Miracle-dz/UniFAR-FTUs huggingface dataset:
Preconditioning against ischemic injury of the central nervous system in aortic surgery : an experimental study in a porcine model with remote ischemic preconditioning and diazoxide

The repair of thoracoabdominal aortic aneurysms carries a substantial risk of ischaemic perioperative spinal cord injury. Although several protective methods have been developed, the risk of paraplegia has not been eliminated. Moreover, aortic aneurysms, including arch aneurysms, are complex clinical challenges requiring cerebral protection with hypothermic circulatory arrest (HCA). Hypothermia lowers the rate of cerebral metabolism and allows a temporary halt of the systemic circulation. However, there is still a risk for cerebral damage and a need for additional neuroprotective methods. During the last 15 years, our research group has used a porcine model to investigate a variety of neuroprotective tools. In this thesis, an animal model was utilized to study the efficacy of remote ischaemic preconditioning (RIPC) to ameliorate ischaemic damage to the central nervous system, and to shed light on the potential mechanism. Moreover, diazoxide, the pharmacological mimetic of RIPC, was tested in the HCA animal model. In the first Study (I), RIPC showed beneficial effect on the spinal cord against ischaemic insult as recorded with motor-evoked potentials. Strikingly, the beneficial effect of RIPC was observed even before the ischaemia. In the second Study (II), some beneficial effect of RIPC was seen in the immunohistochemical analysis of the spinal cord ischemia but the result remains inconclusive. Similarly, the diazoxide-treated animals had better hemodynamic status postoperatively and mildy better antioxidant activity of the brain in the third Study (III). The fourth study (IV) was a review of the current knowledge of RIPC from the cardiovascular point of view. Our studies indicate that RIPC might be a potential adjunct for preventing neuronal ischaemic injury in the setting of thoracoabdominal aortic surgery. Our result indicates that further preclinical studies with diazoxide are required before studies can be conducted in humans.
Renal dysfunction after coronary artery bypass surgery

Background Renal dysfunction or acute renal failure in patients undergoing coronary artery bypass grafting (CABG) is one of the most important causes of morbidity and mortality. The great effect of acute renal dysfunction in the outcomes of CABG surgery demands its study in our population, encouraging to the elaboration of this study, which aimed to identify the incidence and risk factors of renal dysfunction after CABG. Patients and methods Since January 2013 to December 2014, 290 patients were studied who underwent CABG with preoperative normal renal function. In this cross-sectional study, patients were divided into two groups based on the occurrence of renal dysfunction after CABG, and measured variables were compared between the two groups and statistically analyzed. P value less than 0.05 was set as a significant level. Results Renal dysfunction was seen in ∼21.37% of patients after CABG. The mean age of renal dysfunction group was higher than that in the other group, and the difference was significant between the two groups. Moreover, reduced ejection fraction was significantly different between the two groups. Cardiopulmonary bypass time was also statistically significant. Postoperative hemodynamic instability and postoperative bleeding were also statistically significant. Conclusion Our study showed older patients were more prone to acute renal failure. Conditions that affect renal perfusion as reduced ejection fraction, hemodynamic instability, and postoperative bleeding are associated with increased risk of renal dysfunction.
Liposomal Amphotericin B Usefulness in Critical Care Unit: A Review Study

During the last 3 decades, the prevalence and variety of invasive fungal infections increased, especially in the critically ill patients thanks to advances in medical sciences, modification of the instruments, drugs, and protective-therapeutic methods. Such infections are administered by 4 pharmaceutical classes as follows: 1. Polyenes; 2. Azoles; 3. Echinocandins; 4. Pyrimidine analogues. One of these drugs is polyenes consisting of amphotericin and its lipid-based formulation. The lipid formulation of this drug is used due to its fewer side effects compared with the conventional type of the drug that makes it possible to enhance the drug efficacy by increasing the administered dosage. This pharmaceutical class is used to treat the following diseases in the critically ill patients: candidiasis, invasive aspergillosis, mucorales infection, cryptococcal meningoencephalitis, visceral leishmaniosis, persistent fever and neutropenia, renal replacement therapy (RRT) in intensive care unit (ICU), kidney transplantation, and liver problems. Now, the word health organization (WHO) approved liposomal amphotericin B (AmB) as the first-line treatment of visceral leishmaniosis in the Eastern Africa. It was even used with a single dose of 10 mg/kg with 95% efficacy. The current study aimed at investigating the effect of amphotericin and its lipid formulation to treat the aforementioned diseases.
Managerial Humanistic Attention and CSR: Do Firm Characteristics Matter?

