Miracle-dz/UniFAR-FTUs huggingface dataset:
Bacteriological profile and antibiotic susceptibility pattern (antibiogram) of urinary tract infections in paediatric patients

Background: Urinary tract infection (UTI) is one of the most common paediatric infections.It may cause permanent kidney damage. So the knowledge on common causative organism will help in initiation of treatment of UTI. Aim: The aim of this study was to find out the causative agents of urinary tract infections and their antibiotic sensitivity pattern in paediatric patients in S.S. G Hospital, Baroda. Material &Methods: A study was conducted at S.S. G hospital,Barodafrom January 2012 to June 2012. Total 1263 samples collected from paediatric patients suspected of having UTI. The bacterial agents which caused UTI were isolated, characterised & identified using standard microbiological tests. Antibiogramof all the isolates were performed by the disc-diffusion (Modified-Kirby Bauer technique) according to CLSI guidelines using Amikacin, Gentamicin, Cefotaxime, Chloramphenicol, Nitrofurantoin, Piperacillin, Piperacillin+Tazobactum, Ofloxacin, Norfloxacin, Ampicillin+Sulbactum. Results: The prevalence of UTI among paediatric patient was 29.78%. Escherichiacoli (38.42%)were the most frequent cause of UTIfollowed by Klebsiella spp. (23.89%), Acinetobacter spp. (11.33%). Maximum isolates of urinary samples were sensitive to Amikacin(63.79%) and Piperacillin+Tazobactum(63.05%). Conclusion: The prevalence of UTI amongst paediatric patients was high and Escherichia coli were the most frequent etiologic agent followed by Klebsiella species being the second most common. Clinician should prefer Amikacin for treatment of UTI in paediatric patients. In case of Amikacin resistance, Piperacillin+Tazobactum can be used.
Comparative Study of Post Operative Astigmatism Following Small Incision Cataract Surgery-Sics in Superior, Supero-Temporal and Temporal Incision.

This prospective study was designed to evaluate and compare surgically induced astigmatism in small incision cataract surgery through superior, supero-temporal and temporal approach. Astigmatism means no point focus. It is a refractive error that occurs when the optical system does not have the same refractive power at all its meridian. The location and width of incision will determine the amount of surgically induced astigmatism (SIA) in small incision cataract surgery. Temporal and superotemporal incisions are less likely to induce post operative astigmatism than the 12 o' clock incisions. The study was carried out at Tairunnessa Memorial Medical College and Hospital, Gazipur, Faridpur Diabetic Association Medical College and Hospital, Faridpur and General Hospital, Faridpur, Bangladesh, from January 2012 to June 2013.Total number of 120 eyes of 108 patients, both male and female patients were included for the study. We excluded the patients having corneal scar, irregular astigmatism, presence of pterygium and previous intraocular surgery from our study. The mean patient age at the time of surgery was 61.9±8.1 years ranged from 40 to 70 years.The patients were divided into three groups.The three groups had 40 patients each. The patients in group-A underwent manual SICS with a superior incision, the patients in group-B underwent manual SICS with a supero-temporal incision and the patients in group-C underwent manual SICS with a temporal incision. The small incision cataract surgeries were done by applying same surgical technique.The courses of the post operative astigmatic changes were determined by using Auto Refracto Keratometer at 1st week, 6th weeks and 12th week postoperatively. DOI: http://dx.doi. org/10.3329/medtoday.v25i2. 17925 Medicine Today 2013 Vol.25(2): 72-74
ASSESSING THE PRACTICES OF GENETIC COUNSELORS REGARDING HEAD CIRCUMFERENCE MEASUREMENT IN HEREDITARY CANCER ASSESSMENT

