16%. Forty two (59.15%) cases required intensive care unit admission with 22 (30.98%) requiring more than 3 units blood and component transfusion and 12 (16.90)% ventilator support. Surgical intervention in the form of emergency hysterectomy was done in 22 (30.98%) cases and 23 cases had different organ system failures.Conclusions: Obstetrical haemorrhage, hypertensieve disorders, dystocia and sepsis are the leading causes of MNM. The underlying causes for severe morbidity and mortalities were almost the same, therefore evaluation of the circumstancessurrounding MNM could lead to improvement in the care and reduction in maternal mortality.
Molecular characterization of vancomycin resistant enterococci from various clinical samples in a tertiary care hospital

Aim: The aim of this present study was to investigate the molecular characterization of vancomycin resistant enterococci isolated from various clinical samples. Enterococci are aerobic and anaerobic gram positive cocci found in gastrointestinal tract of humans and other animals. Materials and Methods: Enterococcal isolates were isolated from various clinical samples according to standard protocol and sample size of the study was 52. Vancomycin resistance genes VanA and VanB were detected using conventional PCR. Results: The six isolates resistant to Vancomycin confirmed phenotypically were confirmed using Polymerase Chain Reaction. Conclusion: in the present study conclude that, Vancomycin resistant enterococci is a major health problem in the coming years and hence it is necessary to take all adequate measures to identify the resistant strains.
Crenolanib versus midostaurin combined with induction and consolidation chemotherapy in newly diagnosed FLT3 mutated AML.

TPS7068 Background: Despite the approval of multi-targeted protein kinase inhibitor midostaurin for use in combination with chemotherapy which improves 5-year survival in newly diagnosed (NDx) acute myeloid leukemia (AML) associated with FLT3 mutations; the cumulative incidence of relapse in FLT3 mutant AML remains high, with progression often characterized by secondary FLT3-TKD mutations. Crenolanib is a potent pan- FLT3 inhibitor that has shown promising efficacy and tolerability in combination with chemotherapy in Phase 1/2 trials for AML patients with FLT3-ITD or - TKD mutations. This is the first globally initiated, randomized Phase 3 trial comparing the efficacy of two FLT3-TKIs, crenolanib and midostaurin, combined with intensive chemotherapy in NDx FLT3-mutated AML patients. Methods: This Phase 3, randomized, multi-center trial will be conducted at multiple sites worldwide, with a target enrollment of 510 subjects. Patient inclusion was modified to match the midostaurin RATIFY criteria to enroll NDx FLT3-mutated AML (18 – 60 yo), who are eligible for intensive chemotherapy; with the addition of any FLT3-ITD and/or -TKD mutations being eligible. All subjects will receive TKI treatment and will be randomized in a 1:1 ratio to receive either crenolanib (arm A) or the active-control, midostaurin (arm B). All patients will be treated with 7+3 (100 mg/m2 IV cytarabine; 90 mg/m2 IV daunorubicin) and can initiate treatment while awaiting FLT3 results prior to randomization. Consolidation could include chemotherapy (3000 mg/m2 IV HiDAC) for up to 4 cycles and/or Allo-HSCT, depending on patient condition. During induction and consolidation patients on arm A will take crenolanib (100 mg TID) from d9 until 72h prior to the next cycle, and patients on arm B will take midostaurin (50 mg BID) on d8 to d21 of each cycle. Following consolidation or HSCT, patients may receive up to 12 months of FLT3-TKI maintenance. Maintenance efficacy will be evaluated over time using single-cell sequencing to assess MRD. Primary endpoint is event-free survival. Interim analyses will occur at approximately 178 and 267 events, and primary analysis at 356 events. Enrollment is underway as of January 31, 2019. Clinical trial information: NCT03258931.
Oral Cancers Adjacent to Dental Implants: A Descriptive Study

