Miracle-dz/UniFAR-FTUs huggingface dataset:
Etiological study of acute on chronic liver failure among patients admitted in medicine ward in Chittagong Medical College Hospital

Introduction: Acute on chronic liver failure (ACLF) is defined as acute hepatic insult manifesting as jaundice and coagulopathy complicated within 4 weeks by ascites and/or encephalopathy in a patient with previously diagnosed or undiagnosed chronic liver disease. It has various etiology and manifestations, as well as high mortality. These etiologies vary depending on geographical region - from east to west. For example, infectious etiologies predominate in the east whereas alcohol and drugs constitute the majority of acute insults in west. In Asian region, reactivation of hepatitis B virus and superinfection with hepatitis E virus are more common among the infectious etiologies. Objective: As the incidence of chronic liver disease is increasing day by day and the etiology of acute decompensation of underlying chronic liver disease varies depending on geographical location, so it may be different in Bangladesh from other Asian countries. A very few studies have been published so far showing etiological prevalence of Acute on Chronic Liver Failure (ACLF) in Bangladesh. This study has been conducted to address the etiology of ACLF in our perspective . Methods: A cross sectional longitudinal study carried out in the department of Medicine, Chittagong Medical College Hospital. Thirty patients admitted with ACLF as defined by Asia Pacific Association for Study of Liver Disease (APASL) were consecutively included. Detailed history, complete physical examination and laboratory investigations were done for each patient. 77 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 Results: From January 2009 to December 2009, among thirty patients 6 cases (20%) of ACLF was caused by HEV super infection followed by Sepsis (16.67%), variceal bleeding (13.33%) and hepatotoxic drugs (3.33%) respectively. Multiple factors were found in (16.67%) cases while no cause could be identified in (30%) cases. In our study common causes of chronic liver diseases were hepatitis B (50%), hepatitis C (26.67%) and alcohol (16.67%). Among thirty patients five died within forty eight hours of hospital admission. In hospital mortality was 16.67%. Conclusion: Acute on Chronic Liver Failure (ACLF) is one of the commonest causes of mortality, morbidity and socio-economic burden particularly in Bangladesh. Early detection and proper management of acute events that lead to ACLF would alleviate mortality and morbidity. However due to high treatment cost, proper management of chronic liver diseases as well as ACLF cannot be afforded by most people in our country. DOI: http://dx.doi. org/10.3329/jafmc.v9i2. 21837 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013
Analysis for Spontaneous Remission of Chronic Immune Thrombocytopenic Purpura in Children

Results: This study was enrolled for 49 children with chronic ITP. Median age was 3.5 years (0.1-17.3). Male to female ratio was 1:1.9. Initial treatment with intravenous immunoglobulin was received in 36 children (73.3%). Spontaneous remission was shown in 23 children (46.9%) during study period with 4.4 year of median follow up. The relevant factors of remission were observed in younger age at diagnosis, maintenance therapy, and platelet counts at post-diagnosis 1 year, 2 years, 3 years (P<0.05). The most significant parameter for spontaneous remission was platelet count at post-diagnosis 6 months in Kaplan-Meier estimate (P=0.047, RR: 3.47, 95% CI: 1.03-24.04).
Cough-Induced Transient Global Amnesia

Two patients developed acute loss of short term memory of several hours duration while preserving autobiographic memory and exhibiting no focal signs and symptoms following a crisis of severe coughing. The first patient had recurrent allergic bronchitis; the second patient had hereditary pressure palsy neuropathy (HPPN) secondary to a mutation in the PMP 22 gene manifested by protracted cough, eventually ameliorated by the administration of Levetiracetam. Neither of the two patients had history of migraine or epilepsy. Imaging studies failed to show structural or acute vascular lesions on either patient. Symptoms were typical of transient global amnesia (TGA). Because primary TGA (no lesions apparent on imaging) may represent a migraine phenomenon according to previous reports, I propose that these two patients exhibited “cough-induced TGA”, precipitated by a similar mechanism causing cough headache but presenting as pure confusional migraine, or more formally defined, as “cough-induced persistent cognitive migraine aura without stroke. ”
Self-leadership, Job Stress and Job Satisfaction among Clinical Nurses

