Miracle-dz/UniFAR-FTUs huggingface dataset:
Is hypoglycaemia in acute ill children presenting to emergency department investigated properly?

Background: Infants and children presenting to the emergency department with hypoglycemia are a diagnostic emergency and require urgent treatment. We hypothesize that pediatric patients who present with hypoglycemia associated with other acute illnesses are not being investigated properly for the hypoglycemia etiology. Methods: The medical records of all pediatric patients with the diagnosis of hypoglycemia, blood glucose level of <3mmol/L (54mg/dl) and not known to have metabolic or endocrine illness, who presented to the emergency department at Tawam Hospital from Jan 2012 until December 2014, were retrospectively reviewed. Patient's demographic data had been collected in addition to associated diagnosis, hypoglycemic related symptoms, glucocheck, serum glucose, urine ketones, workup and management. Data were analyzed using Excel 2010. Results: Among 514 subjects reviewed, 197 were included. 52% were male and 81% were less than five years of age. The most common associated diagnosis was acute gastroenteritis (AGE), 152 (77%). 46 (23%) had associated hypoglycemic related symptoms, although nonspecific. None of the subjects had specific investigations for hypoglycemia at time of presentation. 16 (8%) were identified as high risk for having pathologic cause for hypoglycemia, however 4 (25%) referred for metabolic and/or endocrinology services. Urine was checked only in 50 (25%) subjects, 45 (90%) of them tested positive for ketones. Conclusion: Evidence based clinical practice guidelines are needed in managing children with hypoglycemia associated with acute illness who are not known to have metabolic or endocrine diseases. In addition, parent's education on proper care of children with AGE is required to prevent hypoglycemia.
Permanent Cardiac Pacing Versus Medical Treatment for the Prevention of Recurrent Vasovagal Syncope

Background—This clinical investigation was performed to compare the effects of permanent dual-chamber cardiac pacing with pharmacological therapy in patients with recurrent vasovagal syncope. Methods and Results—Patients from 14 centers were randomized to receive either a DDD pacemaker provided with rate-drop response function or the β-blocker atenolol at the dosage of 100 mg once a day. Inclusion criteria were age >35 years, ≥3 syncopal spells in the preceding 2 years, and positive response to tilt table testing with syncope occurring in association with relative bradycardia. The primary outcome was the first recurrence of syncope after randomization. Enrollment was started in December 1997, and the first formal interim analysis was performed on July 30, 2000. By that time, 93 patients (38 men and 55 women; mean age, 58.1±14.3 years) had been enrolled and randomized, although follow-up data were available for all patients (46 patients in the pacemaker arm, 47 patients in the pharmacological arm). The int.
Etiology of bacterial diarrhea in children under five years in Kerbala Province, Iraq

Objective: To determine the bacterial causative causes of diarrhea and related factors in children under 5 years in Kerbala Province, Iraq.Methods: The study was conducted on 648 children infected with diarrhea under the age of 5 years, visited hospitals and health centers in the province of Karbala for the period from January 2016 to October 2016 and collected information related to the patient by a special form for that.Results: The results showed that rate of bacterial infection of diarrhea is 244 (37.65%) of the total diseased samples of 648 cases. Rural characterized areas of Kerbala were the highest rate of diarrhea (33) compared with the center of Karbala urban landscape, the distributed highest infection was recorded in the Alhur (43.85%), and the lowest infected rate in the center of the of Karbala (39.75%). Diarrhea increase within May 33 (49.24%) and decrease during January 14 (24.56%) The isolates bacteria were distributed as follows: About 82 isolates (33.6%) from enteropathogenic Escherichia coli (EPEC), followed by 34 isolates (13.9%) Proteus mirabilis, 31 isolates (12.7%) Salmonella Typhimurium, 26 isolates (10.7%) Klebsiella pneumonia, 23 isolates (9.4%) Pseudomonas aeruginosa, 21 isolates (8.6%) Shigella spp, 16 isolates (8.6%) Aeromonas hydrophila, 6 isolates (2.5%) Staphylococcus aureus, four isolates (1.6%) Enterobacter areogenosa, and one isolates (0.4%) Vibrio cholera. There was no significant difference between gender in infected diarrhea patients. Bacterial isolates showed various reactions to the antibiotic used in the study.Conclusions: Enteropathogenic E. coli considered as a most common etiology of bacterial diarrhea in children under 5 years in Kerbala Province, Iraq, especially, aged 12–23 months. All isolates bacteria showed sensitivity to the Norfloxacin and resistant against Trimethoprim, Amoxicillin. Antibiotics should be used wisely after antibiotic susceptibility test.
Atherosclerotic Background of Hepatosteatosis in Sickle Cell Diseases

