Miracle-dz/UniFAR-FTUs huggingface dataset:
Prospective analysis of 30‐day mortality following palliative chemotherapy at a tertiary cancer centre

Thirty‐day mortality after chemotherapy has been suggested as a marker of quality in oncology care. Retrospective audits worldwide have put this figure at between 8.1% and 43%, with previous retrospective Australian audits putting this figure at between 3.4% and 18%. To date, there has not been a prospective cohort study of patients receiving palliative intent chemotherapy at an Australian chemotherapy day unit.
Health and Employment for Adults with Serious Mental Illness: An Examination of Physical Health Conditions, Healthcare Utilization, Health-Related Quality of Life, and Employment

Mounting chronic condition rates, elevated healthcare spending, and increased attention to the importance of structural and social health determinants, have magnified attention to disparities in health and healthcare in the United States. Adults with serious mental illness (SMI) have higher rates of many chronic physical health conditions when compared to the general U.S. population, and co-occurring physical and mental health conditions are associated with higher use of emergency healthcare services and higher healthcare costs compared to those with only one condition. At the same time, while adults with SMI express a desire to work, they experience high rates of unemployment. Research indicates that mental health symptoms and mental health care are related to employment for adults with SMI, however there is a need for further inquiry regarding the roles of physical health and healthcare. Drawing on three theoretical perspectives-the social determinants of heath framework, the health as human capital model, and the behavioral model for health service utilization-this dissertation examined relationships between physical health conditions, healthcare, health-related quality of life, and employment for adults with SMI, at both the bivariate and multivariate levels. Direct and indirect relationship were examined using structural equation modeling (n = 645), and findings suggested that individuals with SMI and co-occurring physical health conditions had higher use of healthcare, and lower health-related quality of life, compared to those with SMI only. Further, healthcare receipt and health-related quality of life mediated relationships between physical health conditions and employment status, and physical health-related quality of life had a stronger relationship with employment than mental health-related quality of life. The findings of this dissertation are discussed, and implications for future research, social work practice, and health policy are provided.
Comparative efficacy and safety of intravenous tramadol and nalbuphine for pain relief in postoperative patients

Aim: To compare the efficacy and safety of single-dose intravenous nalbuphine versus intravenous tramadol for postoperative analgesia. Materials and Methods: In this prospective randomized study, adults with the American Society of Anesthesiologists physical status class I and II undergoing elective surgeries performed under general anesthesia, resulting in mild-to-moderate pain (n = 60), received either intravenous nalbuphine (10 mg) or tramadol (100 mg). Visual analog scale scores for pain, sedation, and nausea and vomiting were monitored for 4 h and compared between the two groups. Statistical Analysis: The mean scores within the groups were analyzed by paired t-test, whereas between the groups by unpaired t-test. The median scores were analyzed by using Mann–Whitney U test. P value <0.05 was considered statistically significant. Results: Reduction in pain after drug administration was statistically significant at all-time points as compared to before administration in both groups (P < 0.5). Pain reduction after 5 min (P = 0.01) and 30 min (P = 0.03) was significantly better with tramadol, whereas after 4 h, it was better with nalbuphine (P < 0.05). Incidence of nausea and vomiting in tramadol and nalbuphine groups was 23.3% and 40%, respectively. No statistically significant difference was observed in sedation, nausea, and vomiting scores between two groups at any time point (P > 0.05). Conclusion: Intravenous nalbuphine and tramadol both provided effective pain relief in patients with postoperative pain. Tramadol resulted in early pain relief but higher incidence of nausea and vomiting.
Does the age of patients with hereditary hemochromatosis at the moment of their first diagnosis have an additional effect on the standard echocardiographic parameters?

