Miracle-dz/UniFAR-FTUs huggingface dataset:
Role of Bethesda system for reporting thyroid lesion and its correlation with histopathological diagnosis

Introduction: Interestingly enough, while TBS is forging ahead to bring about uniformity a thyroid FNA cytology reporting, a similar milestone has also been reported with an application of United Kingdom (UK-RC path system or BTA/RC Path) for reporting thyroid FNA cytology. It achieved practicing activism in 2003 and later got modified in the year 2009 & 2016. The TBS and RC path system being contemporary system of reporting thyroid cytopathology, uniform system of reporting cytopathology of nodular thyroid lesion still is not achieved but activated. Aim: To study the nodular thyroid lesions on FNAC by reporting system of TBSRTC and UK RC Path. Objectives: To compare the categories of the Bethesda system with contemporary categories of UK Royal college of pathologist for cytomorphological diagnosis and overlaps as well as with conventional reporting system and to compare with tissue diagnosis of surgically resected specimen of nodular thyroid lesions for its malignancy risk. Material and Methods: This study is hospital-based observational prospective and analytic study including 255 patients with nodular thyroid lesion. FNAC were carried out with or without under the guidance of sonography. The staining performed were conventional for smears of the aspirate. The smears were classified and categorized by two systems, TBSRTC and UK-RC path system of reporting thyroid lesion. The tissue diagnosis was done for the surgically resected specimens of nodular thyroid lesion in case of patient who underwent surgery. The values of comparative statistics were bought out. Observations: Females predominated over males. The distribution of cases for into the categories of TBSRTC and UK RC Path were as follow: category I/Thy1- 23, category II/Thy2-156, category III/Thy 3a-21/19, category IV/Thy3f-22/24, category V/Thy4-21, category VI/Thy5-16. There were 57 patients underwent surgical intervention in form of total or partial thyroidectomy or lobectomy and had available histopathological examination reports for cyto-histopathology co-relation. Values of comparative analysis show high NPV, PPV and high values of specificity, as compared to conventional. Conclusion: TBSRTC and UK RC path for reporting thyroid cytology are suitable for reporting thyroid nodular lesions on FNAC because of uniformity of nomenclature categories and implication at management with high correlation percentile with subsequent surgically resected specimen of thyroid.
Osteoarthritis in patients with familial Mediterranean fever: genetic basis and anti-inflammatory effect of laser acupuncture

Background Familial Mediterranean fever (FMF) is an autosomal recessive autoimmune disease characterized by recurrent attacks of fever, peritonitis, pleuritis, arthritis, and renal amyloidosis. Arthritis could be the presenting symptom in many cases. Laser acupuncture has analgesic and anti-inflammatory effects on joint arthritis. Aim To highlight the genetic basis of osteoarthritis in patients with FMF and to highlight the anti-inflammatory effect of laser acupuncture on osteoarthritis of knee joint in Egyptian patients with FMF. Patients and methods A randomized controlled study was performed on 40 Egyptian patients with FMF. Molecular analysis of MEFV gene mutations was performed for all selected patients. Twenty patients with FMF were exposed to low-level laser acupuncture sessions (laser acupuncture group) and 20 other patients with FMF did not receive low-level laser acupuncture sessions (control group). Twelve low-level laser acupuncture sessions were implemented for the group treated with laser acupuncture three times per week for a duration of 4 weeks. All patients were checked before and after laser acupuncture sessions for pain intensity, radiography changes, and some inflammatory markers (white blood cell, eosinophils, lymphocytes, erythrocyte sedimentation rate, and C-reactive protein). Results M694V mutation was detected in 40% of patients. Patients with FMF with knee arthritis exposed to low-level laser acupuncture sessions showed significant improvement in pain intensity compared with the control group (P < 0.001). Statistical significance improvement of the treated knees started from the third follow-up laser session revealed by significant improvement in the radiography findings (P < 0.001). The inflammatory markers white blood cell, eosinophils, lymphocytes, erythrocyte sedimentation rate, and C-reactive protein became significantly lower (P = 0.037,P < 0.001,P < 0.001,P < 0.001, andP < 0.001, respectively). Conclusion M694V variant of MEFV gene is more frequent in the Egyptian patients with FMF with osteoarthritis. Low-level laser acupuncture therapy is effective in ameliorating pain of osteoarthritis in patients with FMF.
Effect of liver cirrhosis on patient outcomes from open heart surgery