Background: We tried to understand whether or not there is an atherosclerotic background of hepatosteatosis in sickle cell diseases (SCDs). Methods: All male and female patients with the SCDs were studied. Results: The study included 428 patients (208 females). The mean ages of patients were similar in males and females (30.6 versus 30.1 years, respectively, P>0.05). Smoking (24.0% versus 6.2%) and alcohol consumption (5.0% versus 0.4%) were significantly higher in males (P<0.001 for both). Although the inflammatory nature induced severe weight loss of the SCDs and relatively younger mean ages of the patients, there were nine (4.0%) hepatosteatosis cases in males and six (2.8%) in females (P>0.05). Their mean ages were 37.5 years in males and 31.8 years in females (P>0.05). Their mean body mass indexes were 25.8 kg/m2 in males and 23.2 kg/m2 in females (P>0.05). On the other hand, transfused red blood cell units in their lives (47.6 versus 28.4, P=0.000), chronic obstructive pulmonary disease (25.4% versus 7.2%, P<0.001), ileus (7.2% versus 1.4%, P<0.001), cirrhosis (7.2% versus 1.9%, P<0.001), leg ulcers (20.0% versus 7.2%, P<0.001), digital clubbing (14.0% versus 6.2%, P<0.001), coronary artery disease (18.1% versus 12.9%, P<0.05), chronic renal disease (10.4% versus 6.2%, P<0.05), and stroke (12.2% versus 7.6%, P<0.05) were all higher in males. Conclusion: SCDs are chronic inflammatory processes on vascular endothelium at the capillary level, and terminate with accelerated atherosclerosis induced end-organ failures in early years of life. Hepatosteatosis may actually be one of the hepatic consequences of accelerated atherosclerotic process in the SCDs.
Surgical Management of Obstructive Urolithiasis in Small Ruminants by Tube Cystostomy in Chittagong, Bangladesh

The present study was conducted to evaluate minimally invasive tube cystostomy technique in goats and calves suffering from obstructive urolithiasis having intact and ruptured urinary bladder. This clinical study was carried out on 84 clinical cases (61 goats and 23 calves) based on the history, clinical signs and physical examination along with common laboratory techniques at the Chittagong Veterinary and Animal Sciences University during January 2015-December 2016. Physical parameters like heart rate, respiratory rate, rectal temperature and dehydration status of animals were noted and corrected abnormality before surgery. Some cases had slightly higher haemoglobin (Hb), packed cell volume (PCV) and uric acid and epithelial casts in urine. The study revealed that abnormal calcium-phosphorus ratio was predisposing the animals to urolithiasis. It was found that young ruminants (3-5 months) were most commonly affected in both species. All affected animals were male in this study, in which calves were not castrated but in goats 95.08% animals were castrated. Rupture of bladder was more common in calves as compared to goats. Postoperatively all cases were administered with broad-spectrum antibiotic, anti-inflammatory agent and caliculolytic agents like ammonium chloride. Tube cystostomy with Foley’s catheter was the most satisfactory technique for the management of obstructive urolithiasis in small ruminants. Postoperative complications were recorded only in four animals and remaining 80 animals had a normal recovery from tube cystostomy. Tube cystostomy is a simple, inexpensive and very effective procedure for the treatment of urolithiasis in ruminants.
Primary Pulmonary Synovial Sarcoma: Case Report with Unusual Histology and Diagnostic Pearls