Background: Hereditary haemochromatosis (HH) is an inherited disease in which gene mutation leads to excessive iron absorption and accumulation in different organs, including the heart, which causes damage. Whether the age of patients with HH at the moment of their first diagnosis has an additional effect on the standard echocardiographic parameters was the aim of the study. Material and methods: We prospectively enrolled 20 HH patients, and 20 healthy ageand sex-matched volunteers. Analysis of standard echocardiographic parameters was performed and compared in subgroups of ≥50 and <50 years old (yo). Results: Comparing HH patients with healthy volunteers in ≥50 yo subgroup, significant differences were found in parameters regarding diastolic function (IVS thickness, LVM index, Em, E/Em, PV S/D, LAA index and LAV index). In the <50 yo subgroup we did not find the abovementioned differences, however LVEF appeared to be lower in the HH patients. Conclusions: Despite the lack of clinical symptoms of cardiovascular disease and the lack of deviations in the standard echocardiographic examination, there were a number of differences regarding LV diastolic function parameters in HH patients ≥50 yo, whereas differences regarding LV systolic function were more prominent in HH patients <50 yo when compared with healthy subjects.
Pharmacotherapeutic properties of Telfairia occidentalis Hook F.: A systematic review

Globally, there has been a growing interest in medicinal plants by researchers. Telfairia occidentalis Hook F. (Fluted pumpkin) is cucurbitaceous vegetable grown in West Africa, particularly in Nigeria for its leaves and seeds. The curative properties of fluted pumpkin are popular in Nigerian folklore medicine, and several investigators have validated these therapeutic effects using animal models. The aim of this work therefore, was to review publicly available literature on the pharmacotherapeutic activities of T. occidentalis. Searches were performed on PubMed, Scopus, ScienceDirect, and Google Scholar for related studies, with search dates set between 1990 and 2018. A total of 499 articles were retrieved and analyzed, with 38 studies ultimately retained. Studies contained in this review were carried out in Nigeria, across different locations. 13 categories of pharmacological activities for fluted pumpkin were documented after analyzing full texts of the articles retained. T. occidentalis offers myriad of healing properties that can be explored by pharmaceutical industries. As the search for potent drugs from botanical sources continues, there is need for future investigations to isolate and characterize pharmacologically active agents that confer medicinal properties on fluted pumpkin, as well as elucidate the structures of these agents and pathways by which they exert their healing properties.
Association between Obesity and Oral Symptoms in Korean Adolescents

Methods: The present study used data from the 2015 Korea Youth Risk Behavior Web-based Survey in analyzing 68,043 Korean adolescents. The dependent variables are oral symptoms (tooth pain in eating and gingival bleeding and aching), and independent variables are socioeconomic variables (sex, school type, city scale, economic status, education levels of parents, and academic achievement), health-related variables (drinking, smoking, and body mass index), and oral health-related variables (tooth brushing frequency, and the presence of interdental cleaning, and scaling) were collected by using a self-administered questionnaires. Multiple logistic regression analysis was used to evaluate the association between obesity and oral symptoms while controlling for confounders.
Correlation of Dysfunction and Clinical Recovery in Ischemic Stroke

Objective: To correlate the neurological scales National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankim Scale (MRS) with speech therapy scales Functional Oral Intake Scale (FOIS®) and the Severity Scale: Penetration and Aspiration (ROSENBEK) in the acute phase, after 30 and 90 days of ischemic stroke. Methods: A prospective cohort study in 60 patients, 24 (40.0%) females and 36 (60.0%) were male. All they performed in the first 24 hours of ischemic stroke neurological evaluation through the scales NIHS and the MRS, functional clinical evaluation of swallowing with the application FOIS® and up to 72 hours of ischemic stroke nasolaringofibroscópica the evaluation of swallowing with ROSENBEK. Spearman's correlation test was used and the non-parametric Wilcoxon test, Mann-Whitney. Results: There was in 37.0% of patients in the acute phase, 30.0% after 30 days and 20.0% after 90 days of ischemic stroke. There was moderate correlation between neurological scales NIH and ERm, weak correlation between neurological scales with speech therapy scales and strong correlation between FOIS® and ROSENBEK scales in the acute phase. Conclusions: Moderate correlation between neurologic scales in the acute phase, after 30 and 90 days suggesting that can be used according to availability and experience of each service. Weak correlation of neurological scales with speech therapy scales is not possible isolated use of only one of the assessments. And a strong correlation between the scales speech therapy in the acute phase may facilitate the clinical assessment in services that do not have the instrumental
Evaluation of preoperative predictive factors for difficult laparoscopic cholecystectomy in comparison with intraoperative parameters

