Miracle-dz/UniFAR-FTUs huggingface dataset:
Survivorship - Food for thought: Systematic review of Cancer Survivors Perceptions of Food Related Information

reported to be approximately 50%, with those diagnosed said to live, on average, 10 more years following diagnosis. Cancer patients are considered ‘at risk’ of food borne illness, in particular, from Listeria Monocytogenes. Whilst common, Listeria can prove fatal to cancer patients who may be immune suppressed. Appropriate food safety and nutritional advice is therefore important to ensuring the health and continued recovery of cancer sufferers during the stages of diagnosis and treatment, but also through to survival and transition back into ‘normal’ life. This Mixed Studies Review (MSR) therefore sought to better understand Cancer survivors’ perceptions of food related information, with a view to enhancing the effectiveness of such information in future. The findings revealed a preference for receiving more information as opposed to less, with survivors primarily seeking relevant and prescriptive guidance via practitioners and paper based channels. Food related information was also valued when provided as part of broader lifestyle advice. Theoretical implications are discussed and recommendations for theory and practice are presented, however, the few studies identified by this review provide little evidence on which to base definitive decisions for future practice, in particular with regards to food safety messages. Further research in this area is therefore required.
Manubriosternal Joint Dislocation- A Treatment Dilemma

Manubriosternal joint dislocation is extremely rare and yet there is no definite standard for treating such injury. The reported results of conservative or surgical approach vary between patients. We report a case where different methods of treatment were tried. However, controlling symptoms could only be established by stabilizing the joint using a plate fixation.
Combination treatment of extensive and recalcitrant alopecia areata with oral and topical steroids with topical minoxidil: An open-label study of efficacy and safety in pediatric patients

Background: Alopecia areata (AA) is an autoimmune disorder characterized by nonscarring alopecia affecting scalp and body hair. Treatment of AA in pediatric age group is challenging because of unpredictable course, uncertain natural history, potential side effects of medicines, and psychological morbidity. Moreover, no clear guidelines for treatment of pediatric AA are available. Objective: The objective of this study is to assess efficacy and safety of a combination treatment of extensive and recalcitrant AA with oral and topical steroids with topical minoxidil. Materials and Methods: Sixteen children (nine girls and seven boys) aged 6–15 years with severe and recalcitrant AA were included in this study. All were prescribed the regimen of combination of oral and topical steroid with topical minoxidil 2% solution. Oral steroid was tapered over 12 weeks, and topical steroid was withdrawn at the end of 24 weeks. Patients were maintained on topical minoxidil for next 9–12 months and closely followed up. Results: The average age of participants was 10.81 years, and the duration of disease was ranged from 3 months to 30 months. Response to our regimen was good in cases of extensive AA and ophiasis, compared to alopecia totalis. The participant having alopecia universalis did not respond at all to the regimen. Participants tolerated the regimen well with mild and easy to manage side effects and only few relapses. Conclusion: Finding an effective and safe treatment regimen for AA, especially in children is difficult. Our regimen allows for more rapid lowering of oral doses with maintaining the cosmetic response and minimizing the side effects. Therefore, a trial course of this regiment would seem to be a reasonable approach for nearly hopeless but highly motivated pediatric patients of extensive and recalcitrant AA.
Global Crises, Global Solutions

What an intriguing idea. Convene serious thinkers to create a list of critical issues facing the global community that are amenable to governmental intervention, prune and prioritise the list to the top 10, enlist leading economists to outline the challenges, add thoughtful commentaries, and then rank the final 10. A group called the Copenhagen Consensus under the leadership of Bj⊘rn Lomborg did just this and teamed up with the Economist to disseminate the results. Global Crises, Global Solutions is the result, and disappointing it is, garnering at best two stars. [][1] Ed Bj⊘rn Lomborg … [1]: /embed/graphic-1.gif
Outcome of Well-Differentiated Thyroid Carcinoma Patients Receiving a Cumulative Doses of ? 600 mCi (22GBq) of I-131