PTEN, a tumor suppressor gene, has been identified as an overgrowth susceptibility gene causing Cowden syndrome. Cowden syndrome is characterized by an increased risk for breast cancer and other malignancies, mucocutaneous lesions, and macrocephaly. Macrocephaly is a hallmark of Cowden syndrome, is considered a major criterion for the clinical diagnosis, and is present in an estimated 80% of individuals diagnosed with Cowden syndrome. However, it is unknown what percentage of genetic counselors routinely measure head circumference when evaluating patients for hereditary cancer assessment. This study queried National Society of Genetic Counselors (NSGC) members about current practices and opinions regarding head circumference measurement. A questionnaire was dispersed electronically to all members of NSGC, and those who have practiced cancer genetic counseling in the last six months were eligible to respond. The data from 216 surveys was analyzed using descriptive statistics and qualitative methods including thematic analysis. Eighty-four percent of genetic counselors are not measuring head circumference on every patient presenting for hereditary cancer assessment, nor those who are specifically presenting for hereditary breast cancer assessment. Thematic analysis revealed these individuals feel head circumference measurement should not be standard in a cancer assessment, but reserved for those who are suspicious of Cowden syndrome based on personal or family history. Additionally, some genetic counselors expressed they have not received appropriate training in head circumference measurement. However, the 29% of genetic counselors who believe head circumference should routinely be measured felt it is a quick and easy measurement that is helpful in assessment and is good clinical practice. Thematic analysis also revealed mixed responses about the value of head circumference measurement with the increasing use of next generation sequencing panels. Although macrocephaly is a major diagnostic criterion for Cowden syndrome, there have been diverse outcomes on the exact incidence, ranging from 40-100%. Identification of Cowden syndrome has significant public health implications. Because Cowden syndrome is associated with increased lifetime risks of cancer of multiple organ sites, and because increased screening and consideration of risk-reducing surgery, it is important that health care professionals identify cases of Cowden syndrome in their patient population.
Knee performance after anterior cruciate ligament reconstruction

The aim of this study was to determine differences in isokinetic performance, hop tests, range of motion and thigh circumference between the involved and uninvolved leg in patients after 4, 5, 6 and 8 months after anterior cruciate ligament (ACL) reconstruction and to investigate the possible correlation between the different evaluation methods. Fourteen male subjects submitted to intra-articular reconstruction of the anterior cruciate ligament with patellar tendon graft. All parameters improved from the 4th to the 8th month post-op. The deficits were more pronounced for the quadriceps than for the hamstrings, which regained full function at 5 months. Quadriceps performance and thigh circumference were impaired even after 8 months. According to the Lysholm Score, all subjects scored at least as good function and 54% had excellent results. There was a positive correlation between quadriceps performance and both single and triple hops (0.51-0.63), whilst for the harmstrings the correlations were weak (0.32-0.44). We conclude that: 1) Individuals with anterior cruciate ligament injury present quadriceps weakness even after 8 months of the reconstructive surgery using patellar tendon graft; 2) when an isokinetic dynamometer is not available, horizontal impulse tests can be used to evaluate quadriceps deficiency; 3) thigh circumference should not be used as a measurement to predict muscle performance; 4) the Lysholm Score is not sensitive to detect limitations in muscle performance.
Diagnostic yield of CT urography in the evaluation of young adults with hematuria.

OBJECTIVE CT urography is increasingly used as the initial imaging test in patients with hematuria. The aim of our study was to determine the yield of CT urography in young adults with hematuria to see whether single phase unenhanced CT would have been sufficient. MATERIALS AND METHODS We reviewed medical records of consecutive patients undergoing CT urography between March 2000 and July 2009 at our tertiary medical center. Of 5400 CT urograms performed, 375 (6.9%) in 359 patients aged 40 years or younger with hematuria were included in the study. Urographic findings were tabulated according to their clinical significance. CT images were reviewed to see whether contrast-enhanced images were necessary for diagnosis. RESULTS A clinically significant source was found in 83 of 375 examinations (22.1%), including 42 of 142 (29.6%) for gross hematuria, 29 of 181 (16.0%) for microscopic hematuria, and 12 of 52 (23.1%) for hematuria of unspecified subtype. The most common clinically significant findings were renal or ureteral calculi (n = 73 [75.3%]); four malignancies were also detected. Ninety-two (94.8%) of 97 clinically significant findings were evident on unenhanced images. All significant findings that required contrast-enhanced images for diagnosis occurred in patients with predisposing medical conditions. CONCLUSION A clinically significant source of hematuria was detected in 22.1% of CT urograms of young adults. However, an unenhanced CT alone may be sufficient in patients without additional predisposing medical conditions, thereby reducing radiation dose in this radiosensitive population.
High-spatial-resolution 3-T breast MRI of nonmasslike enhancement lesions: an analysis of their features as significant predictors of malignancy.

