Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence and Complications of Obesity in Sickle Cell Disease.

Background: Obesity is associated with major health problems in the pediatric population and is a fundamental risk factor for adult obesity with its concomitant morbidities. Sickle cell disease (SCD) has historically been associated with poor nutritional status rather than obesity. Children with SCD, however, have many general risk-factors and disease-specific characteristics, such as ethnic distribution and sedentary lifestyle, that may increase their risk for obesity. We hypothesized that the prevalence of obesity in children and adolescents with SCD would reflect that of the general pediatric population and that obesity would be associated with demographic and disease-specific variables. Methods: We conducted a retrospective chart review of all pediatric and young adult patients over the age of two in the Hasbro/RIH Sickle Cell clinics from 1980- 2008, collecting cross-sectional and longitudinal demographic and clinical variables. The primary outcome was the prevalence of overweight and obesity in this population. Secondary endpoints included the association of obesity with demographic and clinical variables and longitudinal growth trends. Body mass indices (BMI) were calculated for each subject, who were then categorized as underweight, healthy weight, overweight, or obese based on the International Obesity Task Force guidelines. Chi-square, Fischer exact tests, and T-tests were used to evaluate associations between overweight/obesity and the hypothesized risk factors and morbidities. Odds ratios were then calculated to determine the strength of these associations. This project was approved by the local Institutional Review Board. Results: The analysis included 149 subjects with a mean age of 13.2±6.5 years, 51% male, and a mean hemoglobin of 9.7±1.8. The mean BMI was 20.5±6.3 with a range from 13.1–49.1. Five percent of the subjects were underweight, 70% healthy weight, 12% overweight, and 13% obese. The most common morbidities included acute chest syndrome (44%), frequent (>3/yr) pain crises (34%), asthma (17%), and obstructive sleep apnea (17%). Overweight and obesity were not associated with gender, race, or insurance status in this population. The overweight/obese group was significantly older than the non-overweight group (15.3 years vs. 12.4 years, p=.02). Obesity was associated with sickle cell genotype: subjects with less severe genotypes were more likely to be obese than those with the most severe genotypes (p Conclusions: In contrast to traditional thinking, this is the first study to demonstrate a high prevalence of overweight and obesity in pediatric SCD. Indeed, the prevalence of overweight and obesity in our children with SCD parallels that of these conditions in the general pediatric population. In those with SCD, obesity is more common in patients with less severe disease and is more widespread in older children. Additionally, obesity is associated with increased risk of SCD-related morbidities such as osteonecrosis and hypertension and is associated with more hospitalizations.
Incidence and factors associated with postnatal depression among Jordanian women

Postnatal depression (PND) is the focus of considerable clinical and research attention however it has been neglected in many developing countries. Using a prospective design with a representative sample of women (n = 353), this longitudinal study aimed to determine the incidence and associated factors in the development of antenatal and postnatal depression in Jordanian women. There are three Phases of the study. During Phase 1 women in their last trimester of pregnancy and receiving public antenatal clinic care were recruited. In addition to obtaining demographic details, a questionnaire sought information on the antenatal factors commonly associated with depression. These included whether the pregnancy was planned, reproductive history, personal and family history of psychiatric illness including antenatal and postnatal depression, relationship with husband, relationship with mother-in-law, and stressful life events. Standardised measures were used to assess depression, social support, worry, anxiety and stress, preparation for birthing and parenthood, and self-efficacy.
The Terminal Complement Inhibitor Eculizumab Reduces Thrombosis in Patients with Paroxysmal Nocturnal Hemoglobinuria.

