Miracle-dz/UniFAR-FTUs huggingface dataset:
Determinants of delay in presentation and clinico-laboratory features of newborns admitted for neonatal jaundice in a tertiary hospital in south-east Nigeria

Background: Neonatal jaundice (NNJ) is one of the most common causes of hospital visit in the first 30 days of life. It is one of nine danger signs of neonatal illness recognized by the World Health Organization. Understanding its clinical and laboratory features will enhance early diagnosis and management to forestall associated morbidities. This study explored the clinical and laboratory features of newborns admitted for NNJ in a tertiary hospital in the south-eastern Nigeria. Methods: It is a descriptive study carried out prospectively over a 18-month period on all newborns admitted for jaundice at the Enugu State University Teaching Hospital. Patients were enrolled consecutively at presentation and relevant clinical and laboratory features in these newborns were documented in a structured admission register designed for this study. These data were subsequently transferred to Microsoft Excel and analyzed with SPSS version 20. Results: A total of 83 (17.0%) out of 487 newborns were admitted for NNJ during the study period. More female newborns (P = 0.321), newborns delivered outside Enugu State University Teaching Hospital (P = 0.09), mothers ≤ 30 years (P = 0.648), and mothers with lower educational attainment (P = 0.502) had delayed presentation to hospital. Poor suckling (42%), fever (38%), and depressed primitive reflexes (38%) were the most common clinical features seen in admitted newborns. Yellowish discoloration of newborns was noticed within the first 24 h of life in only 13%, between 2 and 7 days in 81%, and after the seventh day of life in 6% of newborns. The median (interquartile range, IQR) of the age jaundice was first noticed and when infant was brought to the hospital for evaluation was 3.0 days (IQR 2–5) and 5.0 days (IQR 4–7), respectively. This resulted to a mean onset–presentation delay time of 2.8 ± 2.3 days (∼67.2 h). The mean total serum bilirubin and unconjugated hyperbilirubinemia was 307 ± 145.2 and 257.5 ± 127.6 μmol/L, respectively. Malaria parasite (17%), glucose-6-phosphate deficiency (5%), and ABO incompatibility was seen in 8% of newborns surveyed. Conclusions: NNJ remains a common health problem in our setting. This underscores the need to upscale education of the mothers and caregivers especially those that prefer to deliver outside a tertiary health institution on the need for early presentation in newborns with jaundice associated with poor suckling and reduced activities.
Job satisfaction among healthcare workers at a district hospital in Plateau State, Nigeria

Background: Job satisfaction has been identified as a key factor determining patient satisfaction in health care organizations. This study was undertaken to assess the job satisfaction index among staff in the facility, and to identify factors influencing job satisfaction as a means of improving services in the hospital. Methodology: This was a cross-sectional survey of health care workers conducted using the Linda Powells (Mountains State Group Inc) self-administered questionnaire. This is a 50-item questionnaire assessing eight thematic areas; 1. Overall satisfaction, 2. Planning, 3. General Attitudes, 4. Performance issues, 5. Management issues, 6. Supervisory issues, 7. Training and salary issues, 8. Benefits. Results: Overall, 64.8% of respondents were satisfied with their jobs. The thematic area that had the highest job satisfaction score was general attitudes; while the lowest was benefits 37.7%. Conclusion: The overall job satisfaction was found to be 64.8%. The thematic area that scored highest for level of satisfaction was general attitudes followed by performance issues, supervisory issues and planning. Staff were not satisfied with management issues, training and salary issues and benefits.
The Responsibility of Clinical Pharmacists for the Safety of Medication Use in Hospitalized Children: A Middle Eastern Experience

