Miracle-dz/UniFAR-FTUs huggingface dataset:
Synergistic effect of intrathecal fentanyl and bupivacaine combination for cesarean section

Primary outcome of this study was to determine effectiveness of sensory and motor blockade after spinal anaesthesia with plain bupivacaine and low dose bupivacaine with fentanyl. We also compared the hemodynamic changes, side effects and post-operative effective analgesia between the two groups. In this prospective, double blind, randomized study, 60 patients undergoing elective caesarean section were divided randomly in two equal groups. Group B: Patients received 7.5mg of 0.5% heavy Bupivacaine (1.5mL) and Group BF: Patients received 5mg of 0.5% heavy Bupivacaine (1mL) with 25μg preservative free Fentanyl (0.5mL) intrathecally. The clinical profile of subarachnoid block in two groups and its effect on maternal and neonatal outcome were studied. The mean time required to reach peak sensory level was earlier in Group BF than Group B (P<0.001). Mean maximal pulse rate was significantly more in Group B (103.60 ± 6.92 per min) than in Group BF (P<0.05). Mean minimal systolic arterial pressure was significantly less in Group B (P<0.05). Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly early in Group B (P<0.05). Duration of motor recovery in Group BF was significantly earlier (P<0.05). The duration of effective analgesia was significantly more in Group BF (P<0.05). 16.66% patients in Group BF had statistically significant fewer side effects as compared to 36.66% in Group B. We can conclude that low dose preservative free fentanyl (25µg) with 0.5% hyperbaric bupivacaine for spinal anaesthesia causes satisfactory intra operative sensory and motor blockade, hemodynamic stability, less side effects and effective postoperative analgesia.
Design and Development of a Novel Photoacoustic Imaging System for Detection of Intracranial Hemorrhages

Photoacoustic (PA) imaging has the potential to overcome disadvantages of optical and ultrasonic imaging techniques by combining the two imaging modalities. This allows for exploitation of endogenous contrasts (variants of hemoglobin) to generate energy with light, and provides enhanced resolution by probing for resulting acoustic signals. The resulting platform has widespread applications ranging from structural (vasculature-based) to functional (oxygenation-based) point-of-care clinical imaging. This thesis has been aimed towards the development of a PA system for detection of intracranial hemorrhages. Simulations have been performed using a photon tracking Monte Carlo program and ultrasound wave propagation modeling software, k-wave to simulate light absorption and resultant acoustic signals in tissue. Furthermore, development of a PA imaging setup utilizes a 6-ns pulsed laser operating at 532-nm with a pulse repetition frequency of 28-Hz as the light source. Ultrasonic transducers with centre frequencies ranging from 1to 5-MHz are used to receive acoustic signals produced from the object illuminated. The system is designed in a handheld, probe-like configuration to enable point-of-care detection and/or imaging. Acoustic signals are amplified and collected through a data acquisition system and processed through software to form an image. Simulations have shown sufficient penetration through superficial tissue, and absorption of light by blood at relevant wavelengths (near-infrared range). Black plastic resin phantoms have been used to characterize point-source PA signals, and complex geometries of phantoms have successfully been imaged and reconstructed with the PA system. Phantom geometries have also been imaged through gelatin and bone. The PA system has been successfully shown to image PA absorbers in different
HIV-Associated Hodgkin Lymphoma

