Miracle-dz/UniFAR-FTUs huggingface dataset:
EXPOSURE TOWARDS HAND, FOOT AND MOUTH DISEASE (HFMD) AWARENESS AND SOURCES OF INFORMATION AMONG CARETAKERS

Using a sample of kindergarten caretakers, this study shows that knowledge about Hand food and mouth disease (HFMD) is considered to be moderate (62.0%). Questionnaires were attained from 197 caretakers from a range of kindergarten in Kuala Nerus district, via universal sampling. The study shows that, within the sample of Kuala Nerus caretakers, insufficient HFMD knowledge does not diverge between educational background and source of health information. The research also indicates that those with experience are more conversant workers. Electronic and social media are the most selected channel by the caretakers for obtaining knowledge. KEYWORDS:HFMD, Caretakers, Kindergarten, Source of Information.
PENGARUH EDUKASI BUKU SAKU TERHADAP PERILAKU ASUPAN ZAT BESI IBU HAMIL TERKAIT PENCEGAHAN ANEMIA DEFISIENSI BESI (Studi pada Ibu Hamil Trimester II Akhir di Wilayah Kerja Puskesmas Bangetayu Kota Semarang)

Iron deficiency anemia is one of the most risky nutritional problems suffered by pregnant women. Anemia in pregnancy affects the increased risk of maternal mortality, prematurity, low birth weight and infant mortality, so efforts are needed to improve anemia prevention behavior in pregnant women. The purpose of this study was to determine the effect of nutrition education using pocket book on iron intake behavior in pregnant women. The behavioral domain under study consisted of knowledge, attitudes, the level of iron adequacy and the level of adherence to the consumption of additional blood tablets in pregnant women. The method in this study is Quasy Experimental with the design of one group pre-post test. Instruments for collected data consisted of a questionnaire and a 24-hour nutrient consumption recall form. Sampling of 45 pregnant women using purposive sampling technique according to inclusion criteria. Data were tested for normality using Shapiro Wilk. Data analysis used Paired T-test and Wilcoxon Signed Ranks Test. Different test results showed differences in conditions between before and after education on the knowledge variable (p<0,05), attitude (p<0,05), iron adequacy level (p<0,05) and the level of adherence to the consumption of added tablets (p<0,05). The results of study showed an increase in the knowledge score of 3,7; the attitude score increased by 3,4; the iron adequacy level increased by 12,9% and the increase in the level of adherence to the consumption of additional blood tablets by 12,4%. The conclusion of this study is that there are effects of pocket book education at knowledge, attitudes, the level of iron adequacy and the level of adherence to the consumption of additional blood tablets in pregnant women. Suggestion from this study is that pregnant women should pay more attention to the need for iron intake during pregnancy to avoid the risk of iron deficiency anemia.
Prescription Audit in an Outpatient Pharmacy of a Tertiary Care Teaching Hospital-A Prospective Study

Background: Prescription audit aids in evaluating the quality of medical treatment offered to the patients. It helps to discern any effective changes that would support health care professionals to proffer superior quality of care to the patients. Aim of the study is to carry out prescription audit in the outpatient pharmacy department of a tertiary care teaching hospital. Methods: A prospective observational study was conducted on 500 prescriptions for a span of four months in the outpatient pharmacy department of a tertiary care teaching hospital in South Karnataka, India. All the prescriptions were analyzed based on WHO prescribing indicators and were evaluated for errors in prescription writing. Data were entered and analyzed using into SPSS. Graphic representation has been used for visual interpretation of the analyzed data. Results: Five hundred scripts comprising of 1,661 drugs were analyzed. The average number of drugs per prescription was three. The study encompassed 52% males and 48% females. Most patients were from the age group of 41-60 years. Only 3.6% (18) of medications were prescribed by generic names. Patients received 9% (145) medications contained in Essential Drug List and prescriptions containing antibiotics were 19% (97). Majority of the prescriptions were from Orthopaedics (18.6%) tailed by General Medicine (15.8%). Consecutively Analgesics (12.7%) were the most commonly prescribed drug class, among which Diclofenac and Paracetamol+Tramadol were usually prescribed, this was tailed by gastrointestinal medicines (11.7%). Conclusion: Prescription audit can be helpful to plan appropriate intervention to ensure the rational drug therapy and to evaluate the existing drug use pattern. It also reflects the perspectives of current prescribing pattern in hospitals. Key words: Prescription audit, WHO prescribing indicator, Essential drugs, Outpatient Pharmacy.
The psychosocial impact and outcomes of brain injury

