Miracle-dz/UniFAR-FTUs huggingface dataset:
GC-MS analysis of bioactive compounds in the methanol extract of Clerodendrum viscosum leaves

Background: Clerodendrum viscosum is commonly found in India and Bangladesh. Previously, various parts of this plant were reported for treatment of different types of diseases and there was no report on GC-Ms analysis. Objective: To analyze and characterize the phytochemical compounds of methanol extract of Clerodendrum viscosum using GC-MS. Materials and Methods: The preliminary phytochemical screening of methanol extract was carried out according to standard procedures described in WHO guidelines. Various bioactive compounds of the extract were determined by GC-MS technique. Results: The presence of steroids, triterpenoids, alkaloids, saponins, flavonoids, tannins and carbohydrate was found on phytochemical screening of methanol extract of the leaves. The GC-MS analysis showed 16 peaks of different phytoconstituents namely acetamide,N,N-carbonylbis-, 4-Pyranone,2,3-dihydro-, alpha-D-Galactofuranoside, methyl 2,3,5,6-tetra-O-methyl-, Glycerin, Xylitol, N,N-Dimethylglycine, 4H-Pyran-4-one,2,3-dihydro-3, 5-dihydroxy-6-methyl-, Benzofuran,2,3-dihydro-, 5-Hydroxymethylfurfural, 2(1H)Pyrimidinone,1-methyl-, 2,4-Dihydroxy-5,6-dimethylpyrimidine, 3-Deoxy-d-mannoic lactone, 1,3-Methylene-d-arabitol, Orcinol, n-Hexadecanoic acid and Phenol,4,4′-(1-methyl ethylidene) bis etc. Conclusion: The bioactive compounds present in the methanol extract of Clerodendrum viscosum suggest the application of this extract for the treatment of various diseases by the aborigine tribes.
Adjunctive antiepileptic drugs in adult epilepsy: how the first add-on could be the last

Importance of the field: In adult epilepsies, incomplete seizure control under monotherapy affects ∼ 20 – 25% of patients with idiopathic generalized epilepsies (IGE) and ∼ 20 – 40% of patients with epilepsies with focal seizures (FE). The choice of an adjunctive therapy is therefore a common event. Areas covered in this review: Efficacy studies of add-on anti-epileptic drugs for adult epilepsies – approved since the early 1990s until 2008 – were reviewed. An exception was made for valproate. What the reader will gain: Efficacy studies give important clues for add-on drug choice but – beyond this – we encourage physicians to consider other parameters, especially co-morbidity(ies) and special situation(s). According to clinical and pharmacological data, an original, practical approach is proposed, by which decisions are based on three main criteria, which aim to optimize patients' seizure control and quality of life. The need for drugs that act not only on ‘ictogenesis’ but also on ‘epileptogenesis’ is also discussed briefly. Take home message: Given the increasing disposal of anti-epileptic drugs, the choice of an add-on therapy appears to be partly based on subjective criteria (physician opinions and preferences). In fact, the selection criteria can be clarified as: treatment decisions rely not only on seizure type, efficacy and tolerability profiles but also on patient-related factors.
Association between red blood cell distribution and renal function in patients with untreated type 2 diabetes mellitus

Abstract We assessed whether red cell distribution width (RDW) is associated with microalbuminuria (MAU) in a group of 320 patients with newly diagnosed type 2 diabetes mellitus (T2DM), recruited in Zhengzhou. Patients were divided into normal group and MAU group. Compared with the normal group, the patients with MAU had higher red blood cell count (p = 0.005) and RDW (p < 0.001). The multiple logistic regression indicated that RDW (OR = 3.89, 95% CI: 1.98–7.66, p < 0.001) was an independent risk factor of MAU in newly diagnosed T2DM. Other factors include smoking (OR = 4.44, 95% CI: 2.90–8.72, p < 0.001), higher waist index (OR = 2.17, 95% CI: 1.89–5.26, p = 0.002), FBG level (OR = 2.05, 95% CI: 1.21–3.84, p = 0.008) and uric acid level (OR = 2.18, 95% CI: 1.05–4.52, p = 0.037). The receiver operating characteristic (ROC) curves explored the relationship between MAU and RDW. The area under the curve was 0.79 (95% CI: 0.74–0.84; p < 0.001). Using a cut-off point of 12.8, the RDW predicted MAU in the T2DM patients with a sensitivity of 71.3% and specificity of 66.9%. RDW may be independently associated with MAU in patients with newly diagnosed T2DM. RDW may be treated as effective predictive index in the evaluation of diabetes nephropathy or diabetes-associated complications.
Etravirine in combination with darunavir/ritonavir and optimized background regimen results in suppression of HIV replication in treatment-experienced patients

