Miracle-dz/UniFAR-FTUs huggingface dataset:
Genetic and Pharmacologic Studies Towards Prevention of opioid use disorder

Genetic and Pharmacologic Studies Towards Prevention of opioid use disorder Shane West Kaski Endogenous opioids mediate both analgesic and affective responses to stress. While the mu opioid receptor (MOR) produces the reinforcing euphoric effects responsible for the high abuse potential of traditional opioid analgesics, the kappa opioid receptor (KOR) is hypothesized to mediate the dysphoric component of stress. With increasing rates of opioid addiction, extensive research efforts are focused on better understanding each of these systems and how they interact, with the goal of developing less addictive pain management strategies and better approaches to addiction treatment. With this in mind, we conducted both clinical and preclinical studies aimed at developing better treatment strategies for opioid use and the management of patients with opioid use disorder (OUD). First, we assessed a local cohort of patients with (OUD) for a collection of single nucleotide polymorphisms (SNPs) related to reward processing, with the goal of furthering efforts to develop a gene-based screening mechanism for OUD risk assessment. Second, we conducted preclinical assessments of the G protein-biased KOR agonist nalfurafine as a potential adjuvant medication for increasing the therapeutic efficacy of opioid-based analgesia. Genetic analysis of OUD patients identified two SNPs within the gene encoding the mu opioid receptor, one SNP within the gene encoding the serotonin 2B (5-HT2B) receptor, and one SNP within the gene encoding Regulator of G protein Signaling 2 (RGS2), with the frequency of each SNP varying significantly from that observed in reference populations of European descent. Preclinical investigations with nalfurafine use in mice demonstrated a greater analgesic synergy when co-administered with morphine than morphine co-administered with the unbiased KOR agonist U50,488. As G protein-biased KOR agonists are hypothesized to produce less dysphoria (a therapeutically limiting side effect of KOR agonists), they may present a viable method for reducing the dose of MOR-targeting analgesic necessary for adequate pain relief, thereby reducing the likelihood of developing OUD. Further research is necessary to identify any antitherapeutic effects of co-administering these two classes of drugs, as well as the range of pain modalities for which this approach is efficacious.
Human immunodeficiency virus infection and acquired immune deficiency syndrome vulnerability of men who have sex with men in a border area of West Bengal, India

Background: Studying level of living, awareness about sexually transmitted infections (STIs) including human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) and sex behavior of men who have sex with men (MSMs) is prerequisite for control of increasing AIDS among them in India. Objective: To assess sociodemographics, awareness about STIs including AIDS, and find out the pattern of high risk sex behavior of MSM. Methodology: Cross-sectional survey was undertaken in May, 2012 among MSMs catered by T I program via Nongovernmental Organization "Madhya Banglar Sangram" in Murshidabad District. 62 MSMs were included from five cruising spots sampled randomly out of fourteen such. Information was collected via interview and focused group discussions (FGD) using questionnaire and FGD guide. Blood samples were examined for VDRL reactivity. Results: Median age was 25 years and sexual debut at 13.67 ± 4.29 years. 87% respondents were residing in parental house, 20% was married, 40% had low education, 80.33% had additional jobs but 54% reported poor income. About 56% respondents knew "what is AIDS" and its spread via anal sex, mother to child transmission, needle sharing, sex worker, and blood transfusion reported by 52.46, 50.82, 47.54, 45.90, and 34.43%, respectively. More than 2/3rd, about 40 and 34.43% MSMs played "anal and oral receptive," "anal insertive" and "oral insertive" role. About 33% used condom regularly. Majority knew main symptoms of STIs. About 2/3rd reported discrimination by neighbors. Blood examination showed 6.45% VDRL reactivity. Conclusion: Reducing vulnerability of MSMs to HIV/AIDS requires holistic programs.
Perception and attitudes of parents towards teenage pregnancy in a rural community of Cross river state, Nigeria

