Miracle-dz/UniFAR-FTUs huggingface dataset:
Triple Diagnostic Accuracy on Early Stage Breast Cancer at Cipto Mangunkusumo Hospital and Persahabatan Hospital

Introduction. Breast cancer is the most common cancer in Indonesia with incidence rate 40.3 per 100.000 women and mortality rate 16.6 per 100.000 women. On early stage, the decision for operative procedure (i.e. mastectomy) requires intraoperative frozen section to assess malignancy; which is mostly unavailable in secondary hospitals. The triple diagnostic (TD) test consists of physical examination, breast ultrasonography and fine needle aspiration biopsy is an accurate and simple preoperative diagnostic method that may solve the problem. The study aimed to find out conformance of the triple diagnostic to histopathology findings in those with breast lump where the malignancy was suspected. Method. A study of diagnostic accuracy conducted enrolling subjects with suspected malignant breast lump managed in dr Cipto Mangunkusumo General Hospital (RSCM) and Persahabatan Hospital (RSP) in period of February 2016 to August 2017 who met the criteria: those underwent preoperative triple diagnostic, intraoperative frozen section and histopathology examination. The conformance of TD and frozen section were compared to histopathology findings. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were the focuses of the study. Results. There were 33 subjects enrolled (prevalence of 4.3%), mean age of 49.6 years ± 10.9, were above 40 years (78.8%). Tumor size of 2–5 cm found in 63.6% subjects, and the most histopathology finding was invasive carcinoma (84.8%). Frozen section showed sensitivity of 96.8%, specificity of 100%, PPV of 100%, NPV of 66.7% and accuracy of 97.0%. TD showed sensitivity of 77.4%, specificity of 100%, PPV of 100%), NPV of 22.2% and accuracy of 78.8% (p = 0.016). Conclusion. Triple diagnostic reaches up to 78% accuracy on early stage breast cancer may be used secondary hospital in Indonesia whenever frozen section is unavailable
Blood Urea Nitrogen, Creatinine and Urea Nitrogen-to-creatinine Ratio as Predictors of In-Hospital Adverse Cardiac Events in Acute Myocardial Infarction

Background: Kidney dysfunction affects cardiovascular outcome in patients with acute myocardial infarction. Creatinine, urea nitrogen and urea nitrogen-to-creatinine ratio (UCR) are kidney biomarkers routinely measured in patients with acute myocardial infarction. Their implication in acute myocardial infarction has not been validated. Aims: The study aims to investigate the association between urea nitrogen, creatinine and UCR and in-hospital adverse cardiac events in patients with acute myocardial infarction. Methodology: The study design was cohort. Subjects were patients with acute myocardial infarction. Blood urea nitrogen and creatinine were measured on admission. The UCR was calculated as ratio of urea nitrogen to creatinine. The observation was performed during hospitalization in ICCU to detect the adverse cardiac events, i.e. death, acute heart failure, cardiogenic shock, reinfarction and rescucitated ventricular arrhytmia. The ROC curve was designed to determine the cut-off point of high urea nitrogen, creatinine and UCR. The bivariate and multivariable analysis were performed to establish the independent predictors of adverse cardiac events. A p value < 0.05 was a limit of statistics significance. Results: The subjects of this research were 424 patients. Among them, 96 subjects (22.6 %) developed in-hospital adverse cardiac events. Subjects with adverse cardiac events had significantly higher level of urea nitrogen, creatinine and UCR. The bivariate analysis showed that high urea nitrogen, high creatinine and high UCR were associated with adverse cardiac events. The multivariable analysis showed only high urea nitrogen as an independent predictor for adverse cardiac events (adjusted OR 3.14 (95 % CI:1.37-7.19, p value 0.007)). Conclusion: High urea nitrogen, creatinine and UCR were associated with increased in-hospital adverse cardiac events. Only high urea nitrogen was an independent predictor for in-hospital adverse cardiac events in patients with acute myocardial infarction.
Analysis of the Relationship between Oral Diseases and Glycemic Control of Diabetes in the West African Context: Survey at the Centre Anti-Diabétique d’Abidjan (CADA), Côte d’Ivoire