Purpose: This study was undertaken in order to suggest self-leadership as a method for nurses to lower their job stress and enhance their job satisfaction. So the relations among self-leadership, job stress and job satisfaction were studied. Method: The subjects of study were 123 nurses who have been working in 2 general hospitals located in K city. The data were collected by Q & A and analyzed using descriptive statistics, Pearson's correlation coefficient, t-test, and ANOVA on SPSS Program. Result: Nurses got average 3.50, 2.64 and 3.12 points out of 5 in their self-leadership, job stress and job satisfaction respectively. The self-leadership was negatively correlated with job stress (r=-. 429, p=
Analyze the Levels of Immunoglobulins IgG and IgM in Elderly and Youngs

The aging process is complex and affects a variety of functions, including lower defense capability of the immune system. The immune activity, as most of physiological functions, decreases with age. The principal alterations in humoral immune response are associated with concentration of immunoglobulins, amount and activity of B cells and also the changes in the affinity of the antibodies. The current study aimed to analyze the levels of IgG and IgM antibodies of elderly and young people and to investigate thestatistical differencebetween the groups. The research was a descriptive study and contained young people and elderly from Brazil. The participants of the study were selected randomly through an interview and received medical consultation because patients who presented any pathology that result in commitment of the immune system was excluded. In the present study were evaluated a total of 70 people. After dosing immunoglobulins, a significant decrease of immunoglobulin IgM and an increase of immunoglobulin IgG were observed in elderly. Therefore, we can conclude that this study was important since it was observed that the old individuals has a differences in the levels of IgM and IgG antibodies when it is compared with young people. Based on these facts, we can justify the inability of older peopleto respond adequatelyto new infectionsand their reduced capacity to be immunized against new antigens.
Patient Safety Incidents, Their Contributing and Mitigating Factors in Dentistry

Until recently research on patient safety (PS) focused on secondary care, and little was known about the risks that patients face in primary care and especially in dental care. Only few studies have hitherto focused on the understanding of either the patients or their families about safety in dentistry. The objectives of this thesis were to identify types of dental patient safety incidents (PSIs), the contributory factors that played a role on the origin, development of PSIs, or identify the factors that increased the risk of PSIs, the mitigating factors against PSI, suggested by dentists and PS practices in use in their clinics. Furthermore, this thesis aimed at exploring whether patients or their families are able to observe PSIs in their own dental care. The study findings were derived from two datasets: 1) The first dataset was obtained from an internet-based questionnaire, sent in 2010 that requested practicing dentists to respond to questions on any PSIs that had occurred during the preceding year and any incident mitigating factors. A total of 1041 dentists responded (response rate 54%) and almost one third reported PSI(s) (n=872). 2) The second dataset was compiled from national data on patients or their family complaints and other notifications made against individual dental practitioners or dental practice units (n=948) for six Regional State Administrative Agencies (AVIs) and also from the National Supervisory Authority for Welfare and Health (Valvira) in Finland from 2000 to 2012 inclusive. The study used quantitative and qualitative research methods. Qualitative analyses (root cause analysis and document analysis) aimed to find emergent themes of dental PSIs and the factors related to them. The quantitative analyses examined several variables related to incident types, which included the contributing factors, the mitigating factors and their associations with dentists characteristics. The detected dental incident types in Finland are in many ways identical to reports from other countries. The two datasets provided somewhat different pictures of PSIs in dentistry. The dentists incident reports mostly captured incidents with relatively low severity, whereas patient complaints and supervisory data of healthcare regulators captured rarer but more serious events. This study showed that PS in dentistry is a complex and multidimensional issue and it relates to all aspects of care; diagnostics, treatment, devices and premises, medications, leadership and management, infection control, teamwork, communication, practitioner characteristics and patient characteristics. All dental PSIs in both datasets had a broad array of contributing factors including both human factors and latent system-factors. Compared to the total number of annual dental visits in Finland, severe dental PSIs are rare. However, less severe PSIs are more common, especially in prosthetics, dental surgery, endodontic and restorative treatments. According to dentist reports no significant difference existed in the incident rate between…
Attitude toward death in nursing staffs in hospitals of Rafsanjan (south east Iran)