IntroductIon Individuals with liver cirrhosis (LC) are more prone to have a poorer life expectancy in comparison with their equivalent with the same age by 40% [1]. LC is paving the road toward a higher morbidity and mortality rates when combined with open heart surgery (OHS) owing to many physiological derangements like hematological abnormalities and immunological incompetence. The scarcity of data concerning the outcomes of cardiac surgery in patients with LC puts such type of intervention for a great debate concerning its benefit [2,3]. The calculation of the risk of death following OHS was solved a long time ago by the invention of the risk scoring models [e.g. European System for Cardiac Operative Risk Evaluation (EuroSCORE)], and unfortunately, none of them addressed LC as a risk factor even with their most recent modifications [4]. Seeking improvement in the outcomes of surgery for treatment of portal hypertension and liver transplantation, researchers developed both Child– Turcotte–Pugh (CTP) and the model for end‐stage liver disease (MELD) scores [5,6]. One of the pioneers who first Background We designed this prospective controlled study to evaluate the early postoperative outcomes in patients with liver cirrhosis (LC) after open heart surgery (OHS).
Morphometric and Anatomic Variations of Foramen Ovale in Human Skull and Its Clinical Importance

Objective: There is a paucity of information regarding the specific anatomy and clinical significance of variations of foramen ovale (FO). The present study was undertaken to define this anatomy in more detail and to review the literature regarding these anatomic variations. Materials and Methods: A total of 124 adult human dry skulls were analyzed for the variations in appearance and number of FO being noted. The length and width of the FO of both sides were determined using digital vernier calipers and area (A) was also calculated and analyzed. Results: Of 82 adult skulls, the values for the right side was 7.64 ± 1.194 mm, 5.128 ± 0.827 mm, and 30.808 ± 7.545 mm2 and for the left side the values was 7.561 ± 1.123 mm, 5.244 ± 0.950 mm, and 31.310 ± 8.262 mm2, respectively, for the mean length, width, and area of the FO. The shape of foramen was typically ovale in most of the skulls (56.70%) with some bony variations such as spine, tubercles, bony bridge/bar, and confluence. Conclusion: Such variants in the FO could interfere with transcutaneous needle placement into the FO or distort anatomic relationships during approaches to the cranial base.
Factors Associated with Safe Disposal Practices of Child’s Faeces in Nigeria: Evidence from 2013 Nigeria Demographic and Health Survey

Background: Stool disposal practices have been shown to be associated with childhood diarrhea. There exist variations in explanatory variables of safe child's faecal disposal practices depending on the context of the study. Thus, the need for this study to assess factors associated with safe disposal practices of children's faeces in Nigeria. Methods: This study utilized the 2013 Nigeria Demographic and Health Survey data. Child's faecal disposal practice was classified as safe and unsafe as defined by the World Health Organization/UNICEF Joint Monitoring Program. Binary and multivariate logistic regression models were used to identify factors associated with safe faecal disposal practices. The analysis was restricted to a weighted sample of 19, 288 youngest children in the households. Results: Overall, the prevalence of safe disposal of child's faeces was 59.4%. Safe child's faeces disposal was the highest among older women (64.4%), highly educated women and their husbands (67.1%) and (66.4%), respectively; among rich households (72.3%), Muslim (68.7%), urban areas (68.8%), and in North West zone (78.4%). In multivariate analysis, safe faecal disposal was significantly associated with the age of mother, maternal education level, wealth index, religion, source of water, and type of toilet facility. Marital status, geopolitical zone, having diarrhea in the past 2 weeks before the survey and sex of the child were not significant determinants of safe faecal disposal practice. Conclusion: Understanding the prevailing faecal disposal practices is a prerequisite to the formulation of effective intervention strategies. It is pertinent, therefore, that programs and interventions designed to improve safe child's faecal disposal practices need to take into consideration the factors identified in this study.
Effect of plain and fortified amla fruit powder on aluminum-induced Alzheimer's Disease in Wistar Rats