Life-threatening thromboembolism (TE) is the most feared complication in patients with paroxysmal nocturnal hemoglobinuria (PNH). Thrombophilia in PNH likely involves a hypercoagulable state, possibly due to intravascular hemolysis with scavenging of the coagulation regulator nitric oxide, and platelet activation. Approximately 45% of PNH deaths result from TE. Thrombosis is more frequent in patients with larger PNH clones, but can occur in patients with smaller clones. Primary prophylactic anti-coagulation may reduce the thrombotic risk in PNH patients, although controlled studies have not been performed and there is a known serious hemorrhage risk. A randomized, placebo-controlled, 26-week phase 3 study of the terminal complement inhibitor eculizumab in 87 PNH patients (TRIUMPH) recently demonstrated dramatic reductions in intravascular hemolysis and RBC transfusions; 1 TE was reported with placebo and 0 with eculizumab. This single study was not powered to examine the effect of eculizumab on TE, and we prospectively examined the aggregate TE event rate in eculizumab-treated patients from TRIUMPH, the two other PNH trials, and the subsequent phase 3 extension study as compared to each patient’s pre-treatment event rate. Before receiving eculizumab, examination of patient records identified 126 TE events in 195 patients, and 103 were on anticoagulants. While pre-treatment TE event rates were variable in the 3 individual PNH studies, eculizumab reduced TE in each study. The TE event rate with eculizumab treatment was 1.22 per 100 patient years, compared to 7.49 (p<0.001) in the same patients before eculizumab treatment, corresponding to a reduction of 84% (2 events with eculizumab vs. 12.3 events expected). Sensitivity analyses showed the effect to be robust. With restriction of the pre-treatment observation period to the 12-months immediately before initiation of the trials, the TE event rate with eculizumab was reduced 93% from 17.21 to 1.22, respectively (p=0.013). The TE event rate was reduced from 21.95 pre-treatment in patients with TE prior to the trials (n=63) to 3.42 during eculizumab treatment (p<0.001). Most TE events prior to eculizumab treatment occurred in patients receiving anti-coagulants, indicating that this therapy may be insufficient to prevent thrombosis. Of 103 patients on anticoagulants, there were 54 TE events in 30 patients over 385.73 patient years (14.00/100 patient years) pre-eculizumab compared to no TE events with eculizumab in 101 patient years (0.0/100 patient years; p<0.001), demonstrating that eculizumab reduces the risk of thrombosis in anticoagulated, highly thrombophilic PNH patients. These data show that long-term eculizumab treatment results in a clinically and statistically significant reduction in thrombosis in patients with PNH.
Relationship between Carotid Intima-Media Thickness and Left Ventricular Hypertrophy

Background: Hypertension is a 50% cause of cardiovascular disease and stroke, 40% of cause of death in Diabetics, and is a major risk of kidney failure, pregnancy and dementia. Left ventricular hypertrophy (LVH) is a preclinical manifestation of cardiovascular disease and a strong predictor of cardiovascular morbidity and mortality. Examination of carotid intima-media thickness (CIMT) is one method that can be used to Evaluate the occurrence of coronary heart disease and in Several studies reported that CIMT is also associated with left ventricular function and hypertrophy Methods: This cross-sectional study conducted on hypertensive patients in the outpatient unit in Cardiac Center Haji Adam Malik General Hospital since March 2018-August 2018. Examination of Carotid B-Mode ultrasound was conducted to obtain CIMT values. LVH is assessed by left ventricle mass index (LVMI) as measured by M-mode method using the Cube formulas from echocardiography. Then the analysis is done using the Spearman correlation test to see the relationship between CIMT and LVH Results: The CIMT >0.5 mm have a positive correlation with LVM (r = 0.594, p 0.5 mm has a sensitivity of 83.6%, specificity 90.4%, PPV NPV 76% and 93.8%. The CIMT value of 0:55 mm is considered to be the optimal value in diagnosing LVH in hypertensive patients in our subjects based on the ROC curve with a sensitivity of 83.6% and specificity of 90.5%, and area under the curve of 0.9. Conclusion: There is a positive correlation between carotid intima-media thickness and left ventricular hypertrophy in hypertensive patients
VERION vs IOLMaster: Which is More Accurate in Predicting Post-op Spherical Equivalent Outcomes for Phacoemulsification with IOL Implant Surgery?

