Miracle-dz/UniFAR-FTUs huggingface dataset:
MEDICINES WASTAGE AT A TERTIARY HOSPITAL IN DAR ES SALAAM TANZANIA

Article history: Received on: 29/01/2014 Revised on: 14/02/2014 Accepted on: 07/04/2014 Available online: 28/06/2014 Medicines wastage is a problem in health care delivery systems, however the extent of this wastage and associated factors in many health care settings is less known. The objective of this study was to assess medicines wastage and its associated factors in a hospital setting in Dar es Salaam city Tanzania. Specifically to determine major types of medicines wasted and to identify factors contributing towards the wastage. A cross sectional study was carried out at a tertiary hospital, where patient files were analyzed for last admission treatment information for the year 2012. Results show that about 56.3% of medicines prescribed were dispensed to patients. Out of the dispensed medicines, 730 medicines dosages were wasted. Anti-infective medicines wastage was 18.9%, cardiovascular medicines (8.9%) and the other categories was 23.7% of the total medicines dispensed. The factors contributing to medicines wastage were excess (44%), pilferage (26.5%), patient death and change/stop of medicines. Excess supply and pilferage were the major contributing factors. Measures should therefore be taken to mitigate the sources of wastage identified by this study so as to ensure availability of medicines and their rational use in hospital settings.
RAISING THE BAR: WHY SUPERVISED VISITATION PROVIDERS SHOULD BE REQUIRED TO MEET STANDARDS FOR SERVICE PROVISION

The New York Society for the Prevention of Cruelty to Children (NYSPCC) has provided a supervised visitation program (SVP) for high-risk families for almost two decades. Parents needing supervised visitation often have histories of domestic violence, child abuse and neglect, mental illness or substance abuse, therefore providers delivering services must be adequately trained and supervised in order to protect the child from further harm during the visitation process. This article describes the need for SVP’s, parental issues warranting consideration, the special needs of children in these circumstances, policy recommendations for provider standards, and a certification process to be developed and adopted in New York State.
Gender determination using the mental foramen

Background: Identification and determination of the sex of unknown human skeletal remains have been one of the most challenging tasks for forensic dentistry. The purpose of this study was to determine the feasibility of the analysis of location of the mental foramen on panoramic radiographs for gender determination. Materials and Methods: Thirty radiographs of an equal number of males and females were selected for the analysis of the mental foramen. Distance from the superior and inferior borders of the mental foramen to the lower border (S-L and I-L) of the mandible of both sides were recorded. The data obtained were subjected to statistical analysis. Results: The distances of S-L and I-L were significantly high in males than in females while the distance for the right and left sides of an individual were almost similar in both the male and female groups and the results were nonsignificant. Conclusion: There is a significant difference in the distance from the mental foramen to the lower border of the mandible in males and females.
Global manipulation of digital images can lead to variation in cytological diagnosis

Background: With the adoption of a completely electronic workflow by several journals and the advent of telepathology, digital imaging has become an integral part of every scientific research. However, manipulating digital images is very easy, and it can lead to misinterpretations. Aim: To analyse the impact of manipulating digital images on their diagnosis. Design: Digital images were obtained from Papanicolaou-stained smears of dysplastic and normal oral epithelium. They were manipulated using GNU Image Manipulation Program (GIMP) to alter their brightness and contrast and color levels. A Power Point presentation composed of slides of these manipulated images along with the unaltered originals arranged randomly was created. The presentation was shown to five observers individually who rated the images as normal, mild, moderate or severe dysplasia. Weighted k statistics was used to measure and assess the levels of agreement between observers. Results: Levels of agreement between manipulated images and original images varied greatly among observers. Variation in diagnosis was in the form of overdiagnosis or under-diagnosis, usually by one grade. Conclusion: Global manipulations of digital images of cytological slides can significantly affect their interpretation. Such manipulations should therefore be kept to a minimum, and avoided wherever possible.
Intrinsic risk factors for sport injuries in female volleyball

Background/objective To investigate the incidence and injury mechanism as well as intrinsic risk factors for acute sports injuries in female volleyball. Design Prospective epidemiological study. Setting and participants 174 female volleyball players from Slovenian Divisions I and II were prospectively monitored during 2007–2008 season. Methods All injuries were prospectively documented by team coaches. Prior to the season all players underwent the following tests: anthropometry, sit and reach test, isokinetic strength testing of the knee and shoulder, postural stability testing and vertical jump testing. Main outcome measure was injury incidence; binary logistic regression was used afterwards in order to evaluate the role of different parameters from functional testing on injury occurrence. Results The overall incidence of injuries for the females was 0.35±0.19 per 1000 h of volleyball played. The incidence of injuries in a game situation was higher than in practice (2.10±1.06 vs 0.42±0.24) The most frequent injury was acute ankle sprain 1.45 (1.98), followed by knee injury 0.69 (1.34). Majority of injuries occurred during the competition season (81.4%), in the middle of training (25.58%) or during a game (25.58%). Most injuries occurred during landing (41.4%). Risk factor analysis revealed that previous injury is an important risk factor for acute knee injuries and ankle sprains. Low hamstring quadriceps ratio was related with ankle sprains, while quadriceps strength asymmetry was related to acute knee injuries. Conclusions The results of our study suggest that isokinetic strength testing in previously injured female volleyball players could identify players with increased risk for acute knee injuries and ankle sprains.
A review of the energy expenditure of disabled locomotion with special reference to lower limb amputees

