Miracle-dz/UniFAR-FTUs huggingface dataset:
Toxicité hépatique des antibacillaires : Aspects cliniques et modalités de prise en charge

La toxicite hepatique aux antibacillaires est frequente et peut etre grave. Le controle systematique des transaminases avant et cours de ce type de traitement est indispensable. Les hepatites cytolytiques sont le plus souvent en cause. Les antituberculeux responsables sont l'isoniazide, la pyrazinamide et la rifampicine, et c'est leur association qui augmen te le risque de l'hepatotoxicite.
WORKPLACE VIOLENCE AGAINST MEDICAL STUDENTS IN SHIRAZ, IRAN

BACKGROUND: Violent behavior in the workplace, or workplace violence (WPV), is considered a serious threat to the mental and physical health of employees. WPV ranges from verbal abuse to physical assaults and even sexual harassment. Objectives: Every medical student may be repeatedly exposed to violence in hospitals due to direct contact with the public and patients. This study investigates the prevalence of all types of WPV against medical students. Patients and Methods: A retrospective, cross-sectional study was conducted on 275 medical students in the educational hospitals of Shiraz University of Medical Sciences. The survey questionnaire used was a modified version of a WPV questionnaire translated into Farsi. The questionnaire included demographic information and types of violence experienced including physical violence, verbal violence and sexual harassment. Standard descriptive statistics were used to report the frequency of events. The associations between categorical variables were analyzed using the Chi-square test. Results: Of 193 respondents, 24.9% reported experiencing physical violence, 85.5% reported being verbally threatened and 26.1% reported being sexually harassed. Males were more likely to be exposed to physical violence and females to sexual harassment. Patients' relatives were the most frequent perpetrators of physical and verbal violence while physician colleagues were the main source of sexual harassment Conclusions: As the emotionally stimulated companions of patients were found to be the most frequent perpetrators of physical and verbal violence, providing special training for medical students on how to deal with such incidents, increasing the number of nursery personnel and increasing the quantity and quality of hospital guards is necessary to minimize the prevalence of violence against medical students. Keywords: Workplace Violence; Medical Students; Sexual Harassment; Verbal Violence; Physical Violence; Iran Language: en
Train to retain: the role of specialty training in stemming Malawi's medical brain drain.

Background: There is a growing awareness of the need to retain health workers in low-and middleincome countries. This is particularly the case in Malawi, with few doctors and historically high emigration. Previous retention efforts have focused on salary supplementation and expansion of undergraduate training. There has been little focus on training new doctors to become specialists, despite evidence of its value to Malawian junior doctors. In light of the considerable investment into medical education and retention, this thesis investigates the role of specialty training in stemming Malawi's medical brain drain. Methods: A tracing study was carried out to locate all Malawian doctors who graduated between 2006 and 2012. Literature reviews and qualitative interviews informed the design of a discrete choice experiment exploring junior doctors' preferences for different types of training posts. Nearly all eligible doctors in Malawi participated in the survey. The results were incorporated into a Markov model of the Malawi medical workforce as part of a cost-effectiveness analysis of expanded provision of specialty training. Results: The odds of leaving the public sector and Malawi rose with time after graduation, with most of those outside Malawi in specialty training. Junior doctors had strong preferences for different types of specialty training, with subgroups showing distinct preferences. Doctors would require substantial compensation to undertake training only in Malawi or in less popular specialties. Despite this, expanding training within Malawi was the most cost-effective means to retain doctors in the long-term, although more costly than current government spending. Conclusions: Almost all Malawian junior doctors desire to specialise, but not all specialty training is valued equally. Expansion of specialty training in Malawi, however, would lead to higher returns on investments in medical education. More cost-effectiveness modelling and a “whole-career” perspective to policy interventions would strengthen health workforce policy in low-resource settings.
Do central vestibular findings predict abnormal findings on magnetic resonance imaging?

Abstract Objective To determine whether central findings from vestibular tests predict abnormal findings on magnetic resonance imaging. Method This study was a retrospective case series at a tertiary referral centre. The main outcome measure of this diagnostic intervention study was the positive predictive value of central vestibular findings in relation to magnetic resonance imaging abnormalities. Results Central vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups although they varied according to age group. Optokinetic nystagmus (p < 0.05) and abnormal findings on videonystagmography tests (p < 0.05) were the main predictors of magnetic resonance imaging abnormalities. White matter lesions constituted the bulk of the central lesions on magnetic resonance imaging followed by cortical and cerebellar atrophy. Conclusion Central vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups. Magnetic resonance imaging is medically justified to further evaluate patients with central findings on vestibular studies. Therefore, it is reasonable to request magnetic resonance imaging in these patients.
Reducing Children’s Classroom Sitting Time Using Sit-to-Stand Desks: A Pilot Study