Primary pulmonary synovial sarcoma is rare and poses a diagnostic challenge when unusual histologic features are present and t(x; 18) is negative. We present a case of a 49 year old female with left lung mass and left pleural nodule showing typical clinical and radiologic features of pulmonary synovial sarcoma with focal unusual histomorphology. While dense cellularity, interlacing fascicles, and hyalinized stroma were seen, this tumour showed unusual histologic features not usually seen with pulmonary synovial sarcoma but typical of other neoplasms, in particular, Verocay bodies, rhabdoid morphology, and vague rosette formation. Immunohistochemistry demonstrated PanCytokeratin and CK7 immunoreactivity with focal S-100 expression, but were negative for muscle markers, other melanoma markers, and CD34. The tumour was negative for t(x; 18). In conclusion, awareness of focal unusual histology in otherwise typical pulmonary synovial sarcoma can prevent misdiagnosis, particularly when t(x; 18) is negative.
Uterine Masses by MRI: Indications and Findings

The importance of uterus is the process of reproduction and conservation of the human in the earth as well as motherhood is the dream of every woman to give her sense of femininity and importance in this presence. The purposes of this study was to shed light on the importance of MRI and its diagnostic value for the different types of uterine masses in symptomatic patients. This study was conducted at Saudi German Hospital in the period (2015-2016). Data were retrospectively collected from 100 patients who had come to the Radiology Department from obstetrics and gynecology departments with different symptoms, age range (19-70) years and mean age (2.40 ) years. All patients were subjected to Magnetic Resonance Imaging.Out of 100 patient; (92) were diagnosed by MRI with different uterine masses while 8 cases showed normal result despite the presence of symptoms. Uterine fibroid (35%) was the most common pathologic findings, followed by cervical carcinoma (22%), endometrial carcinoma (14%), endometriosis (11%) and adenomyosis (10%). Uterine fibroids (27 out of 35)patient; was more frequent among patients in the age group of (20-49)y. Cervical carcinoma (12out of 22) cases; was more common among the age group of (20-49)year too. Endometrial carcinoma (7out of 14) cases was frequent among the age group of (>60 )year. Endometriosis and Adenomyosis were common in the age group of (20-49) year. The study results reflect that Magnetic resonance imaging (MRI) is an excellent method for diagnosing and evaluating uterine masses.
The Effects of Short Health Messages Intervention in Improving Knowledge and Attitude on Sexual and Reproductive Health among Late Adolescents at Colleges in Malaysia

Sexual and reproductive health problems among adolescents are increasing in trend. Inadequate knowledge of sexual and reproductive health is the main cause of problems in sexual and reproductive health. Short messages service (SMS) intervention has been implemented widely in health education and the outcomes are positive. Hence, this study was conducted to evaluate the effects of mobile phone messaging in improving sexual and reproductive health among late adolescents (age 18 - 19 years old). A quasi-experimental study was conducted in two Professional Vocasional Colleges in Malaysia. A total of 116 respondents in the intervention group and 130 respondents in the control group had completed the study. There was a series of 24 messages (SMS) sent to the respondents biweekly for 12 weeks. The adolescent girls (mean knowledge score 15.90, sd ± 3.321) in the intervention group had a significantly (P = 0.007) higher mean score in knowledge of sexual and reproductive health than boys (mean knowledge score 13.87, sd ± 4.003) at post intervention. The adolescent boys (mean knowledge scores 15.35, sd ± 4.748) in the control group had a significantly (P = 0.009) higher mean score for knowledge on HIV/AIDS than girls (mean scores 13.08, sd ± 4.325) at post intervention. In the intervention group, the number of respondents with good knowledge and good attitude on HIV/AIDS increased at 3 months post intervention. SMS intervention on knowledge of sexual and reproductive health for adolescents was accepted and effectively improved the knowledge scores and sustained even after 3 months post intervention. Therefore, the SMS intervention should be implemented as an intervention package to improve knowledge and reduce risk in developing sexual and health related problems among adolescents.
Prevalence and identification of ectoparasites on indigenous chickens in Seharti-Samre District, Tigray, Northern Ethiopia

