Miracle-dz/UniFAR-FTUs huggingface dataset:
Enhanced delivery of drugs into and across the skin by ethosomal carriers

In dermal and transdermal delivery, the skin is used as a portal of entry for drugs, for localized and systemic treatment. Because of the barrier properties of the outer layer of the skin, in many cases, permeation‐enhancing agents are needed to achieve therapeutic levels of drug. Classic liposomal systems were found to be effective at forming drug reservoir in the upper layers of the skin, for local skin therapy. Recently, it was found that ethosomal carriers, phospholipid vesicular systems containing relatively high concentrations of alcohol, were very effective at enhancing dermal and transdermal delivery of both lipophilic and hydrophilic molecules. Fluorescent probes delivered from ethosomal systems reached the deep strata of the skin. Delivery of minoxidil to the pilosebaceous units from ethosomes was much greater compared to delivery from classic liposomes. In addition, clinical studies with aciclovir showed that ethosomal formulations were superior to the currently available topical therapy at treating recurrent herpes labialis. Ethosomal systems were also highly effective at transdermal delivery of drugs. In vivo skin permeation of testosterone from patches containing ethosomal drug were more effective at delivering testosterone through rabbit pinna skin than commercially available Testoderm patches. Results using trihexyphenidyl hydrochloride ethosomes indicated that this system has the potential to be further developed into an antiparkinsonian patch. Lastly, the transdermal delivery of insulin from an ethosomal carrier resulted in lower blood glucose levels in normal and diabetic rats in vivo, with a plateau effect lasting for at least 8 h. Drug Dev. Res. 50:406–415, 2000. © 2000 Wiley‐Liss, Inc.
The Effect of Chronic Alcoholism on the Conjunctival Flora

Abstract Aim: We aimed to investigate the effect of alcohol abuse on the conjunctival flora. Materials and methods: The cases were evaluated as two groups. The study group consisted of 55 heavy-drinking males diagnosed with alcohol abuse, while the control group consisted of 55 males without a history of alcohol abuse. Samples were taken from the inferior fornix conjunctiva with sterile cotton-tipped swabs (Amies transport medium) for culture. The samples were inoculated into blood agar, chocolate agar, eosine methylene blue agar and Saboraud-Dextrose agar (Oxoid/UK) with the dilution method. Results: The microorganisms that grew in study group subjects were Coagulase Negative Staphylococcus (CNS) in 30 (54.5%), Staphylococcus aureus in 14 (25.5%), Moraxella spp. in 3 (5.5%), Streptococcus spp. in 3 (5.5), Bacillus spp. in 3 (5.5%), Corynebacterium spp. in 3 (5.5%), Candida spp. in 3 (5.5%), Haemophilus spp. in 2 (3.6%), Acinetobacter spp. in 2 (3.6%), Neisseria spp. in 1 (1.8%) and Micrococcus spp. in 1 (1.8%). The results for control group were CNS in 31 (56.4%), Bacillus spp. in 7 (12.7%), S. aureus in 5 (9.1%), and Corynebacterium spp. in 2 (3.6%). Moraxella spp. , Streptococcus spp. , Candida spp. , Haemophilus spp. , Acinetobacter spp. , Neisseria spp. and Micrococcus spp. microorganisms grew in the conjunctival flora samples of the study group but not in the control group. S. aureus colonization was significantly higher in the study group than the control group (p < 0.05). Conclusion: The S. aureus colonization rate was statistically significantly higher in the study group. Some microorganisms only grew in the conjunctival flora samples of the study group. These findings indicate that the conjunctival flora in persons with chronic alcoholism is different than the normal population.
A comparative study of pre-operative oral clonidine and pregabalin on post-operative analgesia after spinal anesthesia