Teenage pregnancy is a social menace and common public health problem. It is detrimental to both mother and child because teenage mother is not physically, psychologically and economically ready to bear a child. This phenomenon has multiple adverse consequences on maternal health, child health and overall wellbeing of the society. This study investigated the perception and attitudes of parents towards teenage pregnancy in a rural community in Akpabuyo Local Government Area. The objectives included: to determine parents’ perception on teenage pregnancy and to determine parents’ attitudes towards teenage pregnancy. A null hypothesis was stated to test the association between demographic characteristics of parents and their attitude towards teenage pregnancy. Descriptive survey was used and data were collected through self administered questionnaire to a sample of 309 respondents selected through purposive sampling. SPSS version 21.0 was utilized for data analysis. The findings included that 93% of parents claimed that a pregnant teenager outside wedlock is a social deviant and 85.8% said teenage pregnancy is a sign of parental failure. Their attitudinal behaviour showed that the affected girl would be sent away from the family (32.7%), parents would stop her education (49.8%) and that the girl would be abandoned to the man/boy responsible for the pregnancy. Sociodemographic characteristics of parents depicted by gender, education and religion were significantly associated with the attitudes of parents towards teenage pregnancy. Conclusion was made that gaps exist in parental perception and attitudes towards teenage pregnant girls. Therefore, it is recommended that parents should reappraise and strengthen their obligations towards their adolescent/teenage daughters to enable them achieve their full potentials through prevention of teenage pregnancies.
Brief communication (Original). Optimum duration of perioperative antibiotic therapy in patients with acute non-perforated appendicitis: a prospective randomized trial

Abstract Background: Inappropriate use of antibiotics for perioperative antimicrobial therapy can cause considerable complications including emergence of antibiotic resistance, risk of drug reactions and economic implications. Objective: We assessed the use of antibiotics in patients with acute non-perforated appendicitis. Methods: The study was performed on 317 patients aged 15 to 70 years with non-perforated appendicitis who were undergoing open appendectomy. All patients received intravenous ceftriaxone (1 g) and metronidazole (500 mg) immediately after appendectomy. Patients were randomized into one of the following three treatment protocols; A: no further antibiotics, B: three more doses of antibiotics for 1 day (ceftriaxone 1 g every 12 hours and metronidazole 500 mg every 8 hours), or C: a 3-day course of antibiotics (ceftriaxone 1 g every 12 hours and metronidazole 500 mg every 8 hours) as the postoperative antibiotic regimen. Postoperative infective complication was the primary endpoint within the 10-day postoperative follow-up period. Results: A total of 291 patients (female 37.5%), were subjected to final analysis. This included 97 patients in each group. Twenty-six patients failed to return for wound assessment. The groups were comparable in baseline characteristics including age and gender. The Overall frequency of surgical site infection was 6.25%, with 8.2% in group A, 6.25% in group B and 5.2% in group C. The rate of postoperative surgical infection was not significantly different among all groups. There were no perioperative mortalities. No untreated control group could be included for ethical reasons. Conclusion: A combined preoperative single dose of metronidazole and ceftriaxone appears to be sufficient for the prevention of surgical site infections in patients with uncomplicated appendicitis.
The Bone Phone: Improving Time to Pain Medication Administration in Long Bone Patients