Objective The aim was to assess the preoperative predictive factors that determine difficult laparoscopic cholecystectomy (LC) in comparison with intraoperative parameters and outcome. Patients and methods This prospective study include 100 patients having symptomatic cholelithiasis. All patients underwent elective LC in Department of General Surgery in Aswan University Hospital. The collected data include the parameters of preoperative scoring system, which were male sex, old age, history of hospitalization, obesity (BMI), abdominal scar, palpable gallbladder (GB), wall thickness of GB, pericholecystic collection, and impacted stone. The difficulty levels according to preoperative score were easy (0–5), difficult (6–10), and very difficult (11–15). Various intraoperative parameters were faced while doing LC that were considered for intraoperative scoring system, which categorizes the patients into easy, difficult, and very difficult surgical procedure on the basis of time taken in minutes, bile/stone spillage, injury to duct, and conversion to open cholecystectomy. Results In this study, previous history of hospitalization (P=0.001 and 0.01) and wall thickness (P=0.007 and 0.02) were found to be statistically significant in predicting difficult LC in both univariate and multivariate analyses. Other factors such as age (P=0.002), BMI greater than 27.5 (P=0.02), palpable GB (P=0.003), and impacted stone (P=0.01) were found to be statistically significant in univariate analysis in predicting difficult LC. Remaining factors such as sex, abdominal scar, and pericholecystic collection were not found to be statistically significant in predicting difficult LC. Receiver operating characteristic curve for prediction of intraoperative outcome based on preoperative score for difficult/very difficult versus easy cases at cutoff point greater than 5 and area under the curve of 0.86, with 95% confidence interval=0.77–0.92, showed sensitivity of 74.3, specificity of 96.9, positive predictive value of 92.9, negative predictive value of 87.5, and accuracy of 85.6. Conclusion We concluded that the preoperative scoring system is statistically and clinically a good test for predicting the operative outcome in LC.
Comparison of the effect of oral acetaminophen and ibuprofen on patent ductus arteriosus closure in premature infants referred to hajar hospital in Shahrekord in 2016-2017

Background and Aim: Arterial duct in term infants is closed 96 h after birth in normal conditions. In some cases, especially in preterm infants, this duct is not closed after birth, which is called patent ductus arteriosus (PDA). This disease, if left untreated, leads to depressed respiratory capacity and shunt in preterm infants. The aim of this study was to compare the effect of oral acetaminophen and ibuprofen on PDA closure in preterm infants. Materials and Methods: In this clinical trial, 50 infants with a gestational age of < 37 weeks with PDA, confirmed by echocardiography and clinical symptoms, were selected and randomly divided into two groups of 25. One group was orally given acetaminophen at 10 mg/kg body weight (BW) every 6 h for 72 h, and another group received ibuprofen at 10 mg/kg BW on the 1st day and then 5 mg/kg on the 2nd and 3rd days. Before and after the intervention, infants were examined for possible side effects using echocardiography. Results: According to the results before and after the intervention, the PDA diameter was not statistically significant difference between the two treatment groups (P = 0.328 and P = 0.602). Frequency and percentage of the closure of PDA in acetaminophen group were 23 (92%) and in the ibuprofen group 22 (88%) with no statistically significant difference (P = 1.000). The mean levels of blood urea nitrogen, creatinine, and aspartate aminotransferase were not significantly different between the two groups; however, the mean of alanine aminotransferase was higher in the acetaminophen group (P < 0.05). Urine output was normal in both groups; however, the frequency of gastrointestinal complications was higher in the ibuprofen group than in the acetaminophen group (P < 0.05). Conclusion: The results of this study indicate better or equal efficacy of acetaminophen in comparison to ibuprofen to close PDA.
Levothyroxine Replacement for Primary Hypothyroidism Can Be Given Between Meals with Similar Effectiveness at Various Times of the Day