Objectives: Pregabalin and clonidine have anti-nociceptive properties. This study assesses their efficacy in prolonging the analgesic effect of spinal anesthesia and post-operative analgesic requirement in patients undergoing vaginal hysterectomy. Materials and Methods: A total of 90 females in the age group of 30-60 years were randomly allocated in to three groups of 30 each, to receive either oral clonidine (150 μg) or oral pregabalin (150 mg) or oral multivitamin as placebo 1.5 h before spinal anesthesia with 3ml (15 mg) of 0.5% hyperbaric bupivacaine. Intensity of pain was measured on a visual analog scale (VAS) at the end of operation (0 h) then at 1,2,4,6,12 and 24 h thereafter. Diclofenac sodium intramuscularly 1 mg/kg was provided when the VASscore was >4 in the study period. Sedation was defined by Ramsay sedation scale at 0,6,12 and 24 h. Side-effects such as nausea and vomiting, respiratory depression and dryness of mouth were noted. Results: The VAS scores were significantly less in the pregabalin group compared with the clonidine group at 6,12 and 24 h post-operatively with a P < 0.0001. More sedation was seen in the clonidine group than in the pregabalin group (P < 0.05). Analgesic consumption and VAS scores were lower in clonidine and pregabalin group compared with the placebo group (P < 0.05). Conclusion: Oral pregabalin (150 mg) prolongs the post-operative pain relief after spinal anesthesia but produces less sedation compared with oral clonidine (150 μg).
Spinal anesthesia in a caesarian case after dry tap

The case report here is a case of cesarean operation under subarachnoid block, which resulted after a failed lumber puncture, known to be “dry tap. ” The result is that it was uneventful surgery without any additive anesthetics being required after injecting 2.2 ml Bupivacaine 0.5% (H). Although cases have been reported with mixed experiences of dry tap and different causes are also explained, but still there is a need to find few other reasons for “dry tap. ” Hence, thought to present the case for putting forward a question that if there is any more cause for dry tap.
Changes in haematological parameters of children aged 5 to 18 years in Abidjan, Côte d'Ivoire

The Millennium Development Goals include an aspect of children's health. The main purpose of this study was to indicate possible changes in different blood cells on one hand and secondly to establish standards of various parameters of the counts in the blood. The study involved 1,157 children aged 5 to 18 years in four selected municipalities of Abidjan. Blood sampling was done fasting in the morning, between 7 and 9 h for each child to complete blood count. In addition, an electrophoretic profile of each subject was performed from a volume of red blood cells. All observed haematological parameters in children was analyzed by a program Statistical Statsoft Windows version 7.1. The results of the study showed that all haematological parameters in children aged 5 to 18 years did not differ significantly by gender (p > 0.05) except for the red blood cells and thrombocytes. The red blood cells were significantly (p < 0.05) higher among boys (4.9 ± 0.02 × 1012/L) than girls (4.4 ± 0.02 × 1012/L). In contrast, girls (297.5 ± 5.4 × 106/L) in our study showed a significant increase in thrombocytes when compared with boys (285.6 ± 5.6 × 106/L). Morever, significant differences were observed between groups of children according to their age for red blood cells, hemoglobin, hematocrit and thrombocytes. Our investigations in these children have reported normal haematological status (11.5%) against 88.5% for abnormal haematological status. Furthermore, in all, 47% of the children presented with anaemia. The prevalence of studied children with normal hemoglobin was 84.4% against 15.6% for abnormal hemoglobin. Haematological parameters of the selected children are degraded in all. Nutrition, infectious and inflammatory syndromes and hemoglobinopathies could be the main factors. Key words: Children, haematological status, anaemia, hemoglobin phenotype, Cote d'Ivoire.
Comparative study between epidural morphine and bupivacaine with epidural clonidine and bupivacaine for postoperative pain relief in abdominal surgeries