Background: Orthopedic complaints are one of the most frequent reasons for presentations to the pediatric emergency department (PED). National metrics have defined that each child should have a pain assessment and/or pain medication administered within one hour of arrival to an emergency department. Patient surges, transfers from referring hospitals, and acuity can affect the ability of a PED to meet this metric. Objective: To implement a quality improvement process to ensure children presenting to a PED receive a pain assessment and pain medications within one hour of arrival. Methods: We queried our electronic medical record (EMR) for all patients presenting to our level 1 trauma center PED pain for the 90 days prior to implementation and then for the 90 days post implementation of the quality improvement process. The bundle included nursing, support staff, and physician education to quickly identify children with long bone pain then calling the designated physician carrying the “bone phone. ” The physician carrying the bone phone then had 15 minutes to complete an assessment, order pain medication and radiographs and document these interventions in the EMR. Results: During the study period, 553 total fractures were identified with 337 long bone fractures that met inclusion criteria (61%). Of these fractures, 105 required casting and 82 fractures required reduction in the PED, 127 necessitated OR repair, and 23 had a different outcome. Our pre-intervention average time to pain medication was 63 minutes and our time to medication ordered was 45 minutes. Our post-intervention average time to pain medication was 55 minutes and our time to medication ordered was 38 minutes. Conclusions: Our intervention bundle was successful in reducing our time to assessment and time to pain medication administration. Future studies will look at using template orders and chief complaint driven nursing order sets to further reduce the time to pain medication administration for long bone pain patients. Future studies will also benefit from exploring if opiophobia contributes to delayed pain medication administration in the pediatric emergency department.
ROLE OF LEUKOTRIENE RECEPTOR ANTAGONIST IN ACUTE SEVERE ATTACK OF BRONCHIAL ASTHMA IN COMPARISON WITH CONVENTIONAL THERAPY

This study was designed to determine the role of leukotriene receptor antagonist in acute severe attack of bronchial asthma in comparison with conventional therapy. Asthma is a chronic inflammatory lung disease in both the developed and developing countries. Asthmatic patients are at risk of worsening of disease characterized by an increased breathlessness, cough, chest discomfort and wheezing and decreased in expiratory airflow rate. Leukotrienes are lipid mediators synthesized from arachidonic acid, an element of the phospholipid bi-layer membranes. leukotriene D4 (LTD4), and leukotriene E4 (LTE4), which are potent chemo attractants. These chemical mediators are involved in the pathogenesis of asthma. Study results reveled the effectiveness of leukotriene receptor antagonist in preventing many types of aggravated asthmatic responses. Oral administration of leukotriene receptor antagonist in acute asthmatic patients improves airway function. Once-daily treatment with 10 mg of montelukast, as compared with conventional therapy, provided significant protection against severe broncho-constriction. Study also shows that there was no worsening of the disease. Parameters strongly confirmed the role of leukotriene receptor antagonist when in addition added with steroid therapy in the treatment of acute asthma, there were a smooth improvement was noticed.
Evaluation of Temporomandibular Joint Disk Displacement in Asymptomatic Volunteers Using Magnetic Resonance Imaging

Objective: The purpose of this study was to explore magnetic resonance imaging (MRI) findings of bilateral temporomandibular joints with no signs or symptoms of temporomandibular dysfunction to ascertain how disk displacement develops in both joints. Study design: Subjects comprised 54 asymptomatic volunteers (38 males, 16 females; average age 21.2±2.8 years). All 108 temporomandibular joints were analyzed by MRI. Results: Unilateral or bilateral disk displacement was present in 37% of subjects; 25 of 108 joints were classified as partial disk displacement (PDD) and 5 of 108 joints were classified as complete disk displacement (CDD). The numbers of subjects with unilateral and bilateral disk displacement were the same. In cases of bilateral disk displacement, the condition of displacement was likely to match on both sides. Conclusions: CDD may occur without temporomandibular dysfunction, and when disk displacement is bilateral, the condition of both disk displacements is often comparable. The CDD temporomandibular when conditions of the and of joint effusion in asymptomatic CDD signal intensity of retrodiscal imaging in asymptomatic joints, a to the conditions of the left and TMJs. In temporomandibular disorders, prognoses, on unilateral
The postgraduate mentoring program at Deakin University and international student transition

This study adds to the literature as it examines the experiences that international postgraduate (IP) students have with a peer-mentoring program at an Australian University. To analyse transition and peer mentoring thirty-four (34) semi-structured interviews with IP students from Indian, Chinese and other national cohorts were conducted. The study found that transitioning IP students who had a mentor, benefitted as it provided a variety of support mechanisms so that IP students could transition to the next stage. Transition was important for mentors who were able to develop greater self-confidence, graduate attributes and other employability skills.
Defining age-related skin tears: a review

