Miracle-dz/UniFAR-FTUs huggingface dataset:
Paraoxonase 1 gene polymorphism and enzymatic activity as a prognostic marker in cases of poisoning by cholinesterase inhibitor pesticides among Egyptians

Paraoxonase1 (PON1) is a high-density lipoprotein associated A-esterase capable of hydrolysing activated metabolites (oxons) of several pesticides as organophosphorous, including chlorpyrifos, diazinon as well as carbamates. Human PON1 displays polymorphisms in the coding region (Q192R and L55M) and in the promoter and the 3’-UTR regions. Animal studies showed that high levels of PON1 protect individuals against acute organophosphatespoisoning. The PON1 genotype and enzymatic activity together contribute to determining an individual's PON1 “status”. In this study, the role of PON1 gene polymorphismsand its enzymatic activity was assessed as a prognostic marker in cases of acute poisoning by cholinestersase inhibitor (ChEI) pesticides among a sample of Egyptian population. Two equal groups of 100 unrelated individuals participated in the study: an exposed group and non-exposed group as control. Serum paraoxonase1 enzyme activitymeasured as arylesterase activity spectrophotometrically using the substrate phenyl acetate. PON1 Q192R gene was genotyped using PCR-RFLP technique. The PON1 Q192R genotype frequency distribution in control subjects was (QQ=64%, QR=28%, RR=8%) and in patients was (QQ=54%, QR=42%, RR=4%) and this was statistically significant (p=0.029). The arylesterase activity was significantly higher in control than exposed group (p=0.037). Regarding the effect of Q192R genotype and arylesterase activity on the outcome, there was no significant difference between the good and poor prognosis groups. Evaluation of PON1 status may be important for determining individual susceptibility to poisoning by ChEI pesticides. However, the estimated level of arylesterase after exposure to poisoning can’t be used in prediction of prognosis. Moreover, the coding genes show discrepant results even within the same ethnic group.
Menstrual Hygiene and College Absenteeism among Medical Students, Gurugram

SGT Medical College, Faculty of Medical And Health Sciences, Gurugram, Haryana *Corresponding Author Dr Shalini Ray Department of Community Medicine, SGT Medical College, Gurugram, Haryana, India Email: drshalini.medhealth@gmail.com Abstract Menstrual hygiene has not received substantial attention thereby exposing the females to a gamut of diseases. Though menstruation is a physiological process, it is linked with various false practices and taboos. Dysmennorhoa and premenstrual symptoms are known to restrict the activities of young girls and can also an important cause of absenteeism from work and college. With this backdrop, the present study was conducted among medical students to assess the knowledge among medical students regarding menstrual hygiene and to determine the prevalence of college absenteeism during menstruation and find the prevalence of different pre menstrual symptoms. Results: The mean age of menarche was 13.38+1.28 years. Majority of the participants (82.31%) practiced good menstrual hygiene and had adequate menstrual hygiene knowledge. The prevalence of college absenteeism was found to be 45.38%. The main reason for college absenteeism was found to be pain & discomfort (36.92%). It was found that most of girls restricted some activities during menstruation the most common being restricted to visit temple (71.54%). Doctors being the main health care provider should have adequate knowledge about menstrual hygiene and should be an integral part in promotion of reproductive health in the community.
Characteristics of Blood Pressure Profiles as Predictors of Long-Term Outcome After Acute Ischemic Stroke

Background and Purpose— Most patients have elevated blood pressure (BP) in the early phase after an acute ischemic stroke. Mechanism and effects of this BP elevation are not well understood. The benefits of intervention by lowering the initial BP or waiting for spontaneous return to normal values remain debated. We studied the hypothesis that increased BP level and profile variability will adversely affect long-term outcome after stroke with and without thrombolytic treatment. Methods— We studied the 615 patients with acute ischemic hemispheric stroke in the first European Cooperative Acute Stroke Study (ECASS). BP was measured at 2-hour intervals during the first 20 hours after randomization, and then every 4 hours, up to 72 hours after admission. Studied features of individual 0- to 72-hour BP profiles were: baseline BP, maximum and minimum BP, mean level, and successive variation in the BP profile. The end point was good functional recovery (modified Rankin Scale [mRS] score of 0 to 1) at 90 days. Logi.
The Effect of nipple soreness treatment with Purslane Cream and Lanolin on Frequency and duration of Breastfeeding in nursing mothers: A Randomized Clinical Trial

