Miracle-dz/UniFAR-FTUs huggingface dataset:
Medicine Vendors: Self-medication Practices and Medicine Knowledge

Background: Medicine vendors fill the gap created by inadequate skilled professionals required for medicine procurement, storage, and distribution in developing countries. Aim: To evaluate self-medication practice and medicine knowledge among medicine vendors and to determine if a relationship exists between both. Materials and Methods: A descriptive, cross-sectional study was conducted, using a pretested questionnaire on 236 medicine vendors in Jos, Nigeria, sampled through a two-stage stratified design. Data collected were analyzed using the Statistical Package for Social Sciences version 16, and the chi-square test was used to determine the association between variables. Results: Self-medication was common (75.4%) among respondents and was not associated (P>0.05) with any of the demographic characteristics studied. The classes of medicines commonly used by respondents for self-medication were analgesics (31.4%), anti-malarials (22.6%), multivitamins (17.7%), and antibiotics (11.25%). A knowledge assessment test revealed that only 34.3% of the respondents had adequate knowledge. There was no significant (P>0.05) relationship between self-medication practice and medicine knowledge, among the respondents. However, the medicine knowledge scores were significantly (P<0.05) associated with holding a certificate in health sciences, years of experience, and the place of practice of the medicine vendors. Conclusion: The present study demonstrated that self-medication practice was high and inadequate medicine knowledge existed among respondents.
GASTRO PROTECTIVE AND ANTIOXIDANT EFFECT OF EUPHORBIA PROSTRATA AGAINST INDOMETHACIN INDUCED GASTRIC ULCERS IN HEALTHY ADULT MALE ALBINO R ABBITS

Euphorbia prostrate belongs to family Euphorbiaceae locally known as Doodhi is small annual herb. Current study was conducted t o evaluate the gastro protec tive and antioxidant effectiveness of the aerial parts of E . prostrata in indomethacin induced ulcer in adult male albino rabbits. A total 36 mice were taken and divided into 6 equal groups . At day 0 and 14 of experiment the blood sample was collected from each animal and serum was separated from blood which was used for the determination of Total oxidant status (TOS) , Total antioxidant capacity (TAC) , catalase (CAT) and Malondialdehyde (MDA) . At the end of the experiment, all of the rabbits were slaughtere d . The gastric content s were collected to total acid output , gastric pH and gastric volume . To confirm the data results was subjected to one way analysis of variance (ANOVA). Results when compared with the extensive mucosal damage in the indomethacin trate d group , gross evaluation revealed a marked protection of the gastric mucosa in the experimental groups, with significantly reductio n in gastric pH, gastric volume and acid output. In these groups, CAT and TAC levels were significantly increased (P < 0.05) and while MDA and TOS significantly reduced (P < 0.05) which indicate reduction in gastric damage. In conclusion to these results E. prostrata has potent antioxidant properties at dose rate of 240 mg/kg and it is also very effective for the treatment of g astric ulcer at the same dose.
Antidepressant use in pregnancy

Introduction: Depression during pregnancy can affect up to 20% of all women and may be treated effectively with antidepressants. Currently, information on > 20,000 women exposed to antidepressants with pregnancy outcomes is available in the literature. However, there is a continuing fear of physicians prescribing and women taking these drugs during pregnancy, probably due to many of the studies reporting conflicting outcomes and subsequently, the dissemination of these results. Areas covered: The authors searched the literature using Medline, Embase and Reprotox followed by a manual search of retrieved articles and reviews of the topic. The authors then selected key publications in this field which they considered relevant to the subsequent discussion of this topic. Expert opinion: In this review, the authors evaluate the safety of different classes of antidepressants and find no convincing evidence of an increased risk for any adverse outcomes in an appreciable fashion. The authors note that even in studies documenting a potential for harm, the risk is marginal with rarely an odds ratio above 2. Therefore, it is important that each woman discusses the risks/benefits of treatment with her healthcare provider to allow an informed decision to be made based on scientific evidence.
The effect of antibiotics on bone healing: current evidence