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Assessment of fetal and maternal radiation absorbed dose in 18F-FDG PET imaging

Background: Clinical application of PET imaging for diagnosis, staging, re-staging treatment planning and treatment response assessment have become a major focus of studies in the past decades. Fetus is more sensitive to ionizing radiation, consequently, radiation absorption risks need to be assessed carefully. The objective of this article is to accurately estimate the absorbed dose during pregnancy in PET examinations. The method adopted in this article is simulative-analytic. Materials and Methods: The absorbed dose from administrating 18F-FDG during pregnancy is estimated through the BodyBuilder anthropomorphic mathematical phantom (inexpensive) together with Monte Carlo simulations in order to obtain a reliable and feasible methodology. In this simulation, the Specific Absorbed Fractions (SAF) is estimated for organs of 3, 6 and 9-months fetal. Results: The obtained results indicate that the absorbed dose of 18F-FDG PET imaging the fetal is 2.50×10-2 mGy/MBq early; 2.04×10-2 mGy/MBq first three months of pregnancy, 1.80 ×10-2 mGy/MBq second three months, and 1.50 ×10-2 mGy/MBq in the third three months of pregnancy. Maternal absorbed dose estimation here is (R2=0.965) which perfectly corresponds to ICRP publication. Conclusion: The results from Monte Carlo code with BodyBuilder anthropomorphic phantoms and ICRP recommendation are of acceptable correlation. Applying the pure BodyBuilder anthropomorphic phantoms in this simulation, which yields agreeable results in addition to its low time consumption, corresponds to the available finding by other researchers while reducing calculation times. Moreover, the fetal & maternal absorbed doses remain however well below the threshold for any deterministic effects.
T suppressor cell function and number in children with liver disease

Con A stimulated suppressor cell function and the proportion of suppressor T cells were reduced in children with untreated chronic active hepatitis (CAH) but were normal in corticosteroid treated CAH patients, patients with severe acute hepatitis and inactive chronic liver disease. Adults with CAH also have defective suppressor function but a normal proportion ofT suppressor cells. This difference may account for the observation that relapse after treatment withdrawal is less frequent in children than in adults.
Learning from patients about patient-centredness: A realist review: BEME Guide No. 60

Abstract Background: Patient-centred work is an essential part of contemporary medicine. Literature shows that educational interventions contribute to developing patient-centredness, but there is a lack of insight into the associated learning processes. Objective: Through reviewing articles about educational interventions involving patients, we aspire to develop a program theory that describes the processes through which the educational interventions are expected to result in change. The processes will clarify contextual elements (called contexts) and mechanisms connected to learning patient-centredness. Methods: In our realist review, an initial, rough program theory was generated during the scoping phase, we searched for relevant articles in PubMed, PsycINFO, ERIC, CINAHL and Embase for all years before and through 2016. We included observational studies, case reports, interviews, and experimental studies in which the participants were students, residents, doctors, nurses or dentists. The relevance and rigour of the studies were taken into account during analysis. With deductive as well as inductive coding, we extended the rough program theory. Results: In our review, we classified five different contexts which affect how upcoming professionals learn patient-centredness. These aspects are influenced through components in the intervention(s) related to the learner, the teacher, and the patient. We placed the mechanisms together in four clusters – comparing and combining as well as broadening perspectives, developing narratives and engagement with patients, self-actualisation, and socialisation – to show how the development of (dimensions of) patient-centredness occurs. Three partial-program-theories (that together constituting a whole program theory) were developed, which show how different components of interventions within certain contexts will evoke mechanisms that contribute to patient-centredness. Translation into daily practice: These theories may help us better understand how the roles of patients, learners and teachers interact with contexts such as the kind of knowledge that is considered legitimate or insight in the whole illness trajectory. Our partial program theories open up potential areas for future research and interventions that may benefit learners, teachers, and patients.
Epidemiology and Microbiology of Bacterial Bloodstream Infection in a Tertiary Hospital in Nigeria