This study attempted to investigate the influence of managerial humanistic attention on corporate social responsibility. Drawing upon humanistic value, upper echelons theory and behavior decision theory, we developed and tested hypotheses using secondary from manufacturing firms listed at Shanghai Stock Exchange from year 2010 to year 2014. This study showed that managerial humanistic attention can positively affect corporate social responsibility and corporate social responsibility was found to be influenced by firm characteristics. Specifically, the relationship between managerial humanistic attention and corporate social responsibility was stronger: when a firm was older; was bigger; and had more slack resources.
First Description of Partial Atrioventricular Septal Defect in a Rabbit

Abstract Congenital heart diseases have rarely been described in rabbits. The purpose of the present case report is to describe the clinical, radiographic, echocardiographic, and pathological features of a partial atrioventricular septal defect in a pet rabbit. A 3-month-old, 380-g male vaccinated pet rabbit was presented for decreased activity, increased respiratory rate and effort, anorexia, and decreased fecal output of 2 days duration. Total body radiographic images revealed severe cardiomegaly associated with enlarged caudal pulmonary vessels and increased interstitial to alveolar lung pattern. Echocardiographic imaging showed evidence of distended heart chambers, abnormal flow through the atria, and mitral valve regurgitation. The rabbit was treated with furosemide and an angiotensin-converting enzyme inhibitor but rapidly deteriorated and died. Necropsy confirmed the dilation of both ventricles and the presence of a partial atrioventricular septal defect associated with an ostium primum atrial septal defect just over the tricuspid valve and the mitral valve.
The Effect of Implementation of Elderly Respect Training Program in Families on Elder Abuse in Yazd

Original Article Received: 27 Dec 2017 Accepted: 6 May 2018 Introduction: The elderly are among the most vulnerable group in the society, and elder abuse is poses a challenge in the domain of elderly care and support. The present study was conducted with the aim of exploring the effect of implementation of an elderly respect education program in families on the elder mistreatment in the city of Yazd in 2016. Methods: The present study was an experimental study of the field trial type that was conducted on 80 elderly people over the age of 65 years who were covered by Yazd Comprehensive Health Service Centers. This sample was randomly divided into two groups: the intervention group (n= 40) and non-intervention group (n= 40). The sampling units were invited for participating in the study through phone call by healthcare providers. Then, the interviewer completed the questionnaire, after introducing himself and giving explanations on the objective of the study. The data collection tool was the Elder Abuse Scale that included 49 items in eight subscales: care neglect, psychological abuse, physical abuse, financial abuse, authority deprivation, rejection and financial and emotional neglect. In the next step, the families of the elderly in the intervention group were invited to participate in the educational program. The content of this program included different elder abuse subjects, the importance of respecting the elderly in the family and the society, and the role of families in supporting and protecting the elderly. One month after the end of the educational program for families, the elderly in both the intervention group and non-intervention group were invited to be interviewed and the questionnaire was completed. Data analysis was done using software SPSS and through the independent t-test and chi-squared test. Results: Analysis of the mean of elder abuse dimensions in the intervention group indicated that there was a significant difference between the scores before and after the intervention (P< 0.05). The highest level of abuse was seen in the dimension of emotional neglect with the mean of 25.3 and the lowest was seen in the dimension of rejection with the mean of 2.7. The study of the mean of abuse dimensions in the elderly non-intervention group, no significant difference was seen before and after the intervention (P> 0.05). The highest level of abuse was seen in the dimension of emotional neglect and the lowest in the dimension of rejection. Conclusion: The findings indicated that the implementation of the program for educating elderly respect in family was effective in abuse reduction. Therefore, training elderly respect programs are recommended. Also, clarification of this phenomenon from different aspects is better to be considered as a priority.
Nursing care at end of life: a UK-based survey of the deaths of people living in care settings for people with intellectual disability

Background People with intellectual disability are believed to be at risk of receiving poor end-of-life care. Nurses, given their advocacy role and duty to provide compassionate end-of-life care, have the potential to change this situation but research regarding this aspect of their role is limited. Aims This paper thus seeks to answer the question ‘How and when are nurses involved in providing care at end of life for people with intellectual disability? ’ Methods A total of 38 intellectual disability care providers in the UK providing support to 13,568 people with intellectual disability were surveyed. Data regarding 247 deaths within this population were gathered in two stages and subsequently entered into SPSSX for analysis. Results Findings revealed that the majority of deaths occurred between the ages of 50 and 69 years, the most commonly reported cause of death being respiratory problems. Both community and hospital-based nurses were involved in supporting individuals during their final 3 months of life, and sometimes more than one type of nurse provided support to individuals. Generally nursing care was rated positively, although room for improvement was also identified. Conclusions Nurses are involved in supporting people with intellectual disability at end of life and appropriate education is required to undertake this role. This may require change in curricula and subsequent research to determine the impact of such change on nursing support to this population.
Sudden Infant Death Syndrome and Safe Sleep on Twitter: Analysis of Influences and Themes to Guide Health Promotion Efforts

