Miracle-dz/UniFAR-FTUs huggingface dataset:
Frailty In Patients Undergoing Vascular Surgery: A Narrative Review Of Current Evidence

Abstract Frailty is presumably associated with an elevated risk of postoperative mortality and adverse outcome in vascular surgery patients. The aim of our review was to identify possible methods for risk assessment and prehabilitation in order to improve recovery and postoperative outcome. The literature search was performed via PubMed, Embase, OvidSP, and the Cochrane Library. We collected papers published in peer-reviewed journals between 2001 and 2018. The selection criterion was the relationship between vascular surgery, frailty and postoperative outcome or mortality. A total number of 52 publications were included. Frailty increases the risk of non-home discharge independently of presence or absence of postoperative complications and it is related to a higher 30-day mortality and major morbidity. The modified Frailty Index showed significant association with elevated risk for post-interventional stroke, myocardial infarction, prolonged in-hospital stays and higher readmission rates. When adjusted for comorbidity and surgery type, frailty seems to impact medium-term survival (within 2 years). Preoperative physical exercising, avoidance of hypalbuminemia, psychological and cognitive training, maintenance of muscle strength, adequate perioperative nutrition, and management of smoking behaviours are leading to a reduced length of stay and a decreased incidence of readmission rate, thus improving the effectiveness of early rehabilitation. Pre-frailty is a dynamically changing state of the patient, capable of deteriorating or improving over time. With goal-directed preoperative interventions, the decline can be prevented.
Normal Brain Glucose Metabolism of a One Year Infant - Case Report

Results: During the baseline scan, frontal cortex showed comparatively greater SUVs when compared to other cortical and subcortical regions. During the follow-up scan, an increase in SUVs were seen in all regions. When the brain FDG-PET was visually accessed during the baseline maximum FDG uptake was seen in bilateral middle frontal cortex and occipital cortex. During the follow-up scan frontal cortex, posterior cingulate cortex, basal ganglia and occipital cortex showed maximum FDG uptake, this was followed by thalamus, anterior cingulate cortex, parietal cortex and cerebellum. Medial temporal cortex showed the lowest FDG uptake among the other regions of the brain.
Probiotic Frozen Yogurt

Recent trends show that consumers have been searching for functional foods to improve bodily functions and overall health. The purpose was to develop new formulations of frozen yogurt, a food product widely accepted among health conscious consumers, by adding probiotics (Lactobacillus spp.). The developed frozen yogurt formulae were as follows: Formula 1 with no probiotics, Formula 2 containing 3%w/w of probiotics, and Formula 3 containing 4%w/w of probiotics. The survival rate of probiotics in Formula 2 and Formula 3 at Day 30 was 33.89% and 26.67%, respectively. Sensory evaluation was carried out among 60 panelists, using the 9-point hedonic scale method for food acceptance. According to Analysis of Variance, the mean scores of these three formulae were not significantly different (p > 0.05). Formula 1, 2, and 3 obtained the mean score of 7.25 (“like moderately” to “like very much”), 6.97 (“like slightly” to “like moderately”), and 7.27 (“like moderately” to “like very much”), respectively. Keyword: Frozen yogurt, Probiotics, Survival rate
Predictors of Direct-Acting Antivirals Failure in Patients with Chronic Hepatitis C Virus in Ivory Coast: About 5 Cases

Context and Aim: Direct-acting antivirals are the therapeutic revolution in the management of viral hepatitis C, but often with a few cases of failure. The aim of this study was to identify factors that may be implicated in the failure of direct-acting antiviral therapy in patients with hepatitis C virus in Ivory Coast. Methodology: This was a cross-sectional and descriptive study with a retrospective compendium of data from the year 2016 to the year 2018. This study included all patients with chronic viral hepatitis C, patients naive to antiviral treatment, or pre-treated patients in whom a failure to treatment with direct-acting antiviral has been diagnosed. Results: During the study period, 5 patients out of 14 cases of therapeutic failure were included, i.e. 35.71%. Most of the patients were over 50 years (4 out of 5) and predominantly female (3 out of 5). High blood pressure was the most common comorbidity (3 out of 5 patients). Genotype 1 was found in 4 patients versus 1 case of genotype 2. None of the patients had hepatitis B or HIV coinfection. A viral load > 6log was found in 4 patients at baseline. All our patients had hepatic cytolysis. Two of them were cirrhotic. All 4 cases of genotype 1 benefited from the combination sofosbuvir + ledipasvir for 12 weeks and the case of genotype 2 from the combination sofosbuvir + ribavirin for 24 weeks. The resistance mutations were observed mainly on the sequencing of NS5A at the Y93H, L31M, 28L, 30T, 31V, 58S and 93H genes and a case of mutation on the N3 gene sequencing. Conclusion: Age > 50 years, comorbidities (high blood pressure), polymedication, female gender, genotype 1b, viremia > 6log, and cytolysis were the profile of patients with treatment of HCV by direct-acting antiviral failure.
Methods of reducing milk replacer to prepare dairy calves for weaning when large amounts of milk replacer have been fed