Background: Many adjuvants are used to increase the efficacy of epidural local anesthetics for postoperative analgesia. Aims: The aim was to compare the efficacy of epidural morphine (0.1 mg/kg) and clonidine (2 μg/kg) with bupivacaine (0.125%) for postoperative analgesia in abdominal surgeries. Settings and Design: Double-blind retrospective randomized study. Methodology: All the patients (n = 60) varying from age group belonging to American Society of Anesthesiologists I-II were randomly allocated to receive epidural analgesia Group A - Morphine (0.1 mg/kg). + Bupivacaine (0.125%) (n = 30), Group B - Clonidine (2 μ/kg) + Bupivacaine (0.125%) (n = 30). We monitored vitals and requirement of inhalational gases intra-operatively, pain by visual analogue score (VAS) and vitals postoperatively. We used rescue analgesics (injection diclofenac 1 mg/kg intravenous) when VAS score > 5. Postoperatively, various parameters were monitored for first 2 h at intervals of 30 min and at 4, 8, 12, 16, and 24 hourly intervals after giving 1 st dose. Statistical Analysis Used: Continuous data are analyzed by Student′s t-test (paired ′t′- test for intragroup variations and unpaired ′t′- test for intergroup variations). Chi-square test was used for categorical data. A P ≤ 0.05 was considered to be statistically significant. Results: Mean duration of analgesia was 8.35 ± 0.42 h in Group A (morphine) and 7.45 ± 0.44 h in Group B (clonidine). This difference was statistically significant (P < 0.001), indicating a prolongation of analgesia in group morphine. There was no need of rescue analgesia in any subjects. Group A patients were hemodynamically stable and required less inhalation agents intra-operatively compared to group B patients. Conclusions: Epidural morphine plus bupivacaine has a longer duration of analgesia and greater hemodynamic stability as compared to epidural clonidine plus bupivacaine for postoperative analgesia in abdominal surgeries.
The Relationship between Perceived Stress and Morbidity among Adult Inner-City Asthmatics

Background. Psychological stress has been linked in some studies to asthma prevalence and outcomes in children. The authors sought to evaluate the relationship between perceived stress and morbidity among inner-city adults with asthma. Methods. The authors interviewed a prospective cohort of 326 moderate-to-severe asthmatics receiving care at two large, urban, hospital-based general medicine clinics in New York City and New Jersey. Psychological stress was assessed at baseline using the Perceived Stress Scale (PSS), a validated 4-item instrument. Outcomes included the Asthma Control Questionnaire (ACQ), the Asthma Quality of Life Questionnaire (AQLQ), and the Medication Adherence Reporting Scale (MARS) measured at baseline, 1, 3, and 12 months of enrollment. Results. Higher perceived stress was significantly correlated with worse asthma control (ACQ scores; r = .30 to .37, p < .0001), poor quality of life (AQLQ scores; r = −.49 to − .35, p < .0001), and decreased medication adherence (MARS scores; r = −.25 to −.15, p < .028) at baseline and across the follow-up interviews. In multivariate analyses, increased stress remained a significant predictor of worse ACQ (p < .0001), AQLQ scores (p < .0001), and MARS (p < .0001) after adjusting for age, sex, income, number of years with asthma, and comorbidities. Conclusions. Among inner-city asthmatics, higher perceived stress is strongly associated with increased asthma morbidity across a 1-year follow-up. Further research is needed to identify mechanisms mediating the association between stress and asthma morbidity in adults.
Asthma Patients Who Smoke Have Signs of Chronic Airflow Limitation Before Age 45

Background. The frequency of smokers among asthma patients often mirrors the frequency of smokers among healthy individuals. Smoking has been shown to increase the lung function decline in adult asthma patients and change the composition of the bronchial inflammation. Objective. To examine the consequences of smoking in a large cohort of young asthma patients. Methods. Seven hundred ninety-three asthma patients, aged 14 to 44, were examined using lung function measurements, bronchial provocations, clinical interviews, and questionnaires. Results. Forty-five percent of participants were smokers; smokers had significantly lower forced expiratory volume in one second (FEV1), FEV1 in percent of predicted value (FEV1%pred), and FEV1/forced vital capacity (FVC) values compared with nonsmokers, and there was a dose-response relationship between tobacco exposure and these lung function measures. Smoking seemingly affected the FEV1 growth already in adolescence, and before the age of 45, significantly more smokers than nonsmokers had signs of airflow limitation, with FEV1/FVC ratios below 0.70. Smokers had more asthma symptoms despite receiving inhaled corticosteroid (ICS) treatment as frequently as did nonsmokers. Conclusion. The additive effect of smoking on lung function decline in asthma patients is detectable at early ages and leads to signs of airflow limitation before the age of 45 years.
Histoid leprosy: Role of fine needle aspiration cytology in the diagnosis