Background In the United States, sudden infant death syndrome (SIDS) is the leading cause of death in infants aged 1 month to 1 year. Approximately 3500 infants die from SIDS and sleep-related reasons on a yearly basis. Unintentional sleep-related deaths and bed sharing, a known risk factor for SIDS, are on the rise. Furthermore, ethnic disparities exist among those most affected by SIDS. Despite public health campaigns, infant mortality persists. Given the popularity of social media, understanding social media conversations around SIDS and safe sleep may assist the medical and public health communities with information needed to spread, reinforce, or counteract false information regarding SIDS and safe sleep. Objective The objective of our study was to investigate the social media conversation around SIDS and safe sleep to understand the possible influences and guide health promotion efforts and public health research as well as enable health professionals to engage in directed communication regarding this topic. Methods We used textual analytics to identify topics and extract meanings contained in unstructured textual data. Twitter messages were captured during September, October, and November in 2017. Tweets and retweets were collected using NUVI software in conjunction with Twitter’s search API using the keywords: “sids,” “infant death syndrome,” “sudden infant death syndrome,” and “safe sleep. ” This returned a total of 41,358 messages, which were analyzed using text mining and social media monitoring software. Results Multiple themes were identified, including recommendations for safe sleep to prevent SIDS, safe sleep devices, the potential causes of SIDS, and how breastfeeding reduces SIDS. Compared with September and November, more personal and specific stories of infant loss were demonstrated in October (Pregnancy and Infant Loss Awareness Month). The top influencers were news organizations, universities, and health-related organizations. Conclusions We identified valuable topics discussed and shared on Twitter regarding SIDS and safe sleep. The study results highlight the contradicting information a subset of the population is exposed to regarding SIDS and the continued controversy over vaccines. In addition, this analysis emphasizes the lack of public health organizations’ presence on Twitter compared with the influence of universities and news media organizations. The results also demonstrate the prevalence of safe sleep products that are embedded in safe sleep messaging. These findings can assist providers in speaking about relevant topics when engaging in conversations about the prevention of SIDS and the promotion of safe sleep. Furthermore, public health agencies and advocates should utilize social media and Twitter to better communicate accurate health information as well as continue to combat the spread of false information.
Self medication among medical and dental students in tertiary care teaching hospital of Udaipur, India

Background: Self‐medication involves acquiring and consuming medication without the advice of a physician and also resubmitting old prescriptions to purchase medicines. Inappropriate self‐medication causes increase cost of therapy and incidence of adverse drug reactions. Self-medication was significantly higher among undergraduate medical and paramedical students in India. Objective of the study was to evaluate the prevalence of self-medication and perception towards self-medication among the undergraduate medical and dental students.Methods: A pre-designed questionnaire collected the information pertaining to demographic details like age, gender, course, reason, pattern, indications, drugs used for self‐medication. It also included questions concerning their attitude, perception and safety regarding self-medication.Results: The prevalence of self - medication was 76.27%. Larger numbers of females were self-medicating (55.56%). The majority of the students’ self-medicated because of other advice (92.59%), there was statistically significant difference between the male and female medical students to use a previous prescription for the same illness. A total of 136 (76.83%) of the participants opined that self-medication was a part of self-care. Statistically significant differences between male and female students had been observed in safety variables like, “know side effects about your drug”, “increasing drug dose can be dangerous” and “in case of side effects physicians’ help must be sought”. Cold and Cough was the most common (60%) indication for self-medication.Conclusions: The prevalence of self-medication was higher among females. The majority of the students’ self-medicated because of other advice. The stringent policies should be required for medicines which can prevent the increasing trend of self-medicating.
Relationship Between Plasma Glutathione Levels and Cardiovascular Disease in a Defined Population

Background and Purpose— Glutathione (GSH) appears to have marked antioxidant activities and therefore may prevent cardiovascular disease (CVD). However, there are very few reports on this subject. In a community-based case–control study, we tested the hypothesis that low levels of plasma GSH are closely associated with CVD and its clinical types. Methods— The association between fasting plasma total GSH (tGSH) levels and CVD were assessed using conditional logistic regression analysis among 134 CVD cases and 435 age- and sex-matched healthy control subjects. Results— Mean tGSH concentrations were lower in all CVD cases than in the control subjects (3.06 versus 3.71 μmol/L; P=0.0001). Among the CVD types, both the cerebral infarction cases (2.98 versus 3.59 μmol/L; P=0.001) and cerebral hemorrhage cases (2.51 versus 3.43 μmol/L; P=0.0027) had significantly lower tGSH levels than the corresponding control groups had. The same tendency was observed for cases of subarachnoid hemorrhage (3.45 versus 3.83 μmol/.
Immature Platelet Fraction as a Prognostic Indicator of Platelet Recovery in Patients with Thrombocytopenia – An Observational Study

