Miracle-dz/UniFAR-FTUs huggingface dataset:
COVID-19 Viral Pneumonia Complicated with Acute Pulmonary Embolism: A Descriptive Study

Objective To evaluate acute pulmonary embolism in patients with 2019 novel coronavirus (COVID-19) pneumonia using pulmonary CT angiography. Subjects and Methods. From 95 symptomatic patients confirmed with COVID-19 by RT-PCR from 1 May to 14 July 2020 in Dallah Hospital, Riyadh, Saudi Arabia, CT angiography was done for 25 patients suspected to have pulmonary embolism and have no contraindication for contrast study. 11 cases of them showed CT evidence of acute pulmonary embolism (PE). Retrospectively, CT angiography was analyzed and detailed findings were recorded. This study was approved by the Institutional Review Board of our hospital, and the patient consent was waived. Results The mean age of the included patients was 49 ± 11 years; the youngest was 22 years, and the oldest was 64 years. Common symptoms in the 25 cases that underwent CT angiography were fever that was noted in 21/25 cases (84%), shortness of breath in 18/25 cases (72%), cough in 16/25 cases (64%), and severe myalgia/body fatigue in 13/25 cases (52%). The less common symptoms were sore throat in 11/25 cases (44%) and headache in 10/25 cases (40%). Regarding CT findings, 4/25 cases (16%) had unilateral lung disease and 21/25 cases (84%) had bilateral disease, with slight predilection for the right lower lobe (10/25 cases, 40%). Pure ground-glass opacity (GGO) was seen in 13/25 cases (52%), and GGO with consolidation was seen in 12/25 cases (48%). Common accompanying CT signs included crazy paving stone sign in 15/25 cases (60%) and air bronchogram in 12/25 cases (48%). From the 25 patients that showed respiratory deterioration and elevated serum D-dimer level, 11 cases confirmed to have acute pulmonary embolism, while 14 cases showed negative result for pulmonary embolism. 6/11 were male and 5/11 were female. Pulmonary embolism was diagnosed at a mean of 21 days from symptom onset. Unilateral acute pulmonary embolism was seen in 3/11 cases, while 8/11 cases showed bilateral distribution. Among 11 cases with acute pulmonary embolism, no emboli at the central level could be seen, but 3 cases showed pulmonary embolism at the lobar level, 3 cases at the segmental level, and 5 cases at lobar, segmental, and subsegmental levels. Conclusion In patients with confirmed COVID-19, we should maintain a high suspicion for its thromboembolic complications such as acute pulmonary embolism that was mainly diagnosed at the end of 3rd week from symptom onset. We suggest that whenever a CT evaluation of the parenchymal involvement of COVID-19 pneumonia is performed, a simultaneous evaluation of the pulmonary arteries is also essential in order to identify early signs of associated pulmonary embolism.
Minimally invasive intraarticular platelet rich plasma injection for refractory temporomandibular joint dysfunction syndrome in comparison to arthrocentesis

Context: Internal derangements of temporomandibular joint (TMJ) with associated symptoms which do not respond to conservative therapies are refractory cases of temporomandibular joint dysfunction syndrome (TMD). Minimally invasive techniques like arthrocentesis and platelet rich plasma (PRP) injections are usually employed to improve TMJ symptoms and function in these cases. Aims: To compare PRP with arthrocentesis for evaluating the effectiveness of PRP in relieving symptoms of refractory TMJ pain dysfunction syndrome. Setting and Design: A clinical study was carried out on 52 patients of refractory Temporomandibular joint dysfunction syndrome. The patients were divided in two groups that is Group A - test group and Group B -control Group. Methods and Material: Group A consisted of 26 patients who underwent intraarticular PRP injection in TMJ and Arthrocentesis of TMJ was done in 26 patients of Group B. TMJ pain, Maximium Interincisal opening and TMJ clicking were assessed among the group as well as between the groups over a period of 6 months. Statistical Analysis Used: Repeated Measure ANOVA was used to compare the parameters within the groups and T test was used for group comparison at 0.05 level of significance. Result: There was statistically significant difference in pain intensity improvement 1 ± 0.75 versus 3.17 ± 2.13, maximum interincisal opening 39.86 ± 2.86 versus 37.59 ± 4.03 and clicking 6 versus 16 between the PRP group and arthrocentesis group at P < 0.05. Conclusions: Intraarticular PRP injection for the management of refractory TMD is more effective than arthrocentesis in reducing symptoms and functional improvement.
Preparation of human decellularized peripheral nerve allograft using amphoteric detergent and nuclease