Therapeutic options for treatment-experienced HIV-infected patients have been limited. The DUET trial evaluated the use of etravirine, a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI), or placebo, in 1203 treatment-experienced, HIV-infected patients. Eligible patients had to have evidence of NNRTI and protease inhibitor resistance-associated mutations, and evidence of virologic failure, as defined as a plasma viral load > 5000 copies/ml on antiretroviral therapy at the time of screening. Patients in both arms received an optimized background regimen including darunavir/ritonavir. DUET demonstrated superior outcomes in virologic suppression (plasma viral load < 50 copies/ml) and clinical end points including new AIDS-defining illnesses and death, in those randomized to receive etravirine. These results were maintained at 48 weeks of follow-up. Furthermore, etravirine was shown to be safe and well-tolerated over this period. In exploratory analyses, patients in the DUET study with greater number of active agents within the background regimen were more likely to have a fully suppressive response. Taken together, the DUET results highlight the high rates of virological success that can be achieved using new active agents, such as ritonavir-boosted darunavir and etravirine, in treatment-experienced patients with underlying drug-resistant HIV infection.
Effects of silymarin on methotrexate-induced nephrotoxicity in rats

Abstract Methotrexate (MTX) is widely used in the treatment of various malignancies and nononcological diseases but its use has been limited by its nephrotoxicity. Silymarin (SLY), a natural flavonoid, has been reported to have antioxidant, anti-inflammatory and anti-apoptotic effects. This study was carried out to determine whether SLY exerts a protective effect against MTX-induced nephrotoxicity. Rats were divided into six groups: Group 1 (saline, i.p., single injection), Group 2 (0.5% carboxymethyl cellulose (CMC), by gavage once daily for five consecutive days), Group 3 (SLY, 300 mg/kg per day, i.p. for five consecutive days), Group 4 (MTX, 20 mg/kg, i.p., single injection), Group 5 (MTX + CMC similarly as groups 2 and 4) and Group 6 (MTX + CMC + SLY similarly as groups 2, 3 and 4). Histopathologic alterations including apoptotic changes of the kidney were evaluated. MTX injection exhibited dilated Bowman’s space, inflammatory cell infiltration, glomerular and peritubular vascular congestion and swelling of renal tubular epithelium cells. Apoptotic cell death was also markedly increased in renal tubules after MTX administration. SLY treatment resulted in statistically significant amelioration in the histological alterations and reduced the number of TUNEL-positive cells as compared with the MTX treated rats (p < 0.05). In conclusion, SLY treatment leads to a reduction on MTX-induced renal damage in rats. Since SLY is safe and acceptable for human consumption, further studies to define the exact mechanism of the protecting effect of SLY on MTX-induced nephrotoxicity and the optimum dosage of this compound would be useful.
Work-Family Conflict among Female and Male Physicians in Hungary: Prevalence, Stressor Predictors and Potential Consequences on Physicians' Well-Being

Adam, S. & Gyorffy, Z. (2004). Role conflict among female physicians in Hungary: causes, effects and coping strategies. Psychology and Health, 19, 8-9. Adam, S. & Gyorffy, Z. (2006). Burnout among Hungarian female and male physicians: prevalence and potential precursors. Psychology and Health, 21, 10. Adam, S. & Gyorffy, Z. (2006). High prevalence of work-family conflict among female physicians in Hungary: Sources and adverse health outcomes. Journal of Psychosomatic Research, 61, 3. Adam, S. , Gyorffy, Z. , & Susanszky, E. (2007). Associations between work-family conflict and lack of support among physicians. Psychology and Health, 1, 212. Gyorffy, Z. , Adam, S. , & Kopp, M. (2004). Assessment of maternal reproductive morbidity among female physicians in Hungary. Psychology and Health, 19, 71-72. Gyorffy, Z. , Adam, S. , & Kopp, M. (2006). The physician’s profession in Hungary: High prevalence of psychiatric and somatic morbidity. Psychology and Health, 21, 61. Balog, P., Salavecz, G. , Adam, S, Stauder, A. , Purebl, G. , Szekely, A. , & Keltai, M. (2007). Work stress and mental health among nurses. Psychology and Health, 1, 222. Neculai, K. , Gyorffy, Z. , Adam, S. , & Kopp, M. (2006). Work-related correlates of menstrual pain in Hungarian women: a national representative survey. Journal of Psychosomatic Research, 61, 3.
GAS6 intron 8 c.834 + 7G > A gene polymorphism in diabetic nephropathy