Background & Objectives: Immature Platelets or Reticulated Platelets (RP) are newly released platelets which are larger and more reactive than mature platelets and contain RNA. Immature Platelet Fraction (IPF) is the percentage of RPs. It reflects the severity of damage to platelets and the generation of platelets in bone marrow. The objective of the study was to assess whether IPF could potentially be used as a prognostic indicator of platelet recovery in patients with thrombocytopenia. Methods: This is a prospective observational study in 141 eligible patients who were followed up over a period of 5 days. Serial monitoring of platelet count and IPF were conducted on 1 st ,3 rd and 5 th day. An IPF value of >6.1% was considered as high. An increase of platelet count of 20,000cells/μL was considered as significant. The study population was grouped based on clinical diagnosis, aetiology of thrombocytopenia and severity of thrombocytopenia. Descriptive and inference analysis were done. Correlation between change in platelet count with respect to change in IPF was analysed. Results and Discussion: Of 141 patients 68.1% were males and 31.9 % were females. Majority of the patients belonged to age group 21-40 years (42.6%). Dengue was diagnosed in 68.1% of the total patients. Pearson correlation coefficient between change in IPF and change in platelet counts on day1, day3 and day5 were -0.393, -0.455 and -0.393 respectively. IPF had an inverse correlation with respect to platelet counts. p-value obtained was <0.001 which was statistically significant. Kruskal-Wallis Test was done to find if there is any significant difference in IPF among the aetiologies. The p-value obtained was 0.003 which was statistically significant. Hence pair wise comparison of different aetiologies was done. It was found that peripheral destruction of platelets had a significant association with IPF compared to all other aetiologies. Conclusion: There was a moderate inverse correlation between IPF and platelet counts. As the IPF levels fell, platelet levels tended to increase. It had some predictive value in anticipating platelet recovery. In thrombocytopenia, due to peripheral destruction IPF can potentially be used as a screening test. www.jmscr. igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi. org/10.18535/jmscr/v6i8.98
Psychiatric emergency referrals in a tertiary care hospital

Background: Acute psychiatric emergencies such as excitement, violence, stupor, and suicidal attempts, previously the domain of mental hospitals, are now handled by the general hospital psychiatric units. There is a paucity of Indian data concerning psychiatric emergency referrals. Aim: The aim is to study psychiatric emergency referrals in a teaching hospital. Materials and Methods: This hospital-based, descriptive study was undertaken in Emergency Medicine and Psychiatry Departments of a tertiary care hospital during the period of November 2016 to April 2017. All patients were first evaluated by the postgraduate resident on duty of Emergency Medicine Department and triaged using mental health triage scale (MHTS). The total sample size was 60. Sociodemographic particulars of patients and reason of referral were recorded on a special proforma, and the Brief Psychiatric Rating Scale (BPRS) was administered. Psychiatric diagnoses were made according to the International Classification of Disease, 10th Revision Diagnostic Criteria for Research. Results: Out of total 60 patients, 70% were males and 30% female. Most of the patients (41.7%) belonged to the age group of 31–40 years and 53.3% were married. Majority (61%) were referred by family members while 25% were referred by a nonpsychiatric medical professional. The most common reason for psychiatric referral was the presence of coexisting mental symptoms along with physical illness (38%) while 25% were referred as they had predominant psychiatric symptoms. The most common triage category was yellow (38%) and the least common was red category. Schizophrenia (33.3%) was the most common psychiatric diagnosis, followed by alcohol dependence (25%) and mania (16.7%). There was a significant correlation of BPRS score to severity according to triage. Conclusions: The common psychiatric disorders seen in Emergency Department (ED) are schizophrenia, substance use disorder, and mania. MHTS can be easily used by ED doctors for quick and appropriate triage of patients with psychiatric symptoms.
Modern techniques to optimize neuraxial labor analgesia

The pain of labor ranks consistently among the most severe types of pain that a woman will experience during her lifetime. There are many pharmacologic and non-pharmacologic options for pain relief during labor, but neuraxial analgesia remains the most effective and is the gold standard against which other modalities are compared. Neuraxial techniques, for initiation and maintenance, have evolved significantly over the past several decades, and modern techniques allow labor neuraxial analgesia to be administered extremely effectively and safely for both mother and unborn child. Consequently, neuraxial analgesia is an increasingly requested and utilized modality for the provision of labor analgesia [1]. This review will provide a brief overview of key, state-of-the-art techniques for the initiation and maintenance of neuraxial analgesia for labor pain relief. TECHNIQUES TO OPTIMIZE NEURAXIAL LABOR ANALGESIA INITIATION