Miracle-dz/UniFAR-FTUs huggingface dataset:
A STUDY OF EXTENDED SPECTRUM β-LACTAMASE (ESBL) AND AmpC β-LACTAMASE PRODUCING KLEBSIELLA PNEUMONIAE IN NEONATAL INTENSIVE CARE UNIT AT TERTIARY CARE HOSPITAL, AHMEDABAD

Background & objectives: Clinical laboratories need to develop quick screening methods for detection of Extended Spectrum βLactamases (ESBL) & Amplified C (AmpC) β-Lactamase, so that the appropriate medication can be started without delay. Here, we reported the screening & confirmatory methods for detection of ESBL & AmpC in Klebsiella pneumoniae in Neonatal Intensive Care Unit (NICU). Methods: We had tested 600 blood culture samples from the NICU patients. From the positive bacterial isolates, Klebsiella pneumoniae were screened for ESBL & AmpC production followed by confirmatory methods as per Clinical Laboratory Standard Institute (CLSI) guidelines. Results: Out of the 600 blood culture, 266 were positive for microbial growth. Among them, Klebsiella pneumoniae were in 54 patients. Out of 54 Klebsiella pneumoniae, 48 were positive for ESBL in screening method. Out of 48, 41 isolates were ESBL positive & 4 were AmpC positive by Confirmatory test (Modified Three Dimensional Method for AmpC). Interpretation & conclusions: The prevalence of ESBL & AmpC producing Klebsiella pneumoniae in NICU at our institute is 75.92% & 7.4% which is very alarming, and it requires strict implementation of infection control guidelines in NICU by safe hygiene practices, restricted use of broad spectrum antibiotics as empirical therapy in septicemic cases and also formulation of uniform antibiotic policy for such patients based on the current trend of antibiotic resistance. This can be helpful in preventing emergence of multidrug resistance in such organisms.
Prognostic indicators of haemorrhagic gastroenteritis in puppies

Canine haemorrhagic gastroenteritis (HGE) is a common condition manifested by vomiting and diarrhoea in puppies. The aim of the study was to identify the prognostic markers in puppies below 6 months of age with HGE. A total of ten apparently healthy puppies were taken as positive control (Group I). Stool sample obtained from sixty two affected puppies were screened using polymerised chain reaction for infectious agents and classified as follows, puppies with viral enteritis (Group II, n=forty one), bacterial enteritis (Group III, n=six), combined bacterial and viral enteritis (Group IV, n=fifteen). Among the clinical parameters the total WBC, serum albumin, potassium, blood lactate and blood pressure were statistically highly significant (P≤0.01). A total WBC count ≤4100 cu.mm, serum albumin concentration of <2 g/dL, serum potassium of ≤3.4 mEq/L, blood lactate levels of >3.2 mmol/L and systolic blood pressure of ≤90 mmHg were identified as the prognostic values Their interquartile range and median values will be discussed critically.
Clinical And Bacteriological Impact Of Clarithromycin In Streptococcal Pharyngitis: Findings From A Meta-Analysis Of Clinical Trials

Introduction Among the bacterial upper respiratory tract infections (UTRIs), the most medically significant is pharyngitis due to Group A beta-hemolytic Streptococci (GABHS). A 2012 meta-review and a 2016 Cochrane systematic review reported favorably on the comparative efficacy and safety of clarithromycin in pediatric patients with URTIs and in adults with GABHS pharyngitis. In this paper, the evidence base for clarithromycin in patients with URTIs is augmented by a meta-analysis of comparative studies in GABHS pharyngitis. Methods A series of five outpatient trials of clarithromycin for the treatment of streptococcal pharyngitis from an internal database were subjected to meta-analysis. Active comparators comprised penicillin VK and erythromycin. Results Rates of clinical cure or improvement were very similar in all treatment assignments, but the rates of bacteriological cure were numerically higher with clarithromycin than with comparator antibiotics. Adverse events data indicated that clarithromycin was generally well tolerated in these studies, with a relatively low incidence of adverse events and few severe incidents. Discussion Though currently not advised as a first-line therapy for URTI in most guidelines, the results of the meta-analysis indicate that clarithromycin is nevertheless a valid, effective and largely well-tolerated treatment option for GABHS pharyngitis patients who cannot benefit from other agents.
Managing conflict through transformational leadership is collaborative style a solution