Background: Trauma and chronic inflammation are controversial factors because of their potential role as an initiator or as an aggravating factor in the oral carcinogenesis process. Dental implants are related to chronic inflammatory processes and could act as a potential risk factor for oral cancer. Objective: To analyze the oral cancer cases adjacent to dental implants. Methodology: A PubMed database search on studies of oral cancers adjacent to dental implants was conducted. Statistical analysis: The descriptive statistic included means, standard deviations, ranges and percentages. For the comparison of continuous variables, the Student's t-test was used and, for the comparison of categorical variables the Pearson Chi-square test was applied. Results: Thirty studies describing 62 cases of oral cancer adjacent to dental implants were included in this review. These cancers were observed more frequently in patients with an average age of almost 67 years, female gender and mandibular location. The most prevalent harmful habit was the combined consumption of tobacco and alcohol and the most common oral risk lesion was leukoplakia. Almost all were oral squamous cell carcinomas and half were moderately differentiated. Conclusion: Oral cancers adjacent to dental implants seem to have similar characteristics than tumors not related to dental implants.
Comparison of Real time PCR and Conventional PCR for Detection of HLA-B27 in Suspected Ankylosing Spondylitis Patients

Copyright © 2015 2019| SSR-IIJLS by Society for Scientific Research under a CC BY-NC 4.0 International License Volume 05 | Issue 04 | Page 2355 Comparison of Real time PCR and Conventional PCR for Detection of HLA-B27 in Suspected Ankylosing Spondylitis Patients Jaspreet Kaur1, Jaswinder Singh2* 1Senior Research Associate, Department of Biochemistry, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, U.P., India 2Associate Professor, Department of Forensic Medicine and Toxicology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, U.P., India *Address for Correspondence: Dr. Jaswinder Singh, Associate Professor, Department of Forensic Medicine and Toxicology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly-243202, U.P., India E-mail: drjasvinder2013@gmail.com Received: 08 Dec 2018/ Revised: 14 Mar 2019/ Accepted: 16 Jun 2019 ABSTRACT Background: Human leukocyte antigen B27 (HLA-B27) is a major histocompatibility complex (MHC) class 1 molecule that is strongly associated with the chronic inflammatory disease ankylosing spondylitis (AS). The aim of the present study was to evaluate the utility of real time PCR over conventional PCR to find out the involvement of HLA-B27 in relation to age and sex in symptomatic suspected patients. Methods: The present cross-sectional study was conducted on the 320 suspected AS patients. Blood samples from patients were processed for PCR and real time PCR using HLA-B27 as a gene target. Results: Out of 320 samples, 153 (48%) and 163 (51%) patients were found to be HLA-B27 positive in PCR and real time PCR respectively. Out of 153 and 163 positive samples, the positivity rate was maximum i.e. 59% and 61% in the patients of 16-30 years of age in PCR and real time PCR respectively. Furthermore, in terms of gender wise variation, 115 (75%) and 126 (77%) were male and remaining 38 (25%) and 37 (23%) were female in PCR and real time PCR respectively. Our data revealed sensitivity and specificity of real time PCR for HLA-B27 positive cases were 100% (95% CI: 89.11-100% with p-value 0.002) and 94% (95% CI: 73.05-91.21% with p-value 0.012) respectively. The PPV was 93.87% (95% CI: 73.01-105.36% with p-value 0.015) and NPV was 100% (95% CI: 83.19 111.03% with p-value 0.101). Conclusion: It could be concluded that the real time PCR test is a fast, accurate and sensitive method for the diagnosis of AS.
Craniofacial and airway growth in 9–11 years old normal dental occlusion in Iranian adolescents: A longitudinal cephalometric study

Introduction: The present study was aimed to assess the amount and direction of growth in cranial base, jaws, and soft tissue of airway structures by cephalometric analysis in 9–11-years-old Iranian girls and boys. Materials and Methods: Thirty-four Iranian children with normal occlusion and class I molar relationships were recruited, and 2 lateral cephalograms were obtained from 9 and 11-year-old children Cephalometric variables included variables defining cranial base length and angle, maxillomandibular length and height, dental relationship, head and cervical position, soft palate and tongue, vallecula and hyoid position, and pharyngeal dimension. Normal distribution was confirmed by Kolmogorov–Smirnov analysis (P>0.05). Paired t-test was used for assessing growth changes. P value was set at 0.05. Results: Anterior, posterior, and total cranial base length were increased significantly. The increase in total and upper anterior, total and lower posterior facial heights, ramus height, and palatal inclination were statistically significant. Maxillomandibular length increased significantly with insignificant change in their position. Dental relationship and head and cervical posture were stable. Oropharyngeal and nasopharyngeal anteroposterior dimension did not change. However, hypopharynx sagittal length increased significantly. Nasopharyngeal vertical dimension increased and hyoid moved anteriorly and inferiorly. Conclusion: The results of the present study showed that cranial base and jaws grow anteriorly and inferiorly while maintaining dental occlusion and head posture. Most of the airway structures grow simultaneously with craniofacial components.
Clinical and genetic heterogeneity in young onset sporadic Alzheimer's disease

