Miracle-dz/UniFAR-FTUs huggingface dataset:
Rupture of previously scarred uterus

Objective: To determine causative factors, find out associated maternal and faetal morbidity and mortality and to discuss preventive measures. Design: A prospective study. Place and duration of study: Department of Obs. And Gynae, Lahore General Hospital, (PGMI). Lahore for a period of four years, Jan. 2002 to Dec. 2003.Subject and methods: This study was conducted on sixty patients, with rupture of previously scarred uterus. Results: Total number of deliveries during these four years was 15,628. Rupture of uterus occurred in 0.47% cases (1: 214). Out of these rupture of previously scarred uterus accured in 82% cases. Most of the patients were between ages 21 - 30 years unbooked illiterate, belonged to poor class. 83% caesarean sections had been done in some peripheral non teaching hospitals. 13% patients had no labour pains at time of admission. The maternal mortality in this study was 3.33% and fetal mortality was 60%. Conclusion: First caesarean section should only be done if genuinely indicated, by some skilled obstetrician, in well equipped hospital. Patients with scarred uterus should be educated to have regular antenatal checkup and hospital delivery in next pregnancy.
The Value of Therapeutic Drug Monitoring of Vancomycin in Treatment in a Tertiary Hospital, Cho Ray Hospital, Viet Nam

Aims: To evaluate the value of therapeutic drug monitoring (TDM) of vancomycin in clinical practice. Methods: To review retrospectively on 292 hospital cases (111 females, 181 males) treated with vancomycin, July to October 2014, at ChoRay Hospital. The main evaluating parameters were TDM criteria for vancomycin (dose, dosing interval, times of monitoring), trough level, dose adjustment, renal function follow-up, minimum inhibitory concentration of infectious agents, clinical response. Results: Two hundred seventy-five patients (94.2%) received routine dose of 1 g vancomycin per IV infusion time. Dosing interval was given correctly to estimated glomerular filtration rate (eGFR) level 80.8% (235/291). The 1 st monitoring after 9 th dose was in 139 cases (47.6%). Trough level was lower than 10 mg/L in 86 patients (29.5%), higher than 20 mg/L in 96 (32.9%), and 110 in optimal range 10-20 mg/L (37.7%). Age and eGFR were 2 independent predictors for trough level. Original Research Article Hoang et al.; BJMMR, 16(6): 1-16, 2016; Article no.BJMMR. 26806 2 Dose adjustment were done in 6.9% (6/86) patients  10 mg/L, 20.8% (20/96) ones >20 mg/L, and 11.8% (13/110) ones 10-20 mg/L. Vancomycin concentrations in young patients were lower than those in elderly ones with OR = 5.9 [95%CI: 2.6 – 14.0], p = 0.0001. Response sensitivity was 69.3% (13/19) for dose reduction, and 83.3% (5/6) for dose increase. Dose adjustment did not make change in trough level compared to unadjusted ones. Nephrotoxicity rate was found as 8.4%. Treatment failure was 50% in patients with trough concentration/minimum inhibition concentration ratio ≤ 10 compared to 15% in ones with higher ratio > 10, p = 0.034. The failure rate was highest in patients received vancomycin  7 days (22/70: 31.4%), OR: 4 (2.0-7.7) p=0.002. The clinical AUC/MIC ratio cut-off, 190 mg/L/day, had 75.9% and 66.7%, respectively for sensitivity and specificity to predict the success result in treatment. Conclusion: The criteria of TDM on vancomycin were not applied strictly, especially for dosing intervals, dosing adjustment and follow-up thereafter. The clinical pharmacodynamics of vancomycin is dependent on both concentration and duration of treatment.
Investigating teachers' perceptions of integrated quality management system effectiveness on teaching and learning in a rural secondary school