OBJECTIVE The purpose of this study was to analyze the features of nonmasslike enhancement detected on 3-T MRI and to determine which of these features are significant predictors of malignancy. MATERIALS AND METHODS Retrospective review was performed of 124 consecutive patients with nonmasslike enhancement detected on 3-T MRI after biopsy or surgery. We described nonmasslike enhancement using the descriptors in the BI-RADS MRI lexicon. In addition to the BI-RADS descriptors, whether clustered ring enhancement was present and whether surrounding high signal intensity (SI) was present on T2-weighted imaging were assessed. RESULTS Cancer was identified in 85 lesions (69%). Of these lesions, ductal carcinoma in situ (DCIS) was found in 41 (48%) and invasive cancer in 44 (52%). The features found to be significant predictors of malignancy were segmental (p = 0.001), focal (p = 0.006), dendritic (p = 0.017), and clustered ring enhancement (p = 0.026) and surrounding high SI on T2-weighted imaging (p < 0.0001). The features found to be significant predictors of invasive cancer were dendritic enhancement (p < 0.0001) and surrounding high SI on T2-weighted imaging (p < 0.0001). There were no significant predictive features for DCIS. Homogeneous enhancement was found to be a significant predictor of benignancy (p = 0.001). Kinetic patterns were not significant predictors of malignancy. Nonmasslike enhancement of 1 cm or larger was more often malignant than lesions smaller than 1 cm (p < 0.0001). In multivariate analysis, a lesion size of 1 cm or larger was found to be the only significant predictor of malignancy for nonmasslike enhancement. CONCLUSION Segmental, focal, dendritic, and clustered ring enhancement; surrounding high SI on T2-weighted imaging; and a lesion size of 1 cm or larger can act as predictors of malignancy for nonmasslike enhancement detected on 3-T MRI, but kinetic characteristics cannot.
Attrition of Beginning Teachers and the Factors of Collaboration and School Setting

Abstract The purpose of this study was to investigate beginning teacher attrition and the factors of collaboration and school setting (urban, suburban, and rural). Quantitative data were collected from present and former teachers in a Midwest state using the researcher-created Collaboration Survey. Building principals and central office staff supplied attrition data from the 1998-2002 school years. Semi-structured follow up interviews with five percent of the sample population and unsolicited written comments found on the Collaboration Survey provided qualitative data. Aggregate computation of the four-year attrition rate revealed a substantial difference in the attrition rate by school setting. Urban schools had a much lower rate (4%) than did suburban (15%) and rural (17%) schools in the sample. A MANOVA was utilized to examine differences in the degree of collaboration experienced by current beginning teachers and former teachers with less than five years experience. Of the six subscales measuring collaboration, current and former teachers’ total responses did not differ significantly. However, a one-way MANOVA was calculated for the three items comprising two subscales, Commitment and Process. Significant differences were found in one item from each of the two subscales. First, an item concerning the effect of the collaborative group on the beginning teacher’s desire to continue teaching, and second, an item concerning the collaborative group member’s responsibility for a common group of students. A Chi-Square test of independence determined that interdisciplinary teaming did not affect the attrition rate of beginning middle level teachers.
Patient follow-up after concordant histologically benign imaging-guided biopsy of MRI-detected lesions.

OBJECTIVE The purpose of this study was to review the reported experience and suggest follow-up after biopsy for MRI-detected lesions. CONCLUSION Imaging-guided biopsy, using MRI or sonographic guidance, of MRI-detected lesions may result in false-negative results that are not appreciated at the time of the biopsy. A 6-month follow-up MRI is suggested as the most appropriate interval to identify lesions that were missed at biopsy without clinically significant delay in diagnosis of those lesions that are malignant.
Invasive ductal carcinoma of the breast: correlation between tumor grade determined by ultrasound-guided core biopsy and surgical pathology.