Objectives: The present study was designed to evaluate the antioxidant and Nootropic activities of Emblica officinalis against aluminum-induced Alzheimer's disease (AD) in Wistar rats. Materials and Methods: Alzheimer's was induced using aluminum chloride at a dose of 4.2 mg/kg by intraperitoneal route for 28 days. In prophylactic studies, the plain amla powder (500 mg/kg) and fortified amla powder (300 mg/kg) were administered along with the aluminum chloride. In the curative study, the fortified amla powder (500 mg/kg) was administered to Alzheimer's-induced rats. Memory impairment was confirmed by measuring the nootropic activity using Morris water maize. At the end of the treatment, the oxidative stress parameters such as malondialdehyde (MDA), superoxide dismutase (SOD), and catalase were evaluated. Results: The present study showed statistically significant increase in nootropic activity in terms of decrease in latency period in treatment groups when compared with the controlled Alzheimer's-induced group. The administration of amla fruit powder (plain and fortified) decreased the MDA levels and increased the SOD and catalase levels. Conclusion: The present study proved that E. officinalis is a promising tool in antioxidant and neuroprotective activity against aluminum chloride-induced AD.
Comparative evaluation of in vitro antioxidant activities and high-performance liquid chromatography fingerprinting of fruit peels collected from food processing industry wastes

Background: An enormous quantity of fruit peel is obtained from food processing industry as leftover materials which cause environmental pollution if not used judiciously. Objective: The present study was focused to explore antioxidant activities and detect bioactive compounds of three different fruit peel wastes (orange, mango, and pomegranate) collected from fruit processing centers. Materials and Methods: Peel extracts were primarily investigated for total phenolic and total flavonoid content (TFC) in three different solvent systems, namely aqueous–methanolic (20:80, v/v), ethanolic, and aqueous. These were examined for in vitro antioxidant potential by 2,2-diphenyl-1-picrylhydrazyl hydrate (DPPH) and ferric reducing antioxidant power (FRAP) test. Peel waste extracts were further characterized by high-performance liquid chromatography. Results: Pomegranate peel (PP) wastes exhibited significantly (P < 0.01) high concentration of total phenolic content (TPC) and TFC followed by mango peel (MP) wastes and orange peel (OP) wastes. DPPH and FRAP tests revealed significantly (P < 0.01) high antioxidant activity in aqueous–methanolic and aqueous extract of PP. The degree of antioxidant activities in each type of solvent was in the order of PP >MP >OP. Pearson's correlation coefficient analysis revealed a strong association between antioxidant activity and TPC. High concentration of gallic acid, salicylic acid, chlorogenic acid, rutin, and catechin was observed in aqueous–methanolic (20:80, v/v) extracts of PP, and these might be the reason behind the higher antioxidant activities of PP. Conclusion: Results of this study clearly suggest that PP waste contains strong antioxidant molecules and might be used as additive in commercial feed to ameliorate oxidative stress in animals.
The prevalence of different Kennedy's classifications and their relationship with age, gender, and location of the edentulous arches in Palestine

Aim and Objectives:In West Bank, Palestine, there are no studies that have investigated the prevalence of different Kennedy's classifications and their relationship with age, gender, and location of the edentulous arches. Materials and Methods: This study group consists of 716 patients (463 males and 253 females). The patients were clinically examined to determine the Kennedy classification in Department of Prosthodontics, College of Dentistry, Arab American University. Results: A total of 716 participants were enrolled in this study; males (62) exhibited higher tooth loss than females (37). Among the Kennedy's classification, Class III was found to be most common in the maxilla (41%) and Class I in the mandible (39%). The least common class was Class IV in both arches. Conclusions: Kennedy's Class III partial edentulous type was most commonly found in the maxilla and Class I in the mandible.
Persons living with HIV continue to present late for care: A trend analysis from 2011 to 2015

