Miracle-dz/UniFAR-FTUs huggingface dataset:
Control of glycosylated hemoglobin (HBA1C) among type 2 diabetes mellitus patients attending an urban health clinic in Malaysia.

Diabetes mellitus is a public health problem and has become a concern to all levels of society. In Malaysia, the prevalence of diabetes mellitus had increased, from about 0.65% in early 1960s to 2 – 4% in 1980s and 14% in early 21st century. Studies had showed that glucose control is effective in preventing complications from diabetes mellitus. Level of glycosylated hemoglobin (HbA1c) is an accepted indicator of glycaemic control. A cross- sectional study was carried out to determine the level of control of HbA1c among 307 type 2 diabetes mellitus patients attending the health clinic in Bandar Tun Razak, Kuala Lumpur using validated structured questionnaires, while secondary data were obtained from patients’ medical reports. Response rate for this study was 89%. Majority of type 2 diabetes mellitus patients attending the health clinic in Bandar Tun Razak were Malays (79.5%), women (61.9%) and married (77.2%), and with secondary education (49.5%). The mean age of respondents was 56.9 ± 9.5 years, median Body Mass Index (BMI) was 28.5 (IQR: 6.0) and median HbA1c was 7.4% (IQR: 2.7). About three quarter of the type 2 diabetes mellitus patients studied had poor controlled level of HbA1c (≥6.5%). Age (p=0.047), blood pressure (systolic blood pressure p=0.049, and diastolic blood pressure p=0.011) and low density lipid level (p=0.039) had significant relationship with the level of HbA1c. Other risk factors studied had no significant relationship with the level of HbA1c. The study concluded that, there was poor glycaemic control among type 2 diabetes mellitus studied, this exposed them to complications of diabetes mellitus. It is recommended that health education activities, counselling and prevention activities are intensified and targeted to this group of patients.
Localized Transdermal Delivery of Chemopreventive Agents to the Breast

xx CHAPTER ONE: GENERAL INTRODUCTION . 1 1.1. Anatomy of human breast . 2 1.2. Breast cancer . 6 1.3 Treatment for breast cancer . 11 1.3. 1. Surgery. 12 1.3. 2. Radiotherapy . 12 1.3. 3. Chemotherapy . 12 1.3. 4. Targeted therapy . 15 1.3. 5. Hormonal therapy . 17 1.4. Chemoprevention of breast cancer . 21 1.5. Localized therapy . 22 1.5. 1. Intraductal drug delivery . 22 1.5. 2. Localized transdermal drug delivery . 28 1.6. Scope and goals of the present study . 35
Efficacy and Safety Profile of Dabigatran Etexilate for the Prevention of Venous Thromboembolism in Moderately Renally Impaired Patients after Total Knee or Hip Replacement Surgery.

Dabigatran etexilate (Pradaxa ® ), an oral direct thrombin inhibitor, was recently approved in Europe for the prevention of venous thromboembolism (VTE) in patients undergoing elective total knee replacement or total hip replacement surgery. In phase III clinical trials two doses were studied: 220 mg once daily and 150 mg once daily. A post hoc pooled analysis was performed in patients with moderate renal impairment (GFR ≥30 and Table 1: Efficacy and bleeding endpoints in patients with moderate renal impairment (p-value from Fisher’s exact test compared to Enoxaparin)
Falling in older adults with or without visual impairment in community dwellings

Background: The aims of this work were to study visual impairment among community‐dwelling older adults and assess home environments of the elderly with and without visual impairment who had fallen. Methods: Two hundred seventy‐nine older adults were recruited from three community day centers in Hong Kong. Visual acuity and self‐reported falls over the preceding 12 months were documented. For those who had fallen indoors, 37 home visits were conducted. Results: Of the elderly cohort, 15.4% were found to have impaired vision and 29.6% had fallen over the preceding 12 months. While the prevalence of falling in the elderly with impaired vision was similar to those without visual impairment, the visually impaired adults walked more slowly and were not able to reach as far in forward‐reaching tests. In the homes of those with visual impairment who had fallen, there was significantly lower light intensity, a greater number of hazards in home hallways and increased use of floor mats compared to those without vision impairments who had fallen. Conclusions: Older adults with visual impairment did not show a higher incidence of falls, but home safety awareness is important to reduce falls.
|§| Short Report Relative measurement of heavy elements in the bile, gallbladder and gallston