Purpose: The authors aimed to analyse the accuracy in post-operative spherical equivalent outcomes for intraocular lenses implanted for both IOLMaster and VERION systems. Methods: A retrospective audit was carried out of 80 sequential eyes of patients who had cataract surgery using AMO Tecnis monofocal lenses under the care of the senior author using both the IOLMaster and VERION systems from March 2017-November 2017 at Nuffield Health Hereford. A database was used to analyse the results. The patients were measured using both the IOLMaster and VERION systems and the pre-operative spherical predictions were obtained. The actual post-operative spherical equivalent was calculated from the post-operative refraction data and compared to the predictive spherical outcome values using the SRK/T formula for both the IOLMaster and VERION systems. A paired T-test was performed to calculate the statistical significance of the results. Results: There was a mean difference of -0.0496D (95% CI -0.143 to 0.0439) in the post-operative spherical equivalent outcome compared to the IOLMaster prediction and a mean difference of -0.0464D (95% CI -0.14 to 0.0476) compared to the VERION prediction. The range of differences in the post-operative spherical equivalent outcomes was -1.255 to +0.935D compared to the IOLMaster predictions, and -1.305 to +0.89D compared to the VERION predictions. These results did not differ significantly (p >0.05). Conclusion: There was no significant difference in accuracy between the two systems. In addition to its role in astigmatism management, the VERION may be used to help refine postoperative spherical refractive predictions from the IOLMaster.
Addictive disorders, bipolar spectrum and the impulsive link: The psychopathology of a self-regenerating pathway.

of Psychiatry, University of Pisa, Via Roma 67, 56100 Pisa, Italy, EU E-mail; maremman@med.unipi. it 1PISA-SIA (Study and Intervention on Addictions) Group, “Santa Chiara” University Hospital, Department of Psychiatry, University of Pisa, Italy, EU 2 “G. De Lisio” Institute of Behavioural Sciences, Pisa, Italy, EU. 3Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, Lucca, Italy, EU
Effect of a Peer-Tutor Programme on Social, Psychomotor and Physical Fitness of Youth With and Without Intellectual Disability in Nairobi County, Kenya

The positive impact of peer tutoring on student learning is supported by research. However, specific methods on how peer-tutoring works have inconclusively been studied. The present study was designed to further investigate further the effectiveness of using trained peer tutors in enhancing the physical activity participation level of youth with and without intellectual disabilities in Nairobi, Kenya. The study involved 106 youths with and without intellectual disabilities in equal number to participate in the unified programme. Thirty two trained research assistants served as cross-peer tutors. Peer tutors were trained for four days in specific physical activities and motor abilities and also other aspects of teaching methodologies. These included: cueing, prompting, reinforcement, observation and writing individualized Education Programming for learners with disabilities. Data was collected through questionnaires, observation checklists and a physical fitness test protocol. Data collected using the instruments were analyzed using both t-test and Analysis of Variance (ANOVA) to investigate the effects of the peer tutoring programme on participants‟ achievement levels. A significant improvement was noted in motor performance for both participants with and without disabilities. Specifically, there was a marked improvement in both the left handgrip (t(196)=-. 979<0.05), right handgrip (t(196) = -2.798<0.05) kicking (t(196)=2.743<0.05) and right leg balance(t(196) =-3.067<0.05) activities. These were presented in Tables, figures, bar graphs and pie chart. No significant changes were recorded in the physical fitness measures except for the waist to hip ratio which recorded a significant mean change for all participants(t(132)=2.743<0.001) male participants (t(62)=2.139<0.036) and females (t(62)=2.139<0.036). However, linear regression analysis indicated a positive trend for most of the physical fitness parameters evaluated in this study. Both peer tutors and parents‟ views were analysed qualitatively and reported as themes. In both cases, the peer tutors and parents had positive responses about the peer-tutor programme. Peer tutors felt that they had gained experience working with persons with disabilities; they had learned new coaching methods and improved their personal lives by influencing change in other peoples‟ lives. Peer tutors also reported a change in the participants‟ skill level and social development. Parents interviewed also reported a positive change in their children. From the findings of this study, it was recommended that guidelines on the use of peer tutors should be provided to adapted PE teachers to encourage the use of such support groups in the classroom where learners with disabilities are enrolled. Further investigations to understand the extent to which peer tutoring programmes could be transferred to other settings such as playground, lunch time and after school programmes was needed.
A comparative study of diagnosis methods for detection of Helicobacter pylori in gastro-duodenal diseases in Human