Alzheimer’s disease, the commonest neurodegenerative condition, is characterised by accumulation of amyloid plaques and neurofibrillary tangles, neuronal loss, brain atrophy and cognitive impairment. Sporadic young onset Alzheimer’s disease shows marked clinical heterogeneity, with non-memory presentations including the syndromes of posterior cortical atrophy, logopenic aphasia and frontal Alzheimer’s disease, seen in around a third of individuals. This variability presents challenges for diagnosis and may confound clinical trial outcomes, but provides an opportunity to explore factors influencing differential selective vulnerability within neural networks which in turn may provide important clues to Alzheimer’s disease pathogenesis. This thesis describes the recruitment of a cohort of a deeply phenotyped patients with sporadic young onset Alzheimer’s disease (n=45) and healthy controls (n=24), and a series of genetic, clinical, neuropsychological, and structural, diffusion and functional magnetic resonance imaging experiments to explore disease heterogeneity and its associations. There are a number of key findings. APOE e4 genotype contributes to, but does not fully explain clinical heterogeneity, with the youngest ages of onset and most atypical presentations seen in e4-ve individuals. Heterozygosity of the rare TREM2 genetic variant for late-onset Alzheimer’s disease, p.R47H, is shown to confer risk for young onset Alzheimer’s disease, driving younger age of onset rather than clinical phenotype. Regional brain atrophy profiles in APOE e4 genotypes are shown to broadly align with the associated neuropsychological deficits. Microstructural damage studied using diffusion tensor imaging, and – applied for the first time to Alzheimer’s disease – Neurite Orientation Dispersion and Density Imaging – provides a fine-grained profile of white matter network breakdown, revealing regional differences based on APOE e4 genotype, and correlations with focal neuropsychological deficits. Finally, activation fMRI using a music paradigm to probe relationships between cognitive performance and brain function is shown to delineate different patterns of brain activation during memory tasks in different Alzheimer’s disease phenotypes.
An investigation of cognitive-electrophysiological biomarkers and symptom profile in ADHD and bipolar disorder