Context: The clinical and prevention benefits of early initiation of antiretroviral therapy (ART) have led to the adoption of test and treat policy for HIV. Early diagnosis of HIV is crucial for maximal benefits from ART. Aims: This study aims to assess trends in CD4 cell counts at diagnosis and determinants of late presentation. Settings and Design: We analyzed 5-year data from a free HIV/sexually transmitted infection referral clinic immune. Subjects and Methods: Persons presenting for HIV testing from January 2011 to December 2015, for whom CD4 cell count results were available within 3 months of HIV diagnosis, were included in the analysis. Persons on ART were excluded from the study. Statistical Analysis: The predictors of CD4 cell count at presentation were assessed using univariate and multivariate linear regression. Results: Of 1001 persons diagnosed HIV-1 positive, 659 had received CD4 test within 3 months of diagnosis. The median CD4 count at presentation ranged from 212 to 352 cells/cmm in these 5 years and did not show any significant change with time. Nearly 40% had CD4 cell counts below 200 cells/cmm (AIDS); additionally, 23% presented below 350 cells/cmm. Older age (beta: -5.78; P= 0.001), education above matriculation (beta: -123.72; P= 0.014), having current opportunistic infections (beta: -173.58; P= 0.037), and being symptomatic (beta: -101.8; P= 0.002) were predictors of presenting at lower CD4 counts. Conclusion: Between 2011 and 2015, persons with HIV continued to present late in spite of changes in ART access program. Education focused on the benefits of early diagnosis and availability of free immediate treatment in the public sector, are crucial to the achievement of the India's 90-90-90 goals.
World Health Organization Grade III Supratentorial Extraventricular Ependymomas in Adults: Case Series and Review of Treatment Modalities

Context: Supratentorial ependymomas and their anaplastic variants are relatively uncommon central nervous system neoplasms that afflict both adults and children. Aims: Discuss the clinical and pathological features of patients with anaplastic ependymomas involving an extraventricular supratentorial location and review modalities and options of treatment for those rare tumors. Settings and Design: Whereas the treatment algorithm in the pediatric population is well established, however, treatment in the adult population is less defined. Treatment options are exposed through the author's cases and review of the literature. Subjects and Methods: In our case series of two adult patients with supratentorial ependymomas World Health Organization (WHO) Grade III (anaplastic variant), patients presented in both cases in the emergency room after having a generalized tonic–clonic seizure at home the first case, and mild hemiparesis the second case. Results: Patients underwent surgical treatment, and a gross total resection was achieved in both cases. The histopathological examination revealed a diagnosis of anaplastic ependymoma (WHO Grade III). Both patients had additional radiotherapy, and in the first case, adjuvant platinum-based chemotherapy was administered due to leptomeningeal gliomatosis. Conclusion: In our experience, gross total resection was achieved in all patients with supratentorial extraventricular ependymomas WHO Grade III with additional radiotherapy and platinum-based chemotherapy. Patients require initial close serial imaging follow-up. The role of chemotherapy is still uncertain but may be necessary in younger patients and in tumors that behave more like the pediatric ependymomas.
Characterization of human immunodeficiency virus-infected patients of suspected first-line antiretroviral treatment failure within 5 years – Evidence from a tertiary hospital, Kolkata

Objectives: Antiretroviral therapy (ART) has immense survival benefit on human immunodeficiency virus (HIV)-infected people. However, every year, a proportion of patients were failing to the first-line drugs. The aim of this study is to characterize the patients developing first-line failure within 5 years of ART. Materials and Methods: A retrospective observational study was carried out at the Centre of Excellence in HIV care, School of Tropical Medicine, Kolkata. A total of 190 referred patients' data of suspected first-line treatment failure who failed first-line ART within 5 years of initiation were collected and analyzed using R software. Results: Among 190 patients, 100 (52.4%) patients had virologic failure. Male patients 78 (41.05%) outnumbered females 22 (11.57%) and needed to switch to the second-line drugs. The median age was 37 years (range 8–65 years), and the median duration of first-line ART taken was 2.85 years. Among the first-line failed patients, zidovudine, lamivudine, and nevirapine (23.6%) was the most common antiretroviral regimen and 77 (40.5%) referred in the WHO stage I of illness. Seventy-three (38.42%) patients were referred for immunological failure, 26 (13.7%) for both immunological and clinical failure, and only 1 (0.52%) had only clinical failure at the time of referral. We found a significant association of suboptimal adherence (P < 0.05) and high viral load in this study. Conclusion: This study enables that poor adherence was the most important factor responsible for the first-line treatment failure. As adherence is a dynamic process, interventions in every visit following ART initiation should be optimized, and a multidisciplinary approach toward adherence is needed to get the highest treatment outcome benefit.
Angiotensin II receptor blockade blocker pre-treatment largely prevents injury from gradual renal ablation in rats

