Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk Factors for Cardiometabolic Disease among Pacific Islanders in California: Results from the California Health Interview Survey

Author(s): Faruk, Farheen | Advisor(s): Anton-Culver, Hoda | Abstract: Pacific Islanders are often analyzed as a subset of the Asian population. There is a lack of research on the Pacific Islander population in California. Although the Pacific Islander population in the United States is rather small, it is still important to study. The objective of this study determined the risk factors for these cardiometabolic disease conditions in Pacific Islanders. The prevalence of diabetes, high blood pressure, and overweight/obesity were examined in Pacific Islanders, and risk factors associated with these conditions were examined in Pacific Islanders. We found that Pacific Islanders had a weighted prevalence of diabetes that was intermediate in comparison to other race groups. Hypertension was lower than the overall sample prevalence and most race groups. Overweight and obesity prevalence was second highest in the Pacific Islander population. It was also found that the risk factors associated with each disease outcome differed between Pacific Islanders and Whites. Smoking status, high blood pressure, and high BMI were associated with odds of diabetes. Insurance status, diabetes, and high BMI were associated with odds of high blood pressure. Diabetes, high blood pressure, and sex were associated with odds of high BMI in Pacific Islanders.
Survey of Student s Mental Health Status and Some the Related Demographic Parameters of Medical Sciences University-Abadan International Department

Mental health is one of the fundamental issues of student life; giving enough attention that has a direct effect on the growth and development of society, and addressing is the main condition for efficient utilization and educated resources. The present survey was a descriptive-cross sectional study, and the population consisted of 450 students at medical sciences university-Abadan international department that among them 165 subjects were selected through cluster sampling. The data was collected by using the general health questionnaire (GHQ-28) and demographic questionnaire. To determine the students having and lack of the problems, we used the section point 23 as well as used the section point 6 for each of the domains. Then, the data was analyzed by descriptive statistics (percentage, frequency, mean and standard deviation) and inferential statistics (T-Test and correlation coefficient) with software SPSS15.The results showed that the prevalence of mental disorders in 163 college students (48 male and 115 female) was 2.5 percent and in each domain: physical disorder 3.6 %, anxiety disorder 2.4%, social function disorder were 33.2 % , and the rate of depression was 1.2 %, in which the social function disorder was highest and the depression was lowest. There was no significant difference between the mean mental health in men and women at level of 0.05. In addition, there was no significant difference between the mean mental health for single and married student at level of 0.05. Moreover, there was a significant correlation between the mental health score and the order of children birth at the level of 0.05 and at this domain; the correlation coefficient in depression was 0.245, and it was 0.166 in anxiety. However, we observed no significant correlation between the mental health score and the mean the student. To Conclusion, the financial position is one of the most important factor in general health level of students, therefore, the respectful administrators should pay enoughattention to the more welfare facilities of student in the lower social classes is necessary.
Differences Use of Yoga and Self-Tapping Towards Long Pain of Primary Dysmenorrhea on Adolescent

Background : Dysmenorrhea is a common complaint in young women, characterized by pain. Dysmenorrhea pain has a significant impact on women's lives, such as limitations in daily activities. Primary dysmenorrhea can be treated using yoga and self-tapping. Objective: understanding differences on use of Complementary and Alternative Medicine (CAM), such as yoga and self-tapping towards changing long pain of primary dysmenorrheal. Method: Study was conducted by quasi experiment with nonequivalent pretest-posttest control group design. Study was conducted on November 2016 until February2017 in SMK “A” Pedan Klaten and SMK “B” Klaten. Sample of study amounted 88 respondent divided on 47 respondents on experimental group and 41 respondent as control group. The experimental group was given a yoga intervention; control group was given self-tapping. Measuring tool using Numerical Rating Scale (NRS). Data analysis using t-test for independent sample, Mann-Whitney test and Wilcoxon. Result: Statistically yoga and self-tapping were equally effective in reducing the long pain of primary dysmenorrheal with p values of 0.000 and 0.012 respectively. Clinically yoga is more effective in reducing the long pain of primary dysmenorrhea with mean 1,49 compared with self-tapping 0,46. Conclusion: Yoga become more effective intervention on reduction long pain of primary dysmenorrhea compared to self-tapping.
Mortality in Hospitalised HIV/AIDS Patients in a Tertiary Centre in Sub-Saharan Africa: Trends Between 2007 and 2015, Causes and Associated Factors