Background & Aim: Fear of death can cause death anxiety for everyone. In health care professions, death anxiety becomes a routine source of stress and may lead to unwanted consequences. Coping strategies of nurses and different approaches to death can affect the quality of health care services. The aim of this study was to determine attitudes toward death in nursing staff in hospitals of Rafsanjan. Methods & Materials: This was a cross-sectional study. The population study consisted of 400 (all nursing staff) working in hospitals of Rafsanjan University of Medical Sciences (RUMS) in 2012. The data were collected using demographic and death attitude profile revised questionnaires. Results: Fear of death was significantly higher in women, younger participants with little work experience, those without experience of intensive care unit working, and those without a history of education about death (P < 0.0500). Death escape scores were significantly higher in the age group of 31-35 years. An approach toward death was significantly better in women, those with related training, those older than 46 years, and those with over 20 years of work experience. Conclusion: RUMS treatment centers had a favorable attitude toward death in five categories. This is probably due to religious beliefs and looking at death as a bridge to the afterlife.
Differential diagnosis between thymoma and non-thymoma by dynamic MR imaging

Purpose To evaluate the usefulness of dynamic MR imaging for differential diagnosis of anterior mediastinal tumors. Material and Methods: Fifty-nine patients with anterior mediastinal tumors were examined. According to histological diagnosis confirmed by surgery or biopsy, 31 had thymomas and 28 had non-thymoma lesions. The patients underwent dynamic MR imaging with gadopentetate dimeglumine administered as a bolus injection. Sequential images were obtained at 30-s intervals for 5 min. Significant differences in the mean peak times of time intensity curves (TICs) were found by histological type, using the Mann-Whitney test. Results: The mean peak time of the TIC was 1.5 min in thymoma and 3.2 min in non-thymoma cases. The difference was statistically significant. Stages I and II of thymoma showed a mean value of 1.3 min, which was significantly shorter than that of 2.5 min in stage III. Differentiation of thymoma/non-thymoma based on the peak time of dynamic MR imaging showed optimal sensitivity (79%) and specificity (84%) when defining thymomas as lesions having peak time appearing earlier than 2 min and non-thymomas later than 2.5 min, with an accuracy of 81%. Conclusion: Dynamic MR imaging may improve the differential diagnosis between thymoma and non-thymoma and the staging of thymoma.
Assessment of coronary arterial stents by multislice-CT angiography

Purpose: To assess patency and lumen visibility of coronary artery stents by multislice-CT angiography (MSCTA) in comparison with conventional coronary angiography as the standard of reference. Material and Methods: 47 stents of 13 different types were evaluated in 29 patients. MSCTA was performed on a 4-slice scanner with a standard coronary protocol (detector collimation 4 × 1 mm; table feed 1.5 mm/rotation, 400 mAs, 120 kV). Image evaluation was performed by two readers who were blinded to the reports from the catheter angiography. MIP reconstructions were evaluated for image quality on a 4-point scale (1 = poor, 4 = excellent) and stent patency (contrast distal to the stent as an indirect patency sign). Axial images and multiplanar reformations through the stents were used for assessment of stent lumen visibility (measurement of the visible stent lumen diameter) and detection of relevant in-stent stenosis (≥50%). Results: Image quality was fair to good on average (score 2.64 ± 1.0) and depended on the heart rate (heart rate 45–60: average score 3.2, heart rate 61–70: average score 2.8, heart rate >71: average score 1.4). Thirty-seven stents were correctly classified as patent, 1 was correctly classified as occluded and 9 stents were not assessible due to insufficient image quality because of triggering artifacts. Parts of the stent lumen could be visualized in 30 cases. On average, 20–40% of the stent lumen diameter was visible. Twenty-five stents were correctly classified as having no stenosis, 1 was falsely classified as stenosed, 1 was correctly classified as occluded. In 20 stents lumen visibility was not sufficient for stenosis evaluation. Conclusion: Although the stent lumen may be partly visualized in most stents, a reliable evaluation of in-stent stenoses does not seem practical by 4-slice MSCT. Nevertheless, for stent patency evaluation, MS-CTA might provide valuable clinical information. With submillimeter MSCT (e.g., 16-slice scanners) and more sophisticated reconstruction algorithms, further improvements may be expected.
PRACTICE OF ERGONOMIC PRINCIPLES AND COMPUTER VISION SYNDROME (CVS) AMONG UNDERGRADUATES STUDENTS IN CHENNAI

