Miracle-dz/UniFAR-FTUs huggingface dataset:
A 5-year review of measles cases admitted into the emergency paediatric unit of a tertiary hospital in Sokoto, North-Western Nigeria

Background: Measles is a vaccine preventable viral infection which is still responsible for significantly high morbidity and mortality in Sub-Saharan Africa. Failure of routine immunization programs heralds a dismal outlook for this potentially eradicable viral infection. The objective of this study was to determine the hospital prevalence, vaccination status, pattern of complications, and outcome of children admitted with measles into the Department of Pediatrics of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Materials and Methods: This was a 5-year retrospective study from January 1, 2011 to December 31, 2015. Case folders of children below 15 years who were admitted with measles were retrieved, relevant information extracted, and entered into a pro forma. Data was analyzed using SPSS version 22. Results: Total admissions were 6104, out of which 204 were due to measles (prevalence, 3.3%). The mean age was 27.4 ± 18.9 months (range 6–96 months). Those aged 1–5 years were 144 (70.6%). The male-to-female ratio was 1.3:1. Only 28 patients (13.7%) had measles vaccination. Observed complications included bronchopneumonia in 168 (82.4%), acute laryngotracheobronchitis in 24 (11.8%), febrile convulsion in 20 (9.8%), encephalitis in 17 (8.3%), ocular complications in 12 (5.9%), and suppurative otitis media in 6 (2.9%) patients. The presence of complications was related to age <5 years (P = 0.0001) but not to vaccination status (P = 0.41). Forty-four patients died (21.6%), whereas 33 patients (16.2%) had residual problems at discharge. Outcome was related to vaccination status (P < 0.05). Conclusion: Measles is still a significant problem in the study area and it is associated with high morbidity and mortality. More efforts at prevention is necessary.
Human kidney injury molecule-1 and interleukin-18 as predictive markers of nephrotoxicity in acute organophosphorus poisoned patients in Zagazig University hospitals

Organophosphorus (OP) poisoning is a major common cause of mortality and morbidity in most countries. Some clinical cases developed renal injury after acute OP poisoning. The aim of our study is to evaluate the levels of kidney injury molecule-1(KIM-1) and interleukin -18(IL-18) in acute OP poisoned patients as early predictors of OP induced nephrotoxicity. Over a period of one year, the observational cross sectional study was conducted at the Poison Control Center, Zagazig University hospitals, Zagazig, Egypt. The study group consisted of 95 patients who fulfilled the inclusion criteria; the patients were categorized according to Peradeniya organophosphorus poisoning (POP) scale. The serum pseudocholine esterase enzyme (PChE), serum creatinine, urinary KIM-1 and IL-18 were assayed at 0, 12, 24 and 48 h after admission. There were progressive increases in the mean values of KIM-1 and IL-18 at different time intervals especially in severe poisoned patients compared to the increased levels of serum creatinine. The cutoff values of urinary KIM-1 and IL-18 that determined patients with potential AKI were 2.8 ng/ml creatinine (86.9% sensitivity, 94.6% specificity and 0.859% area under curve) and 59 pg/dl creatinine (90% sensitivity, 92% specificity and 0.946& area under curve), respectively. A positive correlation was observed between KIM-1 and IL-18 and serum creatinine. Moreover, KIM-1 is positively correlated with IL- 18. Urinary KIM-1 and IL-18 may be considered as valid markers for prediction of acute kidney injury among acute OP poisoned patients. Key words: Organophosphorus poisoning, IL-18, KIM-1, acute kidney injury.
Assessment of Skin Manifestations in End-Stage Renal Disease Patients Undergoing Hemodialysis in Shahid Beheshti Hospital of Abadan and Vali-e-Asr Hospital of Khorramshahr