The relationship between diabetes and periodontitis is established and described as a bidirectional influence, whereas that with dental caries is still controversial. The objective of this study was to analyze the relationship between blood glucose control and oral diseases in a population of diabetics followed at the “Centre Anti Diabetique d’Abidjan” (CADA). The dental condition of the diabetics included in this cross-sectional study was assessed by the DMF index, periodontal condition by the CPITN and oral hygiene by the OHIS index. Diabetes data were extracted from CADA patient medical records. Blood glucose control has been defined by an average of the blood glucose values of the last 3 months less than or equal to 1.26 g/l. Regression models were constructed to estimate the risk of diabetes imbalance adjusted for all characteristics collected. The sample of 356 diabetics consisted of 53.7% women with an average age of 55.6 years (range: 12 - 85 years). The average DMF index was 7.9 (Std: 6.6) with an estimated prevalence of caries of 77.0%, that of periodontitis of 53.1%. The proportion of subjects with good glycemic control was estimated at 41.3%. The characteristics associated with glycemic control were: dry mouth (p = 0.005), type of diabetes treatment (p < 0.00014) and duration of diabetes (p = 0.039) and periodontal status assessed with the CPITN (p = 0.014). The results of this study confirmed the link between periodontitis and glycemic control of diabetes described in the literature but didn’t find significant association between dental caries and diabetes.
CLINICAL PROGNOSTIC FACTORS IN PRE- AND POST-MENOPAUSAL WOMEN WITH OVARIAN CARCINOMA.

Aims To assess the impact of prognostic factors on the outcome of ovarian carcinoma (OC) and to determine the difference between pre and postmenopausal patients. Design Retrospective cohort, single centre study. Subjects and Methods One-hundred-sixty patients with stage IC-IV OC diagnosed between 2004-2016 were included. Treatment consisted in primary surgery followed by adjuvant chemotherapy (n=127, 79.4%), neoadjuvant chemotherapy followed by surgery (n=27, 16.9%) and chemotherapy alone (3.7%). Results At diagnosis 62 patients (38.8%) were premenopausal. Most patients presented with advanced OC (stage III/IV, 63.1%). After a median follow-up of 60 months, median progression free survival (PFS) for all stages was 36 months and median overall survival (OS) was 96 months. Postmenopausal patients had a poorer oncologic outcome compared with pre-menopausal women (PFS 24 vs. 72 months, p=0.0001, HR=2.32). Other clinical prognostic factors identified were performance status 1 vs. 0 (p=0.0001), ascites (p=0.027). Pathology prognostic factors were tumour grade (G1 vs. G2 and G3, p=0.0001) and endometrioid subtype compared to serous (p=0.008). Patients with residual disease after surgery had an increased risk of recurrence and death (HR=6.1, p=0.0001 and HR=4.2, p=0.0001). Conclusion Premenopausal patients had a better oncologic long-term outcome and stage, ascites, grading, residual disease, were independent prognostic factors.
Grandparents - Grandchildren Relationship in Iran, 2017

Introduction: With the continuing growth of aged populations, it is imperative to find ways to maintain and improve the quality of life in old age. It has been documented that grandparents-grandchildren relationship is significantly contributed to quality of life of older adults. This study was conducted to identify the status and associated factors of grandparents-grandchildren relationship in a sample of Iran. Methods: This cross-sectional study was conducted on 377 community dwelling older adults 60 years and over living in Kashan, Iran. A multistage proportional random sampling technique was applied to obtain the sample. The grandparent -grandchildren relationship was measured by a researcher-developed 16-item scale. The data were analyzed using SPSS version 23 and AMOS 23. Results: The mean age of the respondents was 70.42(SD = 8.20) years. About 62% of the respondents were female and 60.7% were married. The average score of grandparents-grandchild relationship was 67.60(SD = 12.47). The multiple linear regression analysis revealed a significant model (F (11, 365) = 19.05, P < 0.001), where information communication technology of grandparents, geographical distance between grandparents and grandchildren, and the quality of relationship between grandparents and parents of grandchildren were the most important predictors of the grandparents-grandchildren relationship. Conclusion: The findings from the current study showed that status of grandparents-grandchildren relationship is moderate to high and influenced by some factors. It is, therefore, suggested that policymakers pay more attention to strengthening grandparent-grandchild relationship by providing educational programs for families and encouraging the elderly to learn and use information communication technology.
Comparing the effect of ginger and vitamin D3 supplement on inflammatory factors and pain severity in adults with low back pain