OBJECTIVE The purpose of this article is to evaluate the concordance between tumor grade found on ultrasound-guided core biopsies of invasive ductal carcinomas of the breast and subsequent excision specimens. MATERIALS AND METHODS We retrospectively studied 300 consecutive invasive ductal carcinomas (274 women) that were biopsied under sonographic guidance, using 14-gauge core needles exclusively, and that were subsequently excised surgically. A minimum of four cores were taken per lesion. Core biopsy grades were compared with final surgical grades (reference standard). Tumor grade was assigned using the standard modified Scarff-Bloom-Richardson system. The agreement rate was expressed in percentages and in kappa statistics; the rates of overestimation and underestimation were also assessed. The correlation between tumor size (small, ≤ 0.5 cm; medium, 0.6-2.4 cm; and large, ≥ 2.5 cm) and agreement rate was also evaluated. RESULTS The overall agreement between core biopsy and surgical pathology grade was 69% (simple κ = 0.46; 95% CI, 0.36-0.54). Agreement by biopsy grade was 86% (55/64) for grade 3, 66% (118/180) for grade 2, and 55% (23/42) for grade 1. Core biopsy underestimated 24% (70/286) and overestimated 7% (20/286) of the lesions. When discordant, core biopsy differed from excision by no more than one grade. Large tumors were more likely to show underestimation rather than overestimation when discordant (rate of underestimation, 92% for large, 81% for medium, and 33% for small tumors; p < 0.0031). CONCLUSION Ultrasound-guided core biopsy accurately predicts high-grade breast tumors but is moderately accurate for lower-grade lesions. Large tumor size negatively impacts the accuracy of tumor grade found on biopsy and is associated with underestimation.
Evaluation of Pulmonary Function Tests in obese individuals compared to non–obese individuals in age group of 35–55 years

Background & objectives : Obesity has been found to be associated with altered PFTs. Obesity is known to induce respiratory mechanical impairments that may be combined with gaseous exchange abnormalities. The present study was planned to find out the relationship of obesity in terms of increased BMI & Pulmonary dysfunction. Method : Patients were taken by organizing camps at QURESH MEDICAL TRUST, MIRZAPUR, AHEMDABAD and further divided ac-cording to their BMIs into two groups, N = 50 (control group) having BMI between 18.50-24.99 and N=50 (study group) having BMI >30. PFT parameters (FVC, FEV1, PEFR & MVV) were studied in both groups by using spirometer (computerised spirometer GMS-HELLIOS 702) Results: The findings of PFTs showing that FVC, FEV1, PEFR & MVV were reduced in study groups compared to control group and dif- ference was statistically significant (P<0.05) Interpretation & conclusion: Similar to earlier studies done in India & abroad, we also found an impairment of the lung functions in obese having higher BMI than control subjects. There is inverse relationship between BMI & PFTs. Further reduction in weight helps to restore the normal pulmonary functions.
Association between visceral adiposity and colorectal polyps on CT colonography.

OBJECTIVE The purpose of this article is to determine whether there is an association between visceral adiposity measured on CT colonography (CTC) and colorectal polyps. MATERIALS AND METHODS Patients who underwent CTC and same-day optical colonoscopy (n = 1186) were analyzed. Visceral adipose tissue volumes and volume percentages relative to total internal body volume were measured on slices in the L2-L3 regions on supine CTC scans with validated fully automated software. Student t test, odds ratio, logistic regression, and receiver operating characteristic analyses were performed. RESULTS For subjects with (n = 345) and without (n = 841) adenomatous polyps, the mean (± SD) volume percentages were 31.2% ± 10.8% and 28.2% ± 11.3%, respectively (p < 0.0001). For subjects with (n = 244) and without (n = 942) hyperplastic polyps, the volume percentages were 31.8% ± 10.7% and 28.3% ± 11.2%, respectively (p < 0.0001). Comparing the lowest and highest quintiles of volume percentage, the odds ratios for having at least one adenomatous polyp or hyperplastic polyp versus no polyp were 2.06 (95% CI, 1.36-3.13) and 1.71 (95% CI, 1.08-2.71), and the prevalence of having adenomatous polyps or hyperplastic polyps increased by 14% and 8%, respectively. CONCLUSION Subjects with higher visceral adiposity measurements on CTC have a greater risk for the presence of colonic polyps.
Identification of Niclosamide as a New Lead Compound to Suppress the Metastasis of Prostate Cancer Cells