In the quest for education transformation, the South African government employed Integrated Quality Management System (IQMS) in the belief that if teachers were appraised and developed, their performances would be enhanced and the quality of education would be improved. However, teachers had different views and experiences of the effectiveness of IQMS in their work stations. Consequently, the author was interested in “Investigating teachers’ perceptions of Integrated Quality Management System (IQMS) effectiveness on teaching and learning in a rural secondary school”. The investigation was conducted using face to face interviews and document analysis. This study’s findings indicated that IQMS was introduced as a matter of policy compliance, as shown by many teachers’ misunderstandings of its concept. The findings of this study will help to improve IQMS effectiveness or to undertake further research on the feasibility, viability and practicability of IQMS and/or alternatively, the development of a new appraisal system. KEY TERMS AND PHRASES Appraisal and Integrated Quality Management System, Development, Effectiveness, Improvement, Learning in the school, Performance, Teaching in the school, Quality, Quality Education, Quality Assurance. LIST OF ABBREVIATIONS: Continuous Professional Teacher Development (CPTD) Department of Education (DoE) Development Support Group (DSG) Developmental Appraisal (DA) Education Labour Relations Council (ELRC)
Knowledge, attitude and practice regarding exercise among people exercising in gymnasium and recreational parks around Kuantan, Malaysia

Article history: Physical inactivity is becoming a global epidemic and lead to many diseases. This cross-sectional study tried to investigate knowledge, attitude and practice (KAP) regarding exercise among married and single person attending gymnasium and recreational parks. Furthermore, this study tried to look for factors associated with regularity of exercise and to find association between knowledge and attitude on practice of exercise. A total of 103 participants aged above 18 years old were purposely selected to answer an interview-guided questionnaire. Likert scale was used for participants to answer the questionnaire on KAP and the total score for each knowledge, attitude and practice was computed to find the associations using SPSS. The mean age of the respondent wa s 25.34 years (SD=5.699). Knowledge was not significantly associated with practice (r=0.071, p=0.475). There was also no significant correlation between practice and attitude score (r=0.006, p=0.510). Therefore, there is no association between knowledge and attitude on practice of exercise. Besides that, endurance exercise like jogging, cycling and walking was a respondent's choice as their exercise routine. Other than that, there are significant associations between factors of gender (p=0.014), marital status (p<0.001) and age (p=0.005) with regularity of exercise. This study found that single person is more regularly doing exercise than married people. Regularity of exercise could be influenced by motivation. Therefore, relevant policies and campaigns might be able to change and boost people towards practicing exercise regularly in Malaysia.
Méta-analyse des essais cliniques ; intérêts et limites

La meta-analyse permet la synthese reproductible, qualitative et quantitative, des donnees actuelles de la science. Cette synthese est une etape obligatoire de la transmission de l'information therapeutique vers le prescripteur. Par rapport aux methodes traditionnelles de synthese, la meta-analyse presente suffisamment d'avantages pour les rendre obsoletes lorsque, toutefois, elle est applicable. Ses limitations sont determinees par le non respect de ses conditions d'applications et de sa methodologie
The microbial factor in the chemiluminescence of the peripheral blood neutrophils of patients with suppurative surgical infection

The luminol-dependent chemiluminescence of neutrophils in the peripheral blood of 30 healthy adults and 39 patients with the local and generalized forms of purulent infection was studied. Nonstimulated chemiluminescence and the index of chemiluminescence stimulation in the presence of opsonized Staphylococcus aureus added in vitro were determined. The former characteristic was found to be directly and the latter one, inversely related to the concentration of S. aureus, Escherichia coli and Candida albicans, but not E. epidermidis, Pseudomonas aeruginosa or Citrobacter, in the primary focus. At the microbial concentration exceeding 10(4) cells/g of tissue, the former characteristic was essentially higher than the level of chemiluminescence in healthy persons. With the improvement of the general state of the patients and in the absence of microorganisms in the wound as the result of complex treatment this characteristic decreased to values comparable with the reaction of neutrophils in healthy persons.
Rupture of the distal biceps tendon

U razdoblju od 1995. do 2003. ucinjeno je 8 rekonstrukcija ruptura distalne tetive bicepsa. Svi bolesnici su bili muskarci. Dob bolesnika bila je od 32 do 58 godina. Nakon provedene rehabilitacije svi bolesnici su imali punu ekstenziju i fleksiju lakta te supinaciju i pronaciju osim u jednom slucaju. Funkcija lakta bitno je bolja kod bolesnika kod kojih je ucinjena fiksacija tetiva u akutnoj fazi (do 3 tjedna) nego kod onih kod kojih je ucinjena kasnije
Novel role of MBL in HIV-1 related neuroinflammation and CNS impairment in methamphetamine users