Background & aim: Despite the global efforts to promote breastfeeding, women report some problems leading to stop breastfeeding in the early postpartum. Nipple soreness is considered as one of the main causes of early breastfeeding discontinuation. Treatment of this problem could keep breastfeeding for a prolonged period of time. Therefore, the present study aimed to investigate the effect of nipple pain treatment with lanolin and purslane cream on frequency and duration of breastfeeding. Methods: This double-blinded, randomized clinical trial was conducted on 86 breastfeeding women with nipple soreness who attended healthcare clinics in Mashhad, Iran, in 2016. The participants were randomly allocated to two equally sized group (43 in each), receiving purslane cream and lanolin for eight days. The correct method of breastfeeding and using the cream were trained to both groups. The nipple pain score was measured before intervention and on the third and eighth days post-intervention using a numeric pain rating scale. The subjects were also trained to record the duration and frequency of breastfeeding during the study period. Data were analyzed by SPSS version 22 using t-test, Fisher's exact test, Chi-square, and Wilcoxon tests. Results: Two study groups were identical in terms of the pain intensity before intervention. There was a significant difference concerning the pain intensity between the two groups on days 3 and 8. The pain intensity in the purslane cream group was significantly lower than the lanolin group (P<0.001). The frequency of breastfeeding in the purslane group after the fourth day was significantly higher than the lanolin group (P=0.017). However, there was no significant difference between the two groups regarding the duration of breastfeeding (P=0.423). Conclusion: Improving nipple pain by purslane cream can promote the frequency of breastfeeding. As a result, it can be considered as an effective agent in treatment of nipple soreness in nursing mothers.
The Relationship Between Pain and Comorbid Health Conditions in People with Chronic Obstructive Pulmonary Disease

Purpose: To determine if pain and pain interference are associated with comorbid health conditions in people living with chronic obstructive pulmonary disease (COPD) and secondly, to determine if specific types of comorbidities are associated with more pain and a particular location of pain. Methods: Ninety‐two persons with moderate‐tosevere COPD were mailed a package that included: the McGill Pain Questionnaire (MPQ), the Brief Pain Inventory (BPI), and a form to list comorbid health conditions and medications. Results: Of 54 respondents [mean FEV1 48.3%predicted; mean age 72 years], 44 reported pain. On the BPI, 81% of the cohort self‐reported pain, of whom 66% had moderate to very severe pain and 73% had moderate to very high pain interference with daily activities. In those who experienced pain, 73% reported >2 comorbid health conditions and 46% reported >3 comorbid health conditions. Cardiovascular (29%) and musculoskeletal health conditions (20%) were the most commonly reported types of comorbid health conditions reported. Those with musculoskeletal or endocrine health conditions reported higher levels of pain. Pain treatments, primarily nonnarcotic agents, were used by 64% of patients. Conclusions: Significant pain and multiple comorbid health conditions are common in people living with COPD and likely compromise full participation in physical activity in some of these individuals.
Sonographic findings in patients with lower limb swelling, seen at Moi teaching and referral hospital, Eldoret- Kenya

Background: Imaging modalities in lower limb swelling play a major role in identifying various pathologies that have significant impact in clinical outcomes. Ultrasonography has been shown to have comparable outcome with advanced techniques like Magnetic Resonance Imaging (MRI) in soft tissue imaging and it is real time and fairly non-invasive. Objectives: To evaluate clinical findings and describe patterns of sonographic findings in lower limb swelling at Moi Teaching and Referral Hospital (MTRH) Eldoret, Kenya. Methods: This was a cross sectional study done in the MTRH, Radiology and Imaging Department. Using purposive sampling, 109 patients were recruited. 4 declined consent while 2 withdrew. Data was analyzed using STATA version 10. study, Other diagnoses found were; 5 cases lymphadenopathy, cellulitis in 2 cases.
Quality of life and physical activity among younger working age Wroclaw residents