The objective of this study was to evaluate the effect of ginger and vitamin D3 supplement on inflammatory factors and pain severity in adults with low back pain. To achieve the research objectives, 120 patients with chronic low back pain admitted to Akhtar and Imam Hossein Hospitals were selected by random sampling method in 2017. They were randomly divided into three groups: ginger, vitamin D3 and control.The drugs were provided for each group in uniform packages with specific code for six weeks. In order to evaluate the variables, visual analogue scale (VAS, CRP, IL-6) was used before the start of the study and six weeks after the study. Data were analyzed using covariance analysis. The results showed no significant difference between ginger and vitamin D3 in the levels of VAS and IL-6, while significant difference was found between the ginger group and the control group and between vitamin D3 group and control group. Other results revealed that CRP reduction was significantly higher in both ginger and vitamin D3 groups than that in the control group. In addition, ginger led to significant reduction in CRP factor compared to vitamin D3. It is recommended for physicians to use ginger, which has fewer side effects, as a substitute for chemical drugs.
Inhibition of CatSper and Hv1 Channels and NOX5 Enzyme Affect Progesterone-Induced Increase of Intracellular Calcium Concentration and ROS Generation in Human Sperm

Background: Normal sperm function depends on appropriate intracellular calcium (Cai2+) and reactive oxygen species (ROS) levels. Calcium activates NADPH oxidase-5 (NOX5) that leads to ROS generation. The calcium channel of sperm (CatSper) is activated by progesterone and intracellular alkalization. Herein, the interactive role of CatSper, Hv1 channels, and NOX5 enzyme on Cai2+ and ROS generation in human sperm is investigated. Methods: The present laboratory in vitro study was carried out in the School of Medicine, Shiraz University of Medical Sciences (Shiraz, Iran) during 2016. Normal semen samples (n=15) were washed and diluted to 20×106 sperm/mL. The diluted samples were divided into 16 groups containing Ham’s F-10 (the control group), 2 µM NNC (CatSper inhibitor), 1 mM ZnCl2 (Hv1 inhibitor), 1 µM DPI (NOX5 inhibitor), NNC+Zn, NNC+DPI, and NNC+Zn+DPI. The other 8 groups were the same as the above except that they contained 1 µM progesterone. Cell viability and Cai2+ were analyzed by flou-3 AM probe and PI staining, respectively, using flow cytometric method. ROS generation was assessed by chemiluminescence method. Statistical analysis was performed using the one-way ANOVA followed by Tukey’s test. P values <0.05 were considered statistically significant. Results: Progesterone increased Cai2+ and ROS generation. The addition of NNC, Zn, or NNC+Zn significantly decreased Cai2+ in the control and progesterone containing groups. Progesterone-induced ROS generation was decreased significantly in all groups containing NNC, Zn, or DPI and reached to the control level when DPI was added to NNC or Zn. Conclusion: There is a functional relationship between CatSper and Hv1 channels in increasing Cai2++. The activity of CatSper and Hv1 channels are required for progesterone-induced ROS generation by NOX5 enzyme.
Comorbidities in chronic obstructive pulmonary disease: Results of a national multicenter research project.

