Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessing the new ICD-MM classification for assigning the cause of maternal mortality at a tertiary centre in Western India: a retrospective study

Background: The World Health Organisation (WHO) in 2012 introduced the 10th revision of International Classification of Disease (ICD 10) to deaths in pregnancy, labour and puerperium (ICD-MM) for consistent collection, analysis and interpretation of information on maternal deaths. The proper use of this classification requires training to avoid heterogeneity and error in the classification of maternal deaths.Methods: We analysed the Maternal Death Review (MDR) forms of 295 deaths over a period of 5 years (January 2014 to December 2018 inclusive) occurring at a tertiary health centre in Western India. The ICD-MM classification was used to reassign the cause of death.Results: There were 295 deaths in women during pregnancy, childbirth and puerperium during the 5 year period. Of these there were 294 maternal deaths and one coincidental death. There were 173 deaths of the direct type (58.84%), 105 deaths of the indirect type (35.71%) and 16 deaths (5.44%) of the unspecified type. Obstetric haemorrhage was the highest contributor to direct deaths (23.8%) and anaemia contributed to the maximum deaths from indirect causes (13.6%) followed by liver diseases in pregnancy (10.54%). Unanticipated complications of management accounted for 2% of the total deaths. There was considerable inaccuracy in assigning cause of death by consultants who were untrained in the use of the ICD-MM classification.Conclusions: ICD-MM classification promotes an accurate assignment of the cause of death. Training of healthcare providers performing maternal death reviews in the use of this classification is essential to identify accurate underlying cause of death and contributory conditions.
The synergistic antileukemic effects of eltrombopag and decitabine in myeloid leukemia cells

Background Hypomethylating agents (HMAs), such as decitabine (DAC), are currently used as first-line therapy for patients with high-risk myelodysplastic syndromes (MDS) and acute myelogenous leukemia (AML) not eligible for standard chemotherapies. Exacerbation of thrombocytopenia is one of the prevalent complications after HMA treatment. Eltrombopag (EP), an oral thrombopoietin receptor agonist, can efficiently stimulate megakaryopoiesis and elevate platelet counts in MDS/AML patients. However, the significance of combining EP with HMAs in patients with high-risk MDS/AML has not been determined. Purpose To explore the impacts and mechanisms of EP and/or DAC on leukemia cell growth and to explore whether EP exhibits antileukemic effects in the context of DAC treatment in human myeloid leukemia cell lines. Methods In our study, we assessed the anti-leukemic effect of EP in the context of DAC treatment by measuring cell proliferation, apoptosis, cell-cycle distribution, and intracellular reactive oxygen species (ROS) levels. Results Our results showed that the combination of EP and DAC had a more obvious antiproliferative effect than that of DAC as a single agent. EP mainly induced S or G0/G1 phase cell cycle arrest, and DAC arrested the cell cycle in the S or G2/M phase. The combination of EP and DAC had a synergistic effect on cell cycle arrest. Furthermore, single-agent treatment with EP or DAC induced a change in intracellular ROS levels, and the combination of EP and DAC had a synergistic effect on ROS levels, exacerbating leukemia cell death. Conclusion Our study provides in vitro evidence of the synergistic antileukemic effect and potential mechanisms of the combination of DAC and EP on myeloid leukemia cells.
Validação para a população portuguesa do Sexuality Attitudes and Beliefs Survey (SABS)

Objective: To describe the validation process of the Sexuality Attitudes and Beliefs Survey (SABS) for the Portuguese language and its respective psychometric properties. Methods: A methodological and quantitative study with the participation of 49 nursing students. After the translation of the SABS, ensuring the semantic, idiomatic and conceptual equivalence of the content of items, its psychometric qualities were determined. Results: In terms of reliability, the Cronbach's alpha for the final version of 11 items was 0.72, which was 0.80 in the test-retest. The discriminant validity was proven. Conclusion: The Portuguese version of the SABS is valid and reliable for use in investigation studies, both in terms of training as in clinical practice.
In Schizophrenia, PON1 Q192R Genotypes and/or Lowered Paraoxonase 1 (PON1) Enzymatic Activity are Significantly Associated with the Deficit Syndrome, Negative Symptoms, Formal Thought Disorders, Psychomotor Retardation, Excitation and Increased IgA Levels to Gram-Negative Microbiota