Background The American Thyroid Association (ATA) guidelines (1) recommend levothyroxine (L-T4) replacement for treatment of primary hypothyroidism. After its administration, a fraction of the dose is converted to L-triiodothyronine (T3). The thyroid gland secretes both T4 and T3, and a large proportion of the circulating T3 is derived from conversion of secreted T4 to T3. Therefore, it would be ideal to treat hypothyroidism by a method that reproduces all aspects of T4 and T3 production and degradation, including intricately regulated aspects of thyroid hormone secretion and peripheral T3 genesis that are initiated by hypothalamic circadian rhythms, feedback loops, nutritional status, and stress responses.
Anti-microbial Resistance Pattern of Uropathogens Isolated from Hospitalized Patients in Imam Khomeini hospital, Tehran, Iran

Background: Urinary tract infection (UTI) is one of the most common type of bacterial infectious diseases which occurs in all age groups. The aim of this study was to determine anti-microbial resistance pattern of bacterial pathogens causing UTIs in hospitalized patients at the Imam Khomeini Hospital, Tehran, Iran. Material and Methods: Urine samples were collected from 11157 hospitalized patients at different wards of Imam Khomeini Hospital in Tehran, between January 2015 and December 2015.The cultured plates were assessed for significant bacterial growth. Anti-microbial susceptibility test was performed using standard disk diffusion method. Results: Out of the 11157 collected urine samples, significant bacterial growth of 25.38% was observed. The most common cause of UTI was gram-negative bacteria (82.2%). More than 50% of the gram-negative bacteria were resistant to ceftriaxone, ceftazidime and trimethoprim-sulfamethoxazole. Enterococcus spp. (10.1%) was found as the third causative agent of UTIs and the most common gram-positive bacteria. Conclusion: we conclude that the examination of the most common etiological agent of UTIs and their antimicrobial resistance patterns is advantageous and necessary in order to design a guideline for empirical therapy.
Treatment of the medial collateral ligament injuries

Ligament injuries at the medial side of the knee are frequent in both isolated or in the context of more complex injuries. Improved understanding of the anatomy and biomechanics of the ligaments that make up this complex have ultimately enhanced clinical outcomes. These concepts, in association with the results described previously, allow the majority of the lesions on the medial side to be treated non-operatively. There is also a close correlation of the medial structures’ tears with the anterior and posterior cruciate ligaments (PCL) lesions. Different treatment algorithms and several techniques have been described to address injuries of the medial aspect of the knee, especially when combined with other ligament injuries. In this scenario, the treatment is still controversial and full of potential problems. This paper will review the anatomical and physiological basis for treatment of medial collateral ligament injuries, particularly focusing on the treatment flow chart and surgical options.
Effects of a prolonged intervention of breathing exercises after cardiac surgery - a randomised controlled trial

Abstract Objectives: To evaluate the effect of a prolonged intervention of breathing exercises with Inspiratory Resistance Positive Expiratory Pressure for one month after open cardiac surgery concerning lung function, respiratory movements and postoperative pulmonary complications. Methods: A randomised controlled trial comparing the effect of home-based breathing exercise after discharge from the hospital or stop at discharge. Eighty patients were randomly assigned to an intervention group or control group. Forced vital capacity, forced expiratory volume in the first second, peak expiratory flow, respratory movements and saturation were measured at discharge and after the intervention. At follow-up self-reported pulmonary complications were also recorded. Results: A significant increase in forced vital capacity (p = .04) was found in the intervention group compared with the control group, and there were a tendency towards significant differences also in forced expiratory volume in the first second and saturation (p = .06). Respiratory movements increased significantly after one month but there were no significant differences between groups. None of the patients reported being treated for pneumonia. Conclusion: A prolonged intervention of breathing exercise for one month after open cardiac surgery significantly increases forced vital capacity and may accelerate recovery after cardiac surgery. Clinical registration number: FoU in Sweden no 76141.
Correlation between ABCB1 gene polymorphisms, antiepileptic drug concentrations and treatment response