This paper reviews selected studies of the energy cost of motor activities. In comparison with non-disabled subjects, the disabled incur additional energy costs for many activities, but there is evidence that this can be minimised by modifying external factors such as the design of clothing or orthoses and therapeutic strategies aimed at improving exercise performance efficiency.
Adrenal Lesions: Spectrum of Imaging Findings with Emphasis on Multi-Detector Computed Tomography and Magnetic Resonance Imaging

The adrenal gland is a common site of a large spectrum of abnormalities like primary tumors, hemorrhage, metastases, and enlargement of the gland from external hormonal stimulation. Most of these lesions represent nonfunctioning adrenal adenomas and thus warrant a conservative management. Multi-detector computed tomography (CT) and magnetic resonance (MR) imaging are still considered highly specific and complementary techniques for the detection and characterization of adrenal abnormalities. Radiologist can establish a definitive diagnosis for most adrenal masses (i.e., carcinoma, hemorrhage) based on imaging alone. Imaging therefore can differentiate malignant lesions from those benign and avoid unnecessary aggressive management of benign lesions. The article gives an overview of the adrenal lesions and their imaging characteristics seen on CT and MR imaging.
Drug delivery systems for the topical treatment of cutaneous leishmaniasis

Introduction: The parenteral administration of pentavalent antimonials for the treatment of all forms of leishmaniasis, including cutaneous leishamniasis (CL), has several limitations. Therapy is long, requiring repeated doses and the adverse reactions are frequent. Topical treatment is an attractive alternative for CL, offering significant advantages over systemic therapy: fewer adverse effects, ease of administration, and lower costs. Areas covered: This review covers, from 1984 to the present, the progress achieved for the development of topical treatment for CL, using different drugs such as paromomycin (PA), imiquimod, amphotericin B (AmB), miltefosine, and buparvaquone. PA is the most commonly studied drug, followed by AmB and Imiquimod. These drugs were incorporated in conventional dosage forms or loaded in lipid nanocarries, which have been used mainly for improved skin delivery and antileishmanial activity. Expert opinion: Developing an effective topical treatment for CL using these antileishmanial drugs still remains a great challenge. Insights into the most promising delivery strategies to improve treatment of CL with PA and AmB using conventional dosage forms, lipid nanocarriers, and combined therapy are presented and discussed. The results obtained with combined therapy and alternative delivery systems are promising perspectives for improving topical treatment of CL.
Clinical symptoms and treatment of the foot and ankle nerve entrapment syndromes

Summary A nerve entrapment can appear in any location caused by nonspecific local lesions, haematomas, tumours, inflammations or fracture calluses. However, the course and the relationship of the foot and ankle nerves can explain the majority of the compression syndromes as the nerves are connected to fascia, bone, muscles or—most frequently—sheaths. Morphological changes in these tracts, even in the absence of external factors, can explain some of these syndromes. This is the case in osseous (peroneal tuberosity hypertrophy), muscles (flexor digitorum communis accesorius) or neural abnormalities. Foot compression pathology is manifested by a mechanical irritation of peripheral nerves that move in the fibromuscular and osseous-ligamentary tunnels. Patients often complain of sensory symptoms that in some occasions can simulate a rheumathological disorder.
Increased levels of biglycan in endometriomas and peritoneal fluid samples from ovarian endometriosis patients