Background: Bacterial bloodstream infections (BSIs) are a significant cause of morbidity and mortality among hospitalized patients, and data in resource-limited countries are sparse. Methods: A hospital-wide retrospective analysis of microbiologically proven bacteremia was conducted. Sociodemographic data, comorbidities, bacterial isolates, and their antimicrobial susceptibility pattern were recorded. Results:Of the 276 episodes of bacteremia studied, 130 (47.1%) occurred in females. The overall mean age was 15.29 ± 23.22 years. Communityacquired BSI was seen in 179 (65.0%) of the patients, whereas 97 (35%) was hospital-acquired BSI. Gram-negative bacteria 158 (57.2%) were the leading cause of BSI. More than 60% of the isolates were resistant to commonly prescribed antibiotics, especially trimethoprim-sulfamethoxazole, ampicillin, and amoxicillin–clavulanic acid. Conclusions: Gram-negative bacteria are the leading cause of bacteremia with resistance to commonly prescribed antibiotics.
Diagnostic methods used for pediatric TB in sub-Saharan Africa: a literature review

The purpose of this review is to investigate the gap in pediatric TB diagnosis and reporting, and identify interventions that have been found to be effective in Sub-Saharan Africa. In 2017, one million children became infected with TB and 230,000 of these children died. With early diagnosis, child mortality resulting from TB infection can be prevented. TB manifests differently in children; thus, most conventional diagnostic tools fail. In Sub-Saharan Africa alone, it is estimated that 20% of all active TB cases are in children. Since childhood TB is a major public health issue, there is a dire need for better diagnostics and reporting systems. Moreover, TB is the leading cause of death in HIV positive individuals making it important to discuss HIV status and other comorbidities affecting diagnosis and reporting of pediatric TB. BCG vaccination can also interfere with TB diagnosis and high BCG vaccination rates make accurate diagnosis difficult due to cross reactivity with some diagnostic methods. Many children in high TB endemic areas like Sub-Saharan Africa suffer from severe acute malnutrition which complicates early diagnosis in children. For the purpose of this review, HIV positive individuals and malnutrition status will be included in the analysis as well as BCG vaccination rates because all pose challenges to diagnosing childhood TB in Sub-Saharan Africa.
Correlated dynamics of serum IGE and IGE+ clonotype count with allergen air level in seasonal allergic rhinitis

Mechanisms of maintenance of immunological memory in the chronic course of seasonal allergic rhinitis remain poorly understood. The detailed understanding of these mechanisms is required for design of new approaches for allergy treatment. It is known that the level of allergen-specific IgE antibodies (sIgE), which play a key role in the development of the disease, is increased in patients with seasonal allergic rhinitis during pollination season. This study aimed to investigate the dynamics of serum IgE levels and characteristics of the clonal repertoire of IgE-secreting lymphocytes depending on the intensity of the patient's contact with the allergen. For three patients, allergic to birch pollen (22, 22, and 28 y.o.), we measured total IgE and birch pollen specific IgE levels at 6 time points with 2 week interval during the birch pollination season. Immunoglobulin heavy chain gene (IGH) clonal repertoire data for several B-cell subpopulations at different time points were obtained for one patient. We observe growth of the sIgE level (91%, 37%, and 64% compared to the baseline) at the peak of pollination season in all three donors. Initial increase in sIgE and IgE levels coincides with the birch pollination initiation; sIgE and total IgE levels correlate with the birch pollen air level (sIgE: R2 = 0.98 at p < 0.05; total IgE: R2 = 0.95 at p < 0.05). We detected IgE clonotypes only in samples obtained during the birch pollination, which indicates an increase of IGE-expressing cells concentration during this period. The frequency of IgE clonotypes was extremely low compared to that of the clonotypes of other isotypes (IgE — 0.01%, IgM — 48.4%, IgD — 14%, IgG — 17.4%, IgA — 19.8%). Hypermutation and phylogenetic analysis of the sequences from the 13 detected IgE-containing clonal groups showed that these IgE clonotypes could originate from IgG as a result of sequential isotype-switching.
Content Analyses of Telephone Followup of Older People with Chronic Heart Problems using the Omaha System