Methamphetamine (METH) is a highly addictive neurotoxic psychostimulant abused commonly by individuals infected by human immunodeficiency virus (HIV). METH enhances HIV-1 replication in vitro. HIV-1 infection and METH use cause synergistic neuronal death and neurotoxicity via oxidative stress and inflammatory immune response. Mannose binding lectin (MBL), an innate immune protein, binds HIV-1 envelope protein gp120 and activates the complement pathway for HIV-1 opsonization and phagocytosis. Dr. Singh's lab has reported increased MBL expression in HIV encephalitis (HIVE) suggesting MBL-mediated neuroinflammation. Our hypothesis is that METH enhances lectin complement pathway (LCP) protein expression and activation; which are associated with neuroinflammation and immune complex formation. Additionally we hypothesize that this increased LCP activation is associated with meth -enhanced viral replication and increased expression of HIV co-receptors. Our results show that METH significantly enhances MBL expression and LCP activation via MBL-C3d deposition in HIV-infected brain. MBL expression was associated with viral proteins p24 and gp120, and co- localized with HIV co-receptors CCR5 and CXCR4 with higher expression in METH+ HIV+ compared to METH- HIV+ cases which also displayed higher neuroinflammation as marked by increased MCP-1 expression
Family Bonds that Support Coping with Chronic Childhood Illness in the State of Paraíba, Brazil

Objective: Identify family bonds that support coping with chronic childhood illness from the perspective of comprehensive care. Method: This exploratory and descriptive study with a qualitative approach was performed in a public hospital in the Brazilian state of Paraiba between December 2011 and March 2012 through semi-structured interviews with mothers of chronically ill children. Thematic analysis was used for the interpretation of the data. Results: The support bonds constituted by the family include the nuclear and extended family; friends; neighbours; the government; healthcare professionals; and mothers who share the same experience. The social support provided falls under different dimensions, such as instrumental support, emotional support, informational support, reinforcement, and positive social interaction. Conclusion: Knowing the bonds that support families coping with chronic illness and their demands for attention and support is fundamental for providing comprehensive and humanised healthcare to those involved in this trajectory.
Stress Management in Response to Practice Errors: Critical Events in Professional Practice

H ealthcare providers have been educated to believe that they must perform perfectly in clinical practice. Recent studies and initiatives are dispelling this myth and compelling providers to accept their fallibility. Many safety initiatives require nurses, physicians, and pharmacists to change entrenched behaviors and develop additional interdisciplinary skills. However, accepting human imperfections and practicing safety initiatives fail to eliminate the immediate and persistent stress that providers experience because of occurrences involving healthcare errors.
EFFECTS OF SELECTED HERBAL EXTRACTS ON BLOOD CHEMISTRY PROFILES IN RATS

Oral administration of 2 herbal extracts, Coscinium fenestratum (30, 60 and 90 mg/ml) and Gynura divaricata DC (15 and 30 mg/ml), was conducted in male rats for 30 days, and blood chemistry profiles then determined The blood glucose levels of rats receiving C fenestratum extract at concentrations of 30 and 60 mg/ml were significantly lower than those of controls (p<0.05) while the blood cholesterol levels were lower in 30 mg/ml group. The tendency toward decreased blood triglyceride levels was observed in all groups of rats given C fenestratum. G. divaricata extract did not affect blood glucose levels at any concentration, but cholesterol levels were significantly higher than that of controls (p<0 05). The tendency toward decreased blood triglyceride levels was obviously observed in rats administered G. divaricata extract at a concentration of 30 mg/ml.
Self-medication among North Indian first-year undergraduate healthcare students: A questionnaire-based study