Background: The prevalence of skin manifestations in hemodialysis patients is increasing. Objectives: The aim of this study was to evaluate skin manifestations in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Methods: In this descriptive-analytical study, 100 patients undergoing hemodialysis from among 120 patients referring to Shahid Beheshti Hospital of Abadan and Vali-e-Asr Hospital of Khorramshahr were assessed. A demographic questionnaire and a checklist about skin disorders were used for data collection. The data were analyzed by SPSS version 16 software using descriptive and analytical statistics. Results: The most common skin findings were pale skin (87%), dry skin (71%), hyperpigmentation (46%), and purpura (35%). Among nail manifestations, the most common finding was a half-and-half nail (50%) and the rarest symptom was dystrophy (1%). Conclusions: The results of this study indicated that ESRD was associated with multiple skin symptoms, the most prevalent of which were pale skin and dry skin symptoms. Therefore, early diagnosis of these problems is a major step in improving the quality of life of these patients.
A clinicopathological study of cheek carcinoma and different types of reconstructive procedure for its treatment in a tertiary care centre in India

Background: The incidence of oral cancer varies globally and regionally and is closely linked with geographical, social, economical, biological, ethnic, dietary and environmental factors. In India, buccal mucosa (cheek) is the most common site for the lesion having 50% of all the oral cavity cancers and the incidence of oral cancers is about 10.6 % of all cancers. The aim of the study was to study the mucosal lesions with regard to mode of presentation, aetiopathology, histopathological aspects, various surgical modalities.Methods: The prospective observational and descriptive tertiary care institute based case study was undertaken at Medical College, Kolkata. A total of 30 patients were included in the study.Results: Maximum number of patients was in the 51-60 yr age group and the male: female sex ratio was 7:3. The maximum risk factors were found to be smoking and tobacco. 16.67% patients had premalignant lesions namely leucoplakia whereas 73.33% of the patients presented with oral ulcers as the chief complaint. Most of the patients presented in the late stage. Squamous cell carcinoma was the most common histological type. Out of 30 patients, 6 underwent wide local excision only and the rest underwent neck dissection. Mandibulectomy was done in 14 patients, Pectoralis major myocutaneous flap was the most common reconstructive procedure used (43.33%). Conclusions: Cancer of the oral cavity accounts for a high incidence in our country due to our social habits. In spite of easy accessibility to early lesion, the number of locally advanced lesion is very high. This can be prevented by creating health awareness.
Spectrum of Bone Lesions at Pakistan Institute of Medical Sciences

Objective: To study demographic details of bone lesions diagnosed at Pakistan Institute of Medical Sciences (PIMS), Islamabad Patients and Methods: A retrospective analysis of histopathology reports of 222 patients diagnosed to have various types of bone lesion, in the department of pathology at Pakistan Institute of Medical Sciences, Islamabad during a period of five years (July 2005- June 2010) was conducted. These biopsies were evaluated on hematoxylin and eosin (H&E) stained sections from paraffin embedded tissue blocks. Special stains performed whenever required. Results: Pyogenic osteomyelitis comprised 43.6% of all bone pathologies, followed by granulomatous most probably tuberculous osteomyelitis in 7.6%. Chronic osteomyelitis was more commonly observed in 20-30 years of age group and males were affected more as compared to females. The commonest age group for benign lesion was 11-20 years. Primary malignant tumors were noted in 4.9% cases and metastatic tumors were seen in 14.4%. The commonest age group for metastatic tumors was more than 50 years of age. Males were affected more as compared to females in overall bone lesions. Femur was the commonest site in primary bone lesions. Jaw bones and scalp were more commonly involved metastatic tumors. Conclusions: Metastatic tumors were more common than primary malignancies. Scalp and mandible involvement was seen in metastatic tumors and bones of lower limbs were more commonly involved in primary bone lesions. Males were more commonly affected than females in this study.
Primary Ankle Arthrodesis vs ORIF for Severely Comminuted Pilon Fractures