With easy accessibility to combination Antiretroviral Therapy (cART), mortality amongst hospitalized HIV/AIDS patients needs to be described. We aimed at determining the trends, causes and factors associated with in-hospital mortality amongst HIV/AIDS patients in the Douala General Hospital. We retrospectively reviewed hospitalisation records of HIV/AIDS patients hospitalized in the medical wards of the DGH from 2007 to 2015. Four cause-of-death categories were defined: 1. Communicable conditions and AIDS-defining malignancies, 2. Chronic non-communicable conditions and non-AIDS defining malignancies’, 3. Other non-communicable conditions and 4. Unknown conditions. Logistic regression was used to determine factors associated mortality. We analyzed 891 eligible files. The mean age was 43 (standard deviation (SD): 10) years and median length of hospital stay was 9 (interquatile range (IQR)4 - 15) days. The overall all-cause mortality was 23.5% (95% CI: 20.8% - 26.4%). The category - communicable conditions and AIDS defining malignancies represented 79.9%, of deaths and this remained constant for each year during the study period. Tuberculosis was the most common specific cause of death (23.9%). Patients who had two (OR=2.35, 95%CI: 1.35 - 4.06) and more than two (OR=4.23, 95%CI: 1.62 – 11.12) opportunistic infections, a haemoglobin level less than 10g/l (OR=2.38, 95%CI: 1.58 - 3.59) had increased odds of dying. In-hospital mortality is high amongst HIV/AIDS patients at the Douala general hospital. The category - communicable conditions and AIDS defining malignancies - is still the main underlying cause of death. We hope that our findings will help to develop interventions aimed at reducing in-hospital mortality.
Ruptured HCC and Variables in Management-Case Series and Literature Review

The study includes retrospective cases of rupture of HCC operated in our department from since 2012. Variables including size, location, cirrhosis grade, tumour grade, focality, performance status, surgical treatment, post-operative variables including morbidity and mortality are analysed. We wish to present our data on ruptured HCC . seven patients (4M:3F) presented with rupture of HCC. (Table 1)Most common mode of presentation was sudden onset abdominal pain (100%), followed by giddiness (71.4%). Hemodynamic instability was present in 28.5% (n=2). On evaluation, it was found that all were cirrhotic and that 85.71% (n=6) were HbsAg+ and one was of unknown cause for cirrhosis. The lesions were single in 85.71% (n=6) and multiple in 1 patient. The lesions were present in right lobe (n=3), left lobe (n=3) and bilobar (n=1). The mean diameter of the lesions was 6.9 cm (range-3-12 cm). The grade of differentiation was well differentiated in all amenable for surgical resection. Two patients were diagnosed intraoperative and five with preoperative imaging. The surgeries (n=5) included emergency surgery in 2 patients with no preoperative diagnosis of RHA ligation and non-anatomical resection of segment 3⁄4 in one patient. The other five patients were treated by the two stage therapeutic approach where a trial of non-operative management is given to optimize the patient followed by definite surgery. The duration of the trial was a mean of 5.6 days for the patients followed by left hepatectomy in 2 patients and right hepatectomy in one patient. Two patients were managed conservatively one which was followed by TACE and the other by BSC only. On follow up of these patients, 3 patients (42.8%) died during follow up period of 30 months and there was one recurrence after non anatomical resection at 9 months which was managed by RFA. The grade of cell differentiation was classified according to the Edmondson and Steiner system [1].
Knowledge, attitudes and practices of doctors regarding isoniazid preventive therapy in HIV/AIDS patients at Odi District Hospital, Gauteng province, South Africa