Abstract Background - Aim: In animal experiments, growth arrest-specific 6 (Gas6) protein plays a key role in the development of mesangial cell and glomerular hypertrophy in the early phase of diabetic nephropathy, and diabetic nephropathy is prevented by warfarin-induced inhibition of GAS6 protein. It was shown that GAS6 intron 8 c.834 + 7G > A polymorphism is protective against type 2 diabetes mellitus, and AA genotype is associated with higher blood levels of GAS6 protein. Our aim is to investigate whether this polymorphism is a risk factor for diabetic nephropathy in type 2 diabetes mellitus. Method: Eighty-seven patients with diabetic nephropathy were compared with 66 non-diabetic controls in terms of GAS6 intron 8 c.834 + 7G > A polymorphism. Patients with history of stroke, ischemic heart disease were excluded. Each patient was examined by the ophthalmologist to determine diabetic retinopathy. Results: Frequency of GG, GA and AA genotypes are similar in diabetic nephropathy and control groups according to GAS6 intron 8 c.834 + 7G > A polymorphism (p = 0.837). Rate of diabetic retinopathy was 54.02%. In the subgroup analysis, GA genotype was significantly more frequent than GG genotype in patients with diabetic retinopathy when compared to without diabetic retinopathy (p = 0.010). Conclusion: In our study, GAS6 intron 8 c.834 + 7G > A polymorphism was not associated with diabetic nephropathy in type 2 diabetes mellitus. However, heterozygous state of this polymorphism may be a risk factor for diabetic retinopathy in patients with diabetic nephropathy.
Urinary tuberculosis: a cohort of 79 adult cases

Abstract We aimed to investigate the demographic, clinical, diagnostic, treatment and outcome features of patients with urinary tuberculosis (UTB). Patients with UTB admitted to seven separate centers across Turkey between 1995 and 2013 were retrospectively evaluated. The diagnosis of UTB was made by the presence of any clinical finding plus positivity of one of the following: (1) acid-fast bacilli (AFB) in urine, (2) isolation of Mycobacterium tuberculosis, (3) polymerase chain reaction (PCR) for M. tuberculosis, (4) histopathological evidence for TB. Seventy-nine patients (49.36% male, mean age 50.1 ± 17.4 years) were included. Mean time between onset of symptoms and clinical diagnosis was 9.7 ± 8.9 months. The most common signs and symptoms were hematuria (79.7%), sterile pyuria (67.1%), dysuria (51.9%), weakness (51.9%), fever (43%) and costovertebral tenderness (38%). Cystoscopy was performed in 59 (74.6%), bladder biopsy in 18 (22.8%), kidney biopsy in 1 (1.26%) and nephrectomy in 12 (15.2%) patients. Histopathological verification of UTB was achieved in 12 (63.1%) patients who undergone biopsy and in 100% of those undergone nephrectomy. Mycobacterium tuberculosis was isolated in the urine of 50 (63.3%) cases. Four-drug standard anti-TB treatment was the preferred regimen for 87.3% of the patients. Mean treatment duration was 10.5 ± 2.7 months. Deterioration of renal function occurred in 15 (18.9%) patients two of whom progressed to end-stage renal disease and received hemodialysis. Only one patient died after 74-day medical treatment period. Cases with UTB may present with non-specific clinical features. All diagnostic studies including radiology, cyctoscopy and histopathology are of great importance to exclude UTB and prevent renal failure.
Exemestane in postmenopausal women with early or advanced breast cancer: a review

Importance of the field: Inhibition of the aromatase enzyme in postmenopausal women reduces levels of estrogens, which is of therapeutic value in hormone-sensitive breast cancer. Exemestane is a third-generation steroidal irreversible inactivator of the aromatase enzyme used in early and advanced breast cancer for the treatment of postmenopausal women with estrogen-receptor-positive disease. Areas covered in this review: The scientific literature on exemestane, including published articles and abstracts, was searched from 1988 to the present, and the most significant results are included in the review. What the reader will gain: The review outlines the pharmacological characteristics of exemestane and the evidence supporting its use in the treatment of postmenopausal women with early or advanced estrogen-receptor-positive breast cancer. Take home message: Exemestane is an effective and well-tolerated aromatase inhibitor with a defined role in early-stage breast cancer following 2 – 3 years of adjuvant treatment with tamoxifen. Exemestane also has a role in the sequence of hormonal agents employed to control advanced hormone-sensitive breast cancer, in which clinicians may exploit its partial lack of cross-resistance with nonsteroidal aromatase inhibitors.
Changes in physical activity, maximal isometric strength and maximal oxygen uptake from late teenage to adulthood: an eight‐year follow‐up study of adolescents in Denmark