Introduction Small groups working in teams are a common feature of organization structure and process in companies dealing with information technology (IT). These teams are headed by project leaders to facilitate the completion of assignments given to the team. In such small groups, leadership is viewed as a process that includes influencing people to implement the strategies and achieve the objectives (Yukl, David & Fleet, 2002). The desire of a single individual to bring about a change/transformation may not be adequate to push the organization ahead. There is a need for this desire to be planted in a larger number of individuals in the enterprise (Singh, et al., 2000). The desire of a single individual to bring about a change/transformation may not be adequate to push the organization ahead. There is a need for this desire to be planted in a larger number of individuals in the enterprise (Singh, Maheshwari,
Oxidative Stress Status In Patients With Rheumatoid Arthritis.

Background: Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis, which is an autoimmune disease characterized by chronic inflammation of synovial joints, ultimately leading to joint destructions and permanent disability. In RA oxidative stress are impaired (which caused by free radicals) might have an essential role in the etiology of RA. Objectives: The objective of this study was to determine oxidative stress by measuring malondialdehyde and enzymatic status by estimating superoxide dismutase, catalase and glutathione peroxidase in patients of RA and then comparing with healthy individuals. Setting and design: A total 42 patients with Rheumatoid Arthritis (20 females, 22 males) in the age of 30-50 years were included, as a control, 50 matched healthy volunteers (20 females and 30 males) were involve, non of the subjects smokes nor receiving any form of drugs. Subjects with any acute infections or with coexisting system disease such as coronary artery disease, hypertension or chronic renal failure were excluded. Methods: Antioxidant enzymes in erythrocyte , superoxide dismutase (SOD), glutathione peroxidase (Gpx) and Cayalase (CAT) was measured. Malondialdehyde (MDA) along with Copper, Zink and Iron are measured by using the serum of the patients and control group. Results: The serum level of MDL was higher in RA patients compared with the control group, the differences among both groups was statistically significant (P < 0.001) Conclusion There is oxidative stress in RA patients evidenced by increased serum MDA and decreased antioxidant enzymes activity.
RESEARCH ARTICLE KNOWLEDGE, ATTITUDE AND PRACTICE OF PHARMACOVIGILANCE AMONG PRESCRIBERS OF GOVERNMENT MEDICAL COLLEGE AND HOSPITAL, AURANGABAD (MAHARASHTRA)

underreporting of adverse drug reactions (ADR) is a cause for a concern. No medicinal product is entirely or absolutely safe for all people, in all places, at all times.Safety and efficacy are two major concerns about any drug.Though Pharmacovigilance programme was started in India in 1982, the awareness about it is much lower. Multispecialty faculties participated in the study. A questionnaire based evaluation was done. The faculties were explained the detail study procedure, and informed consent was taken. A fixed time was allotted for answering the objective and subjective type of questions. Showed that Overall KAP of Pharmacovigilance scores were low. Findings strongly suggest that there is a great need to create awareness and to promote the reporting of ADR amongst prescribers of GMCH (Government Medical College and Hospital) Aurangabad. One positive finding is healthcare professionals are having a very good positive attitude towards Pharmacovigilance.
What is care coordination?

Introduction Care coordination is a high-priority area for improvement across healthcare systems, but no consensus definition of care coordination exists. Methods This article reviews published definitions of the term “care coordination,” identifies common themes among them, and presents a broad working definition of care coordination. Results The review identified 57 unique definitions of care coordination, ranging widely in the scope of participants, settings, and care processes included. Five major themes emerged from the definitions: care coordination involves numerous participants, is necessitated by interdependence among participants and activities, requires knowledge of others’ roles and resources, relies on information exchange, and aims to facilitate appropriate healthcare delivery. Only one definition identified included all five themes, and no one theme was found in a clear majority of definitions. The synthesized themes were incorporated into a broad working definition of care coordination, which has resulted in numerous uses (e.g. guide for systematic review of interventions, development of a measures repository, reference for this journal’s recast focus on the subject). Discussion Some ambiguity remains about the definition of care coordination, but the breadth of definitions in use underscores its widespread recognition as important for high-quality care. Even as understanding of care coordination continues to evolve, broad and flexible definitions can help guide the iterative process of developing conceptual models, testing them empirically, refining models, generating evidence about what works best, and ultimately improving the quality of care.
Current Topics and Perspectives in Surgical Management of Hepatocellular Carcinoma