Abstract Aim: A possible molecular mechanism of clinically defined multidrug-resistant epilepsy involves drug efflux transporters such as P glycoprotein (P-gp), a member of the ATP-binding cassette subfamily B1 (ABCB1). We have investigated the prevalence of the C3435T, G 2677T/A, and T129C single-nucleotide polymorphisms in the promoter region of MDR1 gene, in Romanian epileptic patients. Methods: 70 epileptic patients evaluated in the Neurology Department of Cluj County Hospital were included in the study. The response to treatment was assessed by reviewing the seizure diaries and the patients were classified as responders or non-responders. Antiepileptic drug (AED) plasmatic concentrations were measured and the patients were divided into 2 groups: first group with AED concentrations in therapeutic range and the second one with sub-optimal AED concentrations. Genotyping the DNA samples, we investigated MDR1 gene polymorphism by polymerase chain reaction (PCR). Results were expressed as genotype and allele frequencies per response group and compared between subgroups. Results: 33 patients (47.14%) were classified as responders, while the remaining 37 patients (52.86%) were classified as non-responders. A comparison of responders and non-responders revealed no significant difference in genotype frequency for any of the three mutations studied. The CT heterozygote for ABCB1 T129C had significantly lower AED concentrations (p=0.041), with no significant difference for the other polymorphisms studied. Conclusions: In our study we found an association of CT variant in ABCB1 C129T with lower AED plasmatic concentrations and no association between ABCB1 variants and the drug responsiveness.
Correlation of Malondialdehyde (MDA) and C-reactive Protein (CRP) Level to Neurodevelopmental Outcome in Children After the Episode of Convulsive Type Status Epilepticus

Refractory and mortality associated with status epilepticus (SE) were correlated with the degree of inflammation-induced neuronal cell death. This study was aimed to investigate the correlation of oxidative stress (Malondialdehyde, MDA) and inflammation (C-reactive protein, CRP) process with neurodevelopmental outcome in children after the episode of convulsive type SE. This study was designed as cross sectional which included 26 convulsive type SE subjects and 15 control subjects. MDA level was measured by thiobarbituric acid (TBA) method, while CRP level was measured by ELISA method. Neurodevelopmental outcome was measured by Bayley-III Scale of Infant and Toddler Development 3 month after the convulsive type SE episode. Results showed that both MDA (independent t-test, p < 0.05) and CRP (Mann-Whitney test, p < 0.05) level was significantly higher in convulsive type SE group as compared to control group. Further analysis also showed that MDA (Spearman correlation test, p = 0.000, r = 0.756) and CRP (Spearman correlation test, p = 0.000, r = 0.835) level was positively correlated with convulsive type SE. In convulsive type SE group, MDA level was negatively correlated with neurodevelopmental outcome but CRP was not. We concluded that MDA level was negatively correlated with neurodevelopmental outcome in children with convulsive type SE, but CRP was not.
Aspirin and colorectal cancer chemoprevention

The role of aspirin in colorectal cancer prevention is currently under intense scrutiny. Low dose Aspirin effectively suppresses the cyclooxygenase-2 enzyme system, which is thought to play an important role in the pathogenesis of colorectal cancer. A number of observational studies and randomized controlled trials have supported a chemoprevention effect. In some instances, regular use of low dose aspirin has provided a nearly 20% reduction in incidence. Compliance and underutilization remain important issues however, as does the incidence of side effects aspirin is a non-steroidal anti-inflammatory drug, and regular use of these medications carries a small but significant risk of gastrointestinal bleeding, which on occasion, can be life-threatening. These are important problems, which need wider recognition and detailed exploration before we can suggest widespread use of aspirin in primary or secondary prevention.