2 Statement of work . 3 Acknowledgements . 4 List of Figures . 11 List of Tables . 13 Thesis outline . 15 Part 1 . 15 Part 2 . 17 Distinct and original contributions. 18 Chapter 1 An Introduction to the Search for Biomarkers in Attention‐Deficit/Hyperactivity Disorder and Bipolar Disorder . 20 1.1 Biomarkers for psychiatric illness . 20 1.2 Clinical expressions of ADHD and BD . 22 1.2.1 Clinical symptoms and epidemiology of ADHD . 22 1.2.2 Gender difference in ADHD symptoms . 24 1.2.3 Clinical symptoms and epidemiology of BD . 25 1.2.4 Gender difference in BD symptoms . 27 1.2.5 Comorbidities and familial relationship in ADHD and BD . 28 1.2.6 Overlap of symptoms in ADHD and BD . 29 1.2. 7 Delineation using clinical measures . 30 1.2. 8 Section summary. 31 1.3 Cognitive and neurophysiological impairments . 33 1.3.1 Neurophysiological methods . 33 1.3.2 Cognitive-neurophysiological abnormalities in ADHD . 36 1.3.3 Cognitive-neurophysiological abnormalities in BD . 41 1.3.4 Cross-disorder comparisons. 44 1.3.5 Gender differences in cognitive-electrophysiological research on ADHD and BD . 47 1.3. 6 Section Summary . 48 Chapter 2 A Matter of Time: The Influence of Recording Context on EEG Spectral Power in Adolescents and Young Adults with ADHD . 50 2.1 Abstract . 51 7 2.2 Introduction . 51 2.3 Methods and materials . 53 2.3.1 Sample . 53 2.3.2 Procedure . 53 2.3.3 Measures . 53 2.4 Results . 55 2.4.1 Group differences . 55 2.4.2 Group by time interactions . 56 2.4.3 Time . 56 2.4.4 Controlling for IQ . 56 2.4.5 Analysis using mid-line electrodes . 56 2.4. 6 Global field synchronisation . 57 2.5 Discussion . 57 2.6 References . 59 Chapter 3 Neurophysiological Conflict Monitoring Impairments in Adolescents and Young Adults with ADHD: A Comparison with Their Unaffected Siblings and Unrelated Controls . 62 3.1 Abstract . 62 3.2 Introduction . 63 3.3 Methods . 68 3.3.1 Sample . 68 3.3.2 Procedure . 72 3.3.3 Tasks and measures . 72 3.3.4 EEG recording and analysis . 73 3.3.5 Statistical analyses . 75 3.4 Results . 76 3.5 Discussion . 91 Chapter 4 Delineating ADHD and Bipolar Disorder: A Comparison of Clinical Profiles in Adult Women. 99 4.1 Abstract . 99 4.2 Introduction . 100 4.3 Methods and Materials . 101 4.3.1 Sample . 101 4.3.2 Diagnosis and recruitment . 101 4.3.3 Procedure . 103 4.3.4 Measures . 104 8 4.3.5 Statistical Analyses . 108 4.4 Results . 108 4.4.1 ADHD Symptoms . 113 4.4.2 Impairment . 114 4.4.3 Mania and depression . 115 4.4.4 Emotional Lability (EL) . 119 4.4.5 Comorbidities . 119 4.5 Discussion . 120 4.5. 1 Distinguishing euthymic BD from ADHD . 121 4.5. 2 Use of the YMRS . 123 4.5. 3 Chronicity and validity of symptom measurement . 124 4.5. 4 Emotional Lability (EL) . 125 4.5. 5 Impairment Ratings
Preformulation as an Aid to Product Design in Early Drug Development

It is axiomatic that the physicochemical properties of candidate drugs can influence their subsequent development. The results of characterization studies carried out will influence their product design. However, in the interest of only doing necessary work, any detailed studies should only be carried out after the candidate drug has successfully overcome the safety and clinical trials performed in early development as many will fail at this stage. Since pharmaceuticals are formulated in a variety of dosage forms, the studies that should be undertaken include those of solid and solution state. In terms of solid-state evaluation, material science has assumed great importance (Cui, 2007), and this is especially true for compounds to be delivered via the inhalation route (Chow et al., 2007; Young et al., 2007). If the solid-state characteristics of the candidate drugs are less than desirable from a formulation perspective, then crystal engineering techniques can sometimes be employed to give them more amenable properties (Chow et al., 2008). Variability of the drug candidate and excipients is the major cause of challenges in the formulation development of new compounds, and so methods for their characterization need to be available (Hagsten et al., 2008). While there are many traditional approaches to dosage form design, newer approaches based on expert systems that require knowledge of the physicochemical properties are being employed to speed up development (Rowe, 1998; Perez et al., 2006; Branchu et al., 2007). Expert systems are discussed further in chapter 8 “Product Optimization. ”
Femoral Neck Fracture in Children- Decompression, Anatomic Reduction and Use of Kirchner Wires to the Rescue?

Femoral neck fracture in children is very rear. Whenever it occurs, it presents a challenge to the orthopaedic surgeon. There are schools of thought on immediate capsular aspiration and surgery. However, some do not believe that capsular decompression and immediate surgery prevent avascular necrosis of the femur. This is the reason for this report, to lend my findings to the debate. This patient is a 7year old female child. She was a victim of truck-pedestrian injury. It was a high energy trauma with resultant displaced intertrochanteric femoral neck fracture(Delbert type IV). There was mild head injury which she recovered from. She did not have capsular decompression. She had open reduction and internal fixation 8 days after injury. We used smooth Kirchner wires for fixation. She was kept on strict bed rest. 6weeks after surgery, she had radiological union and commenced guarded ambulation with a walker(Zimmer frame). Six months post injury, there is no sign of avascular necrosis and patient walks full weight bearing without pain. Conclusion: Delayed surgery in a displaced femoral fracture in children did not affect surgery outcome. Open arthrotomy and immediate decompression may not be necessary in displaced femoral neck fracture. Open and anatomic reduction may be a way to reduced poor outcome.
PEMBELAJARAN BAHASA DENGAN PENDEKATAN BUDAYA