Introduction. Reduction in renal mass in rats results in progressive proteinuria, hypertension, focal-segmental glomerulosclerosis (FSG), atrophy of tubules (AT), and interstitial expansion. We reported that slow reduction of renal tissue in rats (slow ablation) ending in the removal of 1.5 kidneys is associated, over the next six months, with higher albumin excretion rates (AER) and accelerated development of FSG lesions compared to sudden equivalent renal mass reduction. It was hypothesised that slow reduction of nephron numbers allows for a process of conditioning of residual nephrons that increases their susceptibility to subsequent injury. Methods. To test this idea we treated MünichWistar rats with the angiotensin receptor blocker (ARB) losartan for six weeks during the gradual staged surgical removal of 1.5 kidneys, and compared them to sham operated controls, and parallel groups untreated by losartan. Results. Despite discontinuation of losartan over the subsequent six months, ARB pre-treatment completely prevented proteinuria and hypertension in these slow renal ablation rats. ARB pre-treatment also largely prevented the subsequent development of FSG,AT, and interstitial expansion in these animals. Both losartan-treated and untreated renal ablation groups had glomerular enlargement and compensatory hyperfiltration and this was uninfluenced by losartan. Conclusion. Temporary ARB administration during gradual renal mass reduction resulted in long-term prevention of hypertension and albuminuria and greatly reduced FSG and tubular and interstitial lesions. We hypothesise that the preconditioning of residual nephrons in the gradual ablation model which facilitates their subsequent injury, is blunted by renin-angiotensin system blockade.
Prevalence of reproductive tract infections in women attending a tertiary care center in Northern India with special focus on associated risk factors

Background: Reproductive tract infections (RTIs) continue to present major health, social, and economic problems worldwide, and their complications are the most important causes of morbidity and mortality for women, especially in developing countries. Interest in RTIs and their management has increased tremendously because the presence of a RTI in the sexual partner increases the risk of acquisition of HIV. Aims: The aim of this study is to know the prevalence of RTIs, its correlation with clinical features and associated risk factors in women of reproductive age group attending a tertiary care center in Lucknow. Materials and Methods: The present study was conducted on 318 women of the reproductive age group (18–45 years) attending the RTI/sexually transmitted infection clinic at our center; they were evaluated for the prevalence of following RTIs: Chlamydia, gonorrhea, syphilis, bacterial vaginosis, trichomoniasis, and candidiasis; their correlation with clinical features and associated risk factors. Results: The prevalence of reproductive tract infections in women attending our centre reported 9.7%. The prevalence of candidiasis was maximum (11.5%) followed by chlamydia (4.1%), syphilis (4.1%), bacterial vaginosis (1.73%), and trichomoniasis (0.57%). None of the women were found positive for gonorrhea. The most common presentation was genital discharge (52.8%) followed by lower abdominal pain (45.2%). Conclusion: The factors found to be significantly associated with RTI were illiteracy (P < 0.05), unemployment (P < 0.05), history of RTI in patient (P = 0.001), and the presence of RTI in their partner (P < 0.05). The genital discharge was the most common presentation.
The depressed heart

Our appreciation and understanding of the interrelationships between disrupted metabolic function and depression have increased significantly over the last few decades. This review focuses still more specifically on the intersections between cardiovascular disease (CVD) and major depressive disorder (MDD). General pathophysiological mechanisms implicated in both diseases include inflammation, cytokine and hypothalamic–pituitary–adrenal axis dysregulation, oxidative stress, neurotransmitter disruptions, neuroplasticity, and the microbiome. Here, we explore these mechanistic overlaps of depression and CVD, including some discussion of related and frequently comorbid disorders, such as obesity and diabetes, and the closely related “metabolic syndrome. ” Finally, we discuss integrated therapeutic strategies for treating MDD comorbid with CVD.