BACKGROUND Chronic obstructive pulmonary disease (COPD) is associated with various comorbidities, which influence the course of COPD and worsen prognosis. OBJECTIVES The aim of this study was to analyze the comorbidities in a cohort of COPD patients in Poland during 12 months of observation. MATERIAL AND METHODS A total of 444 COPD patients (median age: 66.1 years) in all stages of airflow limitation severity were enrolled. Medical histories and a questionnaire concerning comorbidities were analyzed at baseline and after 12 months (data of 267 patients available). Anthropometric data, pulmonary function, and body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE index) were assessed. RESULTS No comorbidities were reported in 9 patients (2.0%), 101 patients (22.7%) had 1-2 comorbidities, 243 (54.7%) had 3-5, and 91 (20.6%) had more than 5 comorbidities. Cardiovascular diseases (CVDs) were the most frequent ones, followed by peptic ulcer, obstructive sleep apnea (OSA), diabetes, gastroesophageal reflux disease (GERD), and osteoporosis; 11 patients had a history of lung cancer. Cachexia was observed in 11 cases, overweight in 136 cases and obesity in 139 cases. The incidence of CVDs increased with time. The number of comorbidities correlated with the body mass index (BMI) and the number of hospitalizations for extra-pulmonary causes, but not with airflow limitation. The BODE index score increased with the number of comorbidities. CONCLUSIONS In a cohort of Polish COPD patients, the most frequent comorbidities were CVDs. The number of comorbidities affected the BODE index, but not airflow limitation. The BODE index is better than forced expiratory volume in 1 s (FEV1) in the rating of COPD patients' condition. The BMI correlated with the number of comorbidities as well as the number of hospitalizations for extra-pulmonary causes.
Perspective on Diagnostic Criteria for Obesity and Abdominal Obesity in Korean Adults

Excessive body weight is associated with increased health risks in humans. In general, the risk of mortality increases with greater obesity. The 2018 guideline for the management of obesity by the Korean Society for the Study of Obesity proposed the body mass index (BMI) cut-off levels of 25 kg/m2 and 23 kg/m2 as diagnostic criteria for obesity and overweight (pre-obese) in Korean adults, respectively. Abdominal obesity has been defined as waist circumference (WC) ≥90 cm in men and WC ≥85 cm in women. In this review, the validity of these criteria for Korean adults was examined based on the evidence regarding the associations of obesity index with mortality and morbidity. The American Association of Clinical Endocrinologists/American College of Endocrinology algorithm and American Diabetes Association guideline for the medical care of obese and overweight patients support a BMI of 25 kg/m2 and 23 kg/m2, respectively, as the cut-off levels for Asians (and some ethnicities) corresponding to the BMI values of 30 kg/m2 and 25 kg/m2, respectively, for Caucasians. In the future, the optimal cut-off levels for obesity and abdominal obesity may require adjustment as the demographic characteristics of the Korean population change. In addition, development of more valid indicators that better reflect health risks of obesity is needed.
Prevalence and distribution of tooth wear in an elderly cohort in Port Harcourt, Nigeria

Background: The retention of natural teeth and tooth wear is observed to be increasing among old people. Consequently, tooth wear may become a major dental problem among old people. Therefore, the purpose of this study was to determine the prevalence and distribution of tooth wear among the elderly in Port Harcourt, Rivers State, Nigeria. Subjects and Methods: The study was an observational research design among the elderly population in Port Harcourt, Rivers State. The subjects were selected by systematic random sampling and data collected using pilot-tested questionnaire. Tooth wear was recorded using tooth wear index, of Smith and Knight. Data were analyzed using Statistical Package for Social Sciences version 20. Chi-square analysis was used to test association between variables, and statistical significance inferred at P
Chronic Kidney Disease and Coronary Artery Disease

Chronic kidney disease (CKD) and coronary artery disease (CAD) are conditions that, when present together, is considered a high-risk feature. Despite the high prevalence, few studies are dedicated to studying CAD specifically in individuals with CKD, and it is a common exclusion criterion in most trials. This fact leads to gap in the evidence for the management of CAD, which, sometimes, results in undertreatment of CKD patients. In this chapter, authors present peculiarities related to CAD among patients with CKD from physiopathology to diagnostic and therapeutic decisions. An evidence-based approach was used to explore this high-risk subset of CAD patients.
Heart rate variability as a method of autonomic nervous system assessment in selected psychiatric disorders