We retrospectively analyzed 45 cases of HIV-associated Hodgkin lymphoma (HIV-HL). HIV-HL generally is a disease of young white men (mean age, 40.1 years) who acquired HIV infection by homosexual or bisexual behavior (68%), intravenous drug use (24%), and/or blood transfusion (8%). The mean interval between the diagnosis of HIV and HIV-HL was 5.2 years. Morphologic classification of nodal biopsy specimens (2001 World Health Organization criteria) included 15 mixed cellularity Hodgkin lymphomas (MCHLs), 14 nodular sclerosis Hodgkin lymphomas (NSHLs), 9 lymphocyte depleted Hodgkin lymphomas (LDHLs), and 7 classic Hodgkin lymphomas, type not further categorized. The Hodgkin–Reed-Sternberg (HRS) cells expressed positive immunoreactivity with fascin (30/30 [100%]), CD30 (35/37 [95%]), CD15 (32/36 [89%]), bcl- XL (25/31 [81%]), bcl-2 (15/29 [52%]), CD20 (4/34 [12%]), bcl-6 (3/28 [11%]), and Epstein-Barr virus latent membrane protein-1 (32/33 [97%]) and were nonreactive for CD138/syndecan-1. CD4 and CD8 immunostaining showed an inverted CD4/CD8 ratio (<1/20) in all cases. At diagnosis, most patients (n = 27) had high-stage disease (IVE) associated with an aggressive course (16% 5-year survival). LDHL behaved more aggressively than MCHL and NSHL (15% vs 40%, 5-year survival, respectively), as did disease with a sarcomatoid pattern (11% 5-year survival). Chemotherapy and radiotherapy proved efficacious in a minority of these patients.
Calcium Supplement Use Is Associated With Less Bone Mineral Density Loss, But Does Not Lessen the Risk of Bone Fracture Across the Menopause Transition: Data From the Study of Women's Health Across the Nation

Diet is a modifiable factor that is related to bone mass and risk for fractures; however, the use of calcium supplements for bone health is controversial, with little scientific agreement. The purpose of this analysis was to estimate the change in lumbar spine and femoral neck BMD and the risk of bone fracture by the use of calcium supplements among the Study of Women's Health Across the Nation (SWAN) participants. SWAN is a multicenter, multiethnic, community‐based longitudinal cohort designed to examine the health of women across the menopause transition (n = 1490; aged 42 to 52 years at baseline in 1996 to 1997 and followed annually until 2006 to 2008). A mixed‐effect model for repeated measures was used to estimate annualized BMD change across time between supplement users and nonusers, unadjusted or fully adjusted (age, race, height, weight, menopausal status [pre‐, early peri‐, late peri‐, and postmenopausal], DXA scanner mode, alcohol intake, vitamin D supplement use, smoking, and physical activity) and a log‐linear model with repeated measures was used to estimate the relative risk of fracture by calcium supplement use. All models were also stratified by baseline menopausal status. In fully adjusted models, calcium supplement use was associated with less annualized loss of femoral neck BMD (−0.0032 versus −0.0040 g/cm2/year; p < .001) and lumbar spine BMD (−0.0046 versus −0.0053 g/cm2/year, p = 0.021) in the complete cohort. However, this protective association of calcium supplement use with BMD loss was significant only among premenopausal women (femoral neck: −0.0032 versus −0.0042 g/cm2/year; p = 0.002; lumbar spine: −0.0038 versus −0.0050 g/cm2/year, p = 0.001); no significant differences in BMD were observed among women who were early perimenopausal by calcium supplement use at baseline. No significant differences in the relative risk of fracture were observed, regardless of baseline menopausal status. The use of calcium supplements was associated with less BMD loss over more than a decade, but was not related to the risk of incident bone fracture across the menopause transition. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
Low dose gabapentin abolishes ipsilateral tinnitus after peripheral facial palsy: A case report and literature review

A unilateral tinnitus occurred at right ear in a hypertensive and diabetic woman shortly after an ipsilateral peripheral facial palsy. Audiometric tests showed a predominant sensorineural hearing impairment at right ear. Her tinnitus was abolished after an administration of a low dose of gabapentin. In view of a controversy of gabapentin and tinnitus in previous trials, the fi ndings in this patient support that low dose gabapentin can benefi t specifi cally the subgroup of tinnitus patient with sensorineural impairment due to secondary contributing factor.
Radiomorphometric Evaluation of the Frontal Sinus in Relation to Age and Gender in Saudi Population