When the teacher teaches a second language or a foreign language, often times he forgot to convey the culture contained in the language, so the language is often learned the common errors in usage. The learning based culture based on the recognition of culture as a fundamental part of the learning process. Cultural content of Arabic language learning in particular can be integrated in the following stages: a) learning materials, b) the selection and organization of material, c) learning method with a cultural approach, d) evaluation.
A Split Face Comparative Study of Safety and Efficacy of Microneedling with Tranexamic Acid versus Microneedling with Vitamin C in the Treatment of Melasma

Introduction: Melasma is a common pigmentary disorder affecting the face. Although a few risk factors have been identified, the exact pathogenesis remains elusive. Many treatment modalities have been tried, but none have been completely successful. Aim: To compare safety and efficacy of microneedling with Tranexamic acid versus microneedling with Vitamin C in the treatment of melasma. Materials and Methods: It was a split face, comparative study conducted on 30 female melasma patients. After obtaining informed consent, microneedling with Tranexamic acid was done on left side and microneedling with Vitamin C was done on right side of face. The improvement was evaluated on the basis of clinical photographs, MASI, Physician Global Assessment (PGA) and Patient Global Assessment (PtGA) at each visit (0, 4 and 8 weeks). Z test was used to test the significant difference in the means of the 2 groups at 4 weeks and at 8 weeks. Results: At the end of 8 weeks, MASI, PGA and PtGA showed improvement with both tranexamic acid and vitamin C. However the improvement was more with tranexamic acid than with vitamin C, although not statistically significant. Conclusion: Both TXA and Vitamin C are effective and safe treatments for melasma. But, TXA was found to be more effective.
Prevalence of urinary tract infection among pregnant women and possible risk factors

Objectives The aim of this study was to estimate the frequency of urinary tract infection (UTI) during pregnancy and the possible risk factors. Background UTIs during pregnancy are among the most common health problems worldwide, especially in developing countries. It has several adverse outcomes not only on the mother but also on the fetus. Patients and methods A case–control study nested in a cross-sectional investigation was carried out on 250 pregnant women who were attending Berket El Sabae Family Health Center in Menoufia Governorate. Data were collected from the first of September to the end of November 2014. Each participant was assessed using a predesigned questionnaire, which included age, personal history, occupation, present history, past history, obstetric history, and personal hygiene. Urine sample was collected from the studied women for analysis. According to history and urine analysis women were divided into two groups: group I had UTI and group II did not have UTI. Results The result of this study revealed that the frequency of UTIs during pregnancy was 32%, with 63.3% of them having moderate infection. UTIs were more significant among women with an intermediate socioeconomic score (37.9%). The most important risk factors associated with UTI in the studied group were unsatisfied personal hygiene, positive history of diabetes mellitus, anemia, and past history of UTI. Conclusion This study concluded that about one-third of pregnant women had UTI with different degrees of severity. The most important risk factors associated with UTI during pregnancy were unsatisfactory personal hygiene, history of UTI, diabetes mellitus, and anemia. Therefore, the study recommends health education on personal sanitary hygiene and frequent complete urine analysis during pregnancy.
Promoting Physical Exercise Participation: The Role of Interpersonal Behaviors for Practical Implications

The number of people engaging in physical exercise has been decreasing every year. These behaviors are known to be related with non-communicable chronic diseases and to drastically increase premature morbidity and mortality. Since “the lack of motivation” has been pointed out as one of the main reasons for not engaging in physical exercise, several theoretical and empirical studies have been conducted aimed at understanding what influences behavior regulation. According to literature, gym exercisers who perceive exercise instructors as supportive are more likely to maintain physical exercise participation over the long-run. Supporting autonomy, competence, and relatedness should be carefully considered when interacting with health club clients as a way to promote more autonomous motivation. Overall, it seems that exercise instructors should foster a supportive environment for gym exercisers, in order to encourage exercise as a habitual behavior.