Objective: We aimed to detect and report the frequency of occurrence of drug-related problems (DRPs) in a Middle Eastern University Children's Hospital (Isfahan, Iran) and classify them in terms of their nature and cause to clarify the responsibility of clinical pharmacists for the safe utilization of medications in hospitalized children. Methods: In this cross-sectional study which was carried out in Imam Hossein Children's University Hospital affiliated with Isfahan University of Medical Sciences (Isfahan, Iran) from September 2017 to May 2018, DRPs during the hospitalization of pediatric patients in three medical wards, the pediatric intensive care unit, and two neonatal intensive care units were detected and identified concurrently with the treatment process using Pharmaceutical Care Network of Europe data gathering form for DRPs v. 8.01. All cases were verified and validated in a professional focus group before documentation. Findings: We detected 427 DRPs in 201 out of 250 randomly included hospitalized children in which 86% of them were directly reported by the hospital's clinical pharmacist. The highest frequency of DRPs (47.3%) was observed in the age range of 1 month–2 years. Safety of treatment was the most frequently reported as the nature of the problem (43.5%), followed by effectiveness issues (36.8%). The most frequent cause of DRPs was dose selection issues (34.2%), followed by drug-type selection (25.5%), and unavailability of appropriate dosage forms (13.6%). Ninety-eight interventions were proposed by the clinical pharmacist, in which 59.2% of them were accepted. Conclusion: This study confirms the necessity for the active role of clinical pharmacists before, during, and after drug therapy in hospitalized pediatric patients for the safety and proper utilization of drugs in this vulnerable population.
Fine-needle aspiration cytology of nodular thyroid lesions: A 1-year experience of the thyroid cytopathology in a large regional and a University Hospital, with histological correlation

Background: Fine-needle aspiration cytology (FNAC) plays an important role in evaluation of nodular thyroid lesions and in planning appropriate management. Aim: the aim of the study is to reinterpret the FNAC diagnosis using the new 2017 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) and explore its utility and to review the accuracy by correlating with histopathology and analyze the distribution of thyroid lesions. Settings and Design: A retrospective study for a period of 1 year will be undertaken, and all the cases of thyroid FNAC during the study period will be included in the study. Materials and Methods: All FNACs of the thyroid, which were done during the year 2011, were retrieved. The results of adequate FNAC samples were correlated with the histological diagnoses in 50 cases. Statistical Analysis: the statistical analysis was performed using MedCalc Statistical Software Results: About 592 cases were included in the study, after recategorization according to the TBSRTC, Bethesda I – 2 cases (0.33%), Bethesda II – 473 cases (79.8%), Bethesda III – 54 cases (9.1%), Bethesda IV – 23 cases (3.8%), Bethesda V – 3 cases (0.5%), and Bethesda VI – 37 cases (6.25%). The false-negative rate is 9%, accuracy rate is 91%, and rate of malignancy in atypical lesions is 53.3%, with overall rate of accuracy of 61.5%. The incidence of microcarcinoma was 4/50 (8%). Conclusions: The distribution of thyroid lesions in our institute is similar to that seen elsewhere. The rate of malignancy in indeterminate lesions was 33.33%. FNA has a low false-negative rate for diagnosis of thyroid malignancy; however, controversy exists regarding the accuracy of FNA for nodules smaller than 1 cm. The nomenclature change of follicular variant of papillary thyroid carcinoma to noninvasive follicular thyroid neoplasm with papillary-like nuclear features has led to necessary changes in definitions of various categories in 2017 TBSRTC as well and is discussed in this paper.
Candiduria: prevalence and trends in antifungal susceptibility in a tertiary care hospital of mangalore.

Objective: The incidence of Candida has been on rise worldwide. Urinary tract infections (UTIs) as a result of Candida species are becoming, common in hospitalised patients. Clinicians face dilemma in differentiating colonization from true candiduria. The species identification of Candida is important, as non albicans Candida species are increasing in number and more resistant to antifungal drugs. The aim of the study was to find out the frequency of Candida among uropathogens, their speciation and to determine the susceptibilities to antifungal drugs of Candida species isolated from candiduria. Material and Methods: A total of 2900 urine samples were analysed in a tertiary care hospital. Candida species isolated from urine samples were subjected to speciation using CHROM agar and standard yeast identification protocol. Antifungal susceptibility testing for fluconazole, voriconazole, flucytosine, amphotericin B was carried out using VITEK-2 compact system of Biomerieux. Result: A total of 66(2.27%) Candida species were isolated from 2900 urine samples. Among them non albicans Candida species were predominant (69.7%) compared to Candida albicans (30.3%). The Candida isolated were more susceptible to amphotericin B (91%) and flucytosine (82%) compared to voriconazole (72.72%) and fluconazole (66.66%). Conclusion: The present study reiterates the prevalence of Candida species among UTIs and their antifungal susceptibility pattern. Prevalence of non albicans Candida was more than Candida albicans. Non albicans Candida species are more resistant to antifungal drugs compared to C.albicans. Therefore, the species identification of Candida isolates along with their antifungal susceptibility pattern can help the clinicians in better treating the patients with candiduria.
Normative value of the patellar tendon size: A sonographic study of a cohort of healthy adults in a suburb of Lagos, Southwest Nigeria