Background: There is no maximum limit for cumulative dose of I-131 for persistent disease in well-differentiated thyroid carcinoma (DTC) patients. However, most remissions are obtained with cumulative activity equal to or lower than 600 mCi (22 GBq). On the other hand a significantly increased risk of leukemia and secondary cancers has been reported with high cumulative dose of I-131 (? 600 mCi). Above this cumulative activity further radioiodine therapy should be taken on an individualized basis. Objective: The aim of the study was to see the outcome of patients with well differentiated thyroid carcinoma receiving a cumulative doses (CDs) of ? 600 mCi I-131. Patient and Method: A retrospective study of 72 patients with DTC receiving a CDs of ? 600 mCi I-131 in the National Institute of Nuclear Medicine and Allied Sciences (NINMAS), Dhaka during the period of January 1994 up to December 2007 was carried out. Initially all patients were treated by thyroidectomy followed by radioiodine therapy as adjusted by standard protocol. The mean period of follow up was 8.9 ± 6 years. From the medical files, age, gender, histopathological variant, thyroid remnant and radio ablation doses, follow up data were recorded. Age was further categorized as 5 doses to find its association with status on last follow up. Disease free (DF) was established as: undetectable or suppressed serum Tg levels <2.0 ng/mL and stimulated serum Tg level <10 ng/mL, two consecutive negative whole body scans. Results: A total of 38 patients had papillary carcinoma, eight had follicular variant of papillary carcinoma and 26 had follicular carcinoma. Age range at diagnosis was nine to 72 years. There were 22 males and 50 females giving a M: F ratio of about 1:2. Among the 72 patients 25 patients had lymph node metastases, eight had lung metastases and 20 had bone metastases at presentation. Twenty-one patients died during the whole observation period and 20 of them were cancer related. Two patients developed second malignancy. Conclusion: DTC patients with follicular variant, ? 45 years of age, having bone metastasis and significant thyroid remnant have less favourable outcome in spite of high cumulative doses of radioiodine. DTC patients with higher TNM stage and bone metastasis require higher and more radioiodine doses. Bangladesh J. Nuclear Med. 17(2): 114-119, July 2014
The effect of exercise and ACE inhibition on angiotensin II

Within the regulation of blood pressure, the renin-angiotensin system (RAS) plays an essential role with AngII causing vasoconstriction, which increases the blood pressure. AngII is formed after ACE ar cleaved by AngI. We hypothesize that the blunting of AngII production with concomitant exercise reduces improvements in metabolic fitness by removing an important stimulus for capillary growth in exercised muscles. The aim of this research was to expose the pathway by which AngII and ACE are implicated in exercise-induced capillary growth of human muscle. We show that highest increases in indices of metabolic strain are observed after high intense exercise bouts and that the increase in AngII is ACE genotype dependent. Furthermore, subjects with the ACE-II genotype had a significant higher capillary perfusion in the finger after exercise. Our findings of our ACE inhibition study support the view that an angiotensin-regulated mechanism affects the hypoxia-specific gene response in peripheral muscle to endurance exercise and support the notion that the muscle’s transcript regulation by ACE inhibition is related to muscle oxygenation during exercise. This indicates that there is a shift in the activation of the gene program from muscle fibres to the surrounding interstitium after ACE inhibition. In a training study we identified a correlation between increases in VO2max and the changes in capillary-to-fibre-ratio. We further observed that variability in the cardiovascular response, based on VO2max and heart rate at rest, was related to the ACE I/D genotype. Our findings that physiological improvements after exercise are dependent on ACE levels, both due to different ACE genotypes and to taking ACE inhibitors could have clinical repercussions. It may explain the individual variation in the response to exercise rehabilitation in aerobic power and oxygen uptake. These differences in exercise-induced improvements have rarely been valued in pharmacological studies of hypertension and exercise rehabilitation.
MAITLAND’S MOBLIZATION VERSUS CLOSED KINETIC CHAIN EXERCISES AFTER COLLE'S FRACTURE FIXATION -

