Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessment of Auditory Function in Obese Children

Background: Obesity is a chronic condition, associated with multiple comorbidities. Great attention has been paid to the obesity comorbidities such as cardiovascular disease and insulin resistance up to diabetes mellitus (T2DM), there’s evidence suggests that obesity affects hearing. Aim of the study: The aim of the current study was to evaluate the relationship between obesity and hearing in a group of obese children. Methods: The present study was a controlled study that was carried out on 80 children of both genders and divided into study group, 40 healthy obese children, they were subdivided after the study has been completed into; group I, 26 healthy obese children with normal middle ear function. Group II 14 obese children with middle ear dysfunction. Control group, included forty non-overweight children. Results: Our study revealedthat there were significant increase of the pure tone threshold in obese children with middle ear affection in comparison to obese with normal middle ear and the control group. Positive correlation between pure tone with the anthropometric measures, lipid profile and insulin resistance in obese children with diseased middle ear. Cochlear affection in obese children with normal middle ear evidenced by a negative correlation between transient otoacoustic emission with the anthropometry, liver enzymes and insulin resistance. Conclusion: Obesity considered as a risk for conductive hearing loss and cochlear affection.
Knowledge regarding dengue disease among people in an urban area: a cross sectional study

Background: Vector borne diseases are one of the major public health problems worldwide. There is significant disease burden contributed to morbidity and mortality due to Dengue. Vector control is the ideal way to control dengue. But vector control methods can be successful with community participation. Hence it becomes important to assess the community’s knowledge regarding the disease. The objective of the study was to assess the knowledge regarding the dengue disease among people in an urban area.Methods: A community based cross sectional study was conducted among 400 participants. Participants were selected by using systematic random sampling method. Data was collected by house to house visit using predesigned questionnaire.Results: Majority of them (87.75%) identified fever as a cardinal symptom of dengue fever. Only 32.25% knew that dengue fever is transmitted by Aedes mosquitoes. 42% of participants had good knowledge of dengue The main source of information on dengue was from the television.Conclusions: Key finding of this study is that knowledge is poor among the study participants although majority of people had clear understanding of fever, headache, joint pain as common signs and symptoms of dengue fever.
Association between coronary artery disease and responsiveness of aortic stiffness and pulsatile diameter change to nitroglycerin

Aim: This study aimed to evaluate the difference between the effect of nitroglycerin on the aortic stiffness measured by transthoracic M-mode ultrasonography in patients with and without coronary artery disease (CAD). Material and Methods: This study was conducted on one hundredpatients with a presume diagnosis of CAD. The patients who had a SYNTAX score (SS) ≥1 according to the results of coronary angiography constituted the CAD group (n:60), while patients who had a SS=0 constituted the control group (n:40). The stiffness of the ascending aorta and arterial blood pressure were measured before and 10 minutes after the sublingual administration of 800 mcg nitroglycerin. A comparison of each parameter before and after nitroglycerin was evaluated for statistical significance using paired sample t-test. Results: In the control group, after nitroglycerin administration, there was a statistically significant reduction in the pulsatile diameter change (from 2.30±0.79 to 1.74±0.91) and significant increase in stiffness index (from 6.24±2.41 to 9.07±5.88). In the CAD group, after nitroglycerin administration, there wasno statistically significant difference in terms of pulsatile diameter change (from 1.42±0.88 to 1.28±0.68) and stiffness index (from 13.52±7.64 to 13.10±7.85). Conclusion: The effect of nitroglycerin on the aortic stiffness measured by transthoracic M-mode ultrasonography differs in the CAD and control groups. Our findings warrant further studies with a larger population to describe the practicability of this method for the CAD diagnosis.
A local perspective on basal cell carcinoma : frequency of subsequent skin tumours