Introduction: Bone healing is a complex cascade of events that involves the proliferation and differentiation of osteoblastic cells under the influence of signals from growth factors, cytokines and mechanical loading. Several medications have been found to interact negatively with this process including cytostatics, NSAIDs and corticosteroids; however, the effect of antibiotics on bone repair processes remains obscure. Areas covered: The authors offer a comprehensive review of the existing literature on the in vivo and in vitro effect of antibiotics on bone, bone cells and fracture healing. The authors describe the pharmacokinetic characteristics of antibiotics after parenteral administration as well as their levels when applied locally together with a delivery vehicle. Expert opinion: The available experimental data and clinical evidence are rather limited to allow safe conclusions. In vitro studies indicate that high doses administered after systemic administration have little or no direct effect on bone cells. Further studies are desirable to define the effect of higher or prolonged concentrations on bone biology and especially that of high concentrations released by locally implanted antibiotic-delivery systems, that is, bone cement, spacers and beads.
Short Term Efficacy and Safety of Low Dose Tolvaptan in Patients with Acute Decompensated Heart Failure with Hyponatremia: A Prospective Observational Pilot Study from a Single Center in South India

Background: In acute decompensated heart failure (ADHF), diuretic use, the mainstay therapy for congestion, is associated with electrolyte abnormalities and worsening renal function. Vasopressin mediates fluid retention in heart failure. In contrast to diuretics, the vasopressin antagonist tolvaptan may increase net volume loss in heart failure without adversely affecting electrolytes and renal function. Hyponatremia (serum sodium concentration, <135 mEq/L) is a predictor of death among patients with heart failure. Objective: We prospectively observed the short term efficacy and safety of low dose (15 mg) tolvaptan in admitted patients with hyponatremia and ADHF in Indian population. Methodology: A total of 40 patients with ADHF along with hyponatremia (<125 mEq/L) on standard therapy were treated with 15 mg of tolvaptan at a single oral dose for 7 days. Results: Serum sodium concentrations increased significantly after treatment with tolvaptan from baseline (P < 0.02). There was a significant improvement in symptoms and New York Heart Association (NYHA) class after starting tolvaptan (P ≤ 0.05). Total diuretic dose and mean body weight was reduced non-significantly at 7 th day from the baseline. Side-effects associated with tolvaptan included increased thirst, dry mouth and increased urination. Few patients had worsening renal function. However, several patients developed hypernatremia. Conclusion: In this small observational study, tolvaptan initiation in patients with ADHF with hyponatremia in addition to standard therapy may hold promise in improvement in NYHA class and serum sodium. At the same time, we observed that serious adverse events such as renal function deterioration and hypernatremia developed after tolvaptan treatment, which needs to be addressed in future by randomized study with larger sample size.
Do Preferences Impact Behavior and Wellbeing? A Panel Study of Preferred and Actual Working Time 2001-2008/09

Various European studies show that the majority of those employed wish to work fewer hours than they actually do. The question addressed here is whether imbalanced working hours – working hour tensions – influence changes in behavior: do preferences transmit into reality? Based on a Danish longitudinal time-use study, we find that more Danes prefer shorter working hours over longer working hours, which is in contrast to the Americans. Moreover, not only do the vast majority of overworked Danes adjust their working hours, those who are underworked also do so within a decade. Factors behind these changes are analyzed and means to ensure an optimization of time- and money-related wellbeing are discussed.
Effects of Angiotensin-Converting Enzyme Inhibition and Angiotensin II Type 1 Receptor Blockade on β-Adrenoceptor Signaling in Heart Failure Produced by Myocardial Infarction in Rabbits: Reversal of Altered Expression of β-Adrenoceptor Kinase and Giα