ABSTRACT Background: With increasing use of computers by young adults in educational institutions as well as at home there is a need to investigate whether students are adopting ergonomic principles when using computers. Objective: To assess the practice of students on ergonomic principles while working on computers and their association with the symptoms of Computer Vision Syndrome (CVS). Methodology: A cross-sectional study was conducted among the undergraduate students using pre-tested structured questionnaire on the demographic profile, practice of ergonomic principles and symptoms of CVS experienced while on continuous computer work within the past one month duration. Results: Out of 416 students studied, 50% of them viewed computer at a distance of 20 to 28 inches, 61 % viewed the computer screen at the same level, 42.8% placed the reference material between monitor and key board, 24.5% tilted screen backward, 75.7% took frequent breaks and 56.0% blinked frequently to prevent CVS. Students who viewed the computer at a distance of less than 20 inches, viewed upwards or downwards to see the computer, who did not avoid glare and did not took frequent breaks were at higher risk of developing CVS. Students who did not used adjustable chair, height adjustable keyboard and anti-glare screen were at higher risk of developing CVS. Conclusion: The students who were not practicing ergonomics principle and did not check posture and make ergonomic alteration were at higher risk of developing CVS. Keywords: Ergonomic principles, computer vision syndrome, undergraduate students.
Influence of CT on Tumor Classification of Laryngeal Carcinomas

The routine use of CT in 51 consecutive patients with squamous cell carcinoma of the larynx revealed cartilage involvement or extra-laryngeal tumor growth consistent with a T4 tumor which made 14 patients candidates for laryngectomy. Only 5 of these had a T4 classification by clinical examination while 8 cases were upstaged from T3. Except for one supraglottic tumor upstaged from T2 to T4, CT did not change the classification for T1 and T2 tumors, Whose localization was mainly glottic, and there were 2 false-negative examinations. It is concluded that CT is mandatory only in advanced tumors of the glottic region or when the anterior commissure is involved. However, in suspected malignancies of the sub- or supraglottic regions CT should always be carried out because these patients are at an increased risk of unexpected deep tumor growth.
Epicardial Fat Causing Pitfalls in CT and MR Imaging of the Pericardium

To study the complex anatomy of the pericardium and the pericardial recesses, notably the transverse sinus and the recess behind and under the common pulmonary artery, cryomicrotomy sections of 4 frozen cadaver specimens were correlated with CT and MR imaging in multiple planes. In addition, CT chest studies of 254 patients and MR chest studies from 78 patients were reviewed. Epicardial fat interposed between the transverse sinus of the pericardium and the ascending aorta was a normal finding confirmed by cryomicrotomy studies and seen by CT in 23 of 245 patients and in MR imaging in 3 of 78 patients. Epicardial fat indenting the pericardial sac below the common pulmonary artery caused an inhomogeneous signal, mimicking lymphadenopathy on coronal T1 weighted MR images in 4 patients.
The effect of nanoparticle size and nanoparticle aggregation on the flow characteristics of nanofluids by molecular dynamics simulation