physical activity (PA) policy and environmental interventions on the PA among predominately African-American children living in the inner city. We hypothesized that following 3 years of exposure to these PA interventions that transportation and recreational PA levels among children residing in the GHTC communities would increase from 2011 baseline measures compared with follow-up measures repeated in 2014. METHODS: Using the System for Observing Physical Activity and Recreation in Communities (SOPARC) we examined pedestrian/bike routes/trails and recreational park areas within the boundaries of the GHTC communities to assess transport, sports, and recreational PA of children. SOPARC data were collected fall/spring 2010/2011 and then repeated in spring 2014 in each of 8 settings in the GHTC communities during 3 1-h observation periods during 5 days of clement weather. Observations were made during week days in each setting (i.e., Monday through Friday). RESULTS: The SOPARC assessments of the pedestrian/bike routes/trails, and recreational space in GHTC communities yielded a total of 692 child/youth observations in 2011 while repeat measures in 2014 yielded 806 child/youth observations. Children/youth observed in 2014 were four times the odds to engage in moderate/vigorous PA compared to their 2011 counterparts (OR = 4.2, 95% CL, 2.13, 8.5; Mantel-Haenszel Chi Square = 19.36; P< 0.00001). CONCLUSIONS: The present findings support the hypothesis that policy and environmental interventions targeting enhanced infrastructure, signage, and use policies support the likelihood of increased PA levels among children exposed to such interventions over ~ 3 year period. This comparative difference was most remarkable when examining the SOPARC assessment differences along the transport path/sidewalk routes and open recreational space. These results provide evidence that access to ‘urban’ pedestrian/bicycle routes/trails appears to translate into increased opportunities for PA among inner city children/youth.
Negative Life Events, Outdoor Recreation and Activities, Health Related Quality of Life among Young Adults - The Health Survey in Nord - Trøndelag (HUNT 3)

Background A great number of people are affected by Negative Life Events (NLE), such as separation, death in close family and life threatening experiences every year. Findings indicate that such events may cause an impaired Health-Related Quality of Life (HRQoL). Outdoor Recreation and Activities (ODRaA) are believed to increase an individual’s HRQoL. However little scientific research has been conducted in this area. Aims The aim of the study was to investigate the associations between Gender, Age, NLE, ODRaA and HRQoL. Method Data from the third Nord – Trondelag Health Study (2006-2008) were used in the study. Young adults (20-29 yrs, N=2874) participated in the study. Hospital Anxiety and Depression Scale (HADS) were used to assess HRQoL. Associations between gender, Age groups, NLE, ODRaA and HRQoL were assessed by multifactor analysis of variance (one-way ANOVA). Results – Gender, Gender/Age NLE, ODRaA associated significantly with HRQoL. Higher scores of ODRaA associated with higher scores of HRQoL. NLE associated with a lower HRQoL. Females reported a lower HRQoL than males. Discussion – Further research needs to address interventional studies of RCTs as well as longitudinal follow-up studies conducted on populations with the experience on NLE participation in ODRaA vs. non-participants in ODRaA and HRQoL.
Organisational socialisation : longitudinal investigations into newcomer sense-making and adjustment.

This research investigated the organisational socialisation of newcomers, that is, the process by which new employees come to "learn the ropes" of their role and their place within the wider organisational context. The research was longitudinal and focused on a number of issues, of which only the key ones will be mentioned here. First, the development of a measure of the content of newcomer learning during socialisation. Second, a more rigorous assessment of how the socialisation process unfolds over time, and related methodological issues of construct stability during a period of change. Third, an assessment of which factors influence the achievement of positive socialisation outcomes (e.g., organisational commitment). And fourth, newcomers' understanding of insider norms and organisational reality. 2 These issues were investigated in two organisations, the British Army and a multi-national professional services firm. Research was primarily through longitudinal questionnaire studies, over five and three measurement points respectively focusing on the early period of organisational socialisation. A new measure of the content of socialisation learning was developed as part of this thesis, and proved useful in understanding the dynamics of organisational socialisation and predicting outcomes. The longitudinal research designs enabled a greater understanding of the early stages of organisational socialisation which have received little research attention. Further, this allowed a comparison of the organisational socialisation process as it occurs in two disparate organisations. A number of factors were found to influence positive socialisation outcomes, and also newcomer understanding of and adjustment to organisational reality.
Consensus Conference on Sclerotherapy or Varicose Veins of the Lower Limbs

Sclerotherapy has been used to treat varicose veins of the lower limbs for many years. Three names are linked to the development of modem sclerotherapy: Toumay [1], Sigg [21 and Fegan [31. Each of these physicians perfected sclerotherapy techniques that were subsequently used worldwide. The techniques differ in many respects, for example in the use of elastic compression and in the overall plan of treatment. All techniques used in current practice are based on one of these three 'historical' methods.
Antibiotic Stewardship at St Paul’s Hospital