Both angiotensin-converting enzyme (ACE) inhibitors and angiotensin II type 1 (AT1) receptor blockers have been demonstrated to improve symptoms and prognosis in heart failure (HF). We compared the effects of ACE inhibition and AT1 receptor blockade on myocardial β-adrenoceptor desensitization in rabbits with HF established 3 weeks after myocardial infarction (MI) with left circumflex coronary artery ligation. Rabbits with MI were randomized to no treatment, the ACE inhibitor temocapril (0.5 mg/kg/day) or AT1 receptor blocker valsartan (3 mg/kg/day). Echocardiographic examinations showed that, relative to rabbits with untreated MI, rabbits receiving temocapril or valsartan had a limitation of cardiac remodeling and prevention of the development of systolic dysfunction. Circulating plasma norepinephrine levels that were markedly elevated in MI animals were strongly inhibited by temocapril or valsartan therapy. β-Adrenoceptor density, β-adrenoceptor proportion showing high-affinity agonist binding, and basal and isoproterenol-stimulated adenylate cyclase activities were significantly reduced in MI rabbits. These defects were similarly reversed by temocapril or valsartan. Importantly, as found in human HF, myocardial protein levels of β-adrenoceptor kinase 1 and Giα were significantly elevated in MI rabbits, suggesting that these molecules are contributing to the defects in myocardial β-adrenoceptor signaling. The expression levels of these molecules were normalized equally by both treatments. The results suggest that pharmacologically different interventions in the renin-angiotensin system can equivalently improve the derangements in the β-adrenoceptor signaling system in the failing heart. This may be important for the beneficial effects of these agents in HF.
Diagnostic Significance of Interferon-γ in Tuberculous Pleural Effusions

Study objectives Tuberculosis (TB), the single most frequent infectious cause of death worldwide, also is a major cause of pleural effusion, which in TB usually has lymphocytic and exudative characteristics. Differential diagnosis between TB and nontuberculous pleural effusion can be sometimes difficult, representing a critically important clinical problem. Methods We studied 46 patients presenting with pleural effusion to the National Sanyo Hospital between April 2000 and January 2001 (34 men and 12 women; mean age, 64 years). Ten patients (22%) had tuberculous pleurisy, 19 patients (41%) had malignant pleuritis, and 17 patients (37%) had pleural effusion due to an etiology other than tuberculosis or cancer. Pleural fluid concentrations of four suggested markers were measured using commercially available kits. Results The pleural fluid levels (mean ± SE) of adenosine deaminase (83.3 ± 18.2 U/L vs 25.8 ± 20.4 U/L, p Conclusions INF-γ in pleural fluid is the most sensitive and specific among four biological markers for tuberculous pleuritis. Thus, our results suggest that determination of INF-γ at the onset of pleural effusion is informative for the diagnosis of tuberculous pleuritis. Further studies including larger numbers of patients are needed to verify this result.
Monitoring of abnormal muscle response and facial motor evoked potential during microvascular decompression for hemifacial spasm

Background: To determine whether the monitoring of abnormal muscle response (AMR) and facial motor evoked potential (FMEP) during microvascular decompression (MVD) for hemifacial spasm (HFS) might be useful for predicting the postoperative clinical course and final outcomes. Methods: We analyzed 45 HFS patients who underwent both AMR and FMEP monitoring during MVD. Patients were divided into two groups on the basis of post-MVD disappearance (group AMR-A) or persistence (group AMR-B) of AMR. With regard to FMEPs, patients were classified into one of the two groups according to the ratio of the final to baseline FMEP amplitudes recorded for the orbicularis oculi muscle: one group with a ratio of <50% (group FMEP-A), and the other with a ratio of ≥50% (group FMEP-B). Results: Twenty-one of the 26 (81%) patients in group AMR-A were assigned to group FMEP-A, whereas 9 of the 17 (53%) patients in group AMR-B were assigned to FMEP-B (P < 0.05). In 38 of the 40 (95%) patients in whom the AMRs disappeared or persisted at amplitudes <50% that at the baseline, HFS had subsided at the final follow-up. Forty of the 42 (95%) patients whose FMEP amplitude ratios indicated reduction in the amplitudes from the baseline, had complete relief of the symptoms. Nineteen of the 20 (95%) patients whose AMRs disappeared after MVD experienced immediate relief of their symptoms after the operation. With regard to 14 of the 20 (70%) patients whose AMRs persisted at the final recordings, the symptoms of HFS improved over time and eventually subsided (P < 0.001). Conclusions: Intraoperative monitoring of both AMR and FMEP during MVD may be useful in predicting the postoperative outcomes in HFS patients. The AMR-related findings may help to predict whether HFS disappears immediately after surgery or some time later.
Medical Characteristics of Patients with Macular Telangiectasia Type 2 (MacTel Type 2) MacTel Project Report No. 3