Aim: This study aimed to determine patellar tendon (PT) size using sonographic technique. Materials and Methods: PT thickness (PTT), width, and cross-sectional area (CSA) were measured in 277 healthy adults. Mean was computed for patella tendon thickness, its width and CSA for the population. Thereafter, PT was correlated with, height, weight, and body mass index (BMI). Results: In the sample, 31.0% were male and 69.0% were female. Mean PTT, width, and CSA for the population were 4.7 ± 0.4 mm, 22.4 ± 3.8 mm, and 8.3 ± 1.7 mm2, respectively. Mean PTT was 4.8 ± 0.9 mm for men and 4.7 ± 0.2 mm for women; PT was significantly wider and thicker in men than women (P < 0.05). Difference in left and right PT sizes was not statistically significant (P > 0.05). Correlation between PT size and BMI was statistically significant. Conclusion: In healthy controls, a sonographically measured PTT >6 mm could be diagnostic of patellar tendinopathy as it appears to be 4 standard deviations greater than the mean. When using sonographic method to define population-specific normal value of PT size, individuals' gender and weight should be taken into cognizance.
Safety of anti-VEGF treatments in a diabetic rat model and retinal cell culture

Purpose To analyze the safety of different concentrations of anti-VEGF on retinal cells. Methods Non-diabetic and streptozotocin (STZ)-induced diabetic rats received intravitreal rat anti-VEGF injections that had final vitreous concentrations of 0, 0.0625, 0.125 (clinical dose), and 0.25 mg/mL. Rats were also injected with the clinical dose of ranibizumab. TUNEL assay was performed on sectioned eyes to evaluate apoptotic cells. In vitro, rat retinal cell cultures were exposed to 0, 0.0625, 0.125 (clinical dose), and 0.25 mg/mL of ranibizumab for 48 and 72 hrs. Cellular metabolic activity was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, necrosis by lactate dehydrogenase (LDH), and apoptosis by cell death enzyme-linked immunosorbent assay (ELISA). Results Diabetic rats had a significant increase (p<0.03) in apoptotic cell death at half the clinical dose, at the clinical dose, and at double the clinical dose. In vitro, MTT showed a significant decrease (p<0.04) in cellular metabolic activity at the clinical dose and double the clinical dose compared to control at 48 and 72 hrs. LDH showed a significant increase (p<0.04) in necrosis at the clinical dose and double the clinical dose compared to control at 48 and 72 hrs. ELISA showed a significant increase (p<0.04) in apoptosis at half the clinical dose, at the clinical dose, and double the clinical dose, compared to control at 48 and 72 hrs. Conclusions Anti-VEGF treatment may be potentially detrimental to the retina by decreasing cellular metabolic activity and increasing cytotoxicity of retinal cells. The results provide a cautionary note to monitor both the retina and optic nerve status in patients undergoing frequent injections.
Identifying risk factors for high-dose methotrexate-induced toxicities in children with acute lymphoblastic leukemia

Background Whether monitoring of the methotrexate (MTX) concentrations after high-dose MTX (HD-MTX) infusion can predict toxicities is still controversial, especially when HD-MTX therapy is used in the treatment of children with acute lymphoblastic leukemia (ALL), which is different than the previous schedules. The relationship between patient characteristics and severe adverse events (AEs) has yet to be determined. Objective To analyze the relationship between the MTX concentration and toxicities and to identify the risk predictors from patient characteristics for severe AEs during HD-MTX therapy in children with ALL. Methods We conducted a retrospective study on children with ALL who were treated with 388 HD-MTX infusions. The chi-square test and univariate and logistic regression analyses were used to analyze the relationship between the MTX concentrations and toxicities and to identify predictors for severe AEs. Results Febrile neutropenia (P=0.000) and vomiting (P=0.034) were more likely to occur if the infusion had an MTX level ≥1 μmol/L at 44 h, but other toxicities had no correlations with MTX concentration. Predictive factors for toxicities were as follows: higher risk stratification and higher values of albumin (ALB) for leucopenia, higher values of white blood cell count (WBC) for anemia, higher values of ALB and creatinine (Cr) for neutropenia, higher risk stratification and higher 44-h MTX concentration for febrile neutropenia, higher values of alanine transferase (ALT) for elevated ALT, higher values of ALT for elevated aspartate transferase (AST), and higher values of total bilirubin (TBil) for vomiting. Conclusion Routine monitoring of 44-h MTX concentrations is essential to identify patients at high risk of developing febrile neutropenia and vomiting. This study may provide a reference for clinicians to distinguish patients with a relatively high risk of severe AEs based on certain characteristics before HD-MTX infusion.
The effect of berry consumption on cancer risk