Background: Self-medication is the treatment of common health problems by a patient′s own initiatives, without professional supervision. Throughout the world, healthcare students have been found to be more prone to indulge in this unhealthy practice. Aim: This study was conducted to assess the prevalence, practices, and perceptions regarding self-medication among healthcare students from northern India. Materials and Methods: The present survey-based study was conducted on 360 subjects (142 males and 218 females), aged 18-20 years. It included both medical and dental first-year undergraduate students, who were selected using convenience sampling. The data were collected using a validated, semistructured, and self-administered questionnaire. The results were presented as counts and percentages. Statistical Package for the Social Sciences version 13.0 (IBM corporation, Chicago, US) software was used for statistical analysis. Results: The prevalence rate of self-medication was 92.7%. The most common reasons cited were "quick relief" (90.4%) and "illness too trivial for consultation" (88.6%). "Advice from pharmacist" emerged as the main source of self-medication practices (95.8%). Analgesics (92.8%) and antibiotics (90.7%) were the most commonly used drugs, while the most common ailments for which self-medication was used were headaches/body aches (92.8%) and sore throat (85.6%). More than half of the participants had a positive attitude toward self-medication. Conclusion: A vast majority of the healthcare students are oblivious to the potential adverse side effects of self-medication. Therefore, there is an urgent need to appraise them regarding the dangers of indiscriminate drug use along with the implementation of stringent statutory regulations regarding the sale and availability of drugs.
Detection of Circulating Thyroid Tumor DNA in Patients with Thyroid Nodules

This study was conducted to determine the feasibility of detecting BRAF(V600E) circulating tumor DNA (ctDNA) in the plasma of patients with thyroid nodules, with the goal of distinguishing between benign and malignant nodules. Plasma samples from patients undergoing thyroid surgery for thyroid nodules were obtained prospectively preoperatively and one month post-operatively, and quantitative-PCR was used determine the presence of BRAF(V600E) ctDNA. These were compared to formalin fixed paraffin embedded samples from the index nodule. Thirty-eight pairs of preoperative and postoperative plasma samples were collected and analyzed. 6/18 (33.3%) patients with classical PTC and 0/8 (0%) patients with nodular hyperplasia had detectable levels of BRAF(V600E) ctDNA pre-operatively, thus BRAF(V600E) ctDNA was able to distinguish between benign and malignant nodules (p < 0.05). The levels of all samples with detectable BRAF(V600E) ctDNA pre-operatively declined post-operatively (p < 0.05). BRAF(V600E) ctDNA can be detected in plasma. Post-operative drop of BRAF(V600E) ctDNA in all cases suggests its utility as a tumor marker.
Identifying Modifiable Socio-demographic Risk Factors for Severe Hyperbilirubinaemia in Late Preterm and Term Babies in Abuja, Nigeria

Background: Severe neonatal hyperbilirubinaemia remains an important cause of neonatal admissions in Nigeria, often giving rise to irreversible neurotoxicity. Access to effective phototherapy is restricted to a few centers while salvage therapy with exchange blood transfusion may occur too late to reverse acute bilirubin encephalopathy (ABE). Aim: We set out to identify modifiable socio-demographic risk factors for severe neonatal jaundice in babies of ≥34 week gestation at the National Hospital Abuja. Methodology: Late preterm and term babies admitted into Special Care Baby Unit (SCBU) with Original Research Article Audu et al.; BJMMR, 16(8): 1-11, 2016; Article no.BJMMR. 26551 2 jaundice from April 2014 to May 2015 were consecutively recruited into the study with parental consent. Socio-demographic information, history of common risk factors for neonatal jaundice and results of laboratory investigations were obtained for statistical analysis. Jaundice was classified as severe (≥ 20 mg/dl) or non-severe (10-19 mgdl). Bivariate and multiple logistic regressions were carried out to determine the significance of associations between risk factors and severity of jaundice. Results: A total of 123 babies were seen with an Inborn/Out born ratio of 1:2.3. Eighty two percent were term. Severe Jaundice accounted for 43(35%). The mean TSB for babies with severe jaundice was 29.1(9.6) mg/dl while that of controls was 16.9(5.9) mg/dl, (p=0.000). There was no significant difference in the distribution of primary risk factors (ABO/Rh incompatibility, sepsis, G6PD deficiency and concealed haemorrhage) among severe and non-severe groups. Among investigated secondary risk factors, late presentation (P=0.043), being out born (OR=0.164 95% CF=0.054-0.504), vaginal delivery (p=0.012), prematurity (OR=2.233 95% CF=1.051-4.740) and maternal education (p=0.017) were significantly associated with severe jaundice. Over 98% of the mothers had antenatal care while 91% delivered in hospitals/clinics. Thirty two (26%) had signs of acute bilirubin encephalopathy and exchange blood transfusion was done in 50 (40.7%) babies. Recommendation: There is a need to refocus preventive strategies on modifiable risk factors, increasing awareness about the consequences of neonatal jaundice and the essence of early identification as well as prompt hospital presentation.
Treatment of Osteoarthritis by Cutaneous Injection of Salicylate or Saline: A Pilot Study