Background: Primary deficit schizophrenia (DS) is characterized by enduring negative symptoms and represents a qualitatively different disease entity with respect to non-deficit schizophrenia (NDS). No studies investigated the association between the enzyme paraoxonase 1 (PON1) and DS and its phenomenology. Methods: In this case-control study, Thai women and men, aged 18-65 years, were divided in DS (n=40) and NDS (n=40) and were compared to controls (n=40). PON1 activities against 4-(chloromethyl)phenyl acetate (CMPA) and phenylacetate were determined. Moreover, subjects were genotyped for their PON1 Q192R polymorphism and IgA levels responses directed to Gram-negative bacteria were measured. Results: DS is significantly associated with the QQ genotype and the Q allele as compared with NDS and controls. PON1 activities are significantly and inversely associated with negative symptoms, formal thought disorders, psychomotor retardation, excitation and DS. The presence of the Q allele is associated with increased IgA responses to Pseudomonas aeruginosa, Morganella morganii, and Pseudomonas putida as compared with RR carriers. Conclusions: The PON1 Q allele and lower PON1 activities especially against CMPA are associated with DS, indicating lowered quorum quenching abilities as well as lowered defenses against lipoperoxidation and immune activation. It is suggested that lowered PON1 activity in DS constitutes an impairment in the innate immune system which together with lowered natural IgM may cause lower immune regulation thereby predisposing towards greater neurotoxic effects of immune-inflammatory, oxidative and nitrosative pathways and Gram-negative microbiota.
Gene mutation profile and risk stratification in AML1-ETO-positive acute myeloid leukemia based on next-generation sequencing

Gene mutations play an important role in the development and progression of AML1-ETO-positive acute myeloid leukemia (AE-AML). Nevertheless, the gene mutation profile in this subtype of leukemia remains unclear. In addition, the clinical and prognostic effects of different mutant genes may be underestimated. In the present study, gene sequencing was conducted at diagnosis and relapse with next-generation sequencing (NGS) in 64 patients with newly diagnosed AE-AML, and 44/64 (68.8%) patients were found to present with a median of 2 (1–10) recurrent mutations at diagnosis and 6/11 (54.5%) cases were found to present with genetic alterations at relapse. c-KIT mutation was the most common in this cohort, with an incidence of 27/64 (42.2%) at diagnosis, followed by ASXL1 (n=10, 15.6%), MET (n=8, 12.5%), MLH1 (n=6, 9.4%), TET2 (n=5, 7.8%), and FBXW7, TP53 and DNMT3A (n=5, 7.8%). Survival analysis showed that c-KIT (exon 8, 17) but not exon 10 adversely affected survival. In addition, ASXL1 and TP53 were poor impact factors for recurrence-free survival (RFS) (P<0.05), and ASXL1, MET, FBXW7 and TP53 had a negative impact on overall survival (OS) (P<0.05). Multivariate analysis showed that c-KIT (exon 8, 17) [RFS: hazard ratio (HR) 3.36, 95% confidence interval (CI) 1.54–7.34, P=0.002; OS: HR 2.84, 95% CI 1.20–6.71, P=0.018] and ASXL1 mutations (RFS: HR 3.13, 95% CI 1.34–7.32, P=0.009; OS: HR 3.94, 95% CI 1.62–9.61, P=0.003) were independent adverse factors for survival. Further, co-mutation of these two genes showed even worse effect on disease outcome. Collectively, additional gene mutations play critical role in AE-AML. C-KIT and ASXL1 mutations are the two most common mutations in this subtype of leukemia. C-KIT (exon 8, 17) but not exon 10, and also the ASXL1 mutation poorly affect the disease outcome of this disease.
THE EFFECTS OF LOW-VOLUME/MODERATE-INTENSITY AEROBIC TRAINING ON METABOLIC SYNDROME COMPONENTS IN MORBIDLY OBESE MINORITY ADOLESCENTS