Background. literature concerning quality of life and physical activity relationships in younger working-age people is scarce but suggest that some quality of lifefactors depend on physical activity. Objectives. the aim of the study was to identify these relationships. Material and methods. the material included 2,691 participants (1,321 men and 1,370 women) aged 18–44 years living in wroclaw. the international Physical activity Questionnaire, Short Form (iPaQ-SF) served to assess habitual physical activity. Quality of life was determined with the world health organization Quality of life (whoQol-BreF) questionnaire. Results. the 68.5% level of physical activity among wroclaw residents proved to be sufficient in the context of the who recommendations. More than half (56.3%) of the respondents undertook at least 75 minutes of high-intensity physical activity, and 12.2% carried out moderate activity for at least 150 minutes per week. among men, the chance that they would assess their quality of life as high was 82% more in people performing at least 75 minutes of high-intensity physical activity per week than in those undertaking less physical activity. Conclusions. Most participants met the who health-promoting physical activity standards. in the group of men, statistically significant positive relationships were observed between quality of life and high-intensity physical activity.
Maxillofacial Fractures: Its features and Occurrence in Western Uttar Pradesh,India-A retrospective study

Maxillofacial trauma can pose considerable long-term esthetic, complication [1,2]. Maxillofacial fractures vary markedly from one country to another and even within the same country. This variability is due to different socioeconomic status, sex distribution and environmental factors. A WHO statistics report indicated that each year one million people die and between 15 and 20 million are injured due to Road Traffic Accidents [3]. A clear picture of the etiologic and demographic patterns of maxillofacial injuries can assist medical service providers to plan for better management of such cases. Mandible is the most common site of fracture on the face. Even though it is a very strong bone, its position on the face makes it particularly vulnerable for fracture. Mandibular fractures can lead to swelling, restriction of movement of the jaw, and can cause changes in the contour of the jaw. Unlike upper jaw fractures, lower jaw injuries are more likely to heal incorrectly because the bone is much thicker than the upper jaw and prone to problems such as infection. Upper jaw fractures (maxillary fractures) occur in three most common types called the Le Fort I, Le Fort II and Le Fort III fractures , with Le Fort I being the mildest and Le Fort III being the most severe. Head and brain injuries are commonly associated with facial trauma, particularly that of the mid face; brain injury occurs in 15-48% of people with maxillofacial trauma [4], Despite the increasing frequency of morbidity and mortality associated with maxillofacial fractures in India, little has been published in this regard. A scanty literature is available for such type of injuries, even though we see such type of cases in our daily life. The aim of this retrospective study is to investigate the pattern of maxillofacial fractures in western Uttar Pradesh, India over a 3 year period with special attention on age, sex, site, etiological factors and associated injuries, and complications.
Tamoxifen for ovulation induction in infertile PCOS women who did not conceive with 3 or more cycles of clomiphene citrate: A prospective clinical study

Objectives: To assess the ovulatory, pregnancy rates and side effects of tamoxifen (TMX) in women who are infertile with polycystic ovarian syndrome (PCOS) and who did not conceive with three cycles of clomiphene citrate (CC). Study Design: A prospective interventional study. Population: Seventy-four women who were infertile with PCOS and who did not achieve pregnancy after a minimum of three cycles of CC were included in the study. Materials and Methods: TMX was given orally from Day 2 to Day 6 of the menstrual cycle, with a dose of 40 mg in the 1st cycle and 80 mg in the subsequent two cycles. Transvaginal ultrasound was used for follicular monitoring from Day 10 and on every alternate day till the day of ovulation or till the 20th day of the cycle. Statistical Analysis: Ovulation rates with different doses were compared using McNemar test. Kruskal–Wallis test was used to find out differences in maximum follicular diameter and endometrial thickness (ET) between 3 cycles. Results: The mean maximum follicular diameter was 16 ± 5.2 mm, and the mean ET was 8.9 ± 1.7 mm with an ovulatory rate of 41.90% with 40 mg of TMX. Mean increase in the maximum follicular diameters with 80 mg of TMX was higher when compared with 40 mg (P value − 0.000) of TMX. Increasing the dose of TMX in cycles 2 and 3 resulted in a statistically significant increase in the ovulatory rates; however, it was not so with ET. There were no clinical pregnancies, and minor side effects occurred in 14.1% of the participants. Conclusion: TMX induced ovulation only in 56% of the participants, and optimum ET was achieved in 92.7% of the participants; in addition, there were no pregnancies. Hence, TMX is not a useful ovulation inducing agent for CC failure/CC-resistant PCOS.
The risk of suicide in chronic pain patients

