Miracle-dz/UniFAR-FTUs huggingface dataset:
Role of neoadjuvant concurrent chemoradiation in locally advanced unresectable pancreatic cancer: a feasibility study at tertiary care centre.

BACKGROUND Pancreatic cancer has an extremely poor prognosis and prolonged survival is achieved only by resection with macroscopic tumor clearance. There is a strong rationale for a neoadjuvant approach, since a relevant percentage of pancreatic cancer patients present with non-metastatic but locally advanced disease. The objective of the present study was to assess the effect of neoadjuvant chemoradiation therapy (NACRT) on tumor response, down staging and resection, toxicity and any survival advantage. MATERIALS AND METHODS A prospective pilot study was carried out from January 2009 to June 2011 in which 15 patients of locally advanced unresectable pancreatic cancer were included. All patients were treated with NACRT protocol with oral Capecitabine and 3D conformal radiotherapy (3DCRT) of 30 Gy in 10 fractions. The patients were restaged 3 to 4 weeks after the completion of NACRT and explored for resection. RESULTS Out of 15 patients, fourteen were evaluable. Four patients underwent surgery, 5 had partial response but remained unresectable, 2 patients had stable disease and 3 had progressive disease. Most of the toxicities were slight and were in grade 1 to 2. None of the patients developed grade 3 or 4 gastrointestinal or hematological toxicity. The median survival was 15 months for resected patients and 8.6 months for unresected patients, respectively. The 2 year actuarial overall survival was 34.6%. CONCLUSION All patients with locally unresectable pancreatic cancer should be offered chemoradiation therapy, in hopes of down staging the tumor for possible resection and achieving higher survival.
The parents' experience: coping with drug use in the family

The families of drug users are often overlooked in the planning and delivery of services. This paper is based on interviews with parents of heroin users and staff from a support agency that worked with families affected by drug use. Findings highlight the devastation parents experienced in learning that their child was using heroin, and the subsequent impact that this had on their lives. Accessing support from a specialist agency provided tangible benefits for parents. These included a reduced sense of isolation, an increased knowledge of drugs and drug-related issues, and greater empathy for their son or daughter. This resulted in an improved support network for the drug user. However, parents faced many obstacles in accessing support, not least a lack of awareness of their needs amongst appropriate agencies. The paper concludes by highlighting the need to develop further tailored interventions to support families affected by drug use, and to improve the knowledge and awareness of the issue among treatment agencies and a range of other relevant organizations.
Improved Serotonergic Tone Contributes to the Mechanism of Action of St Johnâ€™s Wort in Nicotine Withdrawn Mice

Present study aims to investigate the acute effects of St Johnâ€™s Wort (SJW) on nicotine withdrawal syndrome and serotonergic hypo activity in mice. Adult male Albino mice weighing 20-25g were housed 6 per cage under light and dark conditions at 22Â±3 o C and maintained on lab chow and water ad libitum under standard housing conditions. Nicotine was administered at the concentrations of 3.08mg (1mg of free base) in 100 ml of drinking water for 4 weeks. Nicotine withdrawal was achieved by substituting nicotine containing water with drinking water. Nicotine withdrawn (NW) mice were evaluated for locomotor activity and abstinence signs at 72 h. Whole brain tryptophan (TRP). 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) were measured using high performance liquid chromatography connected to fluorescence detector. St Johnâ€™s Wort (SJW) (500mg/kg) was given intraperitonially 3 h prior to completion of 72 h of nicotine withdrawal period. Behavioral analysis in SJW administered NW mice showed attenuation in nicotine abstinence signs (shaking, scratching, chewing and facial tremors) and locomotor activity when compared with respective controls. NW mice showed decrease in plasma TRP, brain TRP and 5-HT concentrations while increase in 5-HT turnover and corticosterone concentrations as compared to respective controls. SJW administrated NW mice showed decrease in corticosterone levels and 5-HT turnover while plasma TRP, brain TRP and 5-HT synthesis were increased when compared with similarly treated saline injected group. Our findings warrant SJWâ€™s therapeutic efficacy to alleviate nicotine withdrawal associated depression by virtue of its ability to improve serotonergic activity by increasing brain TRP, 5-HT concentrations and decreased turnover.
Smokeless tobacco use: a meta-analysis of risk and attributable mortality estimates for India.