Background: The colle's fracture is the most common fracture site in the upper extremity; it causes functional problems and disabling complications. Treatment of these common fractures and their dysfunctional sequalae continues to challenge surgeons and therapists. Objective: The purpose of this study was to investigate effect of Maitland's mobilization versus closed kinetic chain exercises after stable colle's fracture. Method: Thirty patients had participated in this study. They were assigned randomly into two groups (Group A and Group B) with age ranged from eighteen to fourty five years old. Group A consisted of 15 patients (15 females) received mitland's mobilization with therapeutic ultrasound, group B consisted of 15 patients (15 females) received closed kinetic chain exercises with therapeutic ultrasound for 3 times per week (12) sessions for 4 weeks. Patients were evaluated pre and post treatment for their pain severity, function of the wrist joint, grip strength, wrist joint's ROM and proprioception at 20 wrist flexion, extension, radial and ulnar deviation. Result: The result revealed that there were significant differences between both groups regarding the improvement in function, grip strength, range of motion of flexion, extension, radial and ulnar deviation and there were no significant difference between both groups regarding the improvement in function, grip strength, and joint position sense. Conclusion: Maitland's mobilization versus closed kinetic chain exercises after stable colle's fractures no significant difference in improvement in function, grip strength, and joint position sense, and Maitland's mobilization significantly improve wrist range of motion. Key Word: Colle's fracture, Maitland's mobilization, closed kinetic chain exercises, Proprioception.
Low birth weight in the United States 1-3

PregnancyoutcomesintheUnitedStatesandotherdevelopedcountries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity,mortality,andcost.Widedisparitiesexistinbothpreterm birthandgrowthrestrictionamongdifferentpopulationgroups.Poor andblackwomen,forexample,havetwicethepretermbirthrateand higher rates of growth restriction than do most other women. Low birthweightingeneralisthoughttoplacetheinfantatgreaterriskof later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However,intheUnitedStates,severalnutritionalinterventions,including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations,havenotgenerallyreducedpretermbirthorgrowthrestriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birthorgrowthrestriction.Thesubstantialimprovementinnewborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants. Am J Clin Nutr 2007;85(suppl):584S–90S.
The Safe-T-Sleep ® device: safety and efficacy in maintaining infant sleeping position

Aims The issue of infant sleeping position has socio-political ramifications. Current recommendations endorse supine sleeping as an aid to reducing the risk of sudden infant death syndrome (SIDS). Persistent sleeping of a newborn infant in the same position may induce plagiocephaly without synostosis (PWS). Parents in our craniofacial clinic, whose children present with PWS, often feel torn between apparently conflicting goals – avoiding SIDS and avoiding PWS. The Safe-T-Sleep ® device, a form of infant sleep wrap, purportedly allows safe semi-supine positioning, thus ameliorating PWS (by preventing the infant from lying on the cranial ‘flat spot’) while not increasing the risk of SIDS. Before recommending the device to parents in our plagiocephaly clinics, we designed a prospective, hospital-based trial to assess the safety and efficacy of the device in maintaining selected sleeping positions. This was not a trial of the efficacy of the Safe-T-Sleep ® device in treating plagiocephaly. Methods The devices were trialed on 31 babies, between birth and 11 months of age. A total of 396 hours of observations were recorded. Results The device maintained the selected body position in 94% of recorded observations and head position in 87%. There were no significant adverse events or complications associated with the use of the Safe-T-Sleep ® device. Conclusions The device appears to be safe and effective. It is now being advocated in our clinic as an aid to active counter-positioning strategies to passively correct incipient or established positional plagiocephaly in younger babies. New Zealand has experienced something of an epidemic of sudden infant death syndrome (SIDS) or cot deaths over recent years. As a result, there has been considerable national debate about the issue and research into causal factors is examined with great interest by a wide range of interested parties. Current recommendations from experts in the field strongly advocate supine positioning for sleeping infants, citing a sixfold reduction in the risk of SIDS when compared with a prone sleeping position, and a threefold reduction when compared with side-lying. 1,2,3 Concomitant with the reduction in SIDS rates that these recommendations have produced, is a marked increase in the number of babies in New Zealand referred for advice regarding plagiocephaly without synostosis (PWS) or ‘flat heads’. 4 It is axiomatic that if a neonate, and more especially a premature neonate, is positioned consistently in the same attitude, be it supine, supine with the head turned to one side, or side-lying, the cranium will flatten, simply due to the effects of gravity pressing a soft skull against a relatively unyielding surface (the mattress). A comparable rise in the numbers of PWS referrals has been seen in the USA in the years subsequent to the 1992 recommendation from the American Academy of Paediatrics that supine
Impact of cataract on the quality of life of rural patients in India