Chronic pain patients are at elevated risk for suicide, but suicidality as an escape from persistent suffering is not the full picture. Chronic pain is comorbid with mental health conditions, in particular depression and personality disorders, which carries with it elevated risk for suicidality. The neural networks involved in chronic pain processing overlap those with depression. Affective disorders such as catastrophizing may not only exacerbate painful symptoms but also increase the risk of suicidal ideation independent of pain intensity and depression. Insomnia, likewise common in the chronic pain population, has also emerged as a risk factor for suicide. The use of certain drugs has also been linked to increased suicidality. Thus, an interplay of factors may enhance suicide risk in the chronic pain population. Migraine is more associated with suicidality than other disease conditions, while neuropathic pain seems to confer no additional risk of suicide. The role of cytokine imbalances and inflammatory processes is being explored as a risk factor for suicide in patients with chronic pain and/or mental health disorders. Substance abuse may also play a role in increasing the risk of suicide in chronic pain patients. The chronic pain population is a particularly vulnerable population with respect to suicidality and clinicians should be mindful of these risks in treating chronic pain patients. *Correspondence to: John Bisney, NEMA Research, Inc., 868 106th Ave North, Naples, FL 34108, USA, Tel: 979864 4479, E-mail: john@leqmedical.com
Cochrane review and meta-analysis of trials of action and/or coping planning for health behaviour change

Background: Action Planning and Coping Planning (Implementation Intentions) are well-tested techniques for changing health behaviour. Aims: conduct a Cochrane review of trials of interventions involving action and/or coping planning across health behaviours in adults, and identify effect modifiers (type of plan, outcome measure, follow-up length). Methods: We searched Cochrane, MEDLINE, Embase, CINAHL, PsycINFO, and trial registers up to January 2014. We included randomized trials of interventions involving action and/or coping planning reporting health behaviour outcomes. Random effects meta-analyses were conducted on trials with sufficient data and which delivered action planning only, coping planning only, or both; objectively-assessed or self-reported behaviour; and follow-up length (<1 month, 1-6 months, 7+months). Findings: We included 119 trials involving 34,252 participants. Meta-analysis results (96 trials); for objectively-measured continuous outcomes were: Action Planning: <1month (4 trials, Cohen’s d=0.37[95%CI=0.22-0.52]), 1-6months (8 trials, d=0.29[95%CI=0.17-0.42]), 7+ months (2 trials, d=0.14[95%CI=-0.04-0.32]). Coping planning: (no trials). Action+Coping planning: <1month (no trials), 1-6months (3 trials, d=0.28[95%CI=0.02-0.54)], 7+months (no trials). Meta-analysis results for self-reported continuous outcomes: Action Planning: <1month (15 trials, d=0.48[95%CI=0.25-0.71]), 1-6months (21 trials, d=0.19[95%CI=0.03-0.35]), 7+months (2 trials, d=0.19[95%CI=0.04-0.34]). Coping planning <1month (3 trials, d=0.67[95%CI=0.37-0.96]), 1-6months (8 trials, d=0.59[95%CI=0.18-0.99]), 7+months (no trials). Action+Coping planning: <1month (7 trials, d=0.17[95%CI=0.05-0.29]), 1-6months (18 trials, d: 0.42[95%CI=0.22-0.62)], 7+months (3 trials, d=0.77[95%CI=-0.40-1.94)). Discussion: In this largest review to date, spanning all health behaviours, Action and/or Coping Planning had a small-to-medium effect on objectively-assessed behaviour, and medium effect on self-reported behaviour. There remains considerable unexplained heterogeneity and a need for more trials using objective outcomes and longer-term follow-up.
Chronic Migraine: Burden, Comorbidities and Treatment

1Mersin University Faculty of Medicine, Department of Neurology, Mersin, Turkey 2Istanbul University Cerrahpasa Faculty of Medicine, Department of Neurology, Istanbul, Turkey 3Health Sciences University, Istanbul Training and Research Hospital, Clinic of Neurology, Istanbul, Turkey 4Isparta Suleyman Demirel University Faculty of Medicine, Department of Neurology, Isparta, Turkey 5University of Health Sciences, Gulhane Training and Research Hospital, Clinic of Neurology, Ankara, Turkey
Prevalence of Ovine Lung Worm in and around Jimma, South West Ethiopia