Results: The results identified the 5 most frequent problems and described the interventions most frequently prescribed by the intervention nurse. Circulation was the only physiological problem among the top problems identified. Nutrition, medication regime, physical activity and healthcare supervision were the common healthrelated behavioral problems cited at the initial and final call. Surveillance was the most frequent category of intervention, followed by teaching, guidance and counseling as the second most frequent category of intervention provided to the participants in the study.
The CURRENT TRENDS AND TREATMENTS IN DIABETIC RETINOPATHY

The drastically increasing issues of the disease scenario currently are with different types of diabetes all over the world. It has been reported, approximately 592 million are suffering from the disease throughout the world. It affects differently in different patients with the disease. There have been reports that it is affected differently and also has different side effects. It is also been reported that diabetes mellitus leads to the cause of diabetic retinopathy (DR) and also diabetic macular edema. It is considered as one of the most common causes which is linked to DR. DR has been considered as one of the most important causes for the loss of vision or impaired vision. The drugs show different types of incompatibility such as toxicity, solubility issues, aggregation, and chemical degradation these can be improved by applying several methods. DR is classified according to “Airlie House” into different categories and based on different strategies and consideration. It was found that DR is the main cause for vision loss and also there no much strategies for development of new treatment. The treatment involved is laser photocoagulation and vitrectomy, among these the effective treatment, was found to be laser photocoagulation. This is mainly characterized as proliferative and non-proliferative DR. Different therapeutic agents have been taken for the study these includes vascular endothelial growth factor, renin-angiotensin system inhibitors and nonsteroidal anti-inflammatory drugs, they are certainly different interventions for the treatment, they are nanotechnology and liposome. Nanotechnology applied is the most effective and also acceptable way of treatment.
Multicenter Assessment of Radiation Exposure during Pediatric Cardiac Catheterizations Using a Novel Imaging System

Objectives To quantify radiation exposure during pediatric cardiac catheterizations performed by multiple operators on a new imaging platform, the Artis Q.zen (Siemens Healthcare, Forchheim, Germany), and to compare these data to contemporary benchmark values. Background The Artis Q.zen has been shown to achieve significant radiation reduction during select types of pediatric cardiac catheterizations in small single-center studies. No large multicenter study exists quantifying patient dose exposure for a broad spectrum of procedures. Methods Retrospective collection of Air Kerma (AK) and dose area product (DAP) for all pediatric cardiac catheterizations performed on this new imaging platform at four institutions over a two-year time period. Results A total of 1,127 pediatric cardiac catheterizations were analyzed. Compared to dose data from earlier generation Artis Zee imaging systems, this study demonstrates 70–80% dose reduction (AK and DAP) for similar patient and procedure types. Compared to contemporary benchmark data for common interventional procedures, this study demonstrates an average percent reduction in AK and DAP from the lowest dose saving per intervention of 39% for AK and 27% for DAP for transcatheter pulmonary valve implantation up to 77% reduction in AK and 70% reduction in DAP for atrial septal defect closure. Conclusion Use of next-generation imaging platforms for pediatric cardiac catheterizations can substantially decrease patient radiation exposure. This multicenter study defines new low-dose radiation measures achievable on a novel imaging system.
Out of Pocket Costs of Institutional Delivery in Four Empowered Action Group States of India: An Analysis of NFHS 4 Data