BACKGROUND Use of smokeless tobacco (SLT) is widely prevalent in India and Indian subcontinent. Cohort and case-control studies in India and elsewhere report excess mortality due to its use. OBJECTIVE The aim was to estimate the SLT use-attributable deaths in males and females, aged 35 years and older, in India. MATERIALS AND METHODS Prevalence of SLT use in persons aged 35 years and older was obtained from the Global Adult Tobacco Survey in India and population size and deaths in the relevant age-sex groups were obtained from UN estimates (2010 revision) for 2008. A meta-relative risk (RR) based population attributable fraction was used to estimate attributable deaths in persons aged 35 years and older. A random effects model was used in the meta-analysis on all-cause mortality from SLT use in India including four cohort and one case-control study. The studies included in the meta-analysis were adjusted for smoking, age and education. RESULTS The prevalence of SLT use in India was 25.2% for men and 24.5% for women aged 35 years and older. RRs for females and males were 1.34 (1.27-1.42) and 1.17 (1.05-1.42), respectively. The number of deaths attributable to SLT use in India is estimated to be 368127 (217,076 women and 151,051 men), with nearly three-fifth (60%) of these deaths occurring among women. CONCLUSION SLT use caused over 350,000 deaths in India in 2010, and nearly three-fifth of SLT use-attributable deaths were among women in India. This calls for targeted public health intervention focusing on SLT products especially among women.
Antiproteases as Therapeutics to Target Inflammation in Cystic Fibrosis

Cystic Fibrosis (CF) is the most common fatal inherited disease of Caucasians, affecting about 1 in 3000 births. Patients with CF have a recessive mutation in the gene encoding the CF transmembrane conductance regulator (CFTR). CFTR is expressed in the epithelium of many organs throughout the exocrine system, however, inflammation and damage of the airways as a result of persistent progressive endobronchial infection is a central feature of CF. The inflammatory response to infection brings about a sustained recruitment of neutrophils to the site of infection. These neutrophils release various pro-inflammatory compounds including proteases, which when expressed at aberrant levels can overcome the endogenous antiprotease defence mechanisms of the lung. Unregulated, these proteases can exacerbate inflammation and result in the degradation of structural proteins and tissue damage leading to bronchiectasis and loss of respiratory function. Other host-derived and bacterial proteases may also contribute to the inflammation and lung destruction observed in the CF lung. Antiprotease strategies to dampen the excessive inflammatory response and concomitant damage to the airways remains an attractive therapeutic option for CF patients.
Mixed Species Allometric Models for Estimating above-Ground Liana Biomass in Tropical Primary and Secondary Forests, Ghana

The study developed allometric models for estimating liana stem and total above-ground (TAGB) biomass in primary and secondary forests in the Asenanyo Forest Reserve, Ghana. Liana biomass was determined for 50 individuals for each forest using destructive sampling. Various predictors involving liana diameter and length were run against liana biomass in regression analysis, and , RMSE, and Furnival's index of fit (FI) were used for model comparison. The equations comprised models fitted to untransformed and log-transformed data. Forest type had a significant influence () on liana allometric models in the current study, resulting in the development of forest-type-specific equations. There were significant and strong linear relationships between liana biomass and the predictors in both forests (). Liana diameter was a better predictor of biomass than liana length. Generally, the models which were based on log-transformed data showed better fit (higher FI values) than those fitted to untransformed data. Comparison of the site specific models in the current study with previously published models indicated that the models of the current study differed from the previous ones. This indicates the need for forest specific equations to be used for accurate determination of above-ground liana biomass.
Cysteine proteinase SpeB from Streptococcus pyogenes – a potent modifier of immunologically important host and bacterial proteins

Abstract Group A streptococcus (Streptococcus pyogenes) is an exclusively human pathogen that causes a wide spectrum of diseases ranging from pharyngitis, to impetigo, to toxic shock, to necrotizing fasciitis. The diversity of these disease states necessitates that S. pyogenes possess the ability to modulate both the innate and adaptive immune responses. SpeB, a cysteine proteinase, is the predominant secreted protein from S. pyogenes. Because of its relatively indiscriminant specificity, this enzyme has been shown to degrade the extracellular matrix, cytokines, chemokines, complement components, immunoglobulins, and serum protease inhibitors, to name but a few of the known substrates. Additionally, SpeB regulates other streptococcal proteins by degrading them or releasing them from the bacterial surface. Despite the wealth of literature on putative SpeB functions, there remains much controversy about this enzyme because many of reported activities would produce contradictory physiological results. Here we review all known host and bacterial protein substrates for SpeB, their cleavage sites, and discuss the role of this enzyme in streptococcal pathogenesis based on the current literature.
Are the medical records of high quality in teaching hospitals