Prostate cancer is one of the most common cancer types among males. Metastasis in advanced stages of prostate cancer makes the disease refractory to current treatments and is the leading cause of death of advanced prostate cancer. Drugs targeting metastasis may provide new therapeutic strategies for advanced prostate cancer. We identified the traditional antihelminthic drug niclosamide to have great potential in suppressing the metastatic process of prostate cancer. The drug potently inhibited the migration and invasion of the DU145 prostate cancer cell line. It significantly suppressed the protein levels of key members of the matrix metalloproteinase family (MMP2 and MMP9), as well as cadherins and catenins (E-/N-cadherin and β-catenin), all of which are critical factors in the metastastic process. Further investigation suggested that the motility inhibition of niclosamide on DU145 cells was highly correlated to its suppression of the STAT3 and MAPK signaling pathways.
Juvenile osteochondritis dissecans: is it a growth disturbance of the secondary physis of the epiphysis?

OBJECTIVE The primary physis is responsible for longitudinal bone growth. Similarly, epiphysial growth relies on endochondral ossification from the circumferential secondary physeal [corrected]. injury can result in disruption of normal ossification. The cause of juvenile osteochondritis dissecans (OCD) remains elusive. We hypothesized that juvenile OCD results from an insult affecting endochondral ossification from the secondary physis. The purpose of our study was to evaluate the MRI appearance of the distal femoral epiphysis-particularly the secondary physis-of children with juvenile OCD and to compare these findings with the MRI findings of unaffected children. MATERIALS AND METHODS Knee MRI examinations of 30 children (age range, 8 years 8 months to 13 years 4 months) with OCD and 30 matched control patients were evaluated for skeletal maturity; location of the OCD lesion, if present; secondary physeal [corrected] continuity; overlying chondroepiphysial integrity, contour, and width; signal intensity of subchondral bone; and secondary physeal [corrected] conspicuity. Variables were compared using chi-square tests. RESULTS All children were skeletally immature. Condylar lesions were medial in 24 knees and lateral in six knees. All were in the middle one third, posterior one third, or middle and posterior thirds in the sagittal plane. The majority of lesions spanned the intercondylar and middle one third of the femoral condyle in the coronal plane (73%). There was a significant difference between secondary physeal [corrected] disruption in juvenile OCD condyles compared with unaffected condyles (p < 0.001) and control condyles (p < 0.001). Compared with unaffected and control condyles, the OCD group showed chondroepiphysial widening (p < 0.001) and subchondral bone edema (p < 0.001) on MRI. Neither chondroepiphysial integrity nor chondroepiphysial contour was significantly different between groups (p = 0.21, p = 0.31, respectively). CONCLUSION MRI of children with OCD consistently showed secondary physis disruption, overlying chondroepiphysial widening, and subchondral bone edema. We suggest that disruption of normal endochondral ossification may be associated with juvenile OCD.
Knowledge of Primary Health Care Providers in Nairobi East District, Kenya, regarding HIV-related Oral Facial and Other Common Oral Diseases and Conditions.

Background: In the Kenya primary health care (PHC) setting where most patients, including nearly 1.4 million HIV-infected people, seek medical care, PHC providers are expected to identify and manage HIV-related oral diseases during general consultations. This study aimed to assess the Original Research Article current knowledge of clinical officers and nurses in Nairobi East district of Kenya regarding HIV-related oral diseases and conditions. Design and Methods: A 40-item questionnaire was used in interviewing all 57 PHC providers in 2 administrative divisions in the district in a cross-sectional survey. Assessed categories were: knowledge about HIV-related oral lesions, clinical appearance of HIV-suspected conditions, knowledge about oro-pharyngeal candidiasis (OPC), general dental knowledge, common appearances of OPC, knowledge about periodontitis, causes of dental caries, frequency of general oral examinations and past training in oral health topics. The first 4 categories were confirmed as sub domains, with Cronbach’s alpha of 0.57, 0.54, 0.59 and 0.45 respectively. Results: All 57 PHC providers (15 clinical officers and 42 nurses) completed the questionnaire (response rate 100%). PHC providers did not routinely perform oral examinations. Their knowledge about HIV-related oral health topics and general oral health was found to be generally inadequate. Recommendations: A training module on HIV-related oro-facial lesions for Nairobi PHC providers, incorporating a practical session covering oral examinations, is recommended; especially in this high HIV-prevalence environment.