Title of Document: THE EFFECTS OF LOWVOLUME/MODERATE-INTENSITY AEROBIC TRAINING ON METABOLIC SYNDROME COMPONENTS IN MORBIDLY OBESE MINORITY ADOLESCENTS. Gina Many, Master‘s Thesis Defense, 2010 Directed By: James Hagberg, PhD, Department of Kinesiology, University of Maryland Despite the increased prevalence of obesity and associated diseases among pediatric minorities, the intensity-specific effects of aerobic training have not been examined extensively in adolescent minorities. Fifteen morbidly obese, sedentary and insulinresistant Black and Latino adolescents completed two-months of low-volume/moderateintensity aerobic exercise training to examine the effects of training on three phenotypes dysregulated in obese and physically inactive states: insulin sensitivity (SI); fibrinolytic potential, as indicated by plasminogen activator inhibitor type 1 (PAI-1) and tissue plasminogen activator (t-PA) antigen levels; and chronic low-grade systemic inflammation, as indicated by C-reactive protein (CRP). In response to training, SI increased ~37% (1.00 ± 0.15 to 1.37 ± 0.26 mU . L -1 min -1 , p<0.05) and t-PA antigen levels increased ~15% (6.34 ± 0.51 to 7.32 ± 0.85 ng/mL, p<0.05). No significant changes in CRP or PAI-1 antigen were observed. Our findings demonstrate that aerobic training improves insulin sensitivity and fibrinolytic potential in morbidly obese minority adolescents. THE EFFECTS OF LOW-VOLUME/MODERATE-INTENSITY AEROBIC TRAINING ON METABOLIC SYNDROME COMPONENTS IN MORBIDLY OBESE MINORITY ADOLESCENTS
Comparison of efficacy between intralesional bleomycin and cryotherapy in plantar warts

Objective To compare the efficacy of intralesional bleomycin and cryotherapy in treating plantar warts. Material and Methods A total of 160 patients (80 in each group) were enrolled, who were randomly divided into 2 groups. Group A was treated with 0.1% intralesional bleomycin and group B was treated with liquid nitrogen with a cotton swab. Follow-up was carried out at 02, 04 and 06 weeks and the final efficacy was calculated at the end of 06 weeks. Results Out of 160 patients, 32 (40.0%) male and 48 (60.0%) female were enrolled in intralesional bleomycin group; 30(36.5%) male and 50 (62.5%) females were included in cryotherapy group. Mean±SD of age in intralesional bleomycin and cryotherapy was 28.24±4.2 with C.I (27.30-29.17) and 27.56±3.8 with C.I (26.71-28.40) years, respectively. In comparison of both groups 90% efficacy was found in intralesional bleomycin group whereas 72.5% in cryotherapy group and p value was found to be highly significant i.e. (P=0.005). Conclusion Intralesional bleomycin is more effective than cryotherapy in the treatment plantar warts.
Jejunoduodenal anastomosis as permanent biliary access loop post-hepaticojejunostomy: our experience

Background: Post-hepaticojejunostomy stricture is a common problem may result in liver cirrhosis and portal hypertension and death if not treated. Different modalities to repair it are available including endoscopic management that needs access loop (including jejuno-duodenal access loop) to reach the site of stricture.Methods: This prospective study was done in general surgery department, faculty of medicine, Zagazig University hospitals during the period from January 2016 to December 2018. The study included 23 patients (18 females and 5 males) all needed hepaticojejunostomy to treat biliary injuries during cholecystectomy, biliary stricture post-cholecystectomy or post-hepaticojejunostomy anastomotic stricture. Their ages ranged between 26 to 57 ys with mean age 37.3±5.1. The postoperative course of patients and the feasibility of postoperative endoscopic access to the hepaticojejunostomy and intrahepatic ductal system were assessed.Results: This study included 23 patients (18 females and 5 males) where 19 (82.6%) patients were presented post-cholecystectomy and 4 (17.4%) patients post-hepaticojejunostomy, with different modes of presentation postoperative complications included; 2 patients complicated with chest infection, 3 (13%) patients with wound seroma and infection, 2 (about 8.7%) patients complicated with biliary gastritis and 1 (about 4.4%) patient with mild attack of cholangitis. There was no anastomotic leakage or mortality in the studied group. The trial of access to the hepaticojejunostomy using gastroduodenoscopy was successful in all cases with ease including trial of balloon dilatation. The average hospital stay ranged between 5-7 days.Conclusions: Side-to-side jejunoduodenal anastomosis is a very useful technique as it provides good endoscopic access to hepaticojejunostomy and the intrahepatic ducts and needs more application and further evaluation.
Effects of an Additional Liquid Based Cytology Prepate on Cytological Diagnosis in High-Risk HPV Positive, PaP Test Negative Cases