Background: Documentation of medical data in patient records is needed to improve the quality of healthcare and medical knowledge progress. Documentation of patient history, clinical problems, treatment, and follow-up care are needed to improve practice and research. Objective: To determine documentation of patient records at the internal medicine ward of Imam Khomeini Hospital, Tabriz, Iran. Method: The study was descriptive and 100 patient records were selected through random sampling. Records were related to the patients who had been discharged from the general internal ward during April to June 2000. Data was collected using the questionnaire including 30 closed questions, and 5 open ones. The results were reported in ratios (%) averages and standard deviation. T-test was used to examine the association of length of stay and records data adequacy scores. Data was analysed by the SPSS software. Results: Completeness of the patient records was moderately acceptable (68.7%). The difference between performance of residents, interns and students in documentation of primary diagnoses and differential diagnoses was significant (P<0.001) and performance of residents was more efficient (59.6%), (69.7%). Of the records, 22.2% were without summary sheet. Conclusion: Patient records had many deficiencies. Instructions for documentation are necessary. Regular monitoring and evaluation by the attending physicians and writing skills education could be effective in accurate documentation.
Asupan Karbohidrat sebagai Faktor Dominan yang Berhubungan dengan Kadar Gula Darah Puasa

Peningkatan kadar gula darah memicu peningkatan produksi hormon insulin yang erat hubungannya dengan diabetes melitus. Berdasarkan data Riskesdas, prevalensi diabetes melitus di Indonesia meningkat dari 1,1% (2007) menjadi 2,1% (2013). Penelitian ini bertujuan untuk mengetahui faktor dominan yang berhubungan dengan kadar gula darah puasa pegawai pemberdayaan masyarakat & keluarga dan pegawai sekretariat daerah Kota Depok. Desain penelitian yang digunakan adalah potong lintang dan melibatkan 105 sampel. Variabel independen penelitian meliputi karakteristik individu, asupan zat gizi, hipertensi, aktivitas fisik, status gizi dan pengetahuan gizi. Analisis data yang dilakukan adalah analisis univariat, analisis bivariat menggunakan uji korelasi dan uji beda dua mean, serta analisis multivariat menggunakan uji regresi linear ganda. Hasil penelitian menunjukkan bahwa rata-rata kadar gula darah puasa adalah 95,14±10,863 pada keseluruhan responden, sedangkan 94,07±11,55 mg/dl pada perempuan, dan 96,47±9,92 mg/dl pada laki-laki. Diabetes melitus (≥126 mg/dl) ditemukan sebesar 2,9% dan impaired fasting glucose (100-125 mg/dl) sebesar 22,9%. Berdasarkan hasil analisis bivariat, terdapat hubungan antara usia, asupan karbohidrat, dan aktivitas fisik dengan kadar gula darah puasa (p<0,05). Hasil analisis multivariat menunjukkan bahwa asupan karbohidrat merupakan faktor dominan yang berhubungan kadar gula darah puasa. Increased blood glucose levels lead to excess insulin secretion that is closely associated with diabetes mellitus. Based on Riskesdas, prevalence of diabetes mellitus in Indonesia has increased from 1,1% (2007) to 2,1% (2013). This study was aimed to find dominant factor associated with fasting blood glucose level. Cross sectional design were used to conduct this study and involved 105 samples. Independent variables in this study were individual characteristics, nutrients intake, history of hypertention, physical activities, nutritional status and nutritional knowledge. Bivariate analysis was performed by correlation test and two different test mean. Multivariate analysis was performed by multiple linear regression test. Result showed that the average of employees’ fasting blood glucose level is 95.14±10.863, 94.07 ± 11.55 mg/dL for woman and 96.47 ± 9.92 mg/dl for man. This study found 2.9% employees with diabetes mellitus (³126 mg/dl) and 22.9% employees with impaired fasting glucose (100-125 mg/dl). Result of bivariate analysis showed that associated between age, carbohydrate intake, physical activities with fasting blood glucose level. Result of multivariate analysis showed that carbohydrate intake was a dominant factor related to fasting blood glucose level.
Renal tumors presentation: changing trends over two decades.