Animal studies have shown that amphoteric detergent and nuclease (DNase I and ribonuclease A) is the most reliable decellularization method of the peripheral nerve. However, the optimal combination of chemical reagents for decellularization of human nerve allograft needs further investigation. To find the optimal protocol to remove the immunogenic cellular components of the nerve tissue and preserve the basal lamina and extracellular matrix and whether the optimal protocol can be applied to larger-diameter human peripheral nerves, in this study, we decellularized the median and sural nerves from the cadavers with two different methods: nonionic and anionic detergents (Triton X-100 and sodium deoxycholate) and amphoteric detergent and nuclease (3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS), deoxyribonuclease I, and ribonuclease A). All cellular components were successfully removed from the median and sural nerves by amphoteric detergent and nuclease. Not all cellular components were removed from the median nerve by nonionic and anionic detergent. Both median and sural nerves treated with amphoteric detergent and nuclease maintained a completely intact extracellular matrix. Treatment with nonionic and anionic detergent decreased collagen content in both median and sural nerves, while the amphoteric detergent and nuclease treatment did not reduce collagen content. In addition, a contact cytotoxicity assay revealed that the nerves decellularized by amphoteric detergent and nuclease was biocompatible. Strength failure testing demonstrated that the biomechanical properties of nerves decellularized with amphoteric detergent and nuclease were comparable to those of fresh controls. Decellularization with amphoteric detergent and nuclease better remove cellular components and better preserve extracellular matrix than decellularization with nonionic and anionic detergents, even in large-diameter human peripheral nerves. In Korea, cadaveric studies are not yet legally subject to Institutional Review Board review.
Clinical spectrum and outcome of patients visiting coronavirus screening centre in North India and clinical predictors for COVID-19

Aim: The aim of this study is to elucidate the demographics, symptoms and outcome of sick persons visiting coronavirus (COVID) screening OPD of a tertiary institute in North India. Study Design: The present descriptive, prospective study was done on 1030 patients and information about presenting symptoms, demographics (age, sex, nationality, residence), contact and travel history, comorbidities etc., were recorded. On the basis of criteria given by Indian Council of Medical Research, patients were divided into suspected (SARS-CoV-2) and non-suspected group. Of the suspected patients, with RT-PCR test positive were classified as confirmed COVID-19 case and negative RT-PCR symptomatic individual were defined as negative COVID-19 case. Results: Out of the total patients, 65.6% were male and 34.4% were females. The mean age was 37.04 years. Fever 49.3%, cough 57.1% and sore throat 43.5% were the main symptoms. Comorbidities were seen in 8.5% patients with hypertension (3.5%) and diabetes mellitus (3.4%). Forty patients were positive. Highly significant correlation (P < 0.01) was found between COVID-19 positive status and in patients without any symptoms, between COVID-19 and cough and sore throat, between COVID-19 and comorbidity (diabetes mellitus), between COVID-19 and high-risk exposures (resident of hot spot and history of contact with confirmed case). Our study also found COVID-19 positive status, shortness of breath and tachycardia as independent predictors of mortality (P < 0.05). Conclusions: Most of the patients were young adults and males were mainly affected. Main presentation was cough followed by fever. Infectivity was higher in patients who had underlying comorbid diseases, especially diabetes and chronic kidney disease. Critical patients with decreased oxygen saturation, tachypnoea and tachycardia had strong predictability for COVID-19 positivity. COVID-19 positive status, shortness of breath and tachycardia are important predictors of mortality.
Outcome and its predictors in traumatic brain injury in elderly population: Institutional study from Northern India

