Miracle-dz/UniFAR-FTUs huggingface dataset:
A Study on Gingival Enlargement and Serum Folic Acid Levels in Epileptic Patients on Phenytoin Therapy

Background - Chronic administration of phenytoin has been associated to have a number of adverse effects. Gingival enlargement is one such most often reported adverse drug sequela of long term phenytoin usage with falling serum folic acid levels seen with increase in the duration of phenytoin therapy. There have been studies that report clinical benefits of the use of folic acid as an adjuvant to the anti-epileptic therapy in the prevention of anti-epileptic drug induced gingival enlargement. However, studies conducted in the past have also reported precipitation of epileptic attacks in patients on folic acid adjuvant therapy due to fall in sera levels of phenytoin due to drug interactions. Hence, the study was planned to investigate the association of phenytoin induced gingival enlargement and sera levels of folic acid in epileptic patients on phenytoin therapy. 25 patients between the ages of 18-50 years clinically diagnosed with epilepsy prior to the start of phenytoin therapy were included based on selection criteria and written informed consents were obtained. Assessment of serum folic acid levels and gingival enlargement was done prior to the start of and after 6 months of phenytoin therapy. The results of the study confirmed a significant association between low serum folate levels and increasing severity of phenytoin induced gingival enlargement. The results of the study suggest a higher incidence of gingival enlargement in phenytoin treated epileptic patients with a positive correlation with falling serum folic acid levels as the duration of the therapy increases.
An epidemiological study of common drugs in the health supply chain

Purpose – The study aims to provide insights into the availability of common drugs with respect to disease load, regarding three common childhood diseases, acute respiratory infection (ARI), diarrhoea and malaria. The study flags an important issue regarding the level of expertise of the present system to address humanitarian logistics in case of emergency.Design/methodology/approach – A mixed‐method approach using both qualitative and quantitative study techniques was used to collect data. Hospital level data were collected from randomly selected primary health centers and community health centers. a cohort of three community health centers and nine primary health centers were selected for the study. The data collected were both on disease load and availability of drugs during the study period (2009‐2012), using a retrospective cohort. Expert interviews were conducted of practising medical practitioners on classification of drugs into Vital, Essential and Desirable categories.Findings – Results show that.
Iron Deficiency in Non-Dialyzed Patients with Type 2 Diabetes: A Cross-Sectional Study

Background. Iron deficiency (ID) is a major cause of anemia in diabetes. Data are sparse regarding iron metabolism and its association with anemia in non-dialyzed patients with diabetes and without other overt causes for low haemoglobin level. The objective of this study was to determine the prevalence and characteristics of ID in non-dialysis dependent patients with type 2 diabetes and to assess its association with anemia and diabetic complications. Methods. Data from 400 non-dialysis dependent patients with type 2 diabetes (≥2 years) (excluding patients treated with iron therapy or erythropoietin-stimulating agents, or with foot lesions or amputations or other known clinical causes of ID) were analyzed in a cross-sectional, single-center study. ID was defined as ferritin 70 years and <11.5 g/dL in women. Results. 315 patients (78.8%) were iron deficient (186 absolute ID, 129 functional ID). ID anemia (IDA) was present in 74 patients (18.5%) of 89 patients with anemia from any cause (22.3%). Female gender was the only independent predictor of absolute ID (OR=2.30 95%CI 1.44-3.38, p<0.001). Increasing C-reactive protein was predictive of functional ID (OR=1.03 95%CI 1.01-1.05, p=0.001). The prevalence of IDA and all-cause anemia increased significantly with severity of chronic kidney disease (CKD) and urinary protein excretion (both p<0.001). Concerning diabetes complications we found that severe CKD was significantly associated with IDA (OR 5.32, 95% CI 2.52-11.25; p<0.001) and anemia of any cause (OR 8.39, 95% CI 3.87-18.23; p<0.001); autonomic neuropathy was significantly associated with absolute ID (OR=2.18, 95%CI 1.08-4.43, p=0.027) and proliferative retinopathy was significantly associated with functional ID (OR=1.75, 95% CI 1.02-3-02, p=0.041). Conclusions. Iron metabolism abnormalities, as determined by metabolic inflammatory status and the presence of ID, are frequent in type 2 diabetes and increase with severity of CKD, particularly in patients with autonomic neuropathy and proliferative retinopathy.
Submental dermoid cyst: a case report