PURPOSE We have analyzed the changing trends in surgical treatment of renal tumors over the last 2 decades with regard to age incidence, presentation, incidental detection, and histopathology. MATERIALS AND METHODS Records of renal tumors were analyzed from January 1, 1988 to December 31, 2007. Data were split into 4 parts based on a 5-year time period, 1 for each cohort of patients: cohort 1 (1988-1992)-103 patients, cohort 2 (1993-1997)-161 patients, cohort 3 (1998-2002)-243 patients, and cohort 4 (2003-2007)-304 patients. A comparative study was performed with regard to age incidence, presentation, incidentallomas, histopathology, and management with statistical analysis. RESULTS Out of 811 renal tumors, 17.63% cases were benign and 82.37% were malignant. In the first cohort, 34.95% cases were detected in the seventh decade as compared with cohort 4 in which these were detected in the sixth (34.86%) and fifth decades (21.38%). Incidentallomas increased from 11 (10.67%) in cohort 1 to 84 (27.63%) in cohort 4 (P = 0.001). The cases of surgically treated tumors increased in number from 103 to 304 in cohort 4. Among the presenting features, incidence of weight loss, flank pain, and lump decreased while other clinical syndromes were constant. Only open radical nephrectomy was performed in the first 2 consecutive timeperiods. Laparoscopic radical nephrectomy was increasingly used in cohort 4 as compared with cohort 3 (121 vs 32, respectively). Similarly, open nephron sparing surgery (NSS) was increasingly used in cohort 4 as compared with cohort 3. Among the histopathologies, clear cell carcinoma was most common (73.35 %), but Fuhrman grading showed a trend toward more cases detected with grade 1 and 2 in cohort 4; 23.73% and 61.86%, respectively, as compared with 15.85% and 45.12% in cohort 1 (P = 0.001); more T1 tumors were detected (63.42% in cohort 4 as compared with 41.46% in cohort 1). CONCLUSIONS A majority of renal tumors presented as symptomatic tumors. Recently, tumors are being detected at an early stage and grade; in the younger patients, with an increasing trend of laparoscopic and open NSS.
The epigenetic regulator Cfp1

Abstract Numerous epigenetic modifications have been identified and correlated with transcriptionally active euchromatin or repressed heterochromatin and many enzymes responsible for the addition and removal of these marks have been characterized. However, less is known regarding how these enzymes are regulated and targeted to appropriate genomic locations. Mammalian CXXC finger protein 1 is an epigenetic regulator that was originally identified as a protein that binds specifically to any DNA sequence containing an unmethylated CpG dinucleotide. Mouse embryos lacking CXXC finger protein 1 die prior to gastrulation, and embryonic stem cells lacking CXXC finger protein 1 are viable but are unable to achieve cellular differentiation and lineage commitment. CXXC finger protein 1 is a regulator of both cytosine and histone methylation. It physically interacts with DNA methyltransferase 1 and facilitates maintenance cytosine methylation. Rescue studies reveal that CXXC finger protein 1 contains redundant functional domains that are sufficient to support cellular differentiation and proper levels of cytosine methylation. CXXC finger protein 1 is also a component of the Setd1 histone H3-Lys4 methyltransferase complexes and functions to target these enzymes to unmethylated CpG islands. Depletion of CXXC finger protein 1 leads to loss of histone H3-Lys4 tri-methylation at CpG islands and inappropriate drifting of this euchromatin mark into areas of hetero-chromatin. Thus, one function of CXXC finger protein 1 is to serve as an effector protein that interprets cytosine methylation patterns and facilitates crosstalk with histone-modifying enzymes.
Análise clínica e morfológica da conjuntivite alérgica induzida por ovalbumina e tratada com chalcona em cobaias