Background: Helicopacter pylori play an important role in the pathogenesis of gastroduodenal disease. Appropriate diagnosis of H.pylori infection in the laboratory results in relief of the symptoms and many also be cured without surgical intervention. Method: 76 males and 24 females who underwent diagnostic endoscopy formed the study group. Microscopic examination, culturing, rapid urease test and ELISA test were carried out. Results: Among 100 cases (study group) suffering from gastroduodenal diseases, H. pylori isolated from 18 cases, identified in 54 grams stained smears, rapid urease test was positive in 62 cases, IgG immunoglobulins against H. pylori was detected in 62 cases. Conclusion: No single test can be considered sensitive or specific to detect or rule out H. pylori infection and it is necessary to use a combination of tests.
Oligosaccharides for Dairy Calves

ABSTRACT There is limited information on feeding mannan-oligosaccharides (MOS) and fructo-oligosaccharides (FOS) to calves despite the popularity of these products in the livestock feed industry. A total of 144 Holstein calves (initial BW 44 kg and
Patient Perspectives on the Usefulness of an Artificial Intelligence–Assisted Symptom Checker: Cross-Sectional Survey Study

BACKGROUND Patients are increasingly seeking Web-based symptom checkers to obtain diagnoses. However, little is known about the characteristics of the patients who use these resources, their rationale for use, and whether they find them accurate and useful. OBJECTIVE The study aimed to examine patients' experiences using an artificial intelligence (AI)-assisted online symptom checker. METHODS An online survey was administered between March 2, 2018, through March 15, 2018, to US users of the Isabel Symptom Checker within 6 months of their use. User characteristics, experiences of symptom checker use, experiences discussing results with physicians, and prior personal history of experiencing a diagnostic error were collected. RESULTS A total of 329 usable responses was obtained. The mean respondent age was 48.0 (SD 16.7) years; most were women (230/304, 75.7%) and white (271/304, 89.1%). Patients most commonly used the symptom checker to better understand the causes of their symptoms (232/304, 76.3%), followed by for deciding whether to seek care (101/304, 33.2%) or where (eg, primary or urgent care: 63/304, 20.7%), obtaining medical advice without going to a doctor (48/304, 15.8%), and understanding their diagnoses better (39/304, 12.8%). Most patients reported receiving useful information for their health problems (274/304, 90.1%), with half reporting positive health effects (154/302, 51.0%). Most patients perceived it to be useful as a diagnostic tool (253/301, 84.1%), as a tool providing insights leading them closer to correct diagnoses (231/303, 76.2%), and reported they would use it again (278/304, 91.4%). Patients who discussed findings with their physicians (103/213, 48.4%) more often felt physicians were interested (42/103, 40.8%) than not interested in learning about the tool's results (24/103, 23.3%) and more often felt physicians were open (62/103, 60.2%) than not open (21/103, 20.4%) to discussing the results. Compared with patients who had not previously experienced diagnostic errors (missed or delayed diagnoses: 123/304, 40.5%), patients who had previously experienced diagnostic errors (181/304, 59.5%) were more likely to use the symptom checker to determine where they should seek care (15/123, 12.2% vs 48/181, 26.5%; P=.002), but they less often felt that physicians were interested in discussing the tool's results (20/34, 59% vs 22/69, 32%; P=.04). CONCLUSIONS Despite ongoing concerns about symptom checker accuracy, a large patient-user group perceived an AI-assisted symptom checker as useful for diagnosis. Formal validation studies evaluating symptom checker accuracy and effectiveness in real-world practice could provide additional useful information about their benefit.
Analyses and Assessment of Health Care Workers (HCWs) towards Occupational Hygiene (OH) and Infection Control (IC) Practices in Selected Tertiary Healthcare Facilities within Parts of Niger Delta, Nigeria