Case Definition:Sub mental dermoid cysts are not common. Dermoid apidermoid cysts represent about 0.01% of all oral cysts with an incidence of 1.6 to 6.9% in the head and neck region. The can present at birth and remain undiagnosed until they present cosmetic problems to the patient in adult life. They may also present in adult life with vaying degrees of problems. Reason for reporting: This case is reported because it was first diagnosed when the patient was 6 months old but was not treated and presented in the clinic when it was causing aesthetic problems when the patient was 20 years old. Case Report: The patient was a 20-year old male with a sub mental swelling. The swelling, which measured 6.5cmx5cm clinically, was reported by the sonologist to be 6cmx3.9cm. It was doughy in consistency and did nit interfere with swallowing. It was neither visible nor palpable intra-orally. A sub mental vertical incision was made and the cyst was located on the mylohoid muscle and was excised. The histology confirmed dermoid cyst. No recurrence of the cyst has occurred after 18 months of follow up. Conclusion: Dermoid Cysts are sometimes difficult to diagnose in an infant or new born because they may be small and symptomless. An appropriate referral to and follow up by the oral and maxillofacial surgeon to remove them early is advocated. Keywords: Submental, Dermoid, cyst Orient Journal of Medicine Vol. 17 (1&2) 2005: 24-27
Evaluation of metabolic stability of antimalarial and antiretroviral drugs

The concomitant administration of drugs and antimalarial drugs is recommended for the treatment of HIV (Human Immunodeficiency Virus) patients with malaria resulting in drug-drug interactions (DDI) causing either lack of efficacy or toxicities. Drug metabolism is often the first step in understanding the DDI potential of either a new chemical entity or a combination of drugs. inhibitor (PI) such as is a potent CYP 3A4 inhibitor and may interact with these antimalarial drugs that are metabolized by CYP3A4 to cause metabolism-related DDI's. the present study is an attempt to evaluate the potential for a drug-drug interaction between and through metabolic stability studies. Metabolic stability of antimalarial and drugs alone and in combination with and without and was evaluated using human liver (HLM). The antimalarial drugs , and were metabolically unstable alone (% metabolism ≥ 80%) and in combination with other antimalarial drugs in HLM. , and were metabolically stable (% metabolism ≤ 30%). drug was metabolically unstable while was moderately stable. intrinsic clearance of antimalarial drugs , and decreased from 106.4, 290.6 and 230 ml/min/kg to 32, 44.8 and 49.5 ml/min/kg in the presence of . However, there was no change in the intrinsic clearance of , and in the presence of . did not alter the clearance of antimalarial drugs. This study suggests that affected the clearance of a few antimalarial drugs in HLM probably by the inhibition of CYP3A4 and findings may need to be further evaluated in clinical studies.
Morphometric analysis of Willis circle arteries

Introduction: Willis arterial circle (circulus arteriosus cerebri Willisi) is the most important part of the collateral circulatory system of the brain. It functions in normal and pathological situations such as valvular mechanism and thus allows optimal blood supply of all parts of the brain tissue, which reduces the risk of transient ischemic attack (TIA) and stroke. The main pre-requisite for the normal function of the circle is its completeness and the lack of hypoplastic vessels. Materials and Methods: In this research, we used 100 angiograms of carotid system shown by serial angiography by Seldinger taken from the archives of the Department of Radiology, Clinical Center University of Sarajevo. For morphometric analysis of blood vessels, we used specially designed software program ELLIPSE (ViDiTo, Zoltan Tomoris, Kosice, Slovak Republic, tomori@saske.sk. In this way, it was possible to more easily store and analyze angiograms that were used for morphometric analysis. Results: In our study, larger diameters of blood vessels in Willis circle were observed in the younger subjects compared to older except the diameter of the internal carotid artery, which was about 0.2 to 0.3 mm larger in the older subjects. In both age groups among males, we recorded larger diameters of the internal carotid artery and segment before the circle of the posterior cerebral artery in relation to the female population, while the rear communicating artery in females was 0.1 mm wider in diameter compared to men in category of younger respondents.
VENTRICULAR DYSSYNCHRONY IS COMMON AMONG HEART FAILURE PATIENTS WITH NARROW QRS COMPLEX

