Miracle-dz/UniFAR-FTUs huggingface dataset:
SURVEY OF LEVELS OF ANXIETY AND DEPRESSION IN PARENTS OF CHILDREN WITH CHRONIC ILLNESS

Survey of levels of anxiety and depression in parents of children with chronic illness hadi jafarmanesh , mahdi ranjbaran, katayon vakilian, koroush rezaee, soleyman zand, Reza tajik , Jafarimanesh@arakmu.ac. ir Abstract: Introduction: Parents who have children with chronic disease are susceptible to anxiety and depression. Parental anxiety and depression is associated with decreased sense of responsibility toward care, education and nutrition for their children and also for their mental disorder effect on their children’s mental and emotional health. The purpose of this study was to determine parent’s anxiety and depression of children with chronic disease in Tehran Mofid pediatric Hospital. Method: The present study is cross-sectional study that was conducted in 2010. 440 parents of hospitalized children with chronic diseases were selected with simple random sampling. Study’s tool was Hospital Anxiety and Depression Scale. Data were analyzed with descriptive statistics and Independent t-test and Pearson correlation tests. Results: The results showed that 49.1% of parents had moderate to severe and 24.5% had mild anxiety. Also 31.8% of samples were with moderate to severe depression and 27.3% with mild depression. Child gender, location, duration of hospitalization of children showed significant association with the level of anxiety and depression (p<0.05), as well as a significant relationship between parent's gender, history of anxiety and parent's age with depression levels was observed (p<0.05). Conclusion: According to results of this study, it is recommended to screen depression in parents of children with chronic illnesses in hospitals and clinics Keywords: Anxiety, Depression, Parents, Children, Chronic diseases
Evaluation of relationship of hand wrist radiograph, cervical vertebral maturation with mandibular growth as skeletal maturity indicators in children

Objective: To study the correlation between mandibular growth variables using linear measurements of ramus, body of the mandible and total mandibular length with skeletal maturity indicators such as hand wrist radiographs and cervical vertebral maturation. Materials and Methods: A total of 315 patient-records (lateral cephalograms and hand-wrist radiographs) in the age group of 10–13 years were involved. The cephalometric measurements, representative of the mandibular growth, Condylion-Gonion (Co-Go), Condylion-Gnathion (Co-Gn), Gonion-Gnathion (Go-Gn), and posterior-most point of the mandibular condyle-pogonion (Fg-Pