Miracle-dz/UniFAR-FTUs huggingface dataset:
Autoimmune thyroid pathology in recently diagnosed diabetes mellitus type 1

OBJECTIVE: To analyze the prevalence of autoimmune thyroid disease among adult patients with recently diagnosed diabetes mellitus type I and its possible correlation with beta-cell autoimmunity markers (ICA, GAD, and IA 2) and with the presentation characteristics of diabetes mellitus. PATIENTS AND METHODS: A total of 100 patients diagnosed from 1992 to 1996 were included and anti-thyroid antibodies (Ac), anti-thyroglobulin (aTG) and antiperoxidase (aTPO) were measured. A comparison followed of the clinical characteristics, biochemical markers, and beta-cell immunity markers between the group of patients with positive and negative antibody determinations. Differences between groups were compared by the Student "t" test and non-parametric tests were used for cases not fulfilling the application conditions. RESULTS: Among the 100 patients, 25 had Ac+, two with previously known thyroid pathology and eight diagnosed at that moment. The group with Ac+ was characterized by a predominance of females (68% vs 32%; p = 0.001), lower bicarbonate levels (18.6 +/- 6.1 vs 21.3 +/- 6.4; p = 0.026) and higher requirements for insulin at discharge (0.77 +/- 0.22 vs 0.59 +/- 0.25 IU/kg; p = 0.002). Among patients in the Ac+ group, patients with thyroid pathology were characterized by a higher prevalence of females (90% vs 53.3%; p = 0.05) and a higher percentage of individuals with high anti-TPO titres (80% vs 33.3% higher than 400 IU/ml; p = 0.02). ICAs (66.6% vs 26.6% higher than 40 U JDF; p = 0.05) and IA2 (44.4% vs 0% higher than 12 IU/ml, p = 0.01). CONCLUSIONS: There is a high prevalence of thyroid pathology prevalence among our adult population with recently diagnosed DMI. Patients with thyroid autoimmunity have higher antibody titres to beta-cell and a somewhat more severe clinical presentation form. Prospective studies are required to determine the long term relevance of these differences.
Knowledge and perceptions of antimicrobial stewardship concepts among final year pharmacy students in pharmacy schools across South Africa

Background: Antimicrobial stewardship is currently not mandatory as part of the undergraduate training of pharmacists. Identifying gaps in knowledge and a better understanding of pharmacy students’ perceptions about antimicrobial stewardship could assist in recommendations for appropriate changes to the pharmacy degree curricula that may lead to more appropriate use of antimicrobials, within the multi-disciplinary team.Methods: A descriptive quantitative study with a survey design was conducted at the eight universities offering the pharmacy degree in South Africa. An electronic questionnaire with four main categories on antimicrobial stewardship was administered to final (fourth) year pharmacy students (June–August 2015). Results: An overall response rate of 26.6% (n = 260) was obtained from 978 students, despite a weekly reminder. Most of the respondents were familiar with antimicrobial stewardship programmes in South Africa (71.9%), and claimed to know what antimicrobial stewardship is (83.5%) with sign.
Joint Salvage Procedures for Failed First Metatarsal Phalangeal Joint Cheilectomy

Hallux rigidus is a painful arthritic condition of the first metatarsal phalangeal joint. For over 40 years, cheilectomy has been considered a first-line surgical treatment for mild and moderate cases of hallux rigidus. Despite successful results in the majority of cases, cheilectomy sometimes fails. Therefore, a number of revision surgical treatment options are available including joint-salvaging procedures such as repeat cheilectomy, dorsal osteotomy of the proximal phalangeal base, or interposition arthroplasty with allograft tissue. These revision surgical procedures will be discussed along with factors such as patient age, activity level, reason for primary failure, and severity of hallux rigidus that aid in decision-making. Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
ROLE OF GLUTAMATE-CYSTEINE LIGASE IN MAINTAINING GLUTATHIONE HOMEOSTASIS AND PROTECTING AGAINST OXIDATIVE STRESS

Glutamate-cysteine ligase (GCL) is the rate-limiting enzyme catalyzing the first step of glutathione (GSH) biosynthesis. In higher eukaryotes, this enzyme is a heterodimer comprising a catalytic subunit (GCLC) and a modifier subunit (GCLM); the latter changes the catalytic characteristics of the holoenzyme. In the first part of this dissertation, the heterodimer formation between GCLC and GCLM was investigated, using the yeast two-hybrid system and affinity chromatography. A strong and specific interaction between GCLC and GCLM was observed in both systems. Deletion analysis showed that most regions, except part of the C-terminal region in GCLC and part of the N-terminal region in GCLM, are required for the interaction to occur. Point mutations on selected amino acids were also tested for the binding activity. GCLC C248AC249A and P158L mutants had the same strength of binding to GCLM as the full-length GCLC, yet the catalytic activity was dramatically decreased in these mutations. The functions of GCLC and GCLM were further studied in knockout mouse lines with the targeted disruption of the gene encoding either subunit. Deletion of the Gclc gene specifically in hepatocytes led to a ~98% loss of GSH in liver and plasma. The affected livers showed significant oxidative damage, mitochondrial degeneration, and hepatocyte death. These mice died of hepatic failure around post-partum day 30 (d30). Supplementing N-acetylcysteine in the drinking water, starting at d21, was able to prevent early death; however, these mice developed pathology characteristic of liver cirrhosis. Gclm(-/-) mice, on the other hand, showed no overt phenotype. However, GSH levels decreased to 9-16% of normal in tissues and plasma. Compared to the GCL holoenzyme partially purified from livers of Gclm(+/+) mice, hepatic GCLC in Gclm(-/-) mice showed a ~2-fold increase in Km for glutamate and a dramatically enhanced sensitivity to GSH inhibition. The major decrease in GSH, combined with diminished GCL activity, rendered Gclm(-/-) fetal fibroblasts more strikingly sensitive to chemical oxidants such as hydrogen peroxide. These data demonstrate that both GCLC and GCLM are critical in maintaining GSH homeostasis. Disruption of either component is strikingly detrimental to the cell’s or animal’s protection system against oxidative stress.
Medical specialities with a higgher proportion of malpractice litigations in Catalonia between 2005-2015

A medical error or adverse effect (AE) is a fault that occurs during the delivery of health care that has caused damage to the patient. In Spain, the incidence of patients with AE related with healthcare was a 9.3% and about a 42.8% of the AE are avoidable. Spanish data suggest that we are facing an everyday problem. Each country has a different health, economic and legal situation. Medical malpractice could be defined as a misguided exercise or practice without skill by a physician or other professional, causing damage to the health or the condition of the patient. It has some legal consequences; it is used the term of medical responsibility or liability: moral, civil, criminal and administrative. It is extremely problematic to establish common standards between countries. Consequently, it is needed a specific analysis of the situation, in order to determine the context of AE in our country Objective: The main aim of this study is to determinate which is the specialty or group of medical specialties with a highest proportion of malpractice legal procedures during, regardless of the used courts: civil, penal, etc Methods: This is an observational, longitudinal and retrospective study. Secretaries all around Catalan court will use TEMIS database in order to identify all judgments about medical liability in Catalonia during 2005-2015. Secretaries will send us this information in an anonymous way, deleting all persona data about doctors and patients
Ankle Dorsiflexors Strength Improves Balance Performance in Elderly: A Corelational Study.

The physical ability to maintain balance when moving and the ability to move independently are central requisites for independent living and are thus two important focuses in geriatric rehabilitation. It has been suggested that a decrease in the ability to generate force in the lower extremity muscles contribute to balance impairment and falling. The purpose of this study was to detect balance performance response to improved strength of dorsiflexors muscles in elderly. Fifty healthy elderly subjects, their age ranged 65-75 years, participated in this study. Twenty five subjects (training group) were trained with resisted exercises plus electrical nerve stimulation of ankle dorsiflexors muscles, three times a week for 8 weeks. The control group, included twenty five subjects, received no treatment intervention except encouragement for performing their usual activity of daily living over the 8 weeks of the study. The ankle dorsiflexors muscles force was measured by the hand held dynamometer in Kg and the balance control was measured by the Berg Balance Scale (BBS), the Functional Reach Test (FRT) and the Timed Get Up-Go Test (GUG). These measurements wevr5re applied for both groups before and after 8 weeks. The BBS, FRT and GUG values showed significant changes (12.9%, 35.7% and 51.9% respectively) following training in the trained group. There were no significant changes (0.67%, 6.95% and 14.4%) in the same measures of the control group after 8 weeks. Improved ankle dorsiflexors strength enhances balance performance in elderly.
Ethnopharmacological studies on some wound healing plants of west Champaran

SUMMARY A large number of plants / plant extracts, decoctions, infusions or pastes are equally used by folklore for the treatment of cuts wounds and burns. The present work, thus, is an attempt to analyze the ethno-botanical knowledge base for the treatment of cuts and wounds. A large number of plants used by tribal and folklore with enormous potentials have not been validated for their wound healing activities. This work, therefore, attempts to bridge the lacunae in the validation of the traditional claims and development of safe and effective herbal drugs for cuts and wounds.
Physical and psychological problems experienced and coping strategies used by heart transplant recipients after their operation.

This study is aimed at discovering the basic psychological problems and coping strategies used by heart transplant patients. In addition an important goal is the generation of a theory based on the data collected from interviews with patients. The consequences of the study is to provide nurses with the necessary information to help patients make the maximum use of their existing coping strategies and in the case of ineffective patterns to help them change to more effective ways of dealing with their problems. Forty two heart transplant recipients who had undergone their operation in Royal Infirmary of Glasgow provided the sample for the present study. The primary means of data collection was through informal, in-depth and unstructured interviews. The research approach was based on Glaser and Strauss's principles for the generation of grounded theory and the techniques of comparative analysis and theoretical sampling were employed. Transcripts were coded for themes which were clustered to form named categories. Grounded theory approach to data collection and analysis proved to be appropriate for the research problem as little has been written about the psychological stress for the patient that follows transplant procedures. Although the limited research carried out is of interest and provide many clinical examples they typically focus on the end result of a patient's adjustment to a stressful situation. Unfortunately they ignore the details or processes of the stress and coping strategies of the heart transplant patients. The data produced four categories which conceptualised heart transplants recipients' experience: 1) Traumatic experience, 2) Somebody else's heart in side me, 3) Coping, 4) That's a small price to pay for being alive Vs Too big a price Finally, the categories were arranged around the central theme of the research, heart transplant recipients' experience , to form an analytical version of the story. The theory of "Price to pay for being alive: Coping with the postoperative demands in Heart Transplantation" developed in this study, explains the coping process involved in heart transplant recipients adjustment to the postoperative life. Making the coping process explicit may contribute to an understanding of the problems involved in heart transplantation. Increased understanding of this process could provide indicators for the appropriate care of heart transplant recipients and a theoretical foundation for the education of care professionals. Care professionals, in turn, can assist patients to modify their beliefs about heart transplantation and develop attitudes and beliefs to meet the challenge of living with continual unpredictability.
Antibiotics to cure or harm: Concept of antibiotic resistance among health professional students in Nepal -

Background: Antibiotic is a wonder drug used in the treatment and control of microbial infections and resistance to such drug is a major global health issue because of its extensive and improper use. Health professional students being easy to mould should be made aware to focus on the social aspects of antibiotic management especially the knowledge, attitudes, and practices so that they can aware and help the general population regarding the judicious use of antibiotics in future. Objectives: The objective of this study was to assess the knowledge, attitudes, and practices of health professional students of Birgunj, Nepal towards the use of antibiotic and antibiotic resistance. Material and methods: A cross-sectional study was carried out in two health institutions of Birgunj, Nepal. Data were collected through convenient sampling technique, using a pre-tested structured questionnaire. A total of 176 respondents belonging to Nursing and Dental backgrounds were included in current study. Results: It was found that 87.5% of the respondents started antibiotic usage with doctor’s consultation, whereas, 84.7% of respondents said that indiscriminate and injudicious usage of antibiotics can lead to increased adverse effects on human body. About 98.3% respondents suggested the requirement of more education about antibiotics. Moreover, 61.9% of respondents completed full course of treatment while they were ill. Surprisingly, 19.69% of respondents were unsure about the causes of antibiotic resistance. Conclusion: The level of knowledge and attitude about antibiotic and its resistance amongst the health professional students is high; however, practice of antibiotic is still poor.
Childhood morbidity and treatment pattern at the multipurpose health centre, Ilesa, Nigeria.