Current selection guideline for CRT uses broad QRS duration (>120 ms) as a marker for ventricular dyssynchrony. However, more recent data supports mechanical marker specifically measured by Tissue Doppler Imaging (TDI) as a better criterion to predict response to CRT. Sixty seven patients with significant left ventricular dysfunction (EF less than 40%) and narrow QRS complex were prospectively enrolled. They underwent Tissue Doppler Imaging (TDI) study to evaluate intraventricular mechanical dyssynchrony. Dyssynchrony index which is defined as standard deviation of time to peak systolic velocity in twelve ventricular segments was measured. A value greater than 32.6 is taken to reflect significant ventricular dyssynchrony. Overall 38 patients (56.7%) demonstrated significant dyssynchrony. There was no significant correlation between QRS duration and the Ts-SD-12 (r = 0.14, p = 0.11). Ventricular mechanical dyssynchrony is common in patients with normal QRS duration. Therefore, QRS duration alone will miss a substantial proportion of suitable patients for CRT and therefore deny them this adjunct therapy. We propose echocardiographic parameters, specifically TDI, to be included in patient selection criteria for CRT. (JUMMEC 2009; 12(2): 57-62)
Are Classical and Common Migraine Different Entities?

Concerning migraine and aura, the vast majority of all migraine patients never have an aura. They suffer from pure common migraine. When we then look at patients who do have an aura occasionally, I agree that patients fall into the three groups mentioned. Around 20% of the population suffer from common migraine, so by mere coincidence 20% of all patients with classic migraine should also have common migraine. I do agree, however, that more than 20% of all patients with classic migraine have attacks without aura so that some relationship between the two forms of migraine is obvious. It is stated that both classical and common migraine respond to ergotamine tartrate, and other therapies including metoclopramide, but this has never been shown in controlled trials.
Left ventricular outflow tract obstruction in complete transposition of the great arteries--echocardiography criteria for surgical strategies.

BACKGROUND The arterial switch operation (ASO) may be infeasible in patients with transposition of the great arteries (TGA) and left ventricular outflow tract obstruction (LVOTO). METHODS AND RESULTS Patients with LVOTO were identified among the 229 patients with TGA repaired between 1991 and 2006. Dynamic LVOTO was defined as LVOTO without LVOT abnormalities requiring resection (group I, receiving ASO). Fixed LVOTO was defined as LVOTO with LVOT abnormalities that could (group IIa, receiving ASO) or could not be resected (group IIb, receiving operations other than ASO). Preoperative echocardiography parameters were compared to identify criteria predicting the surgical findings of LVOTO. LVOTO was found in 63 patients (27.5%): 39 with dynamic and 24 with fixed (14 group IIa and 10 IIb) LVOTO. Late, severe neo-aortic regurgitation occurred more frequently in group IIa patients. Echocardiography evidence of isolated subvalvular stenosis, pulmonary to aortic valvular annulus ratio >0.98 or LVOT pressure gradient <22 mmHg predicted dynamic LVOTO (sensitivity 86.3%, specificity 94.7%), whereas that of an annulus ratio <0.85 and a pressure gradient >35 mmHg predicted fixed and non-resectable LVOTO (sensitivity 100%, specificity 100%). CONCLUSIONS Approximately one-fourth of TGA patients had LVOTO. Echocardiography criteria identified those with dynamic or fixed but resectable (ASO) LVOTO with satisfactory sensitivity and specificity.
PENGARUH PEMBERDAYAAN, MOTIVASI DAN LINGKUNGAN KERJA TERHADAP PRODUKTIVITAS KERJA KARYAWAN