The extra hepatic biliary system begins with the hepatic ducts and ends at the stoma of the common bile duct in the duodenum. The common bile duct is approximately 811.5 cm in length and 6-10 mm in diameter. The gallbladder, which is located in the bed of the liver, contains most of the smooth muscle of the organ, in contrast to the body, which is the major strong area and contains most of the elastic tissue. The main constituent of bile is water, electrolytes, bile salt, proteins, lipid, and bile pigments. Sodium, potassium, calcium and chloride have the same concentration in the bile. The major elements involved in the formation of the gallstones are cholesterol, bile pigment, and calcium(1). The suitability of PIXE spectroscopy for trace elements analysis in human tissues lies in the simultaneous analysis of wide range of light and heavy elements. This method is extremely sensitive and multielemental analysis. Absorption of necessary amount of elements for biological organs is from the surroundings or blood. Therefore, a breakdown of the homostatisis is indeed one of the most important indications of diseases (2, 3). The role of trace elements in the biological samples is very important in some diseases. The aim of this study was to compare the relative values of Fe/K, Cu/K and Zn/K for gallstones, gallbladder and bile of specific patient for studying the origin formation of gallstones. In contrast to conventional methods, the shell and center of the sands have been analyzed separately (4).
Sensitivity and Specificity of Electroencephalography (EEG) Among Patients Referred to an Electrophysiology Lab in Bangladesh

Objective: To measure the changes in electro encephalogram (EEG) along with its sensitivity and specificity with clinical seizure among epilepsy patients referred to an electrophysiology lab in a tertiary care hospital of Bangladesh. Methods: This retrospective chart review was carried out in the electrophysiology laboratory of Dhaka Medical College Hospital from January 2011 to December 2013, which included 1154 patients. EEG was obtained through scalp electrodes following international 10/20 system. Information regarding patients was collected from the laboratory register with the help of a checklist. The EEG findings and clinical seizure events were then compared. Result: Among the 1154 patients, age varied from birth to 75 years. The mean age at presentation was 17±11.4 years and most of the patients were less than 10 years old (44.4%). The male predominated in our study (59.2%). Clinically diagnosed seizure was present in 970 patients (84.1%), among which Generalized tonic clonic seizure (GTCS) was the most common clinical type of seizure, followed by secondary generalized seizure in 19.4% (n=224) and focal seizure in 2% (n=30) patients and 6.8% (n=79) patients had pseudoseizure. Among the abnormal EEG (59%), generalized epileptiform discharge was found in 29%, whereas focal and secondary generalized discharge was found in 30%. The most common site of origin of epileptiform discharge was temporal lobe (28.3%). The overall sensitivity of EEG was 66% (ranged from 62% to 68% with a confidence interval (CI) at 95%) and specificity was 79% (72- 84% at 95% CI). The positive predictive value was 58% (55-61% at 95% CI) and negative predictive value was 41% (38-44% at 95% CI). Conclusion: Our study brings out the fact that EEG has a reasonable sensitivity and specificity as a diagnostic test and the superiority being the higher specificity of EEG. J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 215-222
Comprehensive molecular profiling of extrahepatic cholangiocarcinoma in Chinese population and potential targets for clinical practice.