Molecular dynamics simulation is used to investigate the flow characteristics of Cu–Ar nanofluids considering the influence of nanoparticle size and nanoparticle aggregation. Nanofluids viscosity is calculated by equilibrium molecular dynamics based on Green–Kubo equation. Results demonstrate that the viscosity of nanofluids decreases with the increase of nanoparticle size. In addition, nanoparticle aggregation results in the increase of the nanofluids viscosity. Compared with nanoparticle size, nanoparticle aggregation has a larger impact on viscosity. Nanofluids flowing in parallel-plate nanochannels are simulated. The velocity profiles are studied through three nanoparticle sizes (11.55, 14.55, and 18.33 Å) and four nanoparticle aggregate configurations. Results show that the velocity profile of 14.55 Å nanoparticle size is larger than that of other two nanoparticle sizes. As for four nanoparticles, the nanoparticles clustering as a line leads to the maximum velocity profile, while the nanoparticles clustering as a cube causes the minimum velocity profile. Compared with viscosity, nanoparticle aggregation has a greater effect on the velocity profile. When the nanoparticles are evenly distributed, the influence of viscosity on velocity profiles is dominant. Otherwise, the aggregation, aggregate configuration, and distribution of nanoparticles have a dominant impact on the flow characteristics of nanofluids.
Iliac Artery Stenting — Clinical Experience with the Palmaz Stent, Wallstent, and Strecker Stent

A total of 82 iliac artery lesions (62 stenoses and 20 occlusions) were treated with 3 different types of endovascular metallic stents (12 lesions with the Palmaz stent, 36 with the Wallstent, and 34 with the Strecker stent). The complication rate was 12%. Occlusion of 2 Wallstents occurred 4 and 12 weeks after stent placement, respectively. Both stents were recanalized by local fibrinolysis. One Strecker stent occluded after 8 months. The observation period was 3 to 26 months (mean 9.7 months). The patency rate with secondary intervention (fibrinolysis) was 100% after 3 and 6 months, and 98% after 9 months. All 3 stent designs turned out to be effective in the treatment of complicated iliac artery occlusive disease.
3D steady-state MR cisternography in CSF rhinorrhoea

Purpose: To determine the utility of 3D steady-state MR cisternography in the demonstration and localisation of cerebrospinal fluid (CSF) leak in patients with clinically suspected CSF rhinorrhoea. Material and Methods: Six consecutive patients with clinically suspected CSF rhinorrhoea were examined with routine MR evaluation and MR cisternography (MRC). All MR examinations included fast spin-echo (SE) T1WI in axial and sagittal planes, fast SE T2WI in axial and coronal planes and fluid attenuated inversion recovery (FLAIR) images in the axial plane. 3D evaluation was done using the CISS technique with 0.7-mm thickness in the sagittal and coronal planes. The site and extent of the defect, and any brain herniation detected on MRC were correlated with surgical findings. Results: In the 6 patients who underwent surgical exploration and repair, intraoperative findings correlated with the defect revealed by MRC in all cases. Conclusion: In clinically suspected CSF rhinorrhoea, MRC is highly accurate in localising the site and extent of CSF fistula and may be used as the first investigation due to its efficacy and non-invasive nature.
Material

This investigation was carried out at Plant Production Department, Faculty of Agriculture (Saba Basha), Alexandria University, Egypt to study the effect of cotton variety and lint grade on fiber and yarn properties. Six commercial cultivars, Giza 45 and Giza 88 as extra long staple (ELS) and Giza 80, Giza 85, Giza 86 and Giza 90 as long staple (LS) were used. Five lint cotton grades i.e., good to fully good (G/FG), good (G), fully good fair to good (FGF/G), good fair to fully good fair (GF/FGF) and fully fair to good fair (FF/GF) were used. The obtained results indicated that the extra long staple cotton variety Giza 45 and high lint cotton grade good to fully good (G/FG) recorded the highest mean values of the most importance of fiber and yarn properties and the lowest value of short fiber content (%) and yarn evenness CV % and vice versa for the long staple cotton variety Giza 80 and low lint cotton grade fully good fair to good (FGF/G).
Effects of revised diagnostic recommendations on malaria treatment practices across age groups in Kenya

Objective The recent change of treatment policy for uncomplicated malaria from sulfadoxine‐pyrime‐thamine to artemether‐lumefantrine (AL) in Kenya was accompanied by revised malaria diagnosis recommendations promoting presumptive antimalarial treatment in young children and parasitological diagnosis in patients 5 years and older. We evaluated the impact of these age‐specific recommendations on routine malaria treatment practices 4–6 months after AL treatment was implemented.