The purpose of this study is to find out the effect of empowerment, motivation and work environment on employee work productivity. This research was conducted at Legong Keraton Beach Hotel. The number of respondents studied was 41 employees, using saturated samples. Data collection is done through interviews and questionnaires. The analysis technique used is multiple linear regression. The findings in this study were that empowerment, motivation and work environment had a positive and significant effect on employee work productivity. Legong Keraton Beach Hotel is expected to pay more attention to employees, provide opportunities for employees to make decisions, provide support and motivation, provide salaries according to the workload of employees, maintain cleanliness of the environment and maintain good relationships within the company so that it will affect work productivity to achieve goals effectively and efficient. Keywords: empowerment, motivation, work environment, work productivity of employees
Correlação do teste de 1RM com aspectos maturacionais, neuromotores, antropométricos e a composição corporal em crianças e adolescentes

1 Maximum Repetition (1MR) tests have been used in research on strength training effects in children and adolescents. However, little is known about the association between 1MR tests and morphologic, neuromotor and biological maturation variables. Therefore, the purpose of the present study was to analyze the relationship between 1MR tests and body composition, anthropometric variables, neuromotor tests and biological maturation. For such purpose, correlational methodology was used. The study involved 10 boys with average age of 10.28 (±2.20) years old. The variables analyzed were: body mass, stature, circumferences, skinfolds and biological maturation (pubic and axillary hair and genital development). Hence the sample was submitted to a battery of five neuromotor tests and six 1MR tests sessions for upper (UL) and lower (LL) limbs. Data analysis was developed using the Shapiro-Wilk's test (p<0.05), descriptive statistics and the Spearman Correlation Coefficient (p < 0.01; P< 0.05). A strong correlation between age and the 1MR load for UL and moderate for LL was found. Stature presented a moderate correlation with 1MR of UL and strong correlation for 1MR of LL; absolute lean body mass presented moderate and strong correlation for UL and LL, respectively. The 1MR test for UL presented moderate correlation for pubic hair and strong correlation for axillary hair. These results indicated a multifactorial influence in the 1MR test loads demonstrating the importance in the use of morphological aspects, biological maturation and/or chronological age in the results analysis. Considering the weak relationship between the neuromotor and the 1MR tests, although they have been well used in research related to strength training on children and adolescents, their results should be carefully used when the purpose is to get information on the magnitude effects of strength training in that age range.
Practicum in Counseling: A New Training Model.

This study examines the effectiveness of a new counseling practicum training model, which was developed as part of a Professional Development School (PDS) program. Unlike the traditional counseling practicum, the college instructor and graduate students worked together in a school setting one day a week. All supervision was provided on-site and the students were given immediate feedback on their counseling strategies and skills. The study examined what differences, if any, existed in student and classroom teachers' perceptions of the PDS practicum versus the traditional practicum experience. Findings concluded that students in the PDS practicum were significantly more positive about their experience than those in the traditional settings. Results from teacher surveys did not reveal significant differences between practicum settings. (Author) Reproductions supplied by EDRS are the best that can be made from the original document.
Clinical Epidemiology: The Essentials

Now in its Fifth Edition, "Clinical Epidemiology: The Essentials" is a comprehensive, concise, and clinically oriented introduction to the subject of epidemiology. Written by expert educators, this text introduces students to the principles of evidence-based medicine that will help them develop and apply methods of clinical observation in order to form accurate conclusions. The Fifth Edition includes more complete coverage of systematic reviews and knowledge management, as well as other key topics such as abnormality, diagnosis, frequency and risk, prognosis, treatment, prevention, chance, studying cases and cause.
EFFECTIVENESS OF MATHEMATICS INTERVENTION PROGRAM (MIP) AMONG PRIMARY SCHOOL TEACHERS

This one group pretest-posttest study examined the effectiveness of Mathematics Intervention Program (MIP) among 34 primary school teachers in Laguna, Philippines. Teacher’s competency in teaching Mathematics was measured in terms of content knowledge, teaching skills, material organization and presentation, management of learning environment, and teaching attitude. Meanwhile, teacher’s performance were gauged through pre-test, formative test, and post-test which contained the lessons on integers, decimals, fractions, power roots, algebraic expression and equation, measurement, and reasoning. The results showed that before the implementation of MIP, all teachers-participants were evaluated as less competent in teaching mathematics. Their performance based on pre-test results was also poor prior the MIP. During the conduct of this study, the primary school teachers obtained a satisfactory rating in their formative tests which advocated that the intervention program was helping them in improving their craft. The post-test result also marked an improvement in their competence and performance in teaching mathematics. enhancing the pedagogical content knowledge among primary school teachers in mathematics. A more comprehensive study regarding teachers’ competencies and classroom performance may be conducted in the light of professional development and qualification standards for Mathematics teachers. and Dividing; Fractions; Relating Situations to Mathematical Operations; Power Roots, Algebraic Expression and Equation; Measurement- Volume and Surface Areas; and Proportional Reasoning.
Strongyloides stercoralis: Hallazgos Histopatológicos en Mucosa Duodenal 1999-2005