Background: The treatment for highly comminuted pilon fractures remains controversial. The goal of this retrospective cohort study was to compare functional outcomes of primary arthrodesis of the tibiotalar joint (fusion) and open reduction internal fixation (ORIF). Methods: Patients who underwent primary ORIF or fusion for pilon fractures at our institution since 2000 were identified by Current Procedural Terminology (CPT) code. Inclusion criteria for the ORIF cohort were patients with an AO/Orthopaedic Trauma Association type C3 pilon fracture. Additional inclusion criteria for the fusion cohort were patients whose fractures were deemed non-reconstructable by the treating surgeon. Outcome assessment was determined by the Foot and Ankle Outcome Score (FAOS) and Short Form 36-item health survey (SF-36), time to radiographic union or fusion, and wound-healing complications at a minimum of 2 years after their surgery. Results: Nineteen ORIF and 16 fusion patients completed the study’s outcome assessments. A higher rate of nonunion was observed in patients treated by primary ORIF than primary fusion (5/19 vs 1/16). Posttraumatic arthritis was observed in 11 of 19 primary ORIF patients. Primary fusion patients exhibited increased symptoms, pain, and physical role limits but were equivalent to primary ORIF patients on all other functional metrics examined. Conclusions: Primary ankle arthrodesis achieves a lower rate of nonunion and comparable functional outcomes to ORIF in patients with severely comminuted pilon fractures. The higher rate of nonunion observed in the primary ORIF group suggests that primary fusion should be considered an effective procedure for severe injuries to decrease the need for further operative intervention. Level of Evidence: Therapeutic Level III, retrospective cohort.
Effects of Foot Strengthening Exercises and Functional Insole on Range of Motion and Foot Plantar Pressure in Elderly Women

Objective: The purpose of this study was to investigate the effect of foot strengthening exercise program and functional insoles on joint angle and plantar pressure in elderly women. Thirteen elderly women who were enrolled in a university senior citizens academy of a metropolitan city in 2017 were divided into two groups: exercise group with functional insole (n=7) and exercise group without functional insole (n=6). Method: Three-dimensional motion analysis and Pedar-X were performed to compute the joint angle and the foot plantar pressure, respectively. Two-way repeated measure ANOVA was conducted to compare dependent variables within and between groups. The significance level was set at α =. 05. Results: The range of motion (ROM) of the ankle, knee, and hip joints in the exercise group with functional insole increased significantly more than the exercise group without functional insole. In both the experimental group and the comparison group, the maximum foot plantar pressure and the mean foot plantar pressure were decreased, but the comparison group without functional insole showed more decrease. Since the experimental group demonstrated greater pressure than the comparison group in the contact area (forefoot, midfoot), it was distributed over a greater area. Conclusion: The results of this study suggest that participation in foot strengthening exercises and using a functional insole has more positive effects than foot strengthening exercises alone on the joint angle and plantar pressure in elderly women. Increased foot plantar pressure led to an increased contact area (forefoot, midfoot) for distribution of the foot plantar pressure, but the effect of reducing the maximum and average plantar pressures was incomplete. However, wearing functional insoles along with exercise, could help in improving the stability of the joints, by increasing the range of motion, and could help the elderly in movement of the muscles more effectively, leading to an improvement in gait function.
Cytochrome P450 and inflammation : pharmacogenomic approach and molecular aspects of anti-inflammatory effects of theinopyridines

The main part of the thesis is devoted to pharmacogenetic approach to the anti-inflammatory effects of thienopyridine therapy. Taking into the account that activated platelets play a central role in the inflammatory responses and that CYP2C19 gain- and loss-of-function polymorphisms (*2 and *17) are sources of inter-individual difference in response to the anti-platelet effects of thienopyridines, we hypothesized that *2 and/or *17 alleles are also associated with inter-individual variability in the potential inflammation-reducing effects of thienopyridines. The following markers were used to test the hypothesis: CRP, haptoglobin and orosomucoid acid. To be reliably interpretable in daily medical practice, genetic status should be considered for partitioning the reference values of haptoglobin. In a small healthy population, no significant association was observed between *2 allele and changes in levels of inflammatory markers from baseline to 7 days after administration of clopidogrel and our findings did not support the notion that the genetic variations of CYP epoxygenases are associated with the level of inflammatory markers. Also, in post-PCI population consisting of 1128 on-clopidogrel or on-prasugrel patients, CRP levels were observed to be regulated with a significant interaction between smoking and CYP2C19 polymorphisms; this effect was independent to the level of platelet aggregation. Additionally, in a large population of 1000 on-clopidogrel patients, whether there is a potential interaction between clopidogrel and calcium channel blockers. Collectively, we demonstrated in this thesis that inflammatory markers might be alternative tools for the prediction of response to thienopyridines
An early infantile epileptic encephalopathy 19 with dyskinesias dueto a new GABRA1 gene mutation – identification of the first casein the Polish population