Purpose: Analysis of heart rate variability (HRV) based on ECG is a non-invasive method which assesses the activity of both the sympathetic and the parasympathetic part of autonomic nervous system. HRV measurement describes time differences between consecutive heartbeats – intervals between the R waves of the QRS complex. The aim of the article is to present results of research on HRV in selected mental disorders. Views: People with mental disorders have reduced HRV, especially components dependent on parasympathetic activity, and more often than healthy subjects develop cardiovascular diseases. Moreover, drugs psychiatric drugs can also have negative influence on HRV. Reduction of HRV, dependent on sympathetic predominance, has been described in numerous mental disorders – schizophrenia, affective and anxiety disorders, insomnia. Among the antipsychotics, the least favorable for heart is the effect of clozapine, treatment with amisulpride and risperidone seems safe. Antidepressants also have a different cardiological safety profile. The least beneficial is the action of tricyclic antidepressants. Venlafaxine and mirtazapine also lower HRV, while SSRIs, including paroxetine which has the largest in this group cholinolytic action, seem to be safe. In the case of HRV-reducing drugs it is advisable to use the lowest effective dose, as the HRV parameters are reduced with increasing the dose of the drug. Conclusions: HRV analysis is reliable and technically easy to perform. The results of presented studies indicate that HRV assessment may be widely used in psychiatry as a biological marker of an autonomic excitation and to evaluate cardiological safety of drugs.
A survey availability of kerosene is the leading cause of suicidal burns-death of females in Salem district, Tamil Nadu, India

Background: Kerosene is the main culprit for the Burns, occupy 90% remaining 10% burns from other cause that to availability of kerosene at home /working place is the leading provocating cause for suicidal burns, For the past 7 years, we have followed 2645 burns admission (total) that too female burns, almost 98% of them are due to kerosene. In most of the case, suicide is due to some family problem. The remaining 10% burns are accidental burns to assess the burns due to kerosene usage and to analysis the mortality and morbidity among patients.Methods: This survey was conducted from 2010 to 2017. The number of burns patient admitted at our hospital is 2645/ female burns. cause of suicide attempting by self-immolation during 7 years 2010-2017 analyzed. A record sheet designed to extract data such as age, education, occupation, gender, residence, marital status, drug abuse, and extent of the burn injuries as a percent of burned total body surface area (TBSA). Results: A detailed survey conducted for the past 7 years female Burns are almost 90%. Due to suicide remaining 10% accidental. Accidental burns are minor/ moderate. We are able to save the life and reduce the mortality. But suicidal burns almost extensive/ major burns. We are not able to save the life with modern availability of treatment.Conclusions: Finding of the current study manifested a high rate of suicide by self-immolation among young, married, and low educated women in south India. It implies a social problem, and need to an arrangement of a cultural program aimed at improving health, psychological habits, and educational level.
Effects of Hypertension and Type 2 Diabetes on Cerebrovascular and Cognitive Function in Older Adults

The present research examined the effects of hypertension and type 2 diabetes on cerebrovascular and cognitive function in order to better understand how these disorders may contribute to cognitive aging in older adults. Participants provided physiological and medical data, completed neuropsychological tests, and performed a breath hold task in an MRI. The results of group comparisons indicated three clusters across which older adults with comorbid hypertension and type 2 diabetes had lower cerebrovascular reactivity than older adults with hypertension alone. Older adults with comorbid hypertension and type 2 diabetes also had lower global cognitive function than older adults with hypertension alone or control participants. Finally, higher HbA1c predicted lower cerebrovascular reactivity, while both higher HbA1c and higher Framingham Risk Scores predicted lower global cognitive function. These findings underscore the importance of maintaining glucose control (HbA1c) and managing vascular risk factors (Framingham Risk Scores) in older adults.
The Plastic Adaptation to Pathology in Psychiatry. Are Patients with Psychiatric Disorders Pathological Experts?

Psychiatric disorders share the same pattern of longitudinal evolution and have courses that tend to be chronic and recurrent. These aspects of chronicity and longitudinal evolution of psychiatric disorders are currently studied under the neuroprogression framework. Interestingly, considering the plasticity of the brain, it is necessary to emphasize the bidirectional nature of neuroprogression. We review evidence highlighting alterations of the brain associated with the longitudinal evolution of psychiatric disorders from the framework of neuroplastic adaptation to pathology. This new framework highlights that substantial plasticity and remodelling may occur beyond the classic neuroprogressive framework, which is characterized only by loss of grey matter volume, decreased brain connectivity, and chronic inflammation. We also integrate the brain economy concept in the neuroplastic adaptation to pathology framework, emphasizing that to preserve its economy, i.e., function, the brain learns how to cope with the disease by adapting its architecture. This approach can disentangle both the specific pathophysiology of psychiatric symptoms and the adaptation to pathology, thus offering a new framework for both diagnosis and treatment.