A cross sectional study was conducted from February 2014 to February 2015 to estimate the prevalence of ectoparasites and to assess risk factors in indigenous free scavenging chickens in three sub-districts of Seharti-Samre District, northern Ethiopia. Physical examination, hand picking for visible parasites, skin scraping and laboratory based identification of collected parasites were employed on systematically selected 570 indigenous chickens. An overall prevalence of 68.6% (391/570) ectoparasites with a specific prevalence of 44% (251/570), 14.4% (82/570) and 10.2% (58/570) for Echidnophaga gallinacea , Argus persicus and mixed infestations, respectively were recorded. Prevalence of A. persicus , E. gallinacea and mixed infestation showed statistically significant variation between seasons (OR=2.21, 95%, CI=1.539-3.178), housing in kitchen (OR=3.33,95%, CI=2.0228-5.486) and main house (OR=3.19, 95%, CI=1.910-5.304); age group of birds. The odds of ectoparasites infestation were 3.42 and 7.57 times higher for chick and adults compared with the growers. The current study indicated high prevalence of ectoparasites in backyard poultry management system in the study area. E.gallinacea was found to be the most prevalent ectoparasites identified followed by A. persicus . Designing and implementation of appropriate ectoparasite control measures seems mandatory in order to mitigate economical losses due to ectoparasite infestation. Keywords: Backyard; Ectoparasites; Poultry; Prevalence; Sehart-samre
Vascular Events During Follow-up in Patients With Aortic Arch Atherosclerosis

Background and Purpose An association between aortic arch atherosclerosis and vascular events has been demonstrated. However, few data exist regarding follow-up evaluation of this disease. Methods In this study, 183 patients with the diagnosis of aortic arch atherosclerosis were prospectively followed up. This diagnosis was made during an echocardiographic cross-sectional study. In 136 patients, raised plaques with thickness <5 mm had been shown to exist, and in 47 patients complex plaques with thickness ≥5 mm or plaques with mobile components had been demonstrated on the initial transesophageal echocardiography. Results During a mean follow-up period of 16±7 months, vascular events with a presumed embolic origin occurred in 15 patients. The incidence was 4.1 per 100 person-years in patients with raised plaques compared with 13.7 per 100 person-years in the group with complex plaques. The Kaplan-Meier survival analysis revealed a significantly higher rate of vascular events in patients who were found to h.
The Interaction Between the Expression of Proliferative Biomarkers and Clinical Characteristics in Breast Cancer

Introduction: Proliferation of cancer cells and the potential of metastasis depend on the activity of different biomarkers such as proliferative ones. Proliferative biomarkers including ki-67, cyclin E1, cyclin D1, p27, and p21 were analyzed through immunohistochemistry (IHC) in previous studies. Methods: The current study aimed at investigating the utilizing role of RT-PCR in studying proliferative biomarkers including Ki-67, Cyclin E1, Cyclin D1, P27, and P21 to figure out the association between proliferative biomarkers and clinical aspects in patients with early breast cancer. One hundred and twenty-three patients with primary breast cancer were entered in the current study. Patients’ clinicopathological characteristics were obtained and also expressions of the proliferative biomarkers were investigated through RT-PCR on both cancerous and normal adjacent breast tissue. Results: It was observed that in contrast to Cyclin D and P27 , expression of Ki-67, Cyclin E, and P21 were higher in tumor samples compared with normal adjacent tissue. In addition, Cyclin D was higher in ER/PR positive and HER2 negative tumors and it was also higher in greater tumor size. Similarly, Cyclin E expression was higher in greater tumor size. Furthermore, patients with higher expression of P27 experienced worse prognosis. Conclusions: Studying the proliferative biomarkers via a quantitative and automated method in Iranian patients showed that proliferative biomarkers had correlations with clinical aspects. Further studies to analyze the clinical utility of proliferative biomarkers in greater populations are warranted.
Tyrosine Kinase Inhibitor–Induced Pulmonary Arterial Hypertension

The treatment of the malignant hematological diseases has been revolutionized by the use of tyrosine kinase inhibitors (TKI): for example, imatinib in patients with chronic myeloid leukemia. Dasatinib, a second-generation TKI, has been reported to induce severe pulmonary arterial hypertension (PAH). The mechanism of PAH development is presumed to be endothelial cell toxicity through the production of mitochondrial reactive oxygen species. There are other TKIs that are reported to cause PAH, such as: ponatinib, bosutinib, lapatinib, and lorlatinib. The management of PAH due to TKIs primarily involves stopping the TKI treatment, which can lead to clinical and hemodynamic normalization. A third of the patients who develop PAH can have persistent symptoms of dyspnea and right heart failure even after the interruption of the TKIs. For these patients, use of specific PAH treatment is indicated along with close follow-up. In rare cases, TKI-induced PAH can be fatal. Thus, early screening for PAH diagnosis and pr.
Caregivers knowledge of pneumonia and uptake of vaccination in under-five children in Kaduna State, Nigeria