Histoid leprosy is a distinct variant of lepromatous leprosy. It presents clinically as well demarcated cutaneous and subcutaneous nodules similar to dermatofibroma. A 40 year old male, presented with multiple progressive skin lesions on buttock, trunk, face, back and extremities of six months duration. Examination findings revealed multiple, irregular, bilateral, symmetrical shiny cutaneous nodules over the above mentioned sites. Radial, ulnar, radial cutaneous and lateral popliteal nerve thickening was seen. Fine needle aspiration cytology (FNAC) showed features of histoid leprosy, which was confirmed by histopathology. Modified Ziehl-Neelsen stain for Acid fast bacilli was positive. Bacterial index was 6+. Histoid leprosy is an unusual variant of lepromatous leprosy. The identification of histoid leprosy and differentiation of it from lepromatous leprosy helps to facilitate the follow up of patients with regards to the drug sensitivity, relapse and reaction. We present here the role of FNAC in the diagnosis of histoid leprosy.
Pregabalin premedication - A new treatment option for hemodynamic stability during general anesthesia: A prospective study

Background: Hemodynamic responses of laryngoscopy, intubation, and pain are powerful noxious stimulus which should be attenuated by the appropriate premedication, smooth induction, and rapid intubation. Context: The oral pregabalin may attenuate the hemodynamic pressor response with intraoperative hemodynamic stability. Aims: The present study was designed to evaluate the clinical efficacy and safety of oral pregabalin for hemodynamic stability. Settings and Design: This is a prospective blind randomized controlled cohort observation study. Materials and Methods: The 80 adult consented patients of ASA grade I and II of either gender aged 24–54 years who met the inclusion criteria were randomized to receive oral pregabalin 150 mg or placebo capsule, given 60–75 min before surgery. Patients were premedicated with metoclopramide (10 mg), glycopyrrolate (0.2 mg), and fentanyl (1 μg/kg). Anesthesia was induced with propofol and rocuronium and maintained with isoflurane, nitrous oxide, and oxygen. Both groups were assessed for preoperative sedation and changes in heart rate and mean arterial blood pressure before and after the induction and 1, 3, 5, and 10 min after laryngoscopy and intubation, then at 5 min intervals till end of surgery along with postoperative complications. Statistical Analysis: The hemodynamic variables were analyzed by using analysis of variance (ANOVA), Student's t test, and chi square test as appropriate. Results: Preoperative sedation was higher with pregabalin with no significant change in heart rate. The mean arterial pressure was attenuated with oral pregabalin to statistically significant value (P<0.007). The requirement of analgesic drug was reduced with no postoperative respiratory depression, nausea, or vomiting and hemodynamic parameters remained stabilized perioperatively. Conclusions: Oral pregabalin premedication effectively leads to sedation and analgesia with successful attenuation of the adverse and deleterious hemodynamic pressor response.
Multidrug-resistant acinetobacter infection and their susceptibility patterns in a tertiary care hospital

Background: Antibiotic-resistant Acinetobacter nosocomial infection is a leading problem. It acts as an opportunistic pathogen to cause a wide spectrum of infection including nosocomial pneumonia, meningitis, endocarditis, skin and soft tissue infections, urinary tract infection, conjunctivitis, burn wound infection and bacteremia. Multidrug-resistant Acinetobacter infection creates a great problem in hospital setting. Materials and Methods: The clinical specimens obtained from ICU and different surgical and medical wards were investigated using standard microbiological techniques to know the distribution of and their resistant profile. Antimicrobial resistance was studied using the modified Kirby Bauer disk diffusion technique following the CLSI protocol. Results: Major infections found in different medical wards, surgical wards and ICU were due to Acinetobacter baumannii (74.02%), A. lowfii (14.2%), A. haemolyticus (7.79%), A. junii (3.8%) among Acinetobacter spices. Acinetobacter showed increased resistant against majority of commercially available drugs imipenem (5.2%), meropenem (9.75%), piperacillin-tazobactum (18.2%), netilmicin (16.24%), amikacin (14.29%), ceftazidime (74.1%), gentamicin (70.13%), ofloxacin (42.21%). Conclusion: A. baumannii was found to be associated with UTI, RTI, septicemia, bacteremia, and meningitis and wound infection. A. baumannii displayed higher resistance to more number of antibiotics than other nosocomial pathogens from ICU.
Using Information Technology to Reduce Asthma Disparities in Underserved Populations: A Pilot Study