Introduction: Isoniazid preventive therapy (IPT) can reduce the overall risk of active tuberculosis (TB) in people living with HIV/AIDS (PLHIV) by up to 62%. As a result the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended IPT provision as a global strategy to reduce the prevalence of TB for PLHIV. However, whilst there are 84 countries supporting the provision of IPT in their policies, less than 1% of PLHIV in those countries are currently receiving IPT. Approximately 65% of TB patients in South Africa are HIV co-infected. Despite this fact, doctors are hesitant to prescribe IPT to TB-negative HIV-infected patients. Many doctors are also unaware of the current IPT guidelines of South Africa. This study sought to determine the level of knowledge, attitudes and practices of doctors regarding IPT for patients infected with HIV at Odi Hospital in Gauteng.Methods: A cross-sectional descriptive study was undertaken with a standardised questionnaire administered to 51 doctors working at Odi Hospital.Results: There were 51 respondents, many doctors (43.1%) having an excellent knowledge of IPT. Although one-third of the doctors were dispassionate about IPT provision, the majority of respondents (54.9%) had positive attitudes towards IPT provision. On average the doctors had good practices regarding IPT provision (35.3%). There were 12 (23.5%) doctors who were trained for IPT implementation. Although training was not associated with doctors’ knowledge or attitudes towards IPT, it was associated with the practice of IPT implementation.Conclusion: Irrespective of their position, doctors at Odi District Hospital need formal training on the implementation of IPT, as this increases their confidence in IPT and their implementation practices.
Prevalence of associated psychosomatic symptoms in patients of irritable bowel syndrome

Background: Irritable bowel syndrome (IBS) is a functional disorder of gastrointestinal tract with unclear aetiology and no reliable biomarkers like other chronic and functional disorders. Majority of the patients of IBS suffer from various forms of psychosomatic disorders as comorbidity that further exaggerate the complexity of diagnosis and management of IBS. The aim of the present study was to find the prevalence of commonly associated psychosomatic symptoms associated with IBS in the patients of lower socioeconomic strata.Methods: This is a prospective observational study carried out over a period of 10years from November-2007 till October-2017, in HAHC hospital attached to Hamdard Institute of Medical Sciences and Research. A structured questionnaire comprising of a total of 36 closed ended questions was designed. Eleven questions were about the demographic characteristics and twenty-five were pertaining to IBS symptoms according to Manning and Rome III criteria with some necessary modifications. Various psychosomatic illnesses were recorded separately after ruling out the organic cause with appropriate investigations.Results: In the present study out of 4000 patients with IBS symptoms, 70.8% were having some form of psychosomatic symptoms, Patients with psychosomatic disorders were significantly more often young in age and females (53.28%), showing highest number of patients belonging to the age group 26-35years (51.44%). 34% patient had two or more psychosomatic illnesses. Headache (62.26%) and insomnia (63.03%) were the commonest followed by chest pain (36.54%). Chest pain (77.68%), headache (62.26%) and insomnia (56.07%) was more common in male whereas palpitation (60.58%) and breathlessness (57.68%) was more common in female.Conclusions: There is significantly high prevalence of psychosomatic illness in the patients of IBS in the low socio-economic strata. The young patients (productive age group) are more affected which may be responsible for further deteriorating their social and economic condition.
Stakeholders’ perceptions of dietary and related self-management challenges and education programme preferences for type 2 diabetes adults