Malta Medical School Gazette Volume 01 Issue 04 2017 Abstract Background: Basal cell carcinoma (BCC) is the commonest skin malignancy with a significant risk of recurrence and new primaries. The major risk factor is ultraviolet (UV) radiation, which is relevant to Malta, where the UV index is frequently high. Objective: The aim of this study was to follow up patients diagnosed with BCC, analyse the occurrence of subsequent malignant and pre-malignant skin tumours and assess whether variables like age and gender modify risk. This will aid local screening methods and follow-up protocols. Method: Patients registered with BCC in the Malta National Cancer Registry in 2007 were included in our study. Histology results belonging to these patients were followed up until the end of 2014. Risk of developing further lesions when accounting for age and gender was calculated using the Chi^2 test for Independence and hazard ratios. Results: A total of 382 patients were diagnosed with BCC in 2007. Almost one third of these patients (30.1%) had at least another skin tumour biopsied thereafter; 71.7% of these tumours were BCCs. Squamous cell carcinomas and actinic keratoses were also commonly biopsied. Nine patients developed malignant melanoma. The commonest location for BCCs and other non-melanoma skin tumours was the face. Males and the elderly had significantly higher risks to develop further skin tumours, as reflected by our statistical data. Conclusion: Our results are consistent with international data. BCC fulfils most criteria for screening, thus follow-up in high risk patients is recommended.
Heart Failure-Related Palliative Care through Education and Standardized Referral

Heart failure is a complex syndrome affecting over 5.7 million Americans. The annual cost of heart failure in the United States is $31 billion with much of that occurring toward the end of life. Providers struggle with predicting the trajectory of the condition, leaving many patients without resources to make informed decisions and an overall decrease in their quality of life. The purpose of the Standardized Palliative Care Referral for Heart Failure evidence-based quality improvement project was to determine if education and a standardized referral process would increase the number of heart failure related palliative care referrals at an ambulatory heart failure clinic. The project was quasi-experimental with a pretest, posttest assessment of heart failure related palliative care referrals along with provider and patient characteristics. There were 12 cardiology providers who participated in the project. Twelve participating cardiology providers were educated on the palliative care benefits and the supportive guidelines. An alert was built into the electronic medical record based on ICD-10 heart failure codes. The alert fired at the beginning of the encounter and provided patient triggers on when to consider palliative care, allowing the provider to place the palliative care order from the alert. Outcomes measured included palliative care referral rates pre and post intervention along with follow-up care (readmission, emergency room visits, office visits). Results from the pre and post intervention were the same, revealing that 4% of cardiology encounters with heart failure patients resulted in palliative care referrals. Based on these results, further intervention should focus on changing the alert timing from the beginning to the end of the encounter.
A preference for dialogue: exploring the influence of patient preferences on clinical decision making and treatment in primary care physiotherapy

Abstract Background: Eliciting and considering patients’ preferences is essential to any clinical encounter and to good, high quality health care. Little research exists on how preferences are accommodated in decision making and how they influence treatment and rehabilitation. Aims: To explore perceptions of patients with musculoskeletal pain regarding how their preferences were accommodated in clinical decision making and influenced their rehabilitation, and whether their preferences changed during their rehabilitation. Methods: Qualitative interview study. Results: Participants’ preferences had, for the most part, influenced both choice of treatment and rehabilitation as a whole. While preferences were expressed to various extents, and largely perceived to be accommodated in the decision process, a good dialogue was considered essential for collaborative rehabilitation. Treatment decisions were to a large extent made jointly by the physiotherapist and the patient. Regardless of the strength of the preferences, participants appreciated the dialogue with the physiotherapist and the opportunity to discuss treatment options. The participants described how the physiotherapy episode of care had influenced their perceptions of and preferences for different treatment methods. Conclusions: The findings emphasise the importance of eliciting patient preferences, two-way communication and discussing treatment options, in order to stimulate collaborative rehabilitation.
Evaluation of characteristics of the patients who undergo surgical treatment for lung hydatid cyst