ABSTRACT Hepatocellular carcinoma is among the leading causes of cancer-related mortality. Due to the numerous surgical and non-surgical therapeutic options, the treatment strategy requires an optimal selection of patients based on tumor stage and liver functional reserve. A potentially curative surgical resection or liver transplantation is only recommended for patients with early stage disease. In this chapter, we overview the current topics and perspectives in the surgical management of hepatocellular carcinoma by disease stage with a special focus on new surgical techniques and expanding range of indications outside of the accepted Barcelona Clinic Liver Cancer algorithm.
The Clinical Relevance of Dialysate Sterility

In addition to removing toxic solutes, one of the major goals of hernodialysis is to restore the base deficit that results from the accumulation of protons within the patient. This is accomplished by including a base or base precursor (acetate) in the dialysate at concentrations higher than exist in the blood. A favorable gradient is thus established for the movement of base into the patient, neutralizing accumulated acid and restoring the protective buffers in both extracellular and intracellular compartments. Acetate was initially the buffer of choice following studies by Mion et al. in 1964 ( I ) . Acetate proved to be satisfactory for dialysis using dialyzers of low efficiency, since the acetate transferred to the patient could be metabolized without producing unacceptable side effects. The amount of base equivalent transferred to the patient was generally sufficient to treat uremic acidosis. However, the development of progressively more permeable and thus more efficient dialysis membranes resulted in increased transfer of acetate to patients. The inclusion of older, more unstable patients produced reports of acetate-induced dialysis side effects such as nausea, vomiting, cramps, and hypotension. With the advent of three-stream dialysate proportioning equipment, it became possible to dialyze patients using bicarbonate as the buffer without the concomitant precipitation of calcium and magnesium salts observed in the period prior to acetate dialysate (2). Studies comparing the side effects of acetate with bicarbonate dialysate have demonstrated a marked decrease in both subjective and objective symptoms when patients are treated with bicarbonate dialysate (3). Various components of the dialysate can be altered to produce other desired clinical effects. Dialysate calcium can be lowered to 2.5 mEqh and used in conjunction with oral CaC03 as a phosphate binder and intravenous I ,25-dihyroxyvitamin D for more effective control of secondary hyperparathyroidism (4). In addition, dialysate bicarbonate concentrations can be increased to 42 mEq4 for improved control of uremic acidosis (5 ) . Potassium concentrations can be either lowered to 0 mEqA or
Senescence and Inflammatory Markers for Predicting Clinical Progression in Parkinson’s Disease: The ICICLE-PD Study

Background: Cognitive decline is a frequent complication of Parkinson’s disease (PD) and the identification of predictive biomarkers for it would help in its management. Objective: Our aim was to analyse whether senescence markers (telomere length, p16 and p21) or their change over time could help to better predict cognitive and motor progression of newly diagnosed PD patients. We also compared these senescence markers to previously analysed markers of inflammation for the same purpose. Methods: This study examined the association of blood-derived markers of cell senescence and inflammation with motor and cognitive function over time in an incident PD cohort (the ICICLE-PD study). Participants (154 newly diagnosed PD patients and 99 controls) underwent physical and cognitive assessments over 36 months of follow up. Mean leukocyte telomere length and the expression of senescence markers p21 and p16 were measured at two time points (baseline and 18 months). Additionally, we selected five inflammatory markers from existing baseline data. Results: We found that PD patients had shorter telomeres at baseline and 18 months compared to age-matched healthy controls which also correlated to dementia at 36 months. Baseline p16 levels were associated with faster rates of motor and cognitive decline over 36 months in PD cases, while a simple inflammatory summary score at baseline best predicted cognitive score over this same time period in PD patients. Conclusion: Our study suggests that both inflammatory and senescence markers (p16) are valuable predictors of clinical progression in PD patients.
STUDY OF HOMEOSTASIS MODEL ASSESSMENT OF INSULIN RESISTANCE, DYSLIPIDEMIA, ANTIOXIDANT VITAMINS STATUS, SERUM CALCIUM, PHOSPHATE AND PROSTATE SPECIFIC ANTIGEN IN PROSTATE CANCER.