Background: Dominant, heterozygous mutations in the GABRA1 gene on chromosome 5q34 cause a heterogeneous, constantly growing group of neurological disorders. Aim: The aim of the study was to report on an individual with profound psychomotor retardation, extrapyramidal symptoms and epilepsy due to a new mutation in GABRA1 gene (c.799C>A). Material and Methods: The child with unremarkable family and perinatal history, fetal and perinatal primary microcephaly, delayed psychomotor development in a profound degree as well as with impaired global physical development and a failure to thrive. From the first months of life dyskinesias, bruxism, upward eye deviation and oropharyngeal movements were present. However, on sleep EEG generalized spike and wave discharges were present. Whole-exome sequencing (WES) was carried out in the proband. Results: WES results detected disease-causing novel mutation in the GABRA1 gene, the first case in the Polish population. Conclusions: Our observation expands the spectrum of syndromes of EIEE19 associated with GABRA1 gene mutations. This mutation (c.799 C>A) has not been described previously in the literature.
Influence of varieties and cutting schedules of perennial pasture grasses on soil fertility, nutrients content and uptake, productivity and economics in hot arid conditions of Rajasthan.

A field experiment was conducted during 2000–04 on coarse sandy soil having low fertility status to study the manipulation of soil fertility with leys, enhancing fodder productivity with improved varieties, cutting schedules and economics of fodder production. The study showed that soil organic carbon, pH, electrical conductivity and available NPK were not affected significantly either by perennial pastures [Cenchrus (Cenchrus ciliaris L.) or sewan (Lasiurus sindicus Henrard]. Different cutting schedules or their varieties, were improved noticeably over the years compared to their initial levels indicating a positive impact of these pasture grasses on soil fertility status. Nutrients contents in dry fodder of cenchrus and sewan were statistically similar but nitrogen content was significantly higher in half-yearly cutting than annual cutting. Among varieties ‘CAZRI 75’ of cenchrus and ‘CAZRI m 30–5’ of sewan were found containing significantly higher nitrogen compared to their respective other varieties. Nutrients (NPK) uptake was recorded significantly higher in sewan than cenchrus, in half yearly cutting than annual cutting than their respective other varieties. Dry fodder production was significantly higher by sewan (29.39 tonnes/ha) than cenchrus (25.69 tonnes/ha) on yearly as well as total basis. Half-yearly cutting schedule produced significantly higher dry fodder yield than annual cutting schedule during initial two years but reverse trend was observed in latter years and both were found statistically similar on total basis. Among varieties ‘CAZRI 75’ (29.62 tonnes/ha) of cenchrus and ‘CAZRI m 30-5’ (32.75 tonnes/ ha) of sewan gave significantly higher dry fodder yield compared to their respective other varieties on yearly and total basis. Higher gross and net returns were recorded in sewan grass than the cenchrus grass, half-yearly cutting schedule than annual cutting schedule, and in ‘CAZRI 75’ of cenchrus, and ‘CAZRI m 30-5’, of sewan.
Determining the Need for Repeat Testing of Blood Ethanol Concentration: Evaluation of the Synchron Blood Ethyl Alcohol Assay Kit