Skin tears are reported to be the most common wound found amongst elderly individuals, yet there is a lack of evidence and consensus on a definition for these age-related traumatic injuries. A consensus on definition is essential for benchmarking prevalence and incidence and informing clinical diagnosis, management and reporting. This paper examines the extent of similarity and heterogeneity between the published definitions of skin tears and the underpinning evidence for the same. Five criteria were used to evaluate and compare the published skin tear definitions – reference to skin pathology; cause of injury; effect of injury; site of injury; and reference to the population group being studied. As a result of the review and recent research findings, which explicitly demonstrate age-related changes to the structural and mechanical properties of skin and associated increased risk of skin tears, the authors present a new skin tear definition based on these findings. Skin tears are defined as trauma-induced partial or full thickness wounds which primarily occur on the extremities of older persons with age-related changes to the skin’s structural and mechanical support properties, and are commonly associated with elastosis and/or ecchymosis.
Clinical effects of multimodal therapy in patients with knee osteoarthritis Efectele clinice ale terapiei multimodale la pacienţii cu gonartroză

Background. Osteoarthritis (OA) is considered to be the most common rheumatologic disease which affects more than 80% of the population above 55 years. Destruction and loss of articular cartilage is a central feature of OA and chronic pain its cardinal symptom, compromising the mobility and the quality of life of those affected. The failure of conventional treatments, analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs) to satisfactorily control OA progression, combined with their frequent adverse side effects, may explain the increasing use of such SYSADOA (Symptomatic Slow-Acting Drugs for Osteoarthritis) therapies as glucosamine sulfate (GS). Physiotherapy is one of the recommended no pharmacological management options in patients with OA Aims. The aim of the study was to demonstrate effectivness of multimodal therapy for patients with knee OA. Methods. 30 patients, diagnosed with knee OA according to the American College of Rheumatology, stage 2 or 3 (modified Kellgren-Lawrence classification) on frontal knee radiography, were enrolled in the cohort prospective study and were treated with multimodal therapy: 10 days ultrasound therapy, laser therapy, thermotherapy and physical exercises associated with short periods of NSAID (10 days) and GS 1500 mg daily for six months. Pain on visual analogue scale (VAS) and WOMAC score (WS) were evaluated prior to and at the end of therapy. SPSS software version 17 was used for statistical analysis. Results. At the end of therapy a statistical significant decrease of pain on VAS (p=0.045) and WS (p=0.007) was observed. No adverse effects were observed. Conclusions. The multimodal therapy which combines ultrasound therapy, laser therapy, thermotherapy and physical exercises associated with short periods of NSAID (10 days) and GS 1500 mg daily for six months is effective and safe for patients with knee OA.
Wound infection criteria: What is the level of awareness among researchers and clinicians?

For approximately two millennia, the criteria of the Roman Celsus have been used to diagnose infection: redness, swelling, heat, and pain. These criteria have been employed for all infections, regardless of the tissues involved. Each criterion relates to the inflammatory response and, therefore, may be regarded as “limited” insofar as other, noninflammatory signs and symptoms of infection are excluded. The diagnosis of infection is one of the most challenging aspects of wound management. The implications of underdiagnosis include inappropriate treatment and increased morbidity and even mortality. Overor mis-diagnosis can expose the patient to unnecessary treatments and, more broadly, compromise the efficacy of available antibiotic therapies. The emphasis must be to “get it right”. In 1994, Cutting and Harding published what many regard as a seminal article: The diagnosis of wound infection. In the two decades since its publication, various articles clarifying and validating the criteria contained therein – particularly in chronic wounds – have been published (Cutting, 1994; 1997; 1998; Gardner et al, 2001a; b; Cutting and White, 2004; 2005). However, there are strong indications that the criteria of Celsus are still the most widely used. Can this be regarded as “best practice”? What is being taught to students and post-registration clinicians? Is enough being done to improve diagnosis and avoid misdiagnosis? Richard White
UGANDA SESEMAT PROGRAMME: IMPACT AND CHALLENGES IN ITS IMPLEMENTATION