ABSTRACT Abrupt weaning of calves fed over 0.7 kg DM of milk or milk replacer (MR) has reduced ADG in calves by depressing starter intake in numerous trials and laboratories. We compared different gradual weaning programs in two 56-d trials. In trial 1, a 27% CP, 17% fat MR fed at 0.66 kg DM/d for 42 d (LO) was compared with the same MR fed at 0.88 kg/d for 21 d and reduced 0.66 kg/d for 21 d before weaning (HI) and a 22% CP, 27% fat MR fed at 0.79 kg/d for 21 d and changed to the 27% CP, 17% fat MR fed at 0.66 kg/d for 21 d before weaning (HIFAT). Calves fed HI had greater ADG and similar starter intake compared with calves fed LO, whereas calves fed HIFAT had lower starter intake and ADG compared with calves fed LO. In trial 2, a 27% CP, 17% fat MR was fed at 0.66 kg DM/d for 42 d (LO), fed at 0.96 kg/d for 21 d and reduced to 0.66 kg/d before weaning over 21 d (HI), and fed at 0.96 kg/d for 28 d and more gradually reduced compared with HI over 14 d before weaning (HIGRAD). Calves fed both HI and HIGRAD had greater ADG and similar starter intake to calves fed LO. Weaning calves over 14 to 21 d that had been fed MR at 0.88 kg DM or more did not result in reductions in ADG and starter intake.
Effects of school-based point-of-testing counselling on health status variables among rural adolescents

Objective: Rural areas may suffer from a lack of access to health care and programmes to promote behaviours such as healthy eating and physical activity. Point-of-testing counselling is a method of promoting a healthy lifestyle during an individual’s most ‘teachable moment’. Design/Setting: This longitudinal study examined the effects of school-based nutrition education and point-of-testing counselling on nutrition knowledge, weight, blood lipid profile and blood pressure over a 3-year period (2005–2008) among junior high and high school students from a rural community in the Southern USA. Methods: Screening for health variables, followed by point-of-testing counselling sessions, was offered every 6 months, along with nutrition education once a week for 12 weeks. Statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS). T-tests and analysis of variance (ANOVA) were conducted to analyse changes in health outcomes over the course of the study. Results: A total of 233 rural students participated in this longitudinal community-based study. Students who attended at least four sessions (n = 52) were analysed for changes in health outcomes. High-density lipoprotein levels significantly increased between the second and fourth visits. Attending the intervention at least four times stabilised or improved blood values and anthropometric measurements. Significant nutrition knowledge increases were documented among 7th and 8th graders; 6th, 9th and 10th graders also showed modest improvements. Conclusion: Using point-of-testing counselling may be an effective strategy in delaying or preventing the onset of risk factors for obesity and related chronic diseases during adolescence.
Testing Visual Acuity of Young Children: An Evidence-based Guide for Optometrists

The principal reason for optometrists providing eye examinations for children in primary care is to identify those whose visual development is not following normal patterns. The hope is to identify children who require spectacle correction, or who have developed, or are at risk of developing, amblyopia or strabismus. While it is also important to detect pathology and other less common visual deficits or anomalies, the most common visual deficits accessible to treatment or amelioration are amblyopia, strabismus and uncorrected refractive error. Our aim is that children are not disadvantaged by poor vision due to uncorrected refractive error and, where necessary, that they receive early and effective treatment for binocular problems and amblyopia.
SURVEILLANCE OF HOSPITAL ACQUIRED INFECTION IN SURGICAL WARDS IN TERTIARY CARE CENTRE AHMEDABAD, GUJARAT