Antibiotic stewardship has been receiving increasing attention since the consequences of widespread antibiotic use became apparent. For at least the past 15 years, the medical and pharmacy staffs of St Paul’s Hospital have realized the importance of proper antibiotic use, and have established policies, procedures and review bodies in an attempt to optimize antibiotic use. The main driving force for these developments has been the realization of the hospital’s potential excessive financial costs if antibiotics were used inappropriately. Many of the strategies implemented to confine antibiotic use were initiated as cost minimization efforts; however, efforts to minimize antibiotic use also limited the exposure of the hospital’s intrinsic microbiological flora to excessive antibiotic use. The impact of control measures on the prevention or minimization of resistant flora development cannot be accurately measured because a valid monitoring program of antimicrobial resistance was not in place before or after implementation of the control measures. Anecdotally, St Paul’s Hospital has not yet experienced outbreaks of resistant organisms similar to those reported in other Canadian and North American hospitals. The role of control measures taken to prevent antimicrobial resistance outbreaks cannot be verified, but control measures should not have been detrimental to minimizing hospital flora exposure to antibiotics. The medical staff established the Antibiotic Subcommittee of the Pharmacy and Therapeutics Committee in the early 1980s. The purpose of the Antibiotic Subcommittee is to develop policies and procedures that ensure optimal availability and use of antibiotics to treat the infectious conditions of St Paul’s Hospital patients. The subcommittee is chaired by the chair of the medical microbiology laboratory and comprises an infectious disease consultant, a surgeon, a clinical pharmacologist, a hematologist, an intensivist and a pharmacist. This is a similar composition to what has been recommended (1). The subcommittee has attempted many methods of controlling antibiotic use, similar to many of those suggested by the Society for Healthcare Epidemiology of America (2) (Table 1). The following discussion will focus on several strategies employed at St Paul’s Hospital that may have the greatest impact on antibiotic use.
Patients Feeling Severely Affected by Multiple Sclerosis

Eleven months after being interviewed in a study on unmet needs of severely affected multiple sclerosis patients, one participant died by assisted suicide. We reanalyzed the data to find out if our 15 study patients might have brought up the topic of death and dying during episodic interviews that had not primarily addressed this issue. Secondary analysis with regard to the thematic field of death and dying revealed that patients unsolicited brought up this issue within the following categories: “Passing over death and dying,” “Death is not relevant to me,” “We want to keep up the life challenge,” “Death as an option,” and “Wish to have the opportunity to address end of life issues. ” We conclude that the topic of death and dying is of importance to these patients, as they spontaneously mentioned it in multiple varieties. Health professionals should individually acknowledge patients' needs to address death and dying.
Ultrastructural studies of cornea and sclera

The work of Goodfellow et al., (J. Mol. BioI. 119: 231. 1918) and Sayers et al., (J. Mol. BioI. 160: 593. 1982), was repeated using fresh, equilibrated cornea, confirming their finding that the plot of interfibrillar spacing against liydration is a linear relationship. Intermolecular spacing in cornea, sclera and rat-tail tendon was shown to increase rapidly over the hydration range H=O to H≈1, then tan off (physiological hydration is at H=3.2). Intermolecular and interfibrillar spacings rise in unison over the hydration range H=O to H≈1, after which virtually all of the water goes between the fibrils. It was found that freezing corneas to 40oC and then thawing had no effect on normally hydrated or dehydrated corneas, but caused damage to swollen corneas. Freezing to -180°C and thawing resulted in permanent damage to normally hydrated corneas . The changes in intermolecular spacing, D-period spacing, fibril diameter and fibril packing as a result of processing for TEM and SEM have been described. Low temperature embedding in Lowicryl K4M resin produced least disruption in the cornea. The fibril diameter in cornea at normal hydration was established to be 37.4nm±1.4. X-ray data modelling indicates that fibril packing in the cornea is liquid-like, as proposed by Worthington and Inoyue (Int. J. Macromol. 7: 2. 1985). It was shown that the water in the corneal stroma is evenly distributed around the fibrils over the hydration range H=O to H=4. Above H=4 more water is entering the stroma than can be "accounted for if its distribution is uniform. The transmittance of light through the bovine cornea (excluding interference effects), was calculated as T≈12%. Thus, most of the transparency of the cornea must be due to constructive interference as first proposed by Maurice (J. Physiol. 136: 263. 1951). Examination of keratoconus corneas by the the SEM and TEM and showed abnormal epithelial cells, disrupted lamellae, and abnormally arranged proteoglycans. Analysis of X-ray data proved that stromal thinning in keratoconus was not due to closer fibril packing. Also that keratoconus corneas had increased intermolecular spacing, and an abnormal arrangement of proteoglycans along the fibrils. No differences were found between the corneal stroma of normal and myopic chicks. Myopic chick sclera was shown to have more aggrecan proteoglycan which was associated with larger empty spaces, than normal sclera. The fibril attachment sites of the proteoglycans was the same in normal and myopic sclera.
Preoperative Use of PET/CT in Patients With Colorectal and Gastric Cancer and Its Impact on Treatment Decision Making