Introduction: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Survival and functional outcome is significantly poor in the elderly population. There is a need to develop better geriatric specific prognostic models and evidence-based geriatric traumatic brain injury management protocols for better treatment, rehabilitation, and prevention. Aims and objectives: To study the frequency, outcome and correlates of traumatic brain injury in elderly patients. Material and Methods: Frequency, outcome and correlates of traumatic brain injury in patients more than 65 years of age admitted in tertiary care hospital were studied in 160 patients admitted between 1st January 2016 and 31st December 2016 (retrospective analysis) and between 1st January 2017 and 30th June 2018 (prospective analysis). Institutional ethical committee approval was taken. Results: This study concluded that road side accident was the most common cause of traumatic brain injury in elderly in this study. Incidence of traumatic brain injury in elderly was found to be 11.45%. Both non-reacting pupils and low Glasgow coma scale on arrival were significantly associated with poor outcome in terms of mortality. Most of the patients who expired or were discharged against medical advice had associated skull bone fractures, cerebral infarct, diffuse brain edema, subarachnoid hemorrhage, midline shift, lower hemaglobin, higher random blood sugar and higher creatinine as compared to patients who were discharged. All these findings were statistically significant. Conclusion: Low Glasgow coma scale on arrival, non reacting pupils, low hemoglobin, high random blood sugar, high creatinine and intubation on arrival are associated with increased mortality. Associated skull bone fractures, cerebral infarct, diffuse brain edema are predictors of poor outcome. Anticoagulants and associated co-morbidities do not increase the risk of mortality in traumatic brain injury in elderly.
Health Information-Seeking Behavior of Iranian first-time Mothers and First-Time Pregnant Women in Northwest Health Centers of Tehran

Introduction: Pregnancy, especially the first pregnancy and childbirth, affects the women’s quality of life. Improving information-seeking behavior facilitates the decision-making process of women during pregnancy and postpartum. The aim of this study was to investigate the health information-seeking behavior of Iranian first-time mothers and first-time pregnant women. Methods: This research was a cross-sectional-descriptive survey . A self-administered questionnaire was distributed among 358 first-time mothers and first-time pregnant women who attended 9 health centers in the northwest of Tehran, Iran, in 2017. Data were analyzed using SPSS version 24 and by conducting descriptive statistics and Kruskal-Wallis and Mann-Whitney U tests at . 05 significance level. Result: The most important information need of the first- time mothers and first-time pregnant women was "Fetal/newborn health"; the most important source of information used was "gynecologist"; the most important way to access the resources was "visiting a doctor in person," and the most critical barrier to access information was "high costs of visiting a doctor, midwife, or nurse. " Testing the hypotheses showed significant differences between information seeking components and demographic characteristics of the respondents. It was also found that there was no significant difference between the components of information-seeking behavior among two groups of first-time mothers and first-time pregnant women (p>0.05). Conclusion: Making pregnancy-related health information more available and accessible and providing high-quality educational programs at affordable cost in health centers for first-time mothers and first-time pregnant women can help them increase their health literacy and prevent many common complications associated with pregnancy and child health.
A study on the chain propagation of benzoxazine

The chain propagations of Bisphenol A-aniline benzoxazine (defined as BA-a) polymerized by thermal induction and in the presence of various catalysts or curing agents during the curing process before gelation were investigated in this paper. DSC, gel time test and GPC were used to measure the curing behavior, number-average molecular weight (n), glass transition temperature (Tg), gel time (tgel) and curing conversion (α) of different benzoxazine systems. By comparing the experimental results (n and Tg) with the models of step polymerizations and chain polymerizations proposed by Flory et al., three kinds of chain propagations of benzoxazine were observed and confirmed. The step polymerization occurred in the thermal induction or in the presence of catalyst N,N-dibenzylaniline (tAm), and then the non-living chain polymerization and the living chain polymerization occurred, respectively, when indole (Id) and other additives such as phenol (tBp), acid (HA), imidazole (IMZ) etc. were added to benzoxazine as catalysts or curing agents. Moreover, the relationship between the chain propagation and curing kinetics of benzoxazine was also established. The chain propagation of benzoxazine systems involves step polymerization, non-living chain polymerization andliving chain polymerization, the conversion of the gel point (αgel) is almost equal to, less than and greater than the value of the conversion at which the polymerization rate reaches a maximum (αmax), respectively. The results may contribute to a better understanding of the polymerization mechanism of benzoxazine and provide new approaches to effective control of the polymerization kinetics and growth crosslink structures of benzoxazine.
Spectrophotometric Determination of Bismuth with Xylenol Orange