A cross sectional study was conducted from November, 2017 to June, 2018 in and around Jimma to determine the prevalence of ovine lungworm infection, and to identify predominant lungworm species involved in the area. In this study feacal samples were taken from 293 sheep of all age groups, from both extensive and semi-intensive management systems, body condition score and both sexes were examined using modified Baerman technique to see the prevalence of lung worm by extracting L1 larvae from the processed feacal sample. The present study indicated that 67 sheep (22.9% of the total 293 examined sheep) were found infected with different types of lung worm species. The infection rate between male and female animals showed nonsignificant difference (p> 0.05) with prevalence of 23.4% in females and 22.3% in males. The prevalence of lung worm in different age groups (23%, 27% and 29.9% in animals with < 6 months of age, 6-24 months of age and in animals with >24 months of age respectively), age group showed no significance difference. There was a significant difference (P<0.004) in the prevalence of lungworm infection with respect to management 14.8% in semi-intensive and 29.1% in extensive management systems were found respectively. In the case of body condition prevalence rates of (13.6% in good, 22.7% in medium and 29.9% in poor body conditioned animals) were found with p=0.023 with statistically significant association (P< 0.05). D.filaria was found the dominant lung worm species in the study area with 40 (59.7%) of the total infection followed by M.capillaris (25.4%). Mixed infection of these two species was found the least prevalent case in the study area involved only in 14.9% of the total prevalence rate. The result of this study indicated that lungworm infection in sheep is common parasite which induces heavy economic loss that needs greater attention due to its impact on sheep production of the study area. Therefore an appropriate control and prevention intervention should be carried out in order to reduce the losses associated with the parasite.
Are Babies Sensitive to the Context of Acute Pain Episodes? Infant Distress and Maternal Soothing During Immunization Routines at 3 and 5 Months of Age. Infant and Child Development, 14:51-62

Ninety-three healthy full-term Italian infants were observed longitudinally at 3 and 5 months during routine vaccinations. Mothers' behaviour was also observed. Participants were divided into two cohorts depending on procedure of inoculation (the first cohort, n=44, showed more distress; the second cohort, n=49, showed less distress). Results indicate that babies' different levels of behavioural distress correspond to mothers' different soothing strategies. Maternal proximal soothing at 3 months predicts faster infant quieting at 5 months, but concurrent and predictive effects of maternal proximity are apparent only when level of baby distress is not too high. The study confirms the view that young babies are sensitive to the overall context of acute pain episodes, including medical procedure and maternal soothing. Copyright © 2005 John Wiley & Sons, Ltd.
Emergent Transcatheter Aortic Valve Replacement for the Treatment of Severe Aortic Stenosis Patients Presenting With Cardiogenic Shock or Cardiac Arrest; A Case Series

ABSTRACT Background: Patients with severe aortic stenosis (AS) often present acutely with decompensated heart failure, cardiogenic shock or cardiac arrest requiring immediate intervention. Transcatheter aortic valve replacement (TAVR) has been effectively utilized to treat such patients. However, data on emergent TAVR remain scarce. Methods: We report a cases series of consecutive patients who underwent emergent TAVR between July 2016 and December 2017 at our institution. We describe the patients’ characteristics, the rational for intervention, procedural details, and mid-term outcomes. Results: Nine patients underwent emergent TAVR during the study’s period. Mean age was 80.6 ± 9.9, 44% were males, mean left ventricular ejection fraction was 42.8 ± 19.1. The rational for emergent intervention was cardiogenic shock in 6 (67%), cardiac arrest in 2 (22%), and both in 1 (11%). Mean transaortic valve gradient was 49.8 ± 20.4 mmHg. The mean time from event to TAVR time was 9.9 hours (range 2–14). Balloon aortic valvuloplasty was utilized pre-TAVR in four patients (44%), and peri-procedural percutaneous assist devices were used in three patients (33%). Sapien S3 was the most used valve (89%). Procedural success was achieved in 100%, and 8/9 patients (89%) survived to discharge. All surviving patients were alive and in class I/II New York Heart Association (NYHA) symptom category both at 1 month and a mean follow-up of 8.4 ± 3.7 months. Conclusions: TAVR may provide a feasible and effective treatment for patients with decompensated AS requiring emergent intervention. Further studies are needed to identify the optimal algorithm for the management of these patients.