Aim: To evaluate the impact of cataract on the quality of life of rural patients in India. Materials and Methods: Cataract patients visiting a rural hospital in Maharashtra, India were surveyed preoperatively and 3 months after undergoing cataract surgery for their quality of life. Indian visual function (VF) questionnaire 33 was used for this purpose. Expectation and satisfaction from cataract surgery were evaluated separately using subjective questions. The outcomes were compared by gender, age-group and literacy and subjective visual gain (post- and pre-operative vision). Results: Of the 150 patients who participated in the study, the visual acuity of 108 (72%) was <20/200 before surgery. The data show that scores for the general, psychosocial, and VFs were 56.7 ± 18.79, 12.82 ± 4.7, and 20.24 ± 4.17, respectively, for all three before surgery. One hundred and thirty-five (90%) participants expected to be economically productive after cataract surgery. Literate patients and patients <60 years old had higher expectations for improvement of VF from surgery. Conclusions: It is concluded that though the quality of life was decreased across all the domains, the study population contributed economically toward their households before cataract surgery and expected to be able to do so after surgery. Illiterate and older patients had a lower expectation and higher satisfaction from surgery.
Computed tomography predictors for in-hospital mortality in severe and moderate head injury patients

Background: Traumatic brain injury is single leading cause of death and disability following injury. Clinical information collected at baseline and computed tomography ( CT) brain scan findings may predict in-hospital mortality rate. The aim of this study was to evaluate which features on the admission CT scan might add significantly to other baseline clinical information for predicting mortality in patients with head injury. Methods: Baseline CT scans were reviewed for patients with moderate and severe head injuries from head injury registry from October 2007 to October 2009. Baseline demographic and injury status and outcome at discharge or death were recorded. Details from the CT scan using marshals grading was used along with other CT scan findings. CT characteristics like diffuse cerebral edema, mass lesions like extra dural haemotoma, subdural haemotoma, intra parenchymal haemorrhage, traumatic sub arachnoid haemorrhage, intra ventricular haemorrhage, basal cisterns, midline shift were evaluated. All the patients were classified into marshalls divisions. If required repeated scans were evaluated and the worst CT scan has been taken into consideration. Results: 211 CT scans were read from patients with moderate severe head injuries. Out of the 24 patients in grade I, 4 died accounting for 16.666%. In grade II out of 47 patients 9 died accounting for 19.148%. In grade III out of 24 patients 5 died accounting for 20.833%. In grade IV out of 30 patients 11 died accounting for 36.666%. In grade V out of 76 patients 20 died accounting for 27.631%. In grade VI out of 10 patients 6 died accounting for 60%. In this study of 211 patients 55 died accounting for 26.06%. Conclusions: Marshall`s CT grading holds good for mortality prediction in moderate and severe head injury patients. Status of basal cisterns and midline shift serves as independent predictors for in-hospital mortality.
Analytical study of hysterectomies