A method is described for the spectrophotometric determination of 10∼80μg. of bismuth with Xylenol Orange. The error is not likely to exceed ±10 per cent. The molar extinction coefficient of bismuth in 0.1 N nitric acid solution is 1.6×104 at 530 mμ. Instead of nitric acid perchloric acid or sulfuric acid may also be used. The interference of small amounts of zirconium, thorium, and iron can be eliminated by masking. Lead and thallium do not interfere with the determination of bismuth. A 1 :1 complex of bismuth with Xylenol Orange is suggested.
Potential cause affecting bone quality in Saudi Arabia: New insights

Background: Osteoporosis (OP) is a silent systemic disease characterized by decrements in bone mineral density (BMD) and bone microstructure. This study aimed to determine the status of bone quality as well as to investigate the relationship between the glycaemic; lipid; bone profiles; and the BMD. Methods: A retrospective study was conducted at KFHU, Al Khobar, Saudi Arabia analysis of patients who underwent BMD testing between the periods of 2016 to 2018. Based on the T scores, patients were classified as follows: normal (>−1.0), osteopenic (−1.0 to −2.5), or osteoporotic (≤−2.5). Details about medical and demographic information as well as metabolic and bone profiles (fasting blood glucose [FBG], glycated haemoglobin [HbA1c], cholesterol [Chol], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], calcium [Ca], phosphorus [Ph], alkaline phosphatase [ALP], vitamin D 25OHD [Vit D]) were extracted from the medical records system. Results: Out of 4838 extracted profiles, there were 4196 females (85.1%). The mean glycaemic variables of patients showed an abnormal profile (FBG 118 ± 49 and HbA1c 6.6 ± 2). The mean T score showed that the majority of patients had either osteopenic (40%) or osteoporotic (24%) changed. Significant increase in mean HbA1c (7.6 ± 1.7) was obvious among the osteopenic patients when judged against the normal (7.5 ± 1.6; P < 0.033) and osteoporotic (7.4 ± 1.8; P < 0.037). Meanwhile, the mean serum ALP was significantly lower (81 ± 26) in the normal group than in the osteopenic (86 ± 33; P < 0.006) and osteoporotic groups (90 ± 40; P < 0.001). Finally, a linear, logistic regression analysis was found that Ca and ALP levels were significant predictors. Conclusion: This study finds that the main cause that affects bone quality in Saudi Arabia is diabetes mellitus and/or its related metabolic alteration. These results suggest that bone health is clinically significant and should be carefully assessed in diabetes patients.
Effects of primary microglia and astrocytes on neural stem cells in in vitro and in vivo models of ischemic stroke

Transplantation of neural stem cells (NSCs) can protect neurons in animal stroke models; however, their low rates of survival and neuronal differentiation limit their clinical application. Glial niches, an important location of neural stem cells, regulate survival, proliferation and differentiation of neural stem cells. However, the effects of activated glial cells on neural stem cells remain unclear. In the present study, we explored the effects of activated astrocytes and microglia on neural stem cells in vitro stroke models. We also investigated the effects of combined transplantation of neural stem cells and glial cells after stroke in rats. In a Transwell co-culture system, primary cultured astrocytes, microglia or mixed glial cells were exposed to glutamate or H2O2 and then seeded in the upper inserts, while primary neural stem cells were seeded in the lower uncoated wells and cultured for 7 days. Our results showed that microglia were conducive to neurosphere formation and had no effects on apoptosis within neurospheres, while astrocytes and mixed glial cells were conducive to neurosphere differentiation and reduced apoptosis within neurospheres, regardless of their pretreatment. In contrast, microglia and astrocytes induced neuronal differentiation of neural stem cells in differentiation medium, regardless of their pretreatment, with an exception of astrocytes pretreated with H2O2. Rat models of ischemic stroke were established by occlusion of the middle cerebral artery. Three days later, 5 × 105 neural stem cells with microglia or astrocytes were injected into the right lateral ventricle. Neural stem cell/astrocyte-treated rats displayed better improvement of neurological deficits than neural stem cell only-treated rats at 4 days after cell transplantation. Moreover, neural stem cell/microglia-, and neural stem cell/astrocyte-treated rats showed a significant decrease in ischemic volume compared with neural stem cell-treated rats. These findings indicate that microglia and astrocytes exert different effects on neural stem cells, and that co-transplantation of neural stem cells and astrocytes is more conducive to the recovery of neurological impairment in rats with ischemic stroke. The study was approved by the Animal Ethics Committee of Tongji University School of Medicine, China (approval No. 2010-TJAA08220401) in 2010.
Template Effects in the Formation of a Tetramethylene-Bridged Hemicarceplex