The Incidence of Prostate Cancer is increasing day by day all over the world. At present the Incidence is about 5 per 1, 00,000 in India. There is strong evidence that genetic and environmental factors play in important role in pathophyology, of prostatic cancer. In this study HOMA-IR, serum Calcium, Phosphate, Lipid profile, PSA and antioxidant vitamins were estimated. Age matched 50 Prostate cancer cases and 50 controls included in the study. The insulin resistance in all cases and control groups evaluated by estimating fasting blood glucose and insulin levels, by using HOMA IR Formula. Antioxidant vitamins estimated by HPLC, Serum Calcium, Phosphate, lipid profile and Prostate specific antigen by enzymatic kits using Autoanlyzers. In the present study, the values of HOMA-IR, serum Calcium and PSA are (p<0.05) significantly increased than in controls. The Serum alfa tocopherol and ascorbic acid values in cases significantly reduced (p<0.05) than in controls. The growing of prostate cancer is a multifactorial. Insulin resistance, antioxidant vitamins status, hyper calcimeia and dyslipidemia play an important role in pathogenesis of prostate cancer.
A Survey of Nursing Students' Perspectives on Use of Nursing Central© Information Software in Clinical Learning

he information explosion and increasing popularity of electronic information storage means nursing students today must access a variety of information repositories to retrieve health and nursing information. Nurse educators are called to design innovative teaching and learning opportunities for student nurses to attain informatics competence within the current health care environment. This paper reports student nurses’ evaluation of a nursing information software program, Nursing Central © software (Unbound Medicine), that was housed on a handheld personal digital assistant (PDA) and used for a six-week clinical rotation (Jamieson et al., 2009). Eight (32%) of the intervention group nursing students completed the voluntarily online survey that contained open-ended and Likert questions. Study findings suggest that the PDA-based, Nursing Central © software improved access, retrieval, and quality of information to support nursing care in clinical practice. However, further study with a larger, more diverse sample and longer intervention period is required before widespread adoption of this teaching support within nursing education. T
Benign fibro-osseous lesions of the jaws: a clinicopathologic study of 98 Tanzanian patients

Introduction: The benign fibro-osseous lesions (BFOL) are characterized by replacement of the normal bone by cellular fibrous tissue containing various forms of ossification. They encompass common clinical, radiologic and histopathological features and hence pose considerable diagnostic and therapeutic challenges to clinicians and pathologists. Objective: To analyze the clinico-pathological and radiological features of BFOLs of the jaws in patients treated at Muhimbili National Hospital, Tanzania. Material and methods: A retrospective study of files of patients who were diagnosed with BFOLs from January 2011 to December 2013 was done. The collected information included data on demographic characteristics, the duration of the lesion, location of the lesion, presence of swelling, associated symptoms and reported radiological and histological features. Results: A total of 98 patient's records were retrieved. There was a predominance of females (59, 60.2%), with a male to female ratio of 1:1.5. The patient's age at presentation ranged from 5 years to 75 years with a mean age of 29.81 ± 15.28 years. Four types of BFOLs were encountered. Ossifying fibroma were the most frequent (61.2%), followed by fibrous dysplasia (19.4%). Maxilla was more affected than the mandible. Majority (>70%) of the BFOLs were radio-opaque. The common histological features in all four types of BFOL included presence of: woven bone in fibrous stroma, giant cells, loose collagen and foci of hemorrhage. Conclusion: In this sample, BFOLs, were slightly more prevalent in females than males, affecting individuals below 40 years at large. They showed several overlapping clinical, radiological and histological features; thus a combination of different modalities seems necessary for an accurate diagnosis.
Nutritional knowledge of parents and the packed lunch they provide their children