Objectives: To investigate the effects of a second cytology preparation on cytological diagnosis in high-risk HPV positive and PaP smear-negative cases. Methods: This retrospective study was conducted with 57 cases who underwent cytological evaluation and cotest in our center in 2016-2017. All of these cases were high-risk HPV positive, PaP smear-negative and had a second preparation. All preparations were re-evaluated by a cytopathologist and a pathologist. Twenty-five of the cases who had a positive diagnosis in the second preparation had a cervical biopsy. Results: In 46 (80%) of the cases, the cytological diagnosis was the same and negative in the first and second preparations. Second preparations of 11 cases (19.2%) were positive. Twenty of 25 patients (77%) with cervical biopsy had premalignant lesion. Conclusion: In high-risk HPV positive and PaP smear-negative cases, patient management is different from cases where these two tests are positive together. According to our results, 19.2% of high-risk HPV positive and PaP smear-negative cases were given positive cytological diagnosis by second cytology preparation. Biopsy results support our cytological findings. The incidence of positive cytological diagnosis increases in PaP smear with the second preparation. With this protocol, patient management changes, follow-up time and number can be reduced.
Correlates of Anxiety, Depression and the Paternal-Fetal Attachment in Expectant Fathers

The transition of men into fatherhood is a period of adjustment and uncertainty. Research into expectant fathers is neglected in comparison to pregnant mothers. The aim of this study was to analyse the correlates of anxiety, depression and the paternal-fetal attachment in expectant fathers within the United Kingdom (UK). A series of questionnaires were used to measure psychological symptoms, relationship variables, pregnancy variables, demographic variables and the fetal attachment relationship towards their unborn baby during their partner’s pregnancy. A total of one hundred and sixty six expectant fathers completed the study. Anxiety and depression measures were found to be significantly correlated with each other however they did not appear to be significantly associated with fetal attachment levels. Multiple stepwise regression analysis identified the significant variables associated with fetal attachment to be relationship satisfaction and the gestational age of the pregnancy which explained approximately 8% of the variance. Further research is needed into determining fathers who may be at risk of low fetal attachment or psychological distress during pregnancy and how this relates to the fetal attachment towards the unborn child.
Left Ventricular Dysfunction: The Perspective of Echocardiography in Ghana

Introduction: Ghana is one of the fastest growing economies in sub-Saharan Africa which is expected to undergo a significant epidemiologic transition because of industrialisation and economic development. Having transitioned from low to middle income status recently, this study investigated the epidemiology of left ventricular dysfunction (LVD) in patients who were referred for echocardiography. Material and Methods: We conducted a retrospective cross-sectional study on an out-patient population who were referred to the Precise Specialist Clinic in Kumasi, Ghana for echocardiography, from January 2016 to December 2018. Descriptive statistical analyses were performed and the results summarised in the proportions, tables and pie charts. Categorical variables and proportions were compared using Fisher’s exact test and test of proportions respectively. P-value Results: The results show that 61% of the out-patient population referred for echocardiography between 2016 and 2018 had LVD at a mean age of 59 years. In this LVD population, Heart Failure with preserved ejection fraction (HFpEF) and Heart Failure with reduced ejection fraction (HFrEF) accounted for 73% and 27% respectively. The majority of patients with HFrEF also had left ventricular diastolic dysfunction, mitral regurgitation and tricuspid regurgitation.Conclusion: This study shows that, HFpEF was seen in over 70% of patients with LVD, and it occurred at a relatively younger age. Efforts should be made for prevention, early detection and control of conditions such as hypertension, diabetes and obesity which have been shown to be associated with HFpEF.
Evaluation of septas in maxillary sinus with cone-beam computed tomography

Aim: The aim of the study was to examine the prevalence of maxillary sinus septa (MSS) in a Turkish population, using cone-beam computed tomography (CBCT). Methodology: The CBCT images of 350 untreated patients (178 male, 172 female ranging in age between 18 and 65) were included in this study. The presence or absence of MSS was determined in axial, sagittal, and coronal planes by considering gender and side. For statistical evaluation, a chi‐square test was used to determine any differences in the prevalence of MSS with significance set at 5%. Results: MSSs were observed in 201 out of 700 sides (28.71%) and 141 out of 350 patients (40.28%), of which, 70 were in males and 71 in females. MSS were also observed in a higher prevalence on the bilateral side. (17.14%). Female patients showed higher prevalence (41.27%) than the male patients (39.32%). Conclusion: MSS was observed in 40.28% of examined Turkish subjects and detected more frequently in females and on the bilateral side. How to cite this article: Laçin N, İzol BS. Evaluation of septas in maxillary sinus with cone-beam computed tomography. Int Dent Res 2019;9(2):41-5. Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.
Diagnosis and management of chronic obstructive pulmonary disease in Serbia: an expert group position statement