ABSTRACT Purpose: To determine whether the prevalences of various systemic conditions in participants of the MacTel Project Natural History Observation (NHO) Study differ from the corresponding prevalences in the general population. Methods: This report compares the prevalence of systemic disease in participants of the NHO Study with age- and sex-matched controls from three population-based studies from the US, the Netherlands and Australia. Bootstrap simulations were used to evaluate the impact and reliability of the computed statistics. Results: We identified a number of systemic conditions that appear to be more prevalent in cases with macular telangiectasia (MacTel) Type 2 than in the general population that were matched for age and sex with the MacTel cases. Patients with MacTel Type 2 had significantly increased prevalence of diabetes mellitus, higher prevalence of obesity, hypertension and history of cardiovascular disease, compared to their same-aged peers in generally older communities. Conclusion: Systemic disease associated with MacTel Type 2 may help to improve understanding of possible causes of MacTel Type 2. It is hoped that future studies will help to improve our understanding of the pathogenesis of the condition and lead to potential treatments for this ocular disease.
America, guns, and freedom. Part I: A recapitulation of liberty

The role of gun violence and street crime in the United States and the world is currently a subject of great debate among national and international organizations, including the United Nations. Because the Second Amendment to the U.S. Constitution protects the individual right of American citizens to own private firearms, availability of firearms is greater in the U.S. than the rest of the world, except perhaps in Israel and Switzerland. Indeed, although the American people continue to purchase and possess more firearms, homicides and violent crimes have continued to diminish for several decades because guns in the hands of the law-abiding citizens does not translate into more crime. As neurosurgeons, we can be compassionate and still be honest and have the moral courage to pursue the truth and find viable solutions through the use of sound, scholarly research in the area of guns and violence. We have an obligation to reach our conclusions based on objective data and scientific information rather than on ideology, emotionalism or partisan politics.
[Major depression in pregnant women served by the National Materno-Perinatal Institute in Lima, Peru].

OBJETIVOS: Determinar la prevalencia de depresion mayor durante el embarazo y establecer las caracteristicas sociodemograficas y obstetricas de las mujeres embarazadas con depresion mayor atendidas en la consulta externa de un hospital de Lima, Peru. METODOS: Estudio descriptivo transversal de asociacion simple. Se analizaron 222 gestantes de 16 a 42 anos con bajo riesgo obstetrico que acudieron a la consulta externa del Departamento de Obstetricia del Instituto Nacional Materno Perinatal de Lima, Peru, entre el 2 de junio y el 28 de noviembre de 2006. A cada embarazada se le aplico la escala de depresion de Edimburgo y un cuestionario sobre datos sociodemograficos y obstetricos. Se determino la relacion entre las variables de estudio segun la presencia de depresion mayor mediante las pruebas de la χ2 y de la Z, segun el tipo de variable. RESULTADOS: De las 222 gestantes estudiadas, 89 (40,1%) presentaron depresion mayor. Las mujeres casadas tendian a deprimirse menos; las que no planificaron su embarazo y que presentaron complicaciones durante su gestacion tendieron a deprimirse mas que sus pares. No se encontro que la edad, el numero de hijos, la edad gestacional, el nivel educacional, los antecedentes de aborto, el consumo de alcohol u otras sustancias, la falta de apoyo familiar y la percepcion de tener problemas de pareja, familiares, economicos o personales influyeran en la frecuencia de depresion. CONCLUSIONES: La prevalencia de depresion mayor en las gestantes estudiadas fue muy elevada. Se debe prestar especial atencion a las mujeres que manifiestan tener un embarazo no planificado y las que sufren complicaciones durante su embarazo, a fin de llegar a diagnosticos tempranos y aplicar tratamientos oportunos.
A safety evaluation of ranibizumab in the treatment of age-related macular degeneration