Summary Background In clinical laboratories, a common practice used to verify tests prior to reporting is repeat testing. Our objective was to evaluate the differences between the results of blood ethanol concentration (BEC) test repetitions and report on the role of repeat testing to prevent reporting of incorrect results. Methods We conducted a retrospective study of data retrieved from the Bursa Yuksek Ihtisas Training and Research Hospital’s document management system by calculating the percentage change between repeated BEC test runs. To assess for clinical relevance, the bias between two results from the same sample was compared using the 1988 Clinical Laboratory Improvement Amendments’ (CLIA) proficiency testing allowable total error (TEa) limits. Results From a total of 1,627 BEC tests performed between January 2017 and January 2018, 70% (1,133) were repeat tested. Of these, 830 resulted in BECs between 0–5 mmol/L, of which 237 (28.5%) were above the 25% acceptable TEa. Two hundred seventy-six BEC test results were greater than >14 mmol/L, and there was a good consensus between the initial and repeat test results (99%). In this group, the mean bias was 0.0% (95%, CI = -9.8–9.8%). However, three of the repeat test results were considered significantly different. There were two discordant results in the 5–14 mmol/L ethanol level, and the mean bias was 2.1% (95%, CI = -15.0–19.1%). Conclusion The majority of the repeated BEC test values were the same as the baseline value; therefore, there may be limited benefit in continuing such frequent repeated analyses.
The Outcome of Patients with Acute Coronary Syndrome Those Associated with Impaired Glucose Tolerance in AL-Nasiriya Governorate / Iraq

Prediabetes in the form of impaired glucose tolerance (IGT) is common among patients with acute coronary syndrome (ACS). IGT in patients admitted for ACS is associated with increased mortality. We aimed to determine the prevalence of prediabetes in the form of IGT among ACS patients who were known to be neither diabetic nor prediabetic and referred to early coronary angiography. The study included 284 participants. We divided into 2 groups: patients group and control group. The patients group were include 138 patients admitted in AL-Hussein teaching hospital with acute coronary syndrome in the form of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). 98 patients with NSTEMI and 40 patients with STEMI. The control group were 146 participants in the form of medical staff and patients visiting the hospital with conditions other than the ischemic coronary artery disease. All participants were neither diabetic nor prediabetic. 2 hour post prandial blood sugar, blood sugar at 3 days and blood sugar after 6 weeks were done. 22% of the patients group and 6% of the control group were found to have IGT at 2 hour postprandial with highly statistically significant value (P value < 0.0001). 16.6% of the patients group and 7.5% of the control group were found to have IGT at 3 days after the admission with highly statistically significant value (P value < 0.001). 11% of the patients group and 2% of the control group were found to have IGT after 6 weeks of the presentation with also significant statistical value (P value < 0.005). IGT was found in 62% of the female and 38% of the male in patients group. 42% of NSTEMI and 28% of STEMI patients were ended with early percutaneous coronary angiography. There were 11 patient with IGT in the patients group died during the first week of presentation in comparison to 2 patients with normal sugar died during the same period with highly statistically significant value (P value < 0.0001). IGT is common in patients admitted with ACS. IGT is associated with higher mortality among those patients with previously unreported as diabetes mellitus and should be screened for.
A Study of the Correlation between Bacterial Culture and Histological Examination in Children with Helicobacter pylori Gastritis

Helicobacter pylori (H. pylori) is one of the most common chronic bacterial infections in the world, and it is currently estimated that approximately half of the world’s population is infected with the bacterium. The correct diagnosis and effective treatment of H. pylori gastric infection are essential in controlling this condition. The available diagnostic methods have advantages and limitations related to factors such as age of patients, technical difficulty level, costs and extensive accessibility in hospitals. The eradication therapy of H. pylori infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication is antibiotic resistance. Biopsy cultures are the most widely used methods among the antimicrobial susceptibility tests. In case of a negative culture, H. pylori can be clearly recognised in histological sections. The sensitivity and specificity of histology for the diagnosis depend on clinical settings, density of colonisation and the experience of the histopathologist. A prospective study was performed in order to analyse patients with H. pylori gastric infection with positive histology and positive culture versus positive histology and negative culture.