Background: Hydatid cyst is a public health problem, particularly where it is endemic. It is a benign disease and usually asymptomatic unless the symptoms and complications develop. Effective treatment is important because this benign disease can cause considerable mortality and morbidity. The aim of this study was to describe the epidemiological and clinical characteristics of HC, localization (bilateral lungs or multiple organ involvement) and perforation characteristics of HC. Materials and Methods: 160 patients were operated on for pulmonary hydatid disease for about approximately 12 years of time period. Patients were evaluated according to their age, gender, distribution of cysts in the lung, extra-pulmonary organ involvements, presence or absence of perforations, and animal contact stories. Results: Number of the cysts, the cyst diameter, gender, location of the cysts and the liver involvement were found unrelated with the perforation status of the cyst. But, there is a significant difference between the localization of the cysts in the lung and the involvement of the liver. The rates of presence of liver cysts in the case of unilateral right, unilateral left and bilateral cysts in the lung were found as 13%, 25% and 50% respectively. Conclusions: Hydatid cyst is a public health problem and elimination is possible with rigorous work. In case of bilateral pulmonary cysts and the multiple number of cysts, the likelihood of a cyst in the liver is increased. It was concluded that there was no relationship between the presence of cysts in the liver and the absence of perforation in the lung cysts. However, it should be kept in mind in terms of the possible complications that may occur at high perforations in patients who received preoperative albendazole therapy.
Recherche sur l'agent de la maladie de la glande digestive de Ostrea edulis Linné

De nombreuses maladies ont ete decrites depuis longtemps chez les huitres des genres Ostrea et Crassostrea et principalement chez les especes faisant l'objet d'un elevage et ayant donc un interet commercial. L'absence de croissance mais le plus souvent des mortalites restent dans la plupart des cas les symptomes les plus evidents de l'etat presume de maladie. Les effets de ces epizooties sont parfois si graves qu'ils peuvent entrainer la disparition d'une population d'huitres dans une zone determinee comme ce fut le cas pour Ostrea edulis L. en 1920-1921 (Dollfus, 1922) sur certaines cotes d'Europe et pour Crassostrea angulata LMK en 1970-1971 sur les cotes francaises atlantiques et particulierement dans les bassins de Marennes-Oleron et d'Arcachon. Ces cas peuvent etre consideres comme extremes car le plus souvent les huitres sont sujettes a des affections dont les effets n'ont qu'un caractere episodique, ne touchant que partiellement les elevages.
Functional Outcomes of 300 Carpal Tunnel Release: 1.5 cm Longitudinal Mini-incision

Objective: There is an opportunity for median nerve decompression by open surgery in carpal tunnel syndrome which is the most common surgical procedure in neurosurgical practice. The aim of this study is to evaluate the long-term outcomes of carpal tunnel release with 1.5 cm longitudinal mini-incision technique with regarding the effectiveness and safety. Methods: For this prospective study, 300 hands for 188 patients with advanced carpal tunnel syndrome who had indication for neurolysis underwent carpal tunnel release through a 1.5 cm longitudinal mini-incision between March 2011 and 2015. There were 132 (70%) females and 56 (30%) males with a mean age of 40 ± 29.5 years (ranging from 24 to 73) and female to male: About 2.56. 178 operations were performed for the right hand and 122 for the left hand. Preoperatively, all patients were evaluated with clinical examination and nerve conduction studies. The clinical effects of the patients assessed with the Global Symptom Score (GSS) and Visual Analog Patient Satisfaction Scale. Results: The mean follow-up period was 18.6 ± 9.3 months (12–30 months). Postoperatively, 2% (six hands) complained of residual mild pain with tenderness of scar and only 1% (three hands) complained of median nerve damage (neuropraxy) with tingling and numbness but was temporary which improved after 1 week. Five patients (seven hands) loosed strength of their wrists, but muscle force of abductor pollicis brevis reinforced after 1 month. There is no evidence of local infection, stiffness, loss of some wrist strength, or recurrence of the disorder. Postoperative GSS scoring obviously improved than preoperative (P < 0.002). There is no patient who underwent reoperation. The mean time recovery appeared almost 2 weeks. Conclusion: 1.5 cm longitudinal mini-incision method in carpal tunnel syndrome decompression showed satisfactory pain relief, wound healing, and nontender scar with good functional outcomes. The technique was performed safely without major complication.
Platelet to Lymphocyte Ratio for Prioritising Perforated or Gangrenous Appendicitis in a Triage of an Emergency Room