Abstract Objective: Areas of tender cutaneous or subcutaneous thickening (“rheumatic patches”) have been described in patients with osteoarthritis (OA): these are frequently proximal to the affected joint, on the limb or in paraspinal areas. Uncontrolled observations have suggested that injection of these patches with saline or a solution of sodium salicylate can result in a significant improvement in symptoms in the joint itself. The aim of this pilot study was to determine if a large, fully-controlled trial of the therapy is justified, and to obtain preliminary data in order to design such a trial. Design: 48 patients, with OA of the 1st carpo-metacarpal (CMC) joint (“thumb” -16), knee (12) or neck (20), were randomised to receive injections of 0.5% sodium salicylate or normal saline. After six weeks’ observation, they were given up to 6 weekly injections into rheumatic patches, and followed for 12 weeks, further injections being given after six weeks if appropriate. Results: All groups of patients showed a significant improvement in all outcome measures at the first assessment following the initial course of injections. For instance, median subjective pain scores for all patients treated with salicylate fell from 5.50 to 2.35; respective figures for saline-treated patients were 6.15 and 2.85. In most patients the improvement was well-maintained for the next 12 weeks. This was reflected in a reduction in oral medication. There was no significant difference between the salicylate- and saline-treated groups in the initial response. However, there was a trend for salicylate-treated patients to sustain their improvement better over the following six weeks. For instance, patients with OA of the thumb treated with salicylate showed no change in median pain score (2.1); those treated with saline showed a worsening from 3.3 to 4.3 (p< 0.05). Overall the saline-treated patients required a greater mean number of subsequent injections in the assessment period (0.33) than the salicylate-treated patients (0.12). Conclusions: The data in this pilot study indicate that injection of rheumatic patches with salicylate or saline results in major improvement in OA, and suggest that this may be better sustained when salicylate is used. Larger trials of this therapy are justified.
The circadian intracranial pressure would be a prognostic factor in traumatic brain injury?

Abstract Traumatic brain injury (TBI) generally influences circadian rhythms and has been implicated changes in circadian rhythm. Whether TBI-induced changes in circadian rhythm may affect the prognosis or recovery from TBI remains to be investigated. Sixty-two patients with TBI were continuously monitored for intracranial pressure (ICP) during the first 24 hours after the implantation of ICP monitor. The data from each patient were analyzed using the least squares fit of a 24-h cosine function by single cosinor method. Parameters of circadian A (Amplitude)/M (MESOR) were used to evaluate the circadian rhythm of the patients. Student’s t-test and Pearson’s chi-squared test were utilized to analyze the differences between good prognosis group and poor prognosis. A linear regression analysis was then applied to calculate the correlation between circadian A/M of ICP and Glasgow Coma Scale (GCS) before discharge, the Extended Glasgow Outcome Scale (GOS-E), the dosage of mannitol, and time spent in the intensive care unit (ICU), respectively. The results demonstrated that circadian A/M of patients’ ICP exhibited a positive correlation with GCS scores taken before discharge, GOS-E scores, and was negatively correlated with the amount of mannitol, and time spent in the ICU. We conclude that changes in the ICP circadian rhythm in TBI patients could reflect an internal signal of brain damage and, therefore, may be useful to predict a patient’s prognosis and recovery from TBI.