We report a study of the template effect in the formation of tetramethylene-bridged hemicarceplex 7·guest. Two tetrol cavitands were bridged with 1,4-dibromobutane in the presence of suitable template (guest) molecules in N-formylpiperidine as solvent. Selectivity was observed when competing templates were present during the reaction: the relative templating abilities (template ratios) of 30 different guest molecules range by 3600-fold, and manifest a significant preference for para-disubstituted benzenes. Twenty-one of the 30 hemicarceplexes used in this templation study are new. The trend in guest selectivity is markedly different from previous studies in which smaller cavities (e.g., carceplex 2·guest) are formed. In such studies, capsule 3·guest was a good transition state model, whereas this is not the case in the present work.
Relation of oral ulcers to quality of life: a cross-sectional study

Background Oral ulcers affect many dental patients; impairing their lives physically, psychologically, and socially. Due to the absence of information about oral ulcers in our population, the authors undertook a pilot study to obtain a more complete picture of prevalence of oral ulcers, its probable risk factors and its burden on the quality of life. Materials and methods The authors performed a cross-sectional study with 605 adult dental patients. All patients filled a questionnaire inquiring about the risk factors. An oral examination was performed to each participant to determine presence or absence of oral ulcers; and the type of the oral ulcer. Each oral ulcer patient subsequently completed an oral health impact profile-14 questionnaire. Results The prevalence of oral ulcers was 10.3%; half of these were recurrent aphthous ulcers. After adjusting for the predictor variables, rural residents had higher odds for oral ulcers. The authors found that patients with erythema multiforme reported the highest impairment in quality of life; whereas patients with recurrent viral ulcers reported the lowest impairment. Conclusion Patients having erythema multiforme, pemphigus vulgaris and ulcerative forms of oral lichen planus suffer from the poorest quality of life compared to patients having other types of oral ulcers. The study showed the importance of quantifying the impairment of quality of life in patients having oral ulcers to plan their treatment accordingly.
Family physicians/GP and Internist opinions, familiarity and practice behaviour regarding clinical practice guidelines (CPGs) of common medical conditions in Nigeria

Background: Few studies exist on physicians' opinions, attitudes, familiarity and practice behaviour regarding clinical practice guidelines in sub-Saharan Africa. Objectives: To determine the opinions, familiarity, and practice behaviour regarding clinical practice guidelines (CPGs) and factors associated with their use among internists and family physicians/GP in Nigeria. Methods: A semi-structured questionnaire regarding guidelines of five common medical conditions: hypertension, diabetes mellitus, tuberculosis, asthma and hepatitis B encountered in everyday medical practice were self-administered by 183 doctors across the country. Results: Over 90% of respondents believed that guidelines were evidence-based, improved management outcomes, and quality of care, nevertheless, 57.4% were against using them in litigations against doctors. The majority (>70%) of the respondents were familiar with the guidelines except that of hepatitis B. Overall, guidelines were used regularly by 45.9%, used in part by 23.5% and 30.6% never used it. Approximately 50% of physicians had immediate accessibility to them at the point of care. The proportions of respondents reporting a change in practice behaviour ranged from 37.7-57.9% depending on the guideline. The factors associated with guideline-related behaviour change were familiarity with its contents, postgraduate educational training, increased helpfulness score, and practiced >5 years. Conclusions: The present study shows that most physicians have favourable opinions and are familiar with these guidelines, however, the proportions reporting changes in their patient management because of the guidelines are not satisfactory. It is important to ensure guidelines accessibility and promotes factors that encourage their implementation in medical practice.