Pneumonia, though very much a preventable disease, still remains a tangible threat to the lives of under-5 children. Caregivers’ knowledge of pneumonia is important in effective management. The study determined the reported proportion of childhood pneumonia in Kaduna State and assessed caregivers’ knowledge of pneumonia and uptake of pneumococcal vaccine among under-5 children. The mixed method research approach used 500 caregivers of under-five children in urban and rural communities in Kaduna state. Ethical approval and informed consent of participants was obtained before data collection using a pre-tested semistructured questionnaire and a focus group discussion guide. Chi-square statistical test was used to test for association between variables, while data from the focus group discussion was analyzed using thematic coding process. Most respondents were aware of pneumonia, they had local names for it but majority 340 (68%) had poor knowledge of pneumonia. The overall occurrence of pneumonia as reported by respondents among under-five children was 33 (6.6%). The rate of child pneumococcal vaccine uptake as reported by respondents was 105 (21%), the uptake was significantly more among the urban dwellers (p<0.01). The knowledge of pneumonia and uptake of pneumococcal vaccination was poor. Routine and constant health education of the community members on pneumonia is very necessary to preserve lives of under-5 children in our communities. Journal of Medical and Biomedical Sciences (2018) 7(1), 40 - 48
The role of mental health nurses in supporting young people’s mental health: a review of the literature

Purpose Adolescent mental health issues are on the increase, in particular depression, which is now a major public health concern globally. Mental health education is important and young people’s awareness of mental health is potentially limited. This is one factor that creates barriers to seeking support. School nurses and educational professionals recognise that they do not necessarily have the required skill base to support emotional health concerns with young people. The purpose of this paper is to synthesise qualitative evidence related to the nurse’s role in supporting adolescents. Design/methodology/approach A literature review using a systematic approach was undertaken, predominantly through collection of primary qualitative research studies. In total, 22 published studies are included in this review, extracted from four databases – CINAHL, Embase, Medline and Scopus. Findings This review shows that awareness of mental health is needed early in adolescence, while at school, to encourage young people to access support and have knowledge of their own emotional health. The need for further mental health education and provision is asserted. Practical implications Young people benefit from someone who is accessible and familiar to them in schools so that they can access emotional support as and when needed. Careful involvement of families (including extended families) is noted. It is proposed that this role should be a mental health nurse role, who should be accessible within the school environment. Originality/value This paper is original and adds to existing knowledge that mental health challenges are increasing, and more needs to be done in schools to promote mental health and reduce the stigma associated with seeking support.
Genetics is sometimes the Enemy of Parents in the Context of Mental Health Services

The field of genetic epidemiology includes three sets of studies: family, twin, and adoption studies. This commentary argues that findings from these studies are sometimes used to blame parents for the development of developmental disabilities, emotional problems, or problem behaviors in their children. For this reason, this paper concludes that genetics as explanations of psychopathology among children is sometimes the enemy of parents and those parents should avoid mental health practitioners who emphasize genetics in the explanation of why children develop such psychopathology.
The neoantigen landscape underlying clinical response to ipilimumab.

3003 Background: Ipilimumab, an antibody against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), prolongs overall survival and can produce durable tumor regression in patients with advanced melanoma. Ipilimumab activates cytotoxic T-lymphocytes and enables them to destroy tumor cells. However, the molecular determinants of response to ipilimumab are unknown. Methods: Fresh frozen tumor DNA (and matching blood) from 25 melanoma patients treated with ipilimumab was subjected to whole exome sequencing. Exon capture was performed using the SureSelect Human All Exon 50MB kit (Agilent). Enriched exome libraries were sequenced on the HiSeq 2000 platform (Illumina) to a mean coverage of 103X. Somatic mutations and candidate somatic neoantigens generated from these mutations were identified and characterized. Results: Our cohort included complete responders (CR) and nonresponders (NR). Mutational burden ranged from 1-1121 mutations per tumor. Mutational load was significantly associated with clinical respons.