Aim: Some studies suggested Platelet Lymphocyte Ratio (PLR) is associated with perforated or gangrenous appendicitis. This study aimed to evaluate the effectiveness of the platelet-lymphocyte ratio in distinguishing simple acute appendicitis from perforated or gangrenous appendicitis in the clinical emergency setting Method: This study was conducted retrospectively in academic tertiary hospital on 302 patients who had undergone appendectomy for a period of eight years from mid of 2008 to the mid of 2016. We divided them according to their histopathological results two to groups simple acute appendicitis and perforated or gangrenous appendicitis. Results: The study demonstrated that PLR is a useful indicator in diagnosing perforated or gangrenous appendicitis with a cutoff value of 197.57 with sensitivity 63.3% and specificity 38.7% and P=0.057. The risk for developing perforated or gangrenous appendicitis in patients with high Original Research Article Makki et al.; JAMMR, 27(9): 1-7, 2018; Article no.JAMMR. 44906 2 Platelet Lymphocyte Ratio (PLR) was 1.5 times higher than those with standard Platelet Lymphocyte Ratio odds ratio (OR): 1.58 (P=0.002). Conclusion: PLR is a simple, cost-effective is a useful parameter that diagnoses complicated perforated appendicitis.
Abstract 10903: Extraction Outcomes in Patients With Congenital Heart Disease

Introduction: Patients with congenital heart disease (CHD) frequently require implantable cardiac devices. Device infection or malfunction may necessitate lead extraction. Extraction may be challenging due to long lead dwell times, anatomic abnormalities, and prior cardiac surgery. Little is known about extraction outcomes in the CHD population. Methods and Results: This retrospective study included 41 CHD patients and 82 age and gender matched controls that underwent lead extractions at two centers between 2001-2014. Only patients with leads older than 12 months were included. There were 79 leads in CHD patients and 150 in controls. Patients with CHD had a mean age of 39±17 years at extraction and on average their leads had been implanted for 81±84 months, this was not significantly different from the control group. Eighty eight percent of CHD patients had 1 or more cardiac surgeries as compared to only 22% of controls (p<0.001). The number of abandoned leads was also significantly different with 16 aban.
Study on morbidity pattern of neonates admitted to special new born care unit of M.K.C.G. medical college hospital with special reference to hypoglycemia

Background: Children under five are most fragile group of population and so subjected to high mortality and morbidity. Among them, neonatal group is highly suseptible due to poor adaptation of their premature organ system. Neonatal hypoglycemia is a common co-morbid condition contributing to mortality. The objective of the study was to assess the etiology and clinical profile of neonatal hypoglycemia among the neonates admitted to special newborn care unit and to assess the co-morbidity pattern among them.Methods: Type of study was hospital based cross-sectional study at SNCU of MKCG Medical College Berhampur, Odisha. Sample size was 204 neonates who developed hypoglycaemia (blood glucose level <40 mg/dl). Study period was 2016-2017 statistical tests used-percentage and proportion. Statistical software used- SPSS 16 version.Results: Out of total 2616 admission during study period, the incidence of hypoglycemia was 7.79%. 52% were male babies and 58% were out borns. Among the maternal causes, anemia was the most common cause (37.7%). Low birth weight was highest (55.8%) among neonatal factors. Jitteriness and tremor were the major symptoms (32.5% cases). Lethargy and poor feeding were presenting symptoms (19.6% cases). On analysing the outcome, 7.8% neonate died and 78.4% recovered.Conclusions: Being a common co morbid condition and presented with other neonatal problems it is more seen among outborn males and anemic mothers. Cause may be delay in initiation of feeding and interruption of feeding on the way during referral. However proper counseling should be given to caretaker of referral case about feeding on the way. Early detection of hypoglycemia is important to reduce mortality and prevent future sequelae in sick newborns.
Prediction of Outcome of Acutely Intoxicated Patients Admitted To Intensive Care Unit in Mansoura-Dakhlia Governorate-Egypt