Objective: To inform the adaptation of an intervention from a primary healthcare setting to a tertiary setting, the dietary and related self-management challenges and education programme preferences of adults with type 2 diabetes (T2DM) were explored. Setting: A study was undertaken in a tertiary teaching hospital in Gauteng Province, South Africa. Methods: A qualitative approach was employed. Data were collected via focus-group discussions and open-ended self-administered questionnaires from a convenient purposive sample of T2DM patients (n = 28; 40–70 years) and health professionals (n = 10) respectively. Data were analysed using a thematic framework method. Results: Participants revealed diabetes-related knowledge deficits and struggle with adhering to diet, exercise, medication and appointment keeping as problems affecting patients. They also perceived multiple barriers to effective self-management (financial constraints, unsupportive social and physical environments and personal factors). Patients perceived the challenges to greatly impact on their quality of life and consequently the motivation to self-care appropriately. Participants desired an education programme in the form of monthly group meetings with approaches to enhance learning (e.g. use of examples from peers and the provision of education materials). Strategies for motivating and sustaining programme participation (e.g. testimonials from successful participants) were perceived as necessary. Involving family was seen as a key support for positive behaviour change. Conclusion: In adapting the intervention, the participants’ preferences for education need to be considered and the unique challenges addressed. In particular, strategies for enhancing the patients’ motivation and the self-efficacy to effectively self-manage are essential.
The Level of CD4+ T Cell Count among Reproductive Age Women Coinfected with Human Immune Virus, Hepatitis Surface Antigen and Herpes Simplex Virus in Kogi State, Nigeria

Background: There are pockets of evidence to show the existence of co-infections of viral particles in humans. Aim: The study aimed at evaluating the CD4+ T cell count among women of reproductive age co-infected with human immune virus, hepatitis surface antigen and herpes simplex virusin Kogi state, Nigeria. Methodology: 342 females of reproductive age within the ages of 15 - 49 years participated in this study. They were recruited from various local government areas of three Senatorial districts of Kogi state. Blood samples were collected from participants and analyzed for HSV1/HSV2, HIV, HBsAg and CD4 using different scientific methods and procedures. Results: There was no significant differences in mean CD4+ T cell counts between subjects who tested positive and those who tested negative for only HSV1 (p = 0.61), HSV2 (p = 0.95), HIV (p = 0.48) and co-infection for HSV1, HSV2, HIV (0.68). In contrast, mean CD4+ T cell count was significantly higher in those who tested positive compared with those who tested negative for HBsAg alone (p = 0.03) and those co-infected with HSV1, HSV2, HBsAg (p = 0.01). Analysis of variance (ANOVA) indicated no significant differences in CD4+ T cell counts among the different classes of infections. Conclusion: This study shows no decline in the count of CD4+ T cell on the co-infections of HSV1, HSV2 and HIV, but higher significant difference in those co-infected with HSV1, HSV2 and HBsAg was recorded among the women of child bearing age in Kogi state.
Evaluation protocol before, during, and after bronchoscopy-guided swallowing test for decannulation: clinical audit proposal

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Cocaine

Kudos to you for trying to dig up accurate information for your friend. Cocaine (often called coke) is a stimulant and an anesthetic made from coca plant leaves. While it can be used as a local anesthetic and has some medicinal purposes, using it recreationally is currently illegal in the United States. It works by blocking the reuptake of the neurotransmitter dopamine (a chemical responsible for a “reward” sensation in the brain), which leads to dopamine building up in the synapses without being absorbed, which is what creates the feeling of being high. Like many drugs, cocaine can have many serious side effects and be addictive, especially when consumed often, combined with other substances, or taken in large quantities.
Trends of clarification purpose of medical education research in the Asia-Pacific region: A scoping review

Background: In recent years, the Asia-Pacific region has become a hotbed of activity in medical education. Little is known about the progress in advancing the field through clarification research studies situated within a strong conceptual framework vis-a-vis descriptive (“What was done? ”) and justification (“Did it work? ”) research purposes. We aimed to determine the trend in clarification as opposed to descriptive and justification research purposes in the Asia-Pacific region over a 5-year period. Methods: We conducted a scoping review of original research abstracts presented at the 2008, 2010 and 2012 Asia Pacific Medical Education Conferences. All eligible abstracts were classified as descriptive, justification or clarification using the modified Cook (2008) research purpose framework. All abstracts were reviewed by two researchers, with disagreement resolved by consensus. We performed trended Chi-square tests followed by logistic regression adjusted for covariates, to determine the longitudinal trend in clarification studies. Results: Our sample comprised 517 abstracts (2008:136; 2010:195; 2012:186). There was a significant trend towards an increase in clarification studies from 2008 to 2012 (4.4% vs 8.7% vs 12.9%, p=.001), even after excluding submissions from non-Asian countries. When adjusted for covariates, abstracts in 2012 significantly predicted a clarification research purpose compared to 2008 (OR 2.74, 95% CI 1.04-7.23). A non-descriptive study design also significantly predicted clarification studies (OR 7.07, 95% CI 3.17-15.75). Conclusions: Our results of a trend towards increased clarification research purpose affirm the longitudinal progress in quality of medical education research in the Asia-Pacific region. Efforts should be made to promote non-descriptive study designs that are undergirded in clarification research purpose.
The quality of life of patients with epilepsy in Denpasar: A cross sectional study