Background Cholangiocarcinoma (CCA) is a diverse group of malignancies arising from the intra- or extrahepatic biliary epithelium and characterized by its late diagnosis and fatal outcome. Extrahepatic cholangiocarcinoma (ECC) accounts for 90% of CCA. However, little is known about the comprehensive genomic alterations of ECC in Chinese population for providing clinical managements especially targeted therapy. Methods Comprehensive genomic profiling (CGP) was performed with next generation sequencing panel on paraffin-embedded tumor from a cohort of 80 Chinese ECC patients. Results The most frequently altered genes were TP53 (68%), KRAS (46%), SMAD4 (22%), ARID1A (20%) and CDKN2A (19%). Mutual exclusivity was observed between multiple genes including ARID1A:TP53, KRAS:LRP1B and NF2:TP53. Genetic alterations with potential therapeutic implications were identified in 43% of patients. The top three actionable alterations include CDKN2A (n=11), BRAF (n=5) and ERBB2 (n=4). Potentially actionable alterations were mainly enriched in the G1-S transition, homologous recombination repair, MAPK/ERK pathway. Conclusions This is the largest data set of ECC cases providing a comprehensive view on genetic alterations in Chinese population which differs significantly from a US cohort, and indicates the potential clinical implications for targeted therapies.
High Altitude and Human Reproductive Function

Altitude has been reported to have significant effects on the metabolic, cardiovascular and ophthalmological and reproductive function due to prolonged exposure. However, the human body can adjust to acute and chronic reductions in its oxygen supply by increasing respiratory rate, chemical changes in the blood, and by increasing the production of red blood cells. In males, reproduction could be affected by hypoxia at different levels. This could be at hormonal level, during spermatogenesis with epidydimal, seminal vesicular and testicular weight could also be significantly reduced. Chronic state of hypoxia can alter erectile physiology, thus triggering the onset of erection dysfunction (ED). The reproduction in species that have adapted to conditions at high altitude is possible, making adaptation to high altitude vital for survival and for successful reproduction. This review highlight changes in reproductive function consequent to high altitude exposure. Keywords: High altitude, erectile dysfunction, sperm, ovary Afr. J. Biomed. Res . Vol. 22 (January, 2019); 1 - 9
Medicinska edukacija/ Medical education DIFFERENT ASPECTS OF OROFACIAL PAIN (PART I) GLOSSODYNIA/ STOMATODYNIA RAZLI^ITI ASPEKTI OROFACIJALNOG BOLA (PRVI DEO) GLOSODINIJA/ STOMATODINIJA

Stomatodynia/Glossodynia, also known as burning mouth syndrome is mostly considered to be a psychosomatic disorder characterised by painful sensations within the oral cavity, without detectable abnormalities of the mucous membranes or underlying medical disorder. The burning sensation can affect the tongue, lips, gums, hard pallet, soft pallet, and the internal mucosa of the cheeks and throat. Frequently, patients also complain of xerostomia and dysgeusia. Glossodynia has many different causes, including infection, mechanical irritation, allergic reaction, chemical irritation, underlying disease, and dry mouth. Rarely, glossodynia is related to an inherited genetic defect. Emotional disorders, such as anxiety and depression, as well as an extreme fear of cancer are often associated with burning mouth syndrome. We refer not only to symptoms and possible causes, but also to demographic spread, clinical examination and management. Klju~ne re~i stomatodinija/glosodinija, sindrom usta koja gore, simptomi, uzroci, le~enje
The Role of Double Inversion Recovery Imaging in Acute Ischemic Stroke

In the acute phase of brain ischemia, the best strategy to demonstrate restricted water motion related to cytotoxic edema, is diffusion-weighted imaging (DWI) with magnetic resonance imaging (MRI) (1-3). However, single-shot echo-planar imaging (EPI)-based DWI is limited in detecting acute ischemic stroke in some areas of the brain, because of a magnetic susceptibility artifact and a low spatial resolution (4). Also, it is This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Received: March 4, 2019 Revised: May 24, 2019 Accepted: June 10, 2019
Daily sedation interruption versus routine sedation in critically ill children: A systematic review and meta-analysis