A randomly selected group of 88 men and 115 women, aged 23–27 years in 1991, were tested as teenagers in 1983, and then followed‐up in 1991. A mean increase of 15% in maximal voluntary isometric strength was found in men, and no change was found in women over the 8 years. Body weight increased 14% in men and 6% in women. Strength in relation to body weight (N · kg−1) did not change in men, but a small decrease of 3% was found in women. Strength in abdominal muscles decreased in blue‐collar workers but increased in students. Maximal oxygen uptake (V̇o2max (ml · min−1kg−1) decreased 9% in men and 3% in women. The values in 1991 were 47.9 and 39.5 ml · min−1kg−1 for men and women, respectively. Participation in leisure sport activities decreased 1.7 h · week−1 in men and 1.2 h · week−1 in women. Seventy percent of the men and 74% of the women participated in regular leisure sport activity, which was a marked increase from 8 years before, when only 54% of the men and 57% of the women were similarly active. The overall decrease in V̇O2max in men was due primarily to a decrease among blue‐collar workers and unemployed men: 19%vs 4% in other occupational groups. Only 20% of the blue‐collar workers participated in sport activities for more than 4 h · week−1, and 47% did not participate at all. In women, changes in strength and V̇O2max were related to motherhood. Abdominal muscle strength decreased, but arm flexor strength increased in women who had become mothers. V̇O2max decreased 14% in mothers vs 2% in other women. Changes over 8 years in V̇O2max and strength did not relate to changes in physical activity, but a significant relationship between decrease in physical activity and gain in body fat was found in men. Changes in body weight and body fat were the only variables that correlated with changes in strength. None of the observed changes related to changes in V̇O2max (ml · min−1kg−1). For the 23‐ to 27‐year‐olds, the level of physical activity assessed in h · week−1 was almost as high in women as in men.
Assessment of renal functions in patients of chronic liver disease

Abstract Aims and objectives: Renal involvement in patients of chronic liver disease (CLD) is one of the dreaded complications associated with a steep rise in mortality and morbidity. Derangements in various homeostatic mechanisms in CLD leading to direct renal injury or circulatory compromise have been associated with renal impairment. Method: Consecutive cirrhotic patients (n = 100) were included in the study. Structural and functional renal failure was identified and patients were classified into various renal syndromes pre renal, intra-renal and hepatorenal syndrome (HRS). Results: At the time of presentation, 37 patients had renal dysfunction. Thirty patients had pre-renal type of renal failure, six patients had intrinsic renal disease and one patient had structural renal disease. Patients with pre-renal type were further classified into volume responsive pre-renal failure and volume non responsive HRS. Five patients had features suggestive of HRS. Patients with decompensation such as portal hypertension (PHTN), jaundice, upper gastro-intestinal bleed and hepatic encephalopathy had significantly higher incidence of renal derangements as compared to their counterparts. Infection in the form of SBP and/or sepsis predisposed patients to develop renal dysfunction. Conclusion: Renal impairment in patients with advanced liver disease is not an uncommon phenomenon and is more commonly associated with a more advanced disease. Presence of PHTN and various signs of decompensation increase the chances of renal derangements in these patients. In view of rising incidence of CLD and higher survival (due to better treatment options available), one should be vigilant for the renal derangements in these patients.
Analysis of gene mutations in PKD1/PKD2 by multiplex ligation-dependent probe amplification: some new findings