Aims: To investigate if the level of Irish parents’/guardians’ nutritional knowledge reflects the foods they provide in their children’s packed lunch. Another aim of the study was to determine if parents’/guardians’ level of education reflects their level of nutritional knowledge. A final aim of the study was to determine whether boys or girls had healthier lunchboxes. Objectives: To have the children complete a lunchbox questionnaire, and for the parents/guardians to complete a General Nutrition Knowledge Questionnaire for Adults. Study Population: 35 8-9 year old children from a South Dublin primary school and their parents/guardians formed the study population. Methods: A lunchbox questionnaire was completed by the children and a General Nutrition Knowledge Questionnaire for Adults was completed by the parents/guardians. SPSS was undertaken to determine whether any correlations existed between the level of nutritional knowledge and the foods provided; the level of nutritional knowledge and the level of education; and to determine any differences between the boys’ and the girls’ lunchboxes. Results: The results from this study show that level of parental nutritional knowledge does not reflect the foods they provide in their child’s lunchbox (p>0.05). There was no relationship found between level of nutritional knowledge and level of education (p>0.05), nor was there any significant difference (p>0.05) between the health status of the boys and girls lunchboxes. The standard of lunches was low, as was the level of nutritional awareness of the parents/guardians. Conclusion: This study attempts to fill a gap in the literature, investigating whether the level of parental nutritional knowledge reflects the lunches they provide in their children’s packed lunch. The results from this study found that level of nutritional knowledge does not reflect the foods parents/guardians provide in packed lunches. Health promotion strategies are needed to target new areas in order to broaden nutritional awareness in the Irish adult population. Healthy lunchbox strategies are recommended to be employed by parents and/or schools in order to improve the nutritional quality of these meals.
THE EFFECT OF VITAMIN B12 SUPPLEMENTION ON FATIGUE IN HEMODIALYSIS PATIENTS

A B S T R A C T Aims: Fatigue is a frequent symptom in hemodialysis patients that impairs the quality of life and like pain and fever; it is an important biological warning for human health. So far, despite the many interventions to reduce fatigue in hemodialysis patients, still this phenomenon is reported with high prevalence. The aim of this study was to determine the effect of vitamin B12 supplementation on fatigue in patients undergoing hemodialysis. Methods : It was a semi experimental study with the method of before-after, which has been done on 86 hemodialysis patients with a Purposive sampling method within three months in 2011 in one and two chosen hospitals. The intervention was an intravenous injection of 100 mcg/ml of vitamin B 12 after dialysis process which has been done three times a week, within two months and by the end of the intervention in order to assess sustainability of the effect of vitamin B12 there was no interventions for one month. Fatigue measurement questionnaire was completed by participants and it was analyzed by using SPSS18 software and descriptive statistic tests, paired t-test and analysisvariance of the repetitive measures. Results: Fatigue after a month of interfering (p=0.001) and with further reduction after two months (p=0.0001) and one month after the end of intervention (p=0.021) has been significantly reduced. Conclusions: The results indicate the effectiveness of vitamin B12 on the reduction of fatigue in hemodialysis patients. Thus intravenous injection of 100 mcg/ml of Vitamin B12 weekly after dialysis is recommended for hemodialysis patients.
Menstrual pattern among adolescent girls in rural area of Bijapur

Introduction: Adolescence is a crucial period in everyone's life. This is the period of transition from childhood to adulthood. These are formative years when maximum amount of physical, psychological and behavioral changes takes place. For girls, adolescence is period of extreme stress and strain. Menarche and menstruation are bound to elicit tremendous psychological response in them. Objectives of the study: To know the menstrual pattern among adolescent girls. Material methods: Community based cross sectional study was done in rural field practice area of department of community medicine, BLDEA'S Shri B.M. Patil medical college, Bijapur. The study subjects include all adolescent girls who have attained menarche. Results: Mean age of menarche of adolescent girls in the present study was 14 years, mean duration of blood flow 3.9±5.07 days. Mean intermenstrual period 28.7±3.26 days and dysmenorrhoea was present in 27.9% of adolescent girls.