Background: Radiographs have been used for forensic identification purpose. At times when only skull remains are found and other means of identification fail, radiographs of skull may be used for identification purpose. Aim: The objective of this study was morphometric evaluation of the frontal sinus by using digital posteroanterior skull radiograph in relation to age and gender and to establish its forensic importance. Materials and Methods: The study was conducted at Alfarabi Private College for Dentistry and Nursing, Jeddah, Kingdom of Saudi Arabia. It included 400 subjects (200 males and 200 females), aged 14–70 years. Radiographs of the individuals were taken by digital radiography, and morphometric evaluation of frontal sinus was carried out by using Adobe Photoshop CS3 Extended. Results: Unilateral absence of sinus was noted in 2.5% males and 1.5% females. Bilateral absence was noticed in 2% males and 0.5% females. Right and left frontal sinus symmetry was seen in 83.20% of the individuals. The left-dominated asymmetry was observed in 6.98% individuals. The right-dominated asymmetry was observed in 9.82% individuals. Simple logistic regression analysis of gender by different variables showed right width and left width, which are most suited regressors for sex determination. The rate of accuracy in classification of males and females varied from 67.70% to 95.90%. Stepwise multiple regression analysis of estimation of age by different variables showed right sinus height is the best predictor of age. Conclusion: In this study, the radiographic images of the frontal sinus showed significant morphological difference in relation to age and gender in Saudi population. On the basis of this evidence, it is proposed that the morphologic evaluation of frontal sinus can be used for personal identification.
Relationship Between Chronic Pain and Quality of Life in Patients With Acute Leukemia Undergoing Chemotherapy

Background: Chronic pain is one of the most prevalent symptoms in patients with acute leukemia and can affect patients' Quality of Life (QOL) that is a significant factor in assessment of cancer treatments. Also, the goal of curing hematological malignancies is to reach to increased survival and improvement of patients; and this goal will be fulfilled when QOL in patients is promoted. Objectives: The present study aimed to investigate the correlation between chronic pain and Health-Related QOL (HR-QOL) in patients with acute leukemia under chemotherapy in Ahvaz City, Iran. Patients and Methods: This descriptive-analytical study was performed on 90 patients (age range, 18 - 50 years) with acute leukemia under chemotherapy referred to Shafa Hospital in Ahvaz, Iran. The participants were selected through convenient sampling. The outcome measures included the Iranian version of the Short-Form 36 (SF-36) health survey, Numeric Rating Scale (NRS) for assessing the pain, and demographic questionnaire. Data analysis was performed using ANOVA, t-test, chi-square, with the significance level of 95%. Results: The average of pain severity was 6.03 ± 2.06, and the total average of HR-QOL was 46.83 ± 3.62, and the lowest average belonged to physical function (42.17 ± 25.75). No significant difference was found in the average pain between the two genders (P = 0.487); however, there was a statistically significant difference between HR-QOL and gender (P = 0.005). Moreover, no significant difference was detected between the average pain severity and acute leukemia type (P = 0.152). The findings also revealed a significant relationship between pain severity and aspects of HR-QOL, So that, all aspects of QOL were decreased with increased pain severity. Conclusions: The results of the study indicate that chronic pain and HR-QOL in patients with acute leukemia in Ahvaz are in a very adverse condition and require serious reform. The findings of the study can be helpful in the clinical decisions and health care programs to the therapeutic team.
ROLE OF RADIO FREQUENCY IN THE MANAGEMENT OF INFERIOR TURBINATE HYPERTROPHY