Abstract In recent years, several national chronic obstructive pulmonary disease (COPD) guidelines have been issued. In Serbia, the burden of COPD is high and most of the patients are diagnosed at late stages. Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy is poorly implemented in real-life practice, as many patients are still prescribed inhaled corticosteroids (ICS)-containing regimens and slow-release theophylline. In this document, we propose an algorithm for treating COPD patients in Serbia based on national experts’ opinion, taking into account global recommendations and recent findings from clinical trials that are tailored according to local needs. We identified four major components of COPD treatment based on country specifics: active case finding and early diagnosis in high-risk population, therapeutic algorithm for initiation and escalation of therapy that is simple and easy to use in real-life practice, de-escalation of ICS in low-risk non-exacerbators, and individual choice of inhaler device based on patients' ability and preferences. With this approach we aim to facilitate implementation of the recommendation, initiate the treatment in early stages, improve cost-effectiveness, reduce possible side effects, and ensure efficient treatment.
Manifestations et facteurs cliniques predictifs du carcinome hepatocellulaire a Abidjan (Cote d'Ivoire) etude retrospective de 89 cas

Objectifs : etudier la prevalence et les signes cliniques du carcinome hepatocellulaire (CHC) observe dans le service d'hepato-gastro-enterologie du centre hospitalier et universitaire (CHU) de Yopougon et de determiner les facteurs cliniques predictifs en fonction l'evolution clinique du CHC Methodologie : tous les dossiers des patients hospitalises dans le service d'hepato-gastro-enterologie du CHU de Yopougon de Janvier 1990 a Juin 1996 pour CHC ont ete etudies. Trois groupes de patients ont ete constitues selon l'evolution clinique du CHC et compares dans un modele de regression logistique : CHC avec ascite jaune citrin ou hemorragique et CHC sans epanchement liquidien intra abdominal. Resultats : Quatre vingt neuf cas de CHC (75 hommes et 14 femmes, âge median 44 ans) ont ete recenses soit 2,54 % de l'ensemble des hospitalisations. A l'admission, 84,3 % des patients presentaient une douleur abdominale ou de l'hypochondre droit, 62,9 % un ictere, 88,8 % une hepatomegalie nodulaire, 59,6 % une ascite, 88,80 % un amaigrissement et 2,2% un antecedent de cirrhose dans l'histoire clinique. L'ascite etait hemorragique chez 23,6% des patients et de couleur jaune citrin chez 36 % des patients. Les signes endoscopiques d'hypertension portale ont ete retrouves chez 63,8% des 58 patients qui avaient eu une endoscopie digestive haute. Seuls les marqueurs serologiques du VHB et du VHC ont ete effectues chez 38.2 % des patients. La presence d'antigene HBs et ou d'anticorps anti HBc a ete retrouvee chez 97,10 % des patients. Un seul cas d'infection VHC a ete diagnostique. En analyse univariee, la douleur (P = 0,005 %) et l'ictere (P = 0,02 %) etaient les deux principaux signes cliniques significatifs selon l'evolution clinique du CHC independamment de l'hepatomegalie et de l'amaigrissement. En analyse multivariee, seule la douleur apparait significative et moins frequemment associee au CHC avec epanchement liquidien intra abdominal (ascite jaune citrin ou hemorragique) par rapport au CHC sans epanchement liquidien intra abdominal : OR = 0,08; IC 95a/. = [0,01 ; 0,71] ; P = 0,02). Conclusion : En Cote d'Ivoire le CHC reste toujours caracterise par une hepatomegalie nodulaire et douloureuse survenant dans un contexte d'amaigrissement. La douleur est vraisemblablement le signe clinique d'appel plus frequemment associe au CHC sans epanchement liquidien intra abdominal. La promotion de la vaccination contre le VHB, le depistage et le suivi des patients infectes par le VHB ou le VHC permettront de reduire la prevalence de la forme tumorale evoluee de CHC en Cote d'Ivoire.