Berries have been consumed as part of the human diet for thousands of years. It is only recently, however, that their biological properties in relation to cancer inhibition and prevention have been realised. Original research by a number of sources has attributed these chemopreventative actions to the role of anthocyanin compounds in berries. A review of the literature surrounding the chemopreventative effects of berry consumption and cancer risk is explored here in order to summarise the existing evidence and to determine the future routes of research needed. This review concluded that the reliability of existing research in relation to human cancer risk is limited due to it being mainly in vitro and not enough conclusive evidence to show the application in humans. Future research should aim at understanding how berry compounds act on cancer in humans and investigations into why berry compounds are not being incorporated into effective methods for the treatment of cancer, one of the leading causes of death worldwide.
Oral health in patients with Prader-Willi syndrome: current perspectives

Abstract Prader-Willi syndrome (PWS) is a rare complex multisystem disorder and presents several aspects related to dentistry. The purpose of this review is to present current perspectives about oral health in patients with PWS. Delay development, hyperphagia, foamy and highly viscous saliva raise the risk of caries and contribute to tooth wear. Cariogenic foods uncontrolled consumption allows to obesity and dental problems progress worsening systemic disorders. These factors can be controlled. The success in follow-ups with caries free and oral health controlled demonstrate the importance of multidisciplinary team intervention corroborated by support at home from birth to adulthood. Thereby, current perspective on the disease is that there is possibility of proper maintenance of oral health in PWS patients. Guided care interferes positively with the overall well-being and quality of life of the individual with PWS and their family. A multidisciplinary team with a focus on teaching patients and family members will help minimize eventual problems.
Cytokine Regulation from Human Peripheral Blood Leukocytes Cultured In Vitro with Silver Doped Bioactive Glasses Microparticles

Bioactive glasses (BG) applications include tissue engineering for bone regeneration, coating for implants, and scaffolds for wound healing. BG can be conjugated to ions like silver, which might add some antimicrobial properties to this biomaterial. The immunomodulatory activity of ion-doped bioactive glasses particles was not investigated before. The aim of this work was to evaluate the cytotoxic and immunomodulatory effect of BG and silver-doped bioactive glass (BGAg) in human peripheral blood cells. BG and BGAg samples belonging to the system 58SiO2•(36-x)CaO·6P2O5·xAg2O, where x = 0 and 1 mol%, respectively, were synthesized via sol–gel method and characterized. Cytotoxicity, modulation of cytokine production (TNF-α, IL-1β, IL-6, IL-4, and IL-10), and oxidative stress response were investigated in human polymorphonuclear cells (PMNs) and peripheral blood mononuclear cells (PBMCs) cultures. Cell viability in the presence of BG or BGAg was concentration-dependent. In addition, BGAg presented higher PBMCs toxicity (LC50 = 0.005%) when compared to BG (LC50 = 0.106%). Interestingly, interleukin4 was produced by PBMCs in response to BG and BGAg in absence of phytohemagglutinin (PHA) and did not modulate PHA-induced cytokine levels. Subtoxic concentrations (0.031% for BG and 0.0008% for BGAg) did not change other cytokines in PBMCs nor reactive oxygen species (ROS) production by PMN. However, BG and BGAg particles decreased zymosan-induced ROS levels in PMN. Although ion incorporation increased BG cytotoxicity, the bioactive glass particles demonstrated a in vitro anti-inflammatory potencial. Future studies are needed to clarify the scavenger potential of the BG/BGAg particles/scaffolds as well as elucidate the effect of the anti-inflammatory potential in modulating tissue growth in vivo.
Evolution of a Posttraumatic Femoral Head Bone Cyst: A Case Study and Surgical Management