BACKGROUND This is a descriptive case series study that attempt to identify the common presenting complaints why children are brought to the Multipurpose Primary Health Centre (MPHC) at Ilesa and also to examine the treatment pattern of the common illnesses from birth to the first five years of life, from October 2000 to March 2001. METHODS Information was collected by reviewing the case records of all under five children who presented for treatment at the MPHC, Ilesa from October 2000 to March 2001 using a spreadsheet. The age, sex and presenting complaint as reported by their mothers were extracted from the records. The treatment given as recorded by the attending physician was also recorded. RESULTS The findings of the study reveals that for every 20 outpatient visits to the centre, 11 were children under five years. The male to female ratio was 1:1. Overall, fever, cough and diarrhoea were the commonest presenting complaint (77.2% of all presenting complaints) with fever taking the highest percentage (48.8% of all presenting complaints) except for children under 6 months where majority present with cough (31.6% of the presenting complaint of that age group). The disease conditions most commonly treated by the physicians at the centre were malaria, acute respiratory tract infection and diarrhoea. The drugs commonly used are chloroquine, cotrimoxazole, and oral rehydration therapy. CONCLUSION This study has shown that the major burdens of diseases in children under 5 years of age are preventable and are amenable to cost-effective and simple treatment.
The global distribution of comorbid depression and anxiety in people with diabetes mellitus: Risk-adjusted estimates

Background: Previous reports suffer from the problem that they simply pooled data using aggregate means or standard meta-analytic method. The aim of the current study was to re-estimate the point prevalence of comorbid depression and anxiety in people with diabetes. Methods: The estimates were calculated using recently introduced directly standardized effect estimate method, which gives corrected risk-adjusted estimates for the population of interests. Reported are global and regional burden of prevalence, presented as risk-adjusted prevalence estimates with 95% confidence intervals. Results: Globally, the burden of comorbid depression was higher than the burden of anxiety (23.36% vs. 17.58%) symptoms and/or disorder in people with diabetes. There was a higher burden of comorbid depression in people living in developing regions (26.32%), in women (15.41%), and when assessed by self-report scales (SRS) (22.66%). The burden of anxiety was higher in developed regions in people with Type 2 diabetes mellitus (20.15%) and when assessed by SRS (20.75%). No statistically significant differences were observed due to gross heterogeneity across countries. Conclusions: There are wide-ranging differences in studies in developed and developing regions, regarding the burden of comorbid depression and of anxiety among people with diabetes and both conditions affect approximately a fifth of the diabetic population.
The Contribution of Gut-Derived Endotoxins to Liver Injury

The liver serves as the key organ for the removal and detoxification of bacterial endotoxins that are continously absorbed in small amounts from the gastrointestinal tract. This paper postulates that liver injury impairs this detoxification process leading to further liver damage and systemic effects as well. Evidence is reviewed to support the contention that endotoxin may be a major common pathway for liver injury by a variety of agents, and methods of reducing endotoxicity of gut origin are proposed. Finally, a new solid phase radioimmunometric assay for E. coli 026 is described and its usefulness as a gut marker suggested.
Efficacy of individual pain treatment on quality of life

1 1.0 Introduction. 2 1.1 Objective of the study. 2 1.2 The relevance of the patient-perspective. 3 1.3 Theoretical Framework. 3 1.4 Dementia and pain. 7 1.5 Depression. 8 1.6 Social Activities. 9 1.7 Skin problems. 10 1.8 Blood pressure and pulse rate. 11 1.9 Quality of life. 12 1.10 Interplay between physical, physiological and psychological variables and coping in nursing home residents with dementia suffering from chronic pain. 14 1.11 Hypotheses.17 2.0 Methods. 17 3.0 Results.23 4.0 Discussion. 26 5.0 Conclusion. 34 6.0 Implications, limitations and further research. 35 7.0 References. 37
Study of drug resistance in previously treated tuberculosis patients in Gujarat, India.