BACKGROUND: Surgery of inferior turbinates is a divisive subject. Surgical management includes functional and invasive procedures. Radiofrequency ablation –A Minimally invasive welldesigned daycare nasal surgery which also preserves mucosal function of the inferior turbinate. OBJECTIVE: To appraise the efficacy of radiofrequency in the management of inferior turbinate hypertrophy. MATERIALS AND METHODS: current study is a prospective cram conducted in the Department of ENT from August 2013 to August 2014 with 100 patients who had nasal obstruction due to Inferior turbinate hypertrophy and obstinate to medical therapy. Patients were excluded if they had history or physical examination that indicate other causes of nasal obstruction like nasal polyp, nasal tumors, previous nasal surgeries, diabetes mellitus, severe nasal deformities, coagulopathy disorders, severe systemic diseases, radiotherapy to nose. The study was based on history of diagnosis, clinical examination, diagnostic nasal endoscopy and imaging. We used radio frequency generator BM-780II unit with power of 70watt radio wave emission in bipolar mode for 59seconds, stopped the emission once visual blanching of mucous membrane occurred. Postoperative follow up scheduled as follows: 1stmonth, 3rdmonth, 6thmonth, 12thmonth. RESULTS: Among 100 patients 92 patients completely relieved of symptoms, 8 patients showed no improvement based on both subjective and objective parameters. CONCLUSIONS: Simple, harmless, minimally invasive, daycare procedure advantages made the Radiofrequency tissue ablation procedure as one amongst the best apt surgical option for management of inferior turbinate hypertrophy and the current study added credit to its efficiency once again.
Clozapine: the past, present, and future

Today, even after fifty years of its manufacture, the decision to use clozapine still represents a challenge to the clinician because of the complexities involved in accurately assessing its risks and benefits. Debate and uncertainty as to what represents an adequate trial, indications, and the mechanism of action of clozapine is continuing. The authors conducted a review of studies that highlighted its historical aspect, the mechanism of action, efficacy, tolerability, and indications of clozapine in current perspective.
Development of therapeutic vaccine strategies and pre-clinical animal tumor models for head and neck cancers

Head and neck squamous cell cancer (HNSCC) associated with alcohol and tobacco consumption, and recently with human papillomavirus-16 (HPV-16), have bad prognosis despite current therapies. Development of innovative vaccine strategies and adequate pre-clinical tumor models are required to better evaluate HNSCCs. We developed a DNA vaccination that creates non-infectious virus-like particles, which express HPV-16 E7 oncoprotein (pVLP-E7). Results showed that pVLP-E7 induced an E7-specific immune response in vivo and in vitro. Moreover, using an ectopic model of HNSCC that expresses E6/E7 (TC-1), we found that pVLP-E7 intradermic (ID) immunizations induced anti-tumoral responses at early stages. For larger established tumors, pVLP-E7 vaccines were only efficient when administered with TLR-7 and TLR-9 agonists. In an orthotopic model that shares anatomical and inflammatory features with human HNSCC we observed that intra-cheek (IC) infusion of either TC-1 or NR-S1 cells into mice elicited higher numbers of inflammatory infiltrates in the tumor compared to ectopic models. Using this orthotopic IC model, we found that mucosal IC pVLP-E7 vaccination elicited better vaccine-specific CD8+ T-cell responses than ID administration in naive and tumor-bearing mice. Furthermore, pVLP-E7 IC immunizations in combination with TLR agonists led to rejection of established tumors and long-term protection, both of which were associated with E7-specific CD8+ T cell infiltration in tumors and lymph nodes. Our findings demonstrate that pVLP-E7 IC vaccination with adjuvants is efficient against these tumor models and together provides a valuable therapeutic strategy for HNSCCs.
Comparative Cost-Effectiveness of Cranioplasty Implants

Purpose: The aim of this study was to compare operative duration and total hospital costs incurred for patients undergoing elective cranioplasty with a variety of materials, including manually shaped autogenous bone graft and titanium mesh, custom patient-specific titanium mesh, polymethyl methacrylate (PMMA) acrylic, and polyetheretherketone (PEEK) implants. Methods: A single-centre retrospective chart review was used. Patient demographics, defect characteristics, total operative time, and length of hospital stay were obtained. Total costs were sourced from Sunnybrook and standardized to the 2014 to 2015 year. Bivariate and age-controlled multivariate analyses were performed with (n = 119) and without (n = 101) outliers. Results: When outliers were removed, an age-controlled analysis revealed that autogenous implants resulted in an operative time of 178 ± 37 minutes longer than manually shaped titanium implants (P < .01). The average cost of cranioplasty was CAD$18 335 ± CAD$10 265 for manually shaped titanium implants, CAD$31 956 ± CAD$31 206 for custom patient-specific titanium implants, CAD$20 786 ± CAD$13 075 for PMMA, CAD$14 291 ± CAD$5562 for autogenous implants, and CAD$27 379 ± CAD$4945 for PEEK implants (P = .013). When outliers were removed, cranioplasty with PMMA and PEEK incurred greater costs, CAD$4442 ± CAD$2100 and CAD$13 372 ± CAD$2728, respectively, more than manually shaped titanium implants (P < .01). Conclusions: Manually shaped titanium mesh is the most cost-effective implant choice for small cranial defects. Large unknown defects and frontal paranasal sinus defects are most effectively treated with autogenous bone or titanium mesh. Despite prolonged operative duration and inpatient admission, total costs were not significantly increased. Both PMMA and PEEK implants were significantly more costly, which may be a result of higher complications necessitating reoperation.
Inherited Haemoglobin Disorders Among Apparently Healthy Individuals- An Analysis of 105 Cases