Development of posttraumatic subchondral bone cysts without arthritis is infrequent. Subchondral cysts themselves are common, as they are classically a degenerative finding associated with osteoarthritis. However, subchondral cysts associated with microtrauma and no arthritis are uncommon, and there is little literature to guide surgical management of posttraumatic subchondral bone cysts, as they are often managed conservatively. Development of posttraumatic bone cysts in young patients within the weightbearing area of the femoral head presents a unique challenge, particularly in the absence of arthritis, and the best surgical treatment for isolated lesions remains controversial. A majority of the available evidence deals with osteochondral lesions of the knee and ankle. Symptoms vary but can include pain with weightbearing activity and range of motion, as well as mechanical symptoms. Progression of disease and joint surface collapse are also concerns, given the nature of high contact forces through the hip joint and potential surface incongruity that may result in the early development of osteoarthritis. Hip arthroscopy has been increasing in popularity for several decades, and new areas of application continue to emerge. This article reports the case of a young patient with the development of an acute postmicrotraumatic subchondral femoral head cyst and no evidence of osteoarthritis, which was successfully managed with arthroscopic-assisted femoral head drilling and filling the defect with a combination of local autograft and cadaveric bone graft. The evolution of the injury and subsequent cyst formation is clearly documented with advanced imaging and, to our knowledge, has not been described before.
Liraglutide ameliorates nonalcoholic fatty liver disease in diabetic mice via the IRS2/PI3K/Akt signaling pathway

Purpose: High prevalence of nonalcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes has implicated the role of hepatic insulin resistance (IR) in the diseases. To better understand the underlying mechanism, we have evaluated the pathophysiological effects of Liraglutide on NAFLD via the insulin signaling pathway. Patients and methods: A 2×2 factorial experiment was designed. High-fat diet (HFD)-induced NAFLD mice with diabetes were treated with Liraglutide for 10 weeks, while the control mice were saline-treated. Hepatic expressions of InsR, IGF-1R, IRS2, PI3K and Akt at mRNA and protein levels were analyzed with RT-PCR and Western blotting. Hematoxylin and eosin staining, Oil Red O staining and electron microscopy were used to visualize triglyceride accumulation in liver. Results: Liraglutide significantly decreased body weight, fasting blood glucose levels and HOMA-IR scores in HFD mice. Compared with the control mice fed with chow diet, hepatic expressions of InsR, IRS2, PI3K and Akt at both mRNA and protein levels in HFD mice were significantly reduced, but upregulated after Liraglutide treatment. Furthermore, Liraglutide treatment was found to improve hepatic steatosis. Conclusion: The current study thereby provides evidence that Liraglutide ameliorates NAFLD and improves hepatic steatosis mainly by upregulation of the IRS2/PI3K/Akt signaling mediators.
Preemptive analgesia after lumbar spine surgery by pregabalin and celecoxib: a prospective study

Objective To evaluate the preemptive analgesic effect of combination pregabalin with celecoxib for lumbar spine surgery. Methods A prospective, randomized study was conducted among 60 lumbar spine surgery patients and divided into two groups. Postoperative pain relief was achieved with intravenous patient-controlled analgesia with morphine. The preemptive analgesia group received oral pregabalin (150 mg) and celecoxib (200 mg) 2 hrs before surgery, and the control group received a placebo. Pain was assessed by visual analogue scale (VAS). Side effects and morphine consumption were monitored until 48 hrs after surgery. Results VAS score at rest and during movement was statistically significantly lower in the preemptive analgesia group at most time points (p<0.05). Morphine consumption was significantly lower in the preemptive analgesia group compared with control group in the 24 first hours (29.03±4.38 mg vs 24.43±4.94) and 48 hrs (52.23±9.57 mg vs 44.20±10.21 mg), p<0.05. Hemodynamics, respiratory rate, and SpO2 were similar for both groups. The sedation score was only statistically significant at H8 time point. The incidence of nausea/vomiting in the preemptive group did not statistically differ from the control group. Conclusion Preoperative administration of pregabalin combined with celecoxib had a good preemptive analgesia effect and reduced intravenous morphine consumption after lumbar spine surgery. Side effects were mild and transient.