Abstract In our previous low-density-array gene-expression analysis we found an increased expression of biglycan gene in ovarian endometriosis patients. In the present study we evaluated biglycan expression at the protein level in tissue, serum and peritoneal fluid (PF) from ovarian endometriosis patients, patients with benign ovarian cysts and healthy women. Twenty samples of endometriomas and 27 of control tissues (benign ovarian cysts and eutopic endometrium of healthy women) were obtained laparoscopically or by curettage. Serum and PF samples were collected from 56 ovarian endometriosis patients and 40 controls (patients with benign cysts and healthy women). Tissue biglycan levels and serum and PF biglycan concentrations were determined by Western blotting and ELISA, respectively. Biglycan was detected in endometriomas and in benign cysts tissues but differed in glycosylation levels. The PF biglycan concentrations were significantly increased in ovarian endometriosis patients (mean ± SD = 220.3 ± 190.5 pg/mg protein) compared to the whole control group (101.9 ± 94.7 pg/mg protein, p < 0.001), while serum concentrations did not differ significantly. Biglycan appears to be involved in ovarian pathologies and probably has different roles in benign cysts as compared to ovarian endometriomas.
Curbing maternal and child mortality: The Nigerian experience

th African Regional Conference organised by Nurses Christian Fellowship International (NCFI) in Ghana, was utilized to extensively compare notes and discuss salient issues contained in our reviewed work. Existing research works in prints and electronic among others were used in the search and collation of facts and figures contained in the study. Theme of the conference was: Reforming Nursing and Midwifery Care in Africa. Nigeria is the most populous Black Nation and has the maternal mortality rate of 280 to 1150 per 100,000 live births (Onwumere, 2010). Maternal and child mortality is closely linked to poverty with malnutrition as an underlying contributor in over half of these deaths. Factors associated with these problems include, poor socio-economic development, weak health care system and low socio-cultural barriers to care utilization (Ibeh, 2008). The persistent high rate of maternal and child mortality in the country negates the achievement of the 4th and 5th Millennium Development Goals (MDGs). Nigeria, which constitutes just 1% of the world’s population, accounts for 10% of the world’s maternal and under-5 mortality rates. Factors associated with these problems include, poor socio-economic development, weak health care system and low socio-cultural barriers to care utilization. Key interventions identified for curbing these problems include, care during pregnancy, birth and post partum supports in addition to approved child survival intervention.
The association of heavy metals in blood, fish consumption frequency, and risk of cardiovascular diseases among Korean adults: The Korean National Health and Nutrition Examination Survey (2008-2010)

Limited studies are available concerning the effect of heavy metal exposure on cardiovascular diseases. As environmental pollution increases, food contamination, including heavy metal contamination of fish, also increases. However, researches based on the intake of heavy metals, cardiovascular disease, and fish intakes are inconclusive. We assessed an association of heavy metal exposure with cardiovascular disease and fish intake in a nationally representative group of general Korean adults. We used data from the combined 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES), and analyzed the data of 5,139 Koreans who participated in KNHANES. All participants were older than 20 years, and were diagnosed with stroke, ischemic heart disease, or hypertension. The mean blood cadmium, lead concentration, and mercury concentration of subjects were 1.07 ± 0.01 μg/L, 2.49 ± 0.02 μg/dL, and 5.19 ± 0.08 μg/L, respectively. We used the survey logistic regression model to account for the complex sample design of the cardiovascular disease risk in order to estimate the odds ratios (OR). After adjusting for age, education, income, alcohol, smoking, and BMI, the increase of serum cadmium in blood was associated with the increase in the prevalence of hypertension. Further, the increase in blood cadmium concentration was associated with the increase of both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Although higher fish intakes were significantly associated with higher blood mercury concentration (p for trend ＜ 0.0001), fish intakes did not affect either blood cadmium or lead concentration. Comparing the highest fish intake group with the lowest intake group, the OR of hypertension was 0.31 (95% CI: 0.19-0.59) in the crude model for total fish. However, these associations were no longer significant after the adjustment for potential confounding factors. In conclusion, cadmium in blood was associated with an increased risk of hypertension in the general Korean adult population. However, we found no evidence of a clear relationship between cardiovascular disease and frequency of fish consumption.
Immunological and hemostasiological disorders in women with ovarian hyperstimulation syndrome

Abstract To assess the markers of destabilization of homeostasis in women with ovarian hyperstimulation syndrome (OHSS), the investigation of the levels of cortisol, markers of renin-angiotensin-aldosterone system, endothelin, proinflammatory cytokines, acute phase proteins, and parameters of hemostasis was performed. Our survey involved 105 women who became pregnant after IVF: 21 women with symptoms of the early moderate and severe OHSS, 28 women with the late moderate and severe OHSS, and 56 pregnant women undergoing IVF without symptoms of OHSS. It was found significant increase of levels of cortisol, interleukins, the number of leucocytes, concentration of fibrinogen and D-dimers in patients with early and late OHSS. The development of late OHSS is associated with the lower level of IL-8 and ceruloplasmin. The OHSS is characterized by leukocytosis, higher level of IL-6, TNF-α, fibrinogen, D-dimers, thus reflecting the homeostasis imbalance. The determination of the level of fibrinogen, D-dimers, leukocytes can be an important screening test of the intensity of the inflammatory process in patients with OHSS.
Polymorphism of COMT Val158Met is associated with inhalant use and dependence: a Thai substance dependence treatment cohort