Background: Since early 20 th century hysterectomy came into widespread use. The incidence of hysterectomy varies from place to place depending upon the clinical and clinician factors. Sometimes there are considerable problems in clinical assessments as the patient’s complaints, the clinical findings and per-operative diagnosis does not correlate with histopathological diagnosis. This is a retrospective study to correlate and evaluate the sensitivity between the indications, demographic features, clinical presentations, per-operative findings and histopathological diagnosis of patients who underwent hysterectomy. Methods: This study was conducted in the department of obstetrics and gynaecology, in SVMCH and RC, Ariyur, Pondicherry, India. There were 1124 cases of hysterectomies done over a period of five years, from 2011 to 2015. Data was recorded and analyzed from the case record of each patient, which was obtained from the medical record department of the hospital. Results: During the study period there were 1124 cases of hysterectomies done; out of which total abdominal hysterectomy with bilateral salphingo-oophorectomy were 915 cases 81.4%. Leiomyoma is the dominant histopathological diagnosis in our study 22.4%. Both adenomyosis and leiomyoma was present in 6.4% of the cases. In our study the pre-operative diagnosis, specificity to pathological correlation is 91 to 100%, and for leiomyoma it is 99%. Conclusions: Hysterectomy is the preferred procedure in the treatment for pelvic pathologies like fibroid, adenomyosis, pelvic inflammatory disease and malignant disorder, and genital prolapse. Majority of the hysterectomy procedures are performed via an abdominal approach.
SUBTROCHANTERIC FRACTURES OF THE FEMUR: THE RESULTS OF EXTRAMEDULLARY AND INTRAMEDULLARY FIXATION FOR 244 PATIENTS.

Introduction Debate still exists as to the optimum method of fixation for subtrochanteric femoral fractures. Meta-analysis of studies comparing cephalocondylic nails with extramedullary implants for extracapsular hip fractures have suggested that further investigation is required in this area. We present the outcome of the largest series to date of subtrochanteric fractures treated by both methods and with a minimum of one year follow-up. Methods 244 patients with a subtrochanteric femur fracture were treated at one centre over a 21 year period were prospectively studied. 75 were treated with an extramedullary fixation implant and 168 with an intramedullary nail. Surviving patients were followed up till one year from injury. Results The mean age of patients was 74 and 71% were female. Fixation failure requiring revision surgery occurred in 4% of those treated with an extramedullary implant and 6% of those treated with an intramedullary nail, a difference that was not statistically significant. Length of surgery was similar for both operations but transfusion requirements were less for those treated by the intramedullary nail (p Discussion In summary both intramedullary and extramedullary fixation produce comparable outcomes for this fracture.
Defecation disorders in children: Epidemiology and risk factors

Defecation disorders (constipation and fecal incontinence) are widely prevalent functional gastrointestinal disorders in children. Although the pathophysiology of constipation is not known to the precision, there seems to be association with a significant number or socio-cultural factors. Epidemiological patterns of defecation disorders in Sri Lankan children were lacking. In an epidemiological survey, we noted that 15.3% of school children were suffering from chronic constipation and 2.6% were suffering from fecal incontinence. Constipation had an inverse relationship with age and was associated with straining, abdominal pain and blood in the stools. We also found that defecation disorders are associated with both home and school related psychological stress. It was also found that stress generated by the civil war which plagued the country for 3 decades, and all forms of child maltreatments, predisposed children to develop constipation. In addition, children with constipation were suffering from an array of somatic symptoms. They had poor health-related quality of life in all domains and associated fecal incontinence with constipation reduced quality of life to even lower levels. Despite this, surprisingly, only 3% of them sought healthcare consultation for their symptoms. Management of defecation disorders involves several facets. The pharmacological interventions include judicial use of osmotic and stimulant laxatives for children with constipation and loperamide in children with fecal incontinence. Controlling the dietary factors, neuromodulation and surgical interventions are the other possible therapeutic modalities. Above all, controlling the psychosocial factors and making world more safer place for children will reduce the disease burden and the healthcare expenditure.