Epilepsy is the second most common neurological disorder after headache characterized by recurrent seizures in the cerebral region. The main purpose of the treatment of epilepsy is to control seizures without side effects with an optimal quality of life. Measuring quality of life is still relatively a new method in evaluating epilepsy treatment. This study is a cross sectional descriptive study that aims to determine the quality of life of patients with epilepsy using modified QOLIE 31 questionnaire. Epilepsy patients receiving anti epilepsy drug for at least 1 year were enrolled. Demographic, clinical, and treatment parameters were recorded. Quality of Life (QOL) was measured using the modified Quality of Life in Inventory 31 (QOLIE 31) questionnaire for epilepsy. The results obtained a total score of life quality of epilepsy patients 70.29 with the value of each domains: anxiety 66.27; emotional well being 66.27; energy 55.00; medication effect 66.49; social function 80.53; overall quality of life 86.26; cognitive 63.46. We concluded that the quality of life of patients with epilepsy in this study is quite good.
Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States:

Current levels of opioid-related morbidity and mortality in the United States are staggering. Data for 2017 indicate that there were more than 47,000 opioid-involved overdose deaths, and one in eight adults now reports having had a family member or close friend die from opioids. Increasing the availability and reducing the costs of approved medications for those with an opioid use disorder (OUD) is imperative; however, jurisdictions addressing OUDs and overdose may wish to consider additional interventions. Two interventions that are implemented in some other countries but not in the United States are heroin-assisted treatment (HAT; sometimes referred to as supervised injectable heroin treatment) and supervised consumption sites (SCSs; sometimes referred to as overdose prevention sites). Given the severity of the opioid crisis, there is urgency to evaluate tools that might reduce its impact and save lives. In this mixed-methods report, the authors assess evidence on and arguments made about HAT and SCSs and examine some of the issues associated with implementing them in the United States.
Resection of liver metastases from differentiated thyroid cancer: who might benefit? A report of 2 cases with review of literature.

BACKGROUND Liver metastases of differentiated thyroid cancers (DTC) are uncommon. Surgery has proven to be effective in patients with 131I-negative hepatic lesions. Here, we present two patients who underwent liver resection for metastatic DTC. CASE PRESENTATION The first patient is a 36-year-old woman who reported with 70-mm hepatic metastases of papillary thyroid cancer. After primary treatment of cancer, she was disease-free for 8 years when the elevation of TSH levels resulted for the need to search for metastasis. Notably, the 131I SPECT did not show any lesions. The CT scan revealed an 80mm diameter mass in the liver. Histology confirmed metastasis of thyroid cancer. Lack of iodine uptake and the size of lesion excluded treatment with radioactive iodine. Radical resection of the metastasis was performed with good short- and long-term postoperative result. The second patient is a 65-year-old man previously treated for follicular thyroid cancer. When a iodine-negative 70mm diameter metastasis was detected within the liver, he was referred for surgery. Extended right hepatectomy was performed. In a 12-months follow-up, he remained stable, with no signs of recurrence. CONCLUSIONS These two cases show that resection of hepatic metastases of DTC is an option even in the case of large lesions. Given the effectiveness and safety of liver surgery, we reckon that it should be the treatment of choice when possible. The decision to perform surgical treatment should be based on analysis of the ability to perform radical and safe resection.