Acute poisoning is a frequent cause of admission to emergency departments and intensive care units, as it is considered as an important medical emergency requiring early diagnosis and rapid initiation of therapy. The aim of the present study was to assess characteristics, and outcomes of acutely intoxicated patients who were admitted to ICU. Also, design a scoring system regarding priority for ICU admission. The present study was carried out on 40 patients who were admitted to intensive care unit of El Mansoura General Hospitals- Egypt during a period of 6 months. Personal, toxicological, and medical histories, clinical examination and routine investigations were recorded for each patient. At discharge; all patients were reassessed for determination of patients' outcome. The patients were mostly females, single; student aged less than 30 years and from rural areas. The majority of the patients (72.5%) were recovered, 22.5% were died and 5% were referred to hyperbaric oxygen therapy units after carbon monoxide intoxication. Many patients were presented by constricted pupil (45%), respiratory depression (42.5%), altered mental status (42.5%), tachycardia (47.5%), and nausea & vomiting (75%). The highest numbers of cases were poisoned by medicinal drugs (40%) followed by agricultural chemicals (35%). Statistically significant difference between occupation, toxicological amount & frequency, pulse rate, Glasgow coma score, PH & PCO2 and type of poison (zinc phosphide) and patient outcomes was observed. Although many of the patients' characteristics were significantly associated with patient outcome yet none of them was considered significant predictors for death. So, the suggested scoring system depended mainly on clinical data and simple rapid investigation that may be helpful for rapid assessment of the patients after further validation. We recommend the presence of a channel of communication between the general care centers and the poison control centers for consultation about the protocol of treatment of poisoned patients. Nationwide, a mechanism of communication between the poison centers must be done to benefit from the different expertise and to make a uniform protocol for treatment of poisoned cases to decrease the mortality rate and the burden on hospitals resources.
Study of non-alcoholic fatty liver disease in metabolic syndrome

Background: Metabolic syndrome is a clustering of risk factors that increase an individual’s probability of developing atherosclerotic cardiovascular disease, type 2 diabetes mellitus and all cause mortality. Since primary NAFLD has strong association with metabolic syndrome as a whole and various components of metabolic syndrome, it is being debated whether NAFLD is a hepatic component of metabolic syndrome. Hence this study was done to study the prevalence of non-alcoholic fatty liver disease in healthy individuals and in patients with metabolic syndrome and to establish a relationship between NAFLD and Metabolic syndrome.Methods: A total of 122 patients - 61 with metabolic syndrome and 61 without metabolic syndrome fulfilling inclusion and exclusion criteria who presented to the Medicine outpatient Department of Ramaiah Medical College, Bangalore, between October 2014 and September 2016 were included in the study. Baseline variables, laboratory parameters, ultrasound abdomen findings were compared between the groups.Results: Mean age of the subjects in metabolic syndrome group and non-metabolic syndrome group were 52.4±15.4 and 50.7±15.4years respectively. Mean triceps skin fold thickness (in cms) for the subjects in metabolic syndrome group and non-metabolic syndrome group were 19.16±6.1 and 7.59±2.57 respectively (P <0.05). Prevalence of fatty liver on ultrasonography in metabolic syndrome and non-metabolic syndrome were 42.62 % and 21.31% respectively. Overall prevalence of NAFLD was 31.97 %. Conclusions: Overall prevalence of NAFLD from current study was 31.97%. The prevalence of NAFLD was significantly higher in persons with metabolic syndrome than persons without metabolic syndrome.