ABSTRACT Background: Strategies aiming lighter sedation have demonstrated promising results in adults. This review was designed to evaluate the efficacy and safety of daily sedation interruption (DSI) versus sedation protocols in mechanically ventilated children. Methods: This was a systematic review and meta-analysis. We searched MEDLINE, Scopus, Cochrane Library and Web of Science from 1980 to August 2018 for randomized control trials comparing the two forms of sedation in question, with outcomes that included duration of mechanical ventilation, length of stay in the pediatric intensive care unit, total midazolam doses and adverse events. Results: Three studies were included in the review and meta-analysis after fulfilling the inclusion criteria. One was a multicenter trial and two were single-center trials, with a total of 261 patients. There was a shorter duration of both mechanical ventilation and intensive care stay, but with marked heterogeneity. All the results were in favor of DSI except adverse events which were higher in the DSI group. Conclusion: On comparison of DSI to routine sedation, we found evidence of benefit as regards, duration of mechanical ventilation, length of intensive care unit stay and midazolam doses. However, there was some evidence of harm with more adverse events.
Localization of Protein Z (PZ) In Situ in Human Neoplastic Tissues.

Tumor cells synthesize and release procoagulants that lead to multi-factorial activation of factor X and subsequent thrombin generation and fibrin formation that in turn contribute to tumor growth and metastatic spread. The activity of factor Xa is inhibited by TFPI (tissue factor pathway inhibitor). Another mechanism of direct inhibition of factor Xa involves protein Z (PZ). Protein Z is a 62-kD, vitamin K-dependent plasma nonpeptidase glycoprotein, which, in complex with PZ-dependent protease inhibitor (ZPI), inhibits factor Xa in the presence of Ca 2+ and phospholipids. However, data on the presence of the PZ in tumor malignant tissue are lacking. Results obtained from randomized clinical trials indicate that inhibition of blood coagulation may improve the results of anticancer therapy in selected tumor types. The purpose of the study was to evaluate the localization of PZ in situ in colon, breast, gastric, laryngeal, pancreatic, renal, endometrial cancer, non-small cell lung cancer (NSCLC), malignant melanoma and glial neoplasms. Studies were performed on tumor fragments obtained at surgical treatment of proviously untreated patients. Immunohistochemical procedures using the ABC method employed a specific polyclonal antibody directed against human PZ antigen. Protein Z was localized in cancer cell bodies in all types of malignant tumors examined. Staining intensity was more pronounced in less differentiated cancer cells of anaplastic gliomas. In contrast, more differentiated cancer cells of gastric cancer revealed stronger staining than more malignant ones. Cancer cell bodies of NSCLC and renal cancer were characterized by weak intensity of staining for PZ. In the case of pancreatic and renal cancer, as well as malignant melanoma, the intensity of staining for PZ in cancer cell bodies was irregular: both high and low expression of PZ was observed independent of the degree of malignancy. The expression of PZ was also revealed in association with tumor infiltrating macrophages in colon cancer, NSCLC and malignant melanoma. Furthermore, PZ was localized in small blood vessels of colon, renal, endometrial, gastric cancer, NSCLC, malignant melanoma and glial neoplasms. The observed localization of PZ, particularly in association with cancer cells of all malignant tumors examined, suggests that this protein may exert regulatory effects on tumor growth and metastatic dissemination.
The Role of the Tumor Microenvironment in the Development and Progression of Hepatocellular Carcinoma

ABSTRACT There is growing evidence that supports the role of the tumor microenvironment in the development and progression of hepatocellular carcinoma. The tumor microenvironment is composed of cellular components, bioactive substances, and extracellular matrix comprising of proteins such as collagens, proteoglycans, and the linear glycosaminoglycan hyaluronan. Hepatocellular carcinoma generally arises from fibrotic or cirrhotic liver, characterized by alteration in extracellular matrix components. In addition, non-tumoral cells such as mesenchymal stem/stromal cells (MSCs) are typically recruited to the injured or hypoxic area within the tumor. Besides the secretion of immunoregulatory proteins, growth factors, and cytokines, MSCs and hepatic stellate cells can also synthesize hyaluronan, amongst other components, which affects several tumor-associated processes. The tumor microenvironment also contains different types of immune cells. A key component in the genesis of hepatocellular carcinoma is the macrophages, as tumor-associated macrophages (TAM). This chapter provides an overview of the interaction of MSCs-hyaluronan-TAMs and tumor cells, and how this interaction potentially contributes to the development and progression of hepatocellular carcinoma.
Perceived Stressors among College Students in an American and a Korean University