Estrongiloidiasis es una parasitosis cuya presentacion endoscopica e histologica es muy variada, se localiza principalmente en duodeno donde la larva madura a adulto hembra e induce varios patrones de reaccion inflamatoria . Se revisaron todos las laminas histologicas con diagnostico de estrongiloidiasis duodenal , y la descripcion del reporte endoscopico durante un periodo de 6 anos (enero 1999 a noviembre 2005). Los patrones endoscopicos mas frecuentemente descritos fueron pliegues engrosados y de aspecto nodular, se encontro duodenitis severa (segun la clasificacion de Jenkins) en 57% de los casos, y atrofia de las vellosidades en todos los casos, la mayoria calificada de grado 4 (segun la clasificacion Drutt), las celulas plasmaticas no disminuyeron en las duodenitis severas, a diferencia de lo observado en duodenitis peptica. Nuestros hallazgos reflejan un mayor compromiso de nuestros pacientes que la reportada en la literatura revisada. Planteamos estudiar la relacion entre celulas plasmaticas, atrofia de vellosidades, duodenitis severa y estrongiloidiasis.
STD/HIV/AIDS knowledge, beliefs and practices of traditional healers in Botswana

The study investigated knowledge, beliefs, practices and experiences of traditional healers in relation to sexually transmitted diseases (STDs), HIV and AIDS. Traditional healers see about 70% of the African patients, with all kinds of ailments. The advent of HIV/AIDS and the introduction of home-based care in most African countries has increased the case-load of many traditional healers and increased the risk of contact with people living with HIV/AIDS. To protect themselves and their clients they need the right information on HIV/AIDS. Most traditional healers use their bare hands as a diagnostic tool and to apply topical medicine. Many traditional healers also utilize their mouths to suck blood from their patient's body as part of disease management. Most of the patients who are discharged from hospitals on home-based care usually end up at the traditional healer as relatives seek a second opinion or simply because they disagree with the diagnosis of incurable disease. This exposes traditional healers .
historical comparison of survivals why not but only under certain conditions

Background: Meanings, properties and possible implications of specific survival (SS) are worth exploring when computed from mortality tables, particularly by virtue of the relationship with excess mortality (ExcM) and expected mortality (ExpM). Design: The variability of specific mortality (SM) and ExpM reflects the whole range of patients’ fate, from the worst scenario (observed mortality higher than ExpM) to the best (SM equal to ExpM: a condition corresponding to full clinical recovery of the disease). Obviously, SM of patients and ExpM of reference population are conditioned by the same social and clinical factors, which act in parallel on both groups. So, the ExpM of reference subjects corresponds to the average age limit for a given histori cal period, to which the survival of patients can be normalized, also giving the possibility of post-hoc analysis of survival. SS, which results from the difference between observed and expected mortality, is also an index of the years of survival “stolen” by the disease with respect to the expected. All these times can be statistically compared by simple inferential tests. Results: As an example of achievable result, we report a comparative analysis of two randomized trials, conducted in different times and closed several years ago, with identical target patients (advanced-stage Hodgkin lymphoma) and similar treatment (MEC ten-drug chemotherapy in the first study, and the similar CEC in the second, in which cyclophosphamide 650 mg/m2 re placed mechlorethamine 6 mg/m2). The analysis of SS revealed a previously underestimated statistical difference in favor of the patients treated with CEC: the difference seems tom be primarily due to the drug substitution, in spite of their presumed equiva -lence. Years of life lost per year of follow-up in CEC arm: 0.148 ± 0.228; in MEC arm: 0.411± 0.528 (P= 0.02314). Conclusions: The comparative evaluation of SS offers more reliable results and is feasible in post-hoc investigations, even be tween different timeframes.