The advantages of primary positron emission tomography–computed tomography (PET-CT) evaluation of both cancers needs to be clarified. This study aimed to investigate the efficacy of PET-CT compared with computed tomography (CT) in preoperative evaluation of colorectal and gastric cancer patients, and to determine its effects on treatment decision-making. We prospectively evaluated patients who presented with both types of cancer in our clinic between September 2008 and June 2010, using PET-CT and CT. We compared the results with histopathologic findings and determined the changing treatment strategies. In detecting local lymph node positivity, for colorectal cancer patients the sensitivity of PET-CT was 30% and that of CT was 20%; the specificities were the same (100%). For gastric cancer patients, the sensitivity of PET-CT was 38.9% and that of CT was 22%; the specificities were 100% and 83%, respectively. In detecting metastasis, for colorectal cancer patients the sensitivity of PET-CT was 80% and that .
Resurgence of diphtheria: clinical profile and outcome - a retrospective observational study -

Forty percent of the cases occurred in children below 5 years and 70% below 15 years of age. 1 The disease has been almost completely eradicated in many developed countries and in many European countries no cases have been reported for almost a decade and in the USA only 45 cases were reported during 1980–1995. 3 On the contrary, in developing countries, although the incidence has drastically declined, still account for 80– 90% of global burden. Disease in these countries affects both children and young adults. 2 However, a resurgence of the disease has been observed in these countries, largely attributed to waning vaccine immunity in adults and importation of cases from the endemic developing world. The situation faced by us in the developing countries is different. Diphtheria still remains endemic with increase in the fulminant complications and mortality in the last two decades, especially in children above 5 years. Factors like inadequate vaccine coverage, poor socio-economic standards, overcrowding, delayed ABSTRACT
Vitamin a status of 6-10 year old children and some associated factors in Gachoka, Mbeere district, Kenya

The study was carried out to determine household characteristics and individual child factors associated with vitamin A status o f primary school children aged 6-10 years in Gachoka Division, Mbeere District, Kenya. Six schools were randomly sampled for the study namely; Ngenge, Mutus, Gatumbiri, Igumori, Kamurugu and Mutuobare primary schools from which study children were sampled. A total o f 330 children, 51.2% females and 48.8% males and their respective households were studied. Blood and stool samples collected from 120 children were examined for serum retinol levels and gastrointestinal parasites respectively. Dietary data, based on a twenty-four hour recall was collected for 140 children while clinical examination for vitamin A deficiency was done on 287 children. Qualitative and quantitative methods o f data collection were employed in the study. The main study tool was a structured questionnaire which was supplemented with focus group discussion, key informant interviews and secondary data. Serum retinol levels and prevalence o f gastrointestinal parasites were determined with the aid o f well-equipped laboratories and technicians. Results of the study indicate that 37.5% of the children are vitamin A deficient with serum retinol values <10 pg/dl. Alarming rates o f nightblindness (9.8%) and Bitot’s spots (26.8%) were also observed. The prevalence o f vitamin A deficiency was numerically higher among females (57.8%) than ln mâ es (42.2%) and tended to increase with age. Gastrointestinal parasites were prevalent among the cfcldren with 61.7% of the children having one or more of these. Children’s nutrient intake expressed a Percentage of the recommended dietary allowances was relatively high for all nutrients considered
Prevalence of Orofacial Defects Due to Familial Aggregation, at Tertiary Care Centre in Chennai- A Cross Sectional Study

Both cleft lip and cleft palate are orofacial birth defects. A cleft lip may be just a small notch in the lip. It may also be a complete split in the lip that goes all the way to the base of the nose.A cleft palate can be on one or both sides of the roof of the mouth. It may go the full length of the palate . Though orofacial defects, such as cleft lip and cleft palate, are corrected by surgical methods, they do leave behind marks of their occurrence. This causes various complexity problems for patients in society. By doing this study, we will come to know incidence of orofacial defects by familial aggregation due to consanguineous marriages, i.e. marriages within relations. This can be further classified as first degree consanguineous marriage, that is marriage between immediate relations (eg. between brother and sister), then second degree consanguineous marriages, i.e. marriages between first cousins and so on. In this study, we will also come to know the extent of occurrence of these defects in family, i.e. we check if patient’s siblings are also suffering from any kind of these defects. The motive of this study is to create public awareness in mind of people about consanguineous marriages and their effects in form of familial aggregation. Further, this study can be carried out by