Introduction: Inherited hemoglobin disorders present a significant health problem all over the world. Due to migration, this problem is increasing day by day. No definitive data regarding the frequency of hereditary haemoglobin disorders are available in Bangladesh. Iron deficiency is most widely prevalent in the country and beta thalassaemia is also common. Objective: The aim of the study is to determine the relative frequency of inherited haemoglobin disorders among apparently healthy individuals in two different institutes. Methods: This observational cross-sectional prospective study was carried out in the Department of Haematology of Dhaka Medical College Hospital (DMCH), Dhaka for a period of one year from January 2010 to December 2010. Apparently healthy physicians, staffs and students of Dhaka Medical College (DMC) as well as students of Dhaka University (DU) between 18 to 35 years age irrespective of sex were included in the study. Blood samples of specific amount were taken from all these individuals for estimation of CBC, red cell variables and Hb electrophoresis. Results: A total number of 105 respondents were enrolled in this study with the mean age of 25.2 years and female (52.2%) predominance. Hb electrophoresis revealed normal Hb pattern in 89.4% individuals, HbE trait in 4.8%, beta thalassaemia trait in 3.8%. One each of Hereditary Persistence of Fetal Haemoglobin (HPFH) and heterozygous Hb-D Punjab were detected constituting 2.0%. In this present study, a total of 10.6% abnormal Hb pattern was detected. Conclusion: The finding of abnormal Hb pattern on Hb electrophoresis in this study among apparently healthy individuals indicates the high frequency of inherited haemoglobin disorders especially HbE and beta thalassaemia trait in Bangladesh which warrants detection of these disorders and subsequent appropriate genetic counseling. Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014
Stress among Isfahan medical sciences students

Background: This study was undertaken to determine the prevalence of psychological stress among Isfahan medical sciences students. Methods: Cross-sectional, questionnaire-based survey was carried out among the 387 medical sciences students (medicine, pharmacy, and dentistry) of Isfahan, Iran through census. In academic year 2010-2011, Kessler-10 questionnaire was given to the students a month before semester examinations. Scores ≥20 were considered as indicative of positive stress symptoms. Results: The overall prevalence of stress among medical sciences students was found to be about 76.1%. The prevalence of stress among medicine students was 22.7% mild, 23% moderate and 21.4% severe while 32.8% showed no stress. The prevalence of stress among pharmacy students was 22.22%, 22.22%, 26.19%, and 29.36% mild, moderate, and severe and no stress, respectively. The prevalence of stress among dentistry students was 25% mild, 27% moderate, and 10% severe while 37.5% showed no stress. The prevalence of stress was higher (70.6%) in pharmacy students when compared with medicine (66.1%) and dentistry (62.5%) students. The odds of student having stress is higher in dentistry students (OR: 1.44, P= 0.33), where as the odds are decreasing in pharmacy student (OR: 1.16, P=0.66). There is no statistically significant association between gender, ages, and term and having stress symptoms. Conclusions: The high level of stress necessitates interventions like social and psychological support to improve the student's well-being. A prospective study is needed to study the association of psychological morbidity with sources of stress and coping strategies.