Background: Maternal and child health is one of the priority areas in Indian context, particularly in Empowered Action Group (EAG) states of the country. Institutional deliveries are prioritized as one of the important means to reduce MMR and IMR. The current study aims to estimate and compare the out of pocket expenditure associated with institutional deliveries in EAG states of Bihar, Uttar Pradesh, Madhya Pradesh and Chhattisgarh in India. Methodology: The study was conducted through secondary analysis of NFHS 4 data. The study adheres to the approach of ecological study design and aims at comparing the OOPE and its variations at the state level. The data was analysed using SPSS version 20. Statistics of mean, standard deviation and 95% confidence levels for OOPE were computed and compared. Results: Uttar Pradesh had the highest OOPE with mean OOPE for institutional delivery of INR 7616.77, 95% CI (7310.26 – 7923.28), Chhattisgarh had the least OOPE with mean OOPE per institutional delivery being INR 3917.80, 95% CI (3513.40 4294.25). Presence/absence of health insurance had profound impact on the OOPE. Institutional deliveries in UP which were not covered under any Insurance had mean OOPE of INR 11596.54, 95% CI (8832.62 – 14360.45), on contrary institutional deliveries in Chhattisgarh which were covered under insurance schemes had OOPE of INR 3964.84, 95% CI (3220.70 – 4709.00) Conclusion: While OOPE fluctuated with insurance and other socio-demographic factors, existence of inter-state differences reflects on the importance of health service availability in reducing OOPE. Interventions focussing on reducing OOPE should also focus on health system strengthening by improving availability and accessibility of health services.
Chronic low back pain and walking speed: effects on the spatiotemporal parameters and in gait variability

BACKGROUND AND OBJECTIVES : Walking is described as one of the abilities most affected by chronic low back pain. This study aimed to determine if chronic nonspecific low back pain and walking speed affect the spatiotemporal parameters (stride length, swing time, contact time, stride time, stride frequency and walking ratio) and the coefficients of variation of stride length and contact time. METHODS : Ten participants with chronic nonspecific low back pain (low back pain - LG) and ten healthy participants in the control group (CG) walked on the treadmill at preferred self-selected speed, slower and faster than the preferred speed. Spatiotemporal parameters and coefficients of variation were determined by kinematic analysis. Main effects (group and speed) and their interactions were tested using generalized estimating equations method. RESULTS : Our results showed that there were no significant differences between groups or significant interaction between group and speed factors. There was a speed effect. Stride frequency and length increased while contact and stride time decreased as the speed increased. The walking ratio (stride length/stride frequency) patients were able to adjust their
EARLY RESULTS OF TRANSFORAMINAL PERCUTANEOUS ENDOSCOPIC LUMBAR DISCECTOMY UNDER LOCAL AND SEDOANALGESIA

A B ST R A CT Objective: After the first description of percutaneous posterolateral nucleotomy by Kambin in 1973, transforaminal percutaneous endoscopic lumbar discectomy (PELD) was developed and its use has been increasing in recent years. To describe the surgical technique and anesthesia protocol of transforaminal PELD under local and sedoanelgesia in patients with lumbar disc herniations (LDH) and to report our early results. Materials and Methods: We included 20 patients who underwent transforaminal PELD under local and sedoanalgesia within a period of two months between January 2019 and February 2019 and who had at least a three-month postoperative follow-up period. LDH was at L4-5 in 28.6% of the patients, at L5-S1 in 33.3% of the patients, at L3-4 in 14.3% of the patients, both at L4-L5 and L5-S1 levels in 14.3% of the patients, and at L2-L3 in 1 patient. Results: The mean preoperative Visual anolog scale (VAS) score was 9.4±1.8 (range=8-10) and the mean early postoperative VAS score was 1.85±1.2 (range=0-6). During follow-up, recurrent LDH was seen in 2 patients. One patient developed epidural fibrosis. The mean VAS scores were found to be 1.8±1.69 at the third month follow-up. There was a significant difference between the preoperative VAS scores and the VAS scores in the early postoperative and third month follow-up (p<0.001). Conclusion: Transforaminal PELD under local and sedoanalgesia is an alternative method to classical microdiscectomy in patients with LDH. It is a crucial advantage that it does not require general anesthesia and that patients can provide feedback during surgery.