Present study was undertaken to know the rate of Hospital acquired infection in general surgical wards with special reference to surgical site infections with their antibiotic resistance pattern and to find out the source of the infection to develop preventive measures to reduce the risk of hospital acquired infection. Prospective surveillance for hospital acquired infections was performed during period from January 2006 to June 2006 in the wards of general surgery. One day prevalence study was carried out to find out rate of various hospital acquired infections. Incidence rate for Surgical Site Infection (SSI) found out by monitoring all operated cases throughout their stay, and after discharge. All surgical operation theatres were studied in detail to find out various physical parameters, policies and procedures, various cleaning procedures and fumigation. Over all prevalence rate of hospital acquired infections in surgical wards was about 21.9% comprising of 10.9% for SSI, 8% for local blood stream infection (i.e. thrombophlebitis) 2% for urinary tract infection (UTI) and 1% for the other infection (like bed sore). Incidence rate of surgical site infections was 12.72 %. Klebsiella spp. was the most common isolate responsible for SSI. The prevalence of HAI and incidence of SSI in our hospital has encouraged the development of recommendations for prevention of such infections in our hospital.
Refrigerated Shelf Life of Fresh Boneless, Skinless Broiler Thigh Meat

Two similar trials were conducted to evaluate the effects of treating boneless, skinless thigh meat with Cetylpyridinium Chloride (CPC), trade named Cecure , on refrigerated (2.5°C) shelf life. In Trial 1, 0.0 ® (tap water control), 0.5, 1.0 and 1.5% Cecure treatments were evaluated. In Trial 2, a non-sprayed control, ® a tap water control and 0.4, 0.5 and 1.0% Cecure were evaluated. Cecure was applied using a hand-held ® ® spray bottle and applying 7 mL of solution per thigh (3.5 mL/side). In Trial 1, the 0.5% Cecure solution ® resulted in a 1 day extension in shelflife; both the 1.0 and the 1.5% Cecure treatments resulted in a 2 day ® extension in shelf life. In Trial 2, both the 0.4 and 0.5% Cecure treatments resulted in a 1 day extension in ® shelflife; the 1.0% Cecure treatment resulted in a 2 day extension in shelf life. The combined data from the ® two trials suggest that the extension in shelf life observed in these trials was due to the initial reduction (1 to 2 logs) in Aerobic Plate Count (APC) on the day of treatment. The Cecure treatments did not result in any ®
Incidence of Early Post Operative Infection after Primary Total Knee Arthroplasty at an East African Centre

Introduction: Surgical site infections (SSI) may occur after orthopedic surgery and are associated with increased costs, more surgical procedures and death. Various techniques have been developed to reduce this risk. Operation theatres in Africa are not as sophisticated as those in the west and one may expect higher rates of infection after primary Total Knee Replacement Arthroplasties (TKRA). We conducted a study to determine the incidence and risk factors for the development of post operative SSI after primary TKRA at a hospital in Africa over a fourteen year period. Methodology: A retrospective cohort study was conducted of all TKRA patients. The incidence of infection was determined for the first thirty days after surgery. The study was approved by the institution ethics committee. Results: The incidence of early postoperative SSI was 6.49%. We did not identify any risk factors for the development of SSI. Conclusion: There may be an increased risk of early SSI after primary TKRA in our region. Larger studies are needed to identify the modifiable risks factors. Keywords: Total Knee Replacement Arthroplasty, Infection, East Africa
The Effectiveness of Micro-osteoperforations during Canine Retraction: A Three-dimensional Randomized Clinical Trial