Abstract Autosomal dominant polycystic kidney disease (ADPKD) is a serious genetic disorder that can lead to chronic renal disease. Protein dysfunction caused by mutations in the genes polycystic kidney disease 1 (PKD1) and polycystic kidney disease 2 (PKD2) is an important factor in the pathogenesis of ADPKD. In the present study, 30 Chinese patients with confirmed diagnosis of ADPKD, based on ultrasound or computerized tomography (CT) findings were selected, and the exon copy numbers of PKD1 and PKD2 were determined using multiplex ligation-dependent probe amplification (MLPA). MLPA identified exon deletion in 1 case, suspected exon deletion in 4 cases, and suspected duplications in 3 cases. One case of suspected exon deletion was confirmed using quantitative real-time polymerase chain reaction (q-PCR) and sequencing (PKD2 exon 8). A missense mutation was observed in 1 case of exon deletion using q-PCR and sequencing (PKD1 exon 40, c.11333 C>A). The cases of suspected duplications were verified by q-PCR, and the copy number of exon 6 of PKD1 in 1 case of suspected duplication was 3.8 times greater than that in normal controls. Our findings provide new insights into ADPKD screening and mark a possibly meaningful step toward improved diagnosis and treatment of patients with ADPKD.
Improving Diabetic Retinopathy Screening in Africa: Patient Satisfaction with Teleophthalmology Versus Ophthalmologist-Based Screening

Purpose: To assess patient preference for diabetic retinopathy (DR) screening with teleophthalmology or face-to-face ophthalmologist evaluation in Nairobi, Kenya. Materials and Methods: Fifty seven diabetic patients from a one-stop multidisciplinary diabetic clinic (consisting of a diabetologist, nurse educator, foot specialist, nutritionist, ophthalmologist, and neurologist) in Nairobi, Kenya were included if they had undergone both a teleophthalmology (stereoscopic digital retinal photographs graded by an ophthalmologist remotely) and a traditional clinical screening exam (face to face examination). A structured questionnaire with a 5-point Likert scale was developed in both English and Swahili. The questionnaire was administered over the telephone. Ten questions were used to compare patient experience and preferences between teleophthalmology and a traditional clinical examination for DR. A mean score >3.25 on the Likert scale was considered favourable. Results: Successfully telephone contact was possible for 26 (58% male, 42% females) of the 57 patients. The mean ages of the male and female patients were 52.4 and 46.5 years respectively. Patients were satisfied with their teleophthalmology examination (mean 4.15 ± 0.97). Patients preferred the teleophthalmology option for future screenings (mean 3.42 ± 1.52). This preference was driven primarily by convenience, reduced examination time, and being able to visualize their own retina. Conclusion: In this study, diabetic patients preferred a teleophthalmology based screening over a traditional ophthalmologist-based screening. The use of teleophthalmology in Africa warrants further study and has the potential to become the screening model of choice. Cost effectiveness in comparison to an ophthalmologist-based screening also requires evaluation.
Hypertension 2010: what was new for the cardiologist?

Importance of the field: Despite extensive clinical research, still there is some uncertainty regarding management of hypertension, in particular initial and goal blood pressure levels and selection of optimal pharmacotherapy, as well as concomitant medications, to reduce other risk factors. Areas covered in this review: An overview of recent findings from major clinical trials in hypertension (until July 2010), along with a reappraisal of the European Society of Hypertension 2009 guidelines. What the reader will gain: Practical overview of the management of hypertension, including threshold and goal blood pressure in specific situations, choice of antihypertensive medications and indications for treatment of concomitant risk factors. Take home message: Primary benefits of antihypertensive therapy are mediated by blood pressure reduction and the majority of patients will require at least two drugs, with the preference of fixed-dose combinations for effective blood pressure control.
Topical treatment options for drug-induced toxic epidermal necrolysis (TEN)

Importance of the field: Drug-induced toxic epidermal necrolysis (TEN) is a dreadful skin condition. The mortality rate of 25 – 30% is mainly due to both metabolic failures and septicemia following loss of epidermal integrity. Topical treatments are important options in these patients. Areas covered in this review: Topical TEN care includes specific bedding, debridement of epidermal necrosis, applications of bioactive skin substitutes or semi-synthetic and synthetic dressings, as well as antiseptic and antibiotic agents. What the reader will gain: In the early exudating phase of TEN, the use of air-fluidized bed combined with gentle debridement are recommended. Next, an alternating pressure mattress and silver impregnated absorbent dressings should be used. During the re-epithelialization phase, antiseptic or antibiotic creams overlaid with nonadherent dressings favor an optimized moist and bacteria-controlled environment. Take home message: A suitable topical treatment is mandatory in TEN. Skin care procedures must be managed according to the skin condition corresponding to the initial highly exudating/necrotic phase, the secondary moderately exudating stabilized phase and the later re-epidermization phase. Bedding modalities, debridement procedures, applications of bioactive, semi-synthetic and synthetic dressings (silver-impregnated or not) and antiseptic/antibiotic creams should be adapted accordingly.