Background. Low health literacy has been identified as an independent predictor of poor asthma control. The Institute of Medicine considers the role of information technology (IT) as critical in providing “safe, effective, patient centered, timely, efficient, and equitable” care with the potential to reduce health disparities in underserved populations. The aim of this study was to design and evaluate an interactive computer-based questionnaire to assess asthma symptoms in children of parents with limited health literacy and/or limited English proficiency. Methods. Volunteer caregivers attending a mobile asthma clinic were randomly assigned to complete the electronic or the paper-and-pencil version of an asthma screening questionnaire (ASQ) in their language of choice (English or Spanish). In the electronic version, a tablet computer was used to present the ASQ questions as video clips and to collect information through the touchscreen. Participants also completed a demographic questionnaire, a brief health literacy questionnaire, and a system usability and satisfaction questionnaire. Reliability of the paper and electronic self-assessments was evaluated by comparing each participant's answers to information they provided during a nurse-guided structured interview (gold standard). Results. A total of 48 parents participated in the study, 26 completed the electronic ASQ and 21 the paper-and-pencil form. Thirty-five percent of the children had well-controlled asthma (n = 17). Most participants were Spanish speaking (67%) Hispanic (n = 44) mothers (n = 43) with a median age of 32 years. More than half had ≤8 years of education (n = 25) and earned <$20,000 per year (n = 27). The median health literacy score was 32 (range 0–36). The correlation between health literacy scores and years of education was significant (ρ = .47, p < .01). Concordance between the electronic ASQ and the nurse interview was significantly higher than concordance between the paper ASQ and the nurse interview (68% versus 54%; p < .01). All parents who completed the electronic questionnaire reported being satisfied; 96% felt comfortable using it, and found it simple to use. Conclusions. By facilitating the assessment of asthma symptoms at manageable cost, interactive information technology tools may help reduce barriers to access due to inadequate levels of English proficiency and health literacy.
Asthma and Allergic Diseases in School Children from 1992 to 2007 with Incidence Data

Background. Information about change in the prevalence of asthma and allergic diseases and factors related with these diseases would be beneficial in decreasing the burden of these diseases. Objective.To assess (i) change in prevalence of asthma and allergic diseases; (ii) factors associated with asthma and wheeze; and (iii) incidence of asthma and wheeze. Methods. A questionnaire was administered to children aged 7–12 years in first five grades in the same primary school in 1992 (n: 1036), 1997 (n: 738), 2002 (n: 621), and 2007 (n: 422) and filled by the parents. A second survey in 2007 (n: 474, in eight grades) was conducted in the same schoolchildren, 6 months apart, to assess the incidence of asthma and wheeze and the associated factors. Results. Comparison of 1992, 1997, 2002, and 2007 surveys revealed that prevalence of asthma (8.3%, 9.8%, 6.4%, 3.3%, respectively), wheeze (11.9%, 13.3%, 6.4%, 3.1%, respectively), hay fever (15.4%, 14.1%, 7.2%, 3.1%, respectively), and eczema (4.0%, 4.3%, 1.8%, 1.2%, respectively) were significantly lower in 2002 and 2007 compared with that in 1992. Percentage of passive smoking decreased after 1992 (74.0%, 64.0%, 64.1%, and 65.5%, respectively). Incidence of asthma and wheeze in 2007 surveys were 0.9/100 and 1.1/100, respectively. After the adjustment for age and gender, infection in the past, family atopy, and presence of atopic disease (eczema or hay fever) were associated with asthma and wheeze. Maternal smoking and lack of breast feeding were associated with asthma. Male gender, pet ownership in the past, lack of health insurance coverage, snoring, and wood or coal used as fuel were associated with wheeze. Conclusions. Decreased prevalence of asthma and allergic diseases in the last 10 years could be related to decreased rate of passive smoking. Lower socioeconomic status and lack of breast feeding could increase the risk of asthma in children.