A sample of 268 students attending a private university in South Korea and 232 students attending a large public university in the U.S. responded to a measure of stressors used in other studies on college‐level stress. The ratings of both samples yielded high internal consistency and similar factor structures. The ratings did not differ significantly according to the year in school but did yield a significant main effect according to nationality and there was a significant interaction between nationality and gender. The specific stressors that most differentiated the responses of the Korean and American students were finances, academic requirements, housing, planning, and feelings of being overwhelmed. The American students obtained significantly higher scores on the perceived frequency of these stressors than did the Korean students. Only the attainment of personal goals was reported as a more frequent stressor by Korean students than their American counterparts.
effects of bupivacaine versus lidocaine on inflammatory regulation

Background and Objectives: Postoperative pain is common following surgery. Perioperative administration of long-acting local anesthetics like bupivacaine can inhibit central sensitization and decrease pain but may cause inflammation that prolongs both pain and recovery. This study evaluated the effects of the local anesthetics bupivacaine versus lidocaine on inflammatory gene and protein expression and postoperative pain. Methods: We stimulated cultured whole blood with saline, anesthetic (bupivacaine or lidocaine), or lipopolysaccharide to determine the effect of anesthetics on inflammation ex vivo . We also conducted an exploratory, prospective, randomized, double-blind clinical trial in which subjects undergoing root-end endodontic surgery received 2% lidocaine or 0.5% bupivacaine, both with 1:200,000 epinephrine. Biopsies were obtained before as well as immediately following and 48 h after surgery for evaluation of gene expression. Subjects rated pain intensity using a visual analog scale up to 48 h after surgery. Results: Compared to controls, bupivacaine but not lidocaine elevated protein levels of prostaglandin E2 but no other inflam matory mediators ex vivo . In the exploratory clinical study, analyses revealed differential gene expression between treatment groups. Significant differences in baseline-normalized gene expression levels between groups occurred for tyrosinase-related protein 1 and sphingosine kinase 1 immediately following surgery (p<0.001) and matrix metalloproteinase 1 at 48 h after surgery (p<0.0001). There was a trend for higher subject-reported pain in the bupivacaine group at 48 h (p=0.080). Conclusions: Our results confirm that bupivacaine increased certain inflammatory mediators, which may increase postopera tive pain after surgery. Further studies assessing alternate bupivacaine formulations or different pain conditions are needed.
Prosthodontic Rehabilitation of Patients with Double Crown and Locator Attachment - Retained Overdentures Supported by a Combination of Natural Tooth and Strategic Implants: Case Series

Abstract Prosthetic rehabilitation of edentulous patients and patients with one or two own teeth can be established by different treatment modalities. The most commonly used in the treatment of these patients is conventional complete denture or removable partial denture. However, due to increasing problems with this type of therapy, such as insufficient retention, stability, comfort and pain during mastication, it is suggested an overdenture supported by two natural teeth or implants. We will present series of clinical reports. In two clinical cases patients came to the dental office because of the impossibility of wearing lower partial denture, and in one case patient had problems with the upper partial denture. After clinical examination and radigraphic analysis, in all patients, dental implants were implanted. In first case there were implanted two dental implants in the region 41 and 43, in second case it was region 33, and in third case implanatiton is performed in the region of 14, 11, 21. Prosthetic rehabilitation was done after 3-months bone oseointegration period. The treatment consisted in the production of double crowns and overdentures that are retained with locator attachment. This design of the denture significantly improves the quality of patient’s life (the dentures are stable, chewing is improved, the feeling of thermal sensations of food and drink is present, the feeling of taste is complete, and the psychological patient becomes safer).