Introduction: The use of intravitreal ranibizumab has transformed the outcomes for thousands of patients with wet age related macular degeneration (AMD), which is the leading cause of blindness in developed countries. Prior to its introduction, most patients with wet AMD would rapidly lose central vision. The use of intravitreal ranibizumab has been shown to reduce certifiable visual loss by about a half. Current treatment regimens with ranibizumab in wet AMD require multiple injections over several years and so it is highly relevant to review the safety record of this important drug. Areas covered: This review considers the important ocular and systemic adverse events (AE) that have been reported in the literature, particularly in the context of the pivotal clinical trials that have been performed. It also reviews the safety of other anti-VEGF drugs that are used in wet AMD, namely bevacizumab and aflibercept, and compares these drugs with ranibizumab. Expert opinion: Overall, intravitreal ranibizumab can be considered a safe and highly effective drug for patients with wet AMD. However recent concerns about retinal thinning following ranibizumab therapy, possible systemic AE associated with all anti-VEGF drugs and the occurrence of complications relating to drug preparation and delivery must be considered.
An analysis of the safety profile of proteasome inhibitors for treating various cancers

Introduction: Emerging evidence demonstrates that the ubiquitin-proteasome pathway is a promising target for cancer therapy. Bortezomib (Velcade) exhibits great efficacy against multiple myeloma (MM) since the first clinical application. However, there are still several limitations associated with the use of bortezomib, including severe toxicities. To overcome bortezomib’s shortcomings and to improve its safety profile, several second-generation proteasome inhibitors, for example, carfilzomib, ixazomib, oprozomib and marizomib, have been developed and currently tested in various clinical trials. Areas covered: A literature search was carried out using PubMed and Google Scholar. The activity and safety profiling of proteasome inhibitors in treatment of various cancers were reviewed. Expert opinion: Bortezomib, as a single or in combination therapy, demonstrates efficacy against MM or other hematological malignancies in clinical settings. However, it encounters two major problems, the acquired resistance and the severe side effects. Future direction in bortezomib-based therapy should focus on how to increase or retain its efficacy but improve its safety profile through, for example, rational combination therapies. Second-generation proteasome inhibitors have shown benefits in both overcoming bortezomib resistance and reducing related side effects, although these encouraging results should be further confirmed in a larger clinic population.
National genetic evaluation of udder health and other health traits in Denmark

An improved index for udder health and a new index for other health traits than mastitis have been introduced in Denmark. Index for udder health includes information about mastitis in first, second and third parity. SCC and some linear type traits are utilized as information traits. AI bulls with only first batch of daughters (80-100) obtain indexes with reliabilities of app. 75%. Index for other health traits combines information on reproductive diseases, digestive diseases and feet and leg diseases in the period 10 to 180 days after calving in first, second and third parity. Bulls with only first batch of daughters obtain indexes with reliabilities of approx. 60 %. None of the linear type traits are good indicators of other health traits, and for some of the linear traits the favourable correlation is in the opposite direction of the breeding goal for the trait.
Adverse drug reactions associated with antiretroviral therapy during pregnancy

Introduction: Antiretroviral (ARV) drug use during pregnancy significantly reduces mother-to-child HIV transmission, delays disease progression in the women and reduces the risk of HIV transmission to HIV-serodiscordant partners. Pregnant women are susceptible to the same adverse reactions to ARVs as nonpregnant adults as well as to specific pregnancy-related reactions. In addition, we should consider adverse pregnancy outcomes and adverse reactions in children exposed to ARVs during intrauterine life. However, studies designed to assess the safety of ARV in pregnant women are rare, usually with few participants and short follow-up periods. Areas covered: In this review, we discuss studies reporting adverse reactions to ARV drugs, including maternal toxicity, adverse pregnancy outcomes and the consequences of exposure to ARV in infants. We included results of observational studies, both prospective and retrospective, as well as randomized clinical trials, systematic reviews and meta-analyses. Expert opinion: The benefits of ARV use during pregnancy outweigh the risks of adverse reactions identified to date. More studies are needed to assess the adverse effects in the medium- and long term in children exposed to ARVs during pregnancy, as well as pregnant women using lifelong antiretroviral therapy and more recently available drugs.