Abstract Background: Inhalants are abused by adolescents worldwide, but genetic markers of inhalant use or dependence are poorly understood. Objective: We assessed the frequency and association of a functional polymorphism in the gene encoding catechol-O-methyltransferase (COMT Val158Met) in inhalant-dependent (ID) subjects and inhalant users (IU). Methods: Demographic and diagnostic data were collected by interviewing 456 Thai-speaking methamphetamine (MA) users by using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). COMT Val158Met (rs4680) genotyping was acquired by restriction fragment length polymorphism. Individuals with ID or IU were compared with non-ID or non-IU by using a χ2 test. After that, factors associated with ID or IU were analyzed by logistic regression. Blood samples from 217 healthy blood donors were used as controls for ID and IU in the allele frequency comparison. Deviation from Hardy-Weinberg Equilibrium Expectations (HWEE) was also tested. Results: Out of 456 MA users, deviation from HWEE was observed in IU but not in ID, non-ID or from the total sample. The “Met” allele was significantly associated with ID (p = 0.02) and IU (p = 0.002) among MA users, but not in allele frequency comparisons when compared to the healthy control group (p > 0.1). With respect to logistic regression analysis, homo or heterozygosity for the “Met” allele, male sex, younger age, lower level of education, a major depressive episode (MDE), and alcohol dependence were associated with ID. Analyses of IU vs. non-IU yielded the same results except for age and MDE. In addition, individuals with MA-induced paranoia (MIP) were more likely to have used inhalants at least once in their lifetime compared to those without. Conclusion: COMT 158Met, male sex, younger age, lower level of education, MDE, MIP, and alcohol dependence increased risk for inhalant use and/or dependence.
Incidence of Adverse Drug Events and Potential Adverse Drug Events: Implications for Prevention

Objectives. —To assess incidence and preventability of adverse drug events (ADEs) and potential ADEs. To analyze preventable events to develop prevention strategies. Design. —Prospective cohort study. Participants. —All 4031 adult admissions to a stratified random sample of 11 medical and surgical units in two tertiary care hospitals over a 6-month period. Units included two medical and three surgical intensive care units and four medical and two surgical general care units. Main Outcome Measures. —Adverse drug events and potential ADEs. Methods. —Incidents were detected by stimulated self-report by nurses and pharmacists and by daily review of all charts by nurse investigators. Incidents were subsequently classified by two independent reviewers as to whether they represented ADEs or potential ADEs and as to severity and preventability. Results. —Over 6 months, 247 ADEs and 194 potential ADEs were identified. Extrapolated event rates were 6.5 ADEs and 5.5 potential ADEs per 100 nonobstetrical admissions, for mean numbers per hospital per year of approximately 1900 ADEs and 1600 potential ADEs. Of all ADEs, 1% were fatal (none preventable), 12% life-threatening, 30% serious, and 57% significant. Twenty-eight percent were judged preventable. Of the life-threatening and serious ADEs, 42% were preventable, compared with 18% of significant ADEs. Errors resulting in preventable ADEs occurred most often at the stages of ordering (56%) and administration (34%); transcription (6%) and dispensing errors (4%) were less common. Errors were much more likely to be intercepted if the error occurred earlier in the process: 48% at the ordering stage vs 0% at the administration stage. Conclusion. —Adverse drug events were common and often preventable; serious ADEs were more likely to be preventable. Most resulted from errors at the ordering stage, but many also occurred at the administration stage. Prevention strategies should target both stages of the drug delivery process. (JAMA. 1995;274:29-34)
Methods for the Evaluation of Polyphenolic Content in “Uva Di Troia Canosina” Grape and Seeds at the Different Maceration Stages

Seeds and skins derived from the small berries of “uva di Troia canosina” grape, a Vitis vinifera variety autochthonous of Apulia region (South Italy), collected at four different stages (“Tesi” 1–4) of the fermentation process were extracted by means of a maceration. The extracts were purified and analyzed, in order to study the influence of fermentation over grape seed and skin polyphenolic content. Seed extraction was performed by a multistep maceration with two solvents: ethanol and acetone, the former giving the best results; moreover, the extracts were purified with pure ethyl acetate in order to enrich their polyphenolic content. On the other hand, skin extraction was achieved by a single-step maceration in methanol and a purification with a brominated synthetic adsorbent resin. The evaluation of the extraction yield and polyphenolic content was carried out by TLC, UV/VIS, and LC/DAD analyses. In the seed extracts, the characteristic polyphenols (catechin, epicatechin, and procyanidin B1 and B2) useful for the development of a nutraceutical product, endowed with antioxidant properties, were present, while no resveratrol was detected in “uva di Troia canosina” grape skin extracts, even in an LC/MS-MS analysis.