Healthcare workers are exposed to a variety of hazards which predisposes these “indispensable carers” to various life threatening infections and diseases. This study is aimed at analyzing and assessing HCWs towards Occupational hygiene and Infection control practices in Federal Medical Centre Owerri and Federal Medical Centre Yenagoa health care facility in Niger-Delta, Nigeria. Descriptive cross sectional study using a structured questionnaire and walk-through safety checklist was employed. A total of 379 healthcare workers were selected through disproportionate stratified Original Research Article Galley Proof Allen et al.; AJRNH, 2(2): 1-14, 2019; Article no.AJRNH. 51719 2 sampling from the two facilities. The questionnaires were self-administered and analyzed using SPSS Version 22.0. Frequencies and chi-square were computed. 60.7% of respondents were male, dominant age group; 30 – 39 yrs, nurses represented a larger proportion (34.8%) of healthcare workers; 51.7% and 48.3% of respondents in FMC Yenagoa and FMC Owerri respectively had a high (good) knowledge of hazards and controls. There was a significant difference with chi-square as, 9.710 p-Value <0.008. High level of attitude was 44.7% in Owerri and 21.2% in Yenagoa, chisquare 18.295 p-Value <0.001. Overall level of industrial hygiene and infection control practices was low in both facilities. The checklist revealed that both facilities were of imminent high risk category. Health care workers at FMC Yenagoa had higher exposures to hazards than FMC Owerri. Working in FMC Owerri predisposes workers to higher health hazards than in FMC Yenagoa. There was better administrative controls including trainings and immunizations in FMC Yenagoa than in FMC Owerri.
IMPACT OF AN EDUCATIONAL INTERVENTION ON SMOKING CESSATION AMONG MEDICAL STUDENTS OF SRINAGAR, UTTARAKHAND, INDIA

Background: Tobacco smoking is the leading most common cause of preventable death and disease. The medical students should be equipped with the knowledge and skills to promote smoking cessation skills among their future patients. Aim: To study the factors responsible for smoking behaviour among medical students of a government medical college in Srinagar, Garhwal uttarakhand and to assess the impact of an educational intervention on smoking cessation. Materials and Methods: A cross-sectional study followed by an educational intervention was conducted from June 2014 to may 2015. Out of 491 medical students in the college, 89 students, who were found to be current smokers on the basis of history, were included in the study. The criteria for current smoker were the student who has smoked at least once in past one year. Data was analysed using Pearson’s chi-square test and p-value <0.05 was considered significant. Results: Of all the 89 smokers, 91% were hostellers, 74.1% started smoking themselves after joining college and 58.4% had been stimulated by the peer group. Before intervention, 89.8% students believed that smoking helps to relieve stress which significantly decreased to 57.3% after intervention. As a result of the intervention, 65.1% started nicotine replacement therapy (NRT) to quit smoking and 47.2% showed a significant reduction in the number of cigarettes smoked per week. Two students (2.2%) quit smoking altogether. Conclusion: Simple educational intervention through a power point presentation is effective in motivating students to attempt quitting cigarettes and can be replicated at larger scale.
Learning curve or experience-related outcome: what really matters in paediatric laparoscopic pyeloplasty

Introduction The process of improving one’s skills over time is called a “learning curve”. This term has attracted great attention during the last decades, especially in relation to laparoscopic techniques. Aim To assess the outcome of paediatric laparoscopic pyeloplasty (LP). Material and methods Retrospective analysis of the consecutive LPs. The inclusion criteria: (1) children aged < 18 years, (2) transperitoneal approach, and (3) the same operating paediatric urologist (RC). Patients with a history of any procedure on the upper urinary tract were excluded. Any surgical reintervention during follow-up was defined as a failure. The outcomes of LPs performed before 2012 (G1) were compared to those conducted between 2012 and 2016 (G2). Fisher’s exact test was used for statistical analysis. Results Ninety patients met the inclusion criteria, and a total of 95 LPs were performed. The mean operation time was 155 min, and the mean hospitalisation period was 2.4 days. In G1, 19 patients underwent Anderson-Hynes LP, 16 had Fenger non-dismembered LP and two underwent vascular hitch. In G2, 54, 2 and 2 patients underwent these procedures, respectively. The overall success rate was 91.5%. There were six failures in G1 and three in G2 (p = 0.147). Of the Anderson-Hynes LPs, 1/19 in G1 and 3/58 in G2 required reintervention (p = 1). For Fenger LPs, this was 4/16 and 0/2, respectively (p = 1). Only one patient required reoperation after vascular hitch. Conclusions The surgeons’ learning curve reflects their experience with regard to the entire therapeutic process, but not exclusively their manual skills.