The Secondary Science and Mathematics (SESEMAT) programme has been recognized as an effective tool in enhancing the quality of teaching and learning science and mathematics in secondary schools. The SESEMAT programme was introduced in 2005 with the purpose to improve the teaching ability of science and mathematics teachers at secondary level; and to improve performance in those subjects. The main objective of the study was to assess the impact of the SESEMAT programme on science and mathematics in Uganda; a case study of Jinja district located in Eastern part of Uganda. It also found out the challenges of implementing the SESEMAT programme. However, the study focused mainly on fifteen secondary schools out of the 26 secondary schools in the district and the period under consideration was 2009-2013. The researcher used a descriptive cross sectional survey, where data was collected at one point in time from a cross-section of respondents. This was useful in the study because it involved collecting data from a relatively large number of respondents from various schools in the district. Primary data was collected mainly through in-depths interviews and self-administered questionnaires instruments. Both quantitative and qualitative analyses were employed on data collected from 135 respondents. The findings show that, the SESEMAT programme had the greatest impact on: improved teachers and student's attitudes towards science and mathematics; improved the performance of students in the national examinations; and has developed/promoted practical teaching as thought by; as thought by the respondents respectively. The study also discovered most challenges hindering the programme as: Time consuming; inadequate science/ instructional materials; and high enrollment of students in class respectively. The researcher recommends the policymakers, development partners and the government through the MoES to ensure that, there is right balance of the teaching staff within a department; that the level of resources provided for teaching is sufficient; reduce the teacher student ratio/ decongest the classes; and finally recommends prospective researchers to assess the role of secondary science and mathematics education in industrial and technological development; and a similar study to be conducted in other districts with a large sample for comparison of the findings.
ORIGINAL ARTICLE The Beneficial Effects Of Noni Fruit Juice In Diabetic Patients

Background: There is no scientific evidence to support the beneficial effects of noni fruit juice which is claimed as a “natural health enhancer” and is consumed extensively. Aim: To evaluate the beneficial effects of noni fruit juice on glycaemic control, lipid profile and antioxidant activity and its safety in diabetic patients. Settings and Design: A hospital based, randomized, placebo-controlled, double-blind study Material and Methods: 34 diabetic subjects with normal haematological, serum potassium, renal and liver function test and electrocardiogram readings were enrolled into the study. After collecting venous blood for biochemical efficacy measures, the subjects were randomly allocated to two treatment groups, either to receive noni juice or to get placebo, at a dose of 30 ml/day. The efficacy measures included fasting and postprandial blood glucose, complete lipid profile with fasting, serum fructosamine and endogenous antioxidants like super oxide dismutase and reduced glutathione. The safety and efficacy measures were repeated after 21 days of treatment with placebo or noni juice. Statistics: The baseline characteristics were compared between the groups using the unpaired t test. Pre-post treatment changes in the efficacy measures within each group and between the groups were analyzed by applying the repeated measures ANOVA test. P<0.05 was considered to be statistically significant. Results: The efficacy measures were comparable between the two groups at the entry into the study. The influence of the two treatments on blood glucose levels, on the lipid profile and on the endogenous antioxidant activity were similar, without statistical significance. The noni and placebo treated groups came out with decrease and increase in serum fructosamine levels, respectively, both changes being statistically insignificant. Between groups, the comparison of these changes appeared to be statistically significant (p=0.036). The safety measures were within the normal range and no adverse events were reported. Conclusion: Consumption of noni juice for 21 days yielded elusive results on glycaemic control. It’s beneficial effects on plasma lipid profile and endogenous antioxidant activity were not established. Consumption of the lowest recommended doses of noni fruit juice for a short period of 21 days was found to be safe in diabetic patients. Long term studies with a large population may be needed for evidence of the favourable effects of noni juice on organ functions.