PURPOSE: To study for clinical and morphological point of views, the effects of a chalcone in allergic conjunctivitis induced by ovalbumim in guinea pig. METHODS: Fifty-four white male guinea pigs weighing approximately 400 g were used in the study. All animals were sensitized by intraperitoneal injection of ovalbumin suspended in Freunds complete adjuvant solution. Conjunctivitis was induced by the ovalbumin by instillation of ovalbumin in conjunctival sac of right eye´s. The animals were randomized in 3 groups agreement with the proposed treatment: chalcone,corticoid and saline. The clinical analysis were recorded at 5, 10 e 40 min, 7 e 24 h after induced and daily until 7 days after induced. Morphologic analysis consisted in evaluating edema, necrosis, vascularization and exocytosis at the 1, 3 and 7 days following induction of conjunctivitis. RESULTS: Clinical alterations were more accentuated 24 h after induction. Inflammatory signs were less apparent in chalcone group as compared to saline Corticoid group presented less inflammatory signs when compared to chalcone and control groups. Morphologic analysis disclosed that chalcona effect is similar to corticoid effects. CONCLUSION: It is concluded that chalcona had therapeutic effect in the allergic conjunctivitis induced by ovalbumine in guinea pigs.
Inverted papilloma of the urinary bladder: Rigorous surveillance needed? An Indian experience.

AIMS Inverted papilloma (IP) is an uncommon benign neoplasm of the urinary tract. Its multiplicity, recurrence, and association with transitional cell carcinoma (TCC) leads to conflicting clinical conclusions regarding its biological behavior, and hence, the need for rigorous follow-up protocols. In this study, we review all cases of urinary bladder IP in our institution and determine the need for strict follow-up. MATERIALS AND METHODS We included consecutive patients from August 2004 to August 2008 with IP of the urinary bladder in this study who did not have prior or concurrent urothelial carcinoma. A single pathologist performed the histologic review. The patients had undergone strict a follow-up schedule every 6 months. RESULTS In our study of the 24 patients, the mean age at presentation was 53.5 (range 22-81) years. The mean follow-up period was 25.8 months (range 6-58 months). Of the 24 patients, 21 were men and 3 were women. No patient had a synchronous or previous bladder tumor. The most common presenting symptoms were macroscopic hematuria and dysuria. All were solitary tumors except one, most commonly found at the bladder neck and trigone. The average follow-up period was 2.5 years without any evidence of recurrence. CONCLUSIONS We conclude that when diagnosed by strictly defined criteria, IP as benign urothelial neoplasm was with extremely low incidence of recurrence and good prognosis. It does not seem to be a risk factor for TCC, especially if located in the bladder. Therefore, a good transurethral resection is adequate therapy and follow-up protocol as rigorous as those for TCC may not be necessary.
Relationship between backache and psychological and psychosocial job factors among the nurses

To gain more insight into the prevalence rates of backache and to determine the relation between occupational stress among the Nurses . In this cross-sectional study a questionnaire was carried out among 400 nursing personnel in three general hospitals in Amol, Iran. The questionnaire had 3 sections: demographic information, psychosocial stress related to work, and of psychological stress related to work. The annual prevalence was 80% of the cases. Results indicated that, there was a significant relationship between low back pain and female gender (OR=2.8), exercise (OR=0.4), height (OR=1.06) and weight (OR=1.4). Also a significant relationship existed between LBP relationship with colleagues (OR=1.8) and hastiness at work (OR=0.6). Out findings show that low back pain was common and a serious problem among nurses. Moreover, we found positive association between low back pain and job stresses.
Cetuximab plus radiotherapy in patients with unresectable locally advanced squamous cell carcinoma of head and neck region--a open labelled single arm phase II study.

PURPOSE To evaluate feasibility, safety and outcome of cetuximab concurrent with radiotherapy in locally advanced head-neck cancer. MATERIALS AND METHODS Between March 2007 and January 2008 eligible cases of locally advanced unresectable (Stage IV) squamous cell carcinoma of head and neck were enrolled in this single arm, open labeled phase II Study. They were treated with cetuximab for a duration of 8 weeks and concomitant RT for 7 weeks (starting one week after initiating Cetuximab). RESULTS A total of 19 eligible patients were enrolled. The median age of patients was 53 years, all patients happening to be male. The performance status of the patients was 0/1. The location of the primary tumor was oropharynx in 12 cases, oral cavity in 4, larynx in 2, and hypopharynx in one case. The overall response rate (ORR) was 68.42% and the overall survival at 2 year was 84 %. All 13 patients who completed two years follow-up after completion of study treatment continued to be alive with no evidence of disease progression. One patient also remained alive with progressive disease. CONCLUSIONS Cetuximab concurrent with radiotherapy is a safe and effective option in advanced head-neck cancer patients.