CONTEXTE : Departement de la tuberculose et des maladies thoraciques et centre de formation et de diagnostic de tuberculose de l'Etat (SDTTC), un centre de traitement directement observe de courte duree (DOTS) a Ahmedabad, Etat de Gujarat, Inde. L'etude a ete menee par une revue retrospective des donnees des patients entre janvier 2000 et aout 2001. OBJECTIF : Evaluer le type de resistance medicamenteuse parmi les patients tuberculeux traites anterieurement qui restaient symptomatiques ou avaient une bacilloscopie positive malgre un traitement medicamenteux antituberculeux d'un minimum de 5 mois, sous DOTS. SCHEMA : On a evalue retrospectivement 1.472 patients atteints de tuberculose pulmonaire qui avaient recu un traitement antituberculeux quant a leur type de resistance aux medicaments grâce a des cultures et a des tests de sensibilite des bacilles acido-resistants (BAAR) des expectorations a l'egard de l'isoniazide, la rifampicine, la streptomycine et l'ethambutol. RESULTAT: Parmi les 1.472 patients evalues, il y avait au total 804 cas d'echec de traitement (54,6%) et 668 cas de rechute (45,4%). La culture a ete positive chez 822 patients (373 echecs et 449 rechutes). On a mis en evidence une resistance a un ou plusieurs medicaments chez 482 (58,64%) de ces 822 patients (261 echecs et 221 rechutes). la resistance concernait un medicament chez 86 patients (10,46%), deux medicaments chez 149 patients (18,13%), trois medicaments chez 122 patients (14,84%) et quatre medicaments chez 125 patients (15,21%). La resistance a un seul medicament a concerne le plus souvent l'isoniazide (62 patients, 7,5%), puis la streptomycine (12 patients, 1,4%), la rifampicine (huit patients, 0,97%) et l'ethambutol (quatre patients, 0,4%). La resistance aux seuls isoniazide et rifampicine a ete observee chez 76 patients (9,2%). CONCLUSION : Dans le traitement de la tuberculose pulmonaire, la resistance a l'egard des medicaments est un probleme majeur. La detection du type de resistance aux medicaments et le traitement grâce a des medicaments antituberculeux de deuxieme ligne en regime approprie sont necessaires pour le traitement des echecs et des rechutes afin de reduire l'emergence de cas de tuberculose a germes multiresistants.
Ludwig′s angina: Analysis of 28 cases seen and managed in Sokoto, Northwest Nigeria

Objectives: To determine the prevalence, seasonal presentation, and management of Ludwig′s angina in Northwest Nigerian Tertiary Health Facility. Patients and Methods: Cases of Ludwig′s angina that presented and managed by the Dental and Maxillofacial Surgery Unit of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, between 2013 and 2015 were retrieved. Data were stored and analyzed using IBM SPSS (IBM Corp., Armonk, NY, USA) Statistics for windows version 20. Results: Over the review period, 36 patients presented with clinical features of Ludwig′s angina. Only 28 cases were analyzed and 8 cases had incomplete data and were excluded from the analysis. Of the 28 patients, 23 (82.1%) were males while 5 (17.9%) were females with a male: female ratio of 4.6:1. The mean age of the sample was 32.3 ΁ 11.6, range 18-60 years. A majority of the patients were in low socioeconomic group with 11 (39.3%) patients being peasant farmers. Odontogenic infection was responsible for the disease in 27 (96.4%) cases while only 1 (3.6%) case was idiopathic. Of those with odontogenic etiology, 18 (64.3%) were due to sequelae of caries. Microbiology, culture, and sensitivity in few cases revealed Streptococcus species, Pseudomonas aeruginosa, and Staphylococcus aureus. Most of the cases recorded no bacterial growth after 24 h incubation period. Twenty-five patients (89.3%) survived the disease while 3 (10.7%) died. Conclusions: Management of Ludwig′s angina in a resource- and personnel-scarce setting can be very challenging. Early surgical decompression, aggressive empirical antibiotics, and nutritional support have contributed to the low mortality in our series.
DEGRADATION OF VANILLIN IN SOIL‐CLAY MIXTURES TREATED WITH SIMULATED ACID RAIN

Significant vanillin degradation occurred only in soil amended with 9% montmorillonite and not in soil amended with 9% kaolinite or in soil without addition of clay minerals. Progressively decreasing amounts of vanillin were mineralized in the montmorillonite-amended soil with increasing acidification with H2SO4, and complete inhibition of mineralization occurred at a soil pH of 1.6.