Aim: A major challenge in orthodontics is decreasing treatment time without compromising treatment outcome. The purpose of this split-mouth trial was to evaluate micro-osteoperforations (MOPs) in accelerating orthodontic tooth movement. Materials and Methods: Eight patients of both genders were selected, age ranging between 15 and 40 years, with Class II Division 1 malocclusion. The participants in this trial with MOPs were randomly allocated to either the right or the left side, distal to the maxillary canine. First maxillary premolars were extracted as part of the treatment plan on both sides and then canine retraction was applied. Miniscrews were used to support anchorage. MOP side received (three small perforations) placed on the buccal bone, distal to the maxillary canine, on randomly selected side using an automated mini-implant driver and the other side was the control side. Blinding was used at the data collection and analysis stages. The primary outcome was the rate of canine retraction measured with a three-dimensional (3D) digital model from the baseline to the first 2 weeks superimposed at the rugae area from the baseline to the first, second, and third months. The following secondary outcomes were examined: anchorage loss, canine tipping, canine rotation, root resorption, plaque index, and gingival index. Pain level, pain interference with the patients’ daily life, patients’ satisfaction with the procedure and degree of ease, willingness to repeat the procedure, and recommendation to others were also evaluated. Results: No statistically significant difference was observed in the rates of tooth movement between the MOP and the control sides at all-time points (first month: P = 0.77; mean difference, 0.2 mm; 95% CI, −0.13, 0.18 mm; second month: P = 0.50; mean difference, −0.08 mm; 95% CI, −0.33, 0.16 mm; third month: P = 0.76; mean difference, −0.05 mm; 95% CI, −0.40, 0.29 mm). There were also no differences in anchorage loss, rotation, tipping, root resorption, plaque index, periodontal index, and pain perception between the MOP and control sides at any time point (P > 0.05). MOPs had no effect on the patients’ daily life except for a feeling of swelling on the first day (P = 0.05). Level of satisfaction and degree of easiness of the procedure were high. Conclusion: According to our clinical trial, MOPs cannot help in speeding up a canine retraction.
Evaluation of the antioxidant properties and oxidative stability of Pecorino cheese made from the raw milk of ewes fed Rosmarinus officinalis L. leaves

Summary The aim of this work was to study the effect of rosemary leaf dietary supplementation on the antioxidant activities and total phenolic content of Pecorino cheese. Three hundred and twenty-four sheep were randomly assigned to two dietary groups, which received a standard diet based on lucerne hay and concentrate (400 g per day). The concentrate of the rosemary supplemented group contained 2.50% dried rosemary leaves. The trial lasted 7 weeks. Cheesemaking was performed 3, 5 and 7 weeks from the start of the trial. The Pecorino cheese antioxidant activity was modified by the diet. Rosemary supplementation increased the total phenolic content, enhanced the antioxidant properties and decreased the lipid oxidation of cheese. A slight decrease in flavour was detected in cheeses after 7 weeks of rosemary administration.
Adolescent Obesity: its correlates and associated morbidity

Obesity is currently one of the major public health problems, in both developed and developing countries. Obesity is a risk factor for metabolic syndrome. Increasing rates of childhood obesity and more sedentary lifestyles has led to an age shift in metabolic syndrome which now occurs at an earlier age. Thus, the present study was conducted to get an idea about the occurrence of obesity among adolescent school children, risk factors associated with the condition and the related morbidity among them. MATERIALS AND METHODS: A cross-sectional descriptive study carried out in two higher secondary government girl schools with the help of a pre- designed and pre-tested questionnaire. RESULTS: Out of 245 students 16.73% were overweight and 6.54% were obese. Among overweight students, 59.65% exercised less than 4 hours a week, 61.4% watched TV ≥ 4 hours per week, 87.72% consumed junk food ≥ 4 days per week and 45.61% skipped meals. Puberty related menstrual irregularities, hypothyroidism, acne and stria were more commonly found in overweight students CONCLUSION: The rapidly increasing prevalence of obesity accompanied by unhealthy lifestyle habits among adolescents is one of the most challenging dilemmas of public health importance.
Evaluation of Knowledge And Perception Of Malaysian Health Professionals About Telemedicine

Background: Incorporation of Information Technology (IT) advancements in healthcare has been growing in the recent past. There is convincing evidence that developing countries can also benefit from telemedicine and other IT applications in healthcare. The Malaysian government, in mid-1996, launched the multimedia supercorridor (MSC) project. As a new medical technology in the country, it takes a huge effort to make professionals understand this new concept. Objectives : To evaluate the readiness of healthcare professionals in the country in accepting and providing telemedicine services and to access levels of perception and opinion towards telemedicine, and to access knowledge factors in relation to telemedicine. Materials and Methods : A cross sectional survey was carried out among various healthcare professionals using a proper sampling frame obtained from a list of health care providers in all state Department of Health in the country. The study questionnaire consists of 3 main parts; background and demograph y, perceptions and acceptance and knowledge level. The questionnaires were mailed to the respondents and the completed questionnaires were analyzed as per the study objectives. Results: The total response rate in this study was 32.48% (369/1136). On average, the respondents were young and with 10 years of experience.The majority of the respondents mentioned that computers are important for them for internet use (84%) and using software packages (83%). Only 31% wish to accept the reduction of face-toface communication with patients and other health professionals. Majority of respondents have used CD ROMs (82%), e-mail (84%) and modem (76%), while more than three quarters of the respondents have no experience with using smart cards, computer assisted learning (CAL), teleradiology, telesurgery, telenursing and telepharmacy, respectively. Conclusion: The majority of respondents mentioned that their computers are important for them for internet use and using software packages. Nearly half of the respondents felt that computers are important for their profession. Most respondents have used CD ROMs and e-mail facilities. In general, the respondents have a low inclination towards working in rural areas for a telemedicine project.
Nosocomial infections and antibiotic resistance in a tertiary university hospital pediatric intensive care unit

Aim: Nosocomial infections (NI) cause failed treatments and long hospitalization periods in pediatric intensive care units (PICUs), leading to severe rates of mortality, morbidity and high hospitalization costs. This study intends to offer a retrospective review of the types of NI, active pathogens as well as antibiotic resistance profiles of inpatients followed up and treated in the PICU of a tertiary university hospital. Material and Methods: In this study, in-patients who were treated in an intensive care unit between January 2014 and June 2018 were evaluated retrospectively. Patients’ data were obtained from the Infection Control Committee database. Based on this data, the rate of NIs, the distribution of NIs by the systems, the invasive device-related infection rate, the infectious agents and the antibiotic resistance of these agents at the PICU were determined within the specified time-frame. Results: In this study, 536 patients receiving treatment at a PICU between January 2014 and June 2018 were examined. A NI episode developed in 69 (12.6%) of these patients. The NI rate was 12.87/100 applications. The mean hospitalization length of stay of the patients was 17.65 days. Bloodstream infections due to the use of central venous catheters were the most common form of NI. In this study, of all the NI agents, Gram (-) microorganisms were isolated the most. The most commonly isolated microorganism was Acinetobacter baumannii (A. baumannii). The rate of carbapenem resistant A. baumannii was 85%. Conclusion: In PICUs, surveillance measures for infection control and rational use of antibiotics are important in terms of preventing high mortality and morbidity rates and hospitalization costs due to resistant microorganisms.
A Study of Prevalence of Metabolic Syndrome in Patients of Psoriasis of North India.

Aim: To assess the prevalence of Metabolic Syndrome in patients of psoriasis and its relation with disease severity. Materials and Methods: The study was cross sectional and hospital based. It was conducted on one hundred psoriasis patients of psoriasis between 18 to 70 years of age and of either sex. The severity of disease was assessed using PASI and BSA involved. Metabolic syndrome was diagnosed on the basis of South Asian Modified National Cholesterol Education Program’s Adult Treatment Panel III. Results: The overall prevalence of MS in our study was 42%, which is nearly three times as compared with the prevalence of MS in general population. Presence of MS did not have any association with the severity of psoriasis as assessed by PASI and BSA involvement. Overall disturbances in lipid profile (31% and 29% were having high TG level and low HDL level respectively) and abdominal obesity (30%) were the most important factors contributing to increased prevalence of MS. These were followed by increased BP(26%) and high FPG level (23%). Conclusion: Due to increased prevalence of MS in psoriasis, dermatologists should go for simple Original Research Article
The Empty Chair Appointment

The objective was to test an intervention to reduce failed rates for psychiatric appointments. We collected data for this study of the characteristics of patients who missed appointments from March 2011 through September 2012. A phone triage assessment intervention was implemented to address chronic first-time failed attendance appointments (N = 78). The main reason for failed appointments was transportation difficulties. The first-time appointment show rate increased after implementing an assessment intervention. Phone assessment intervention was practical and may improve nonattendance for psychiatric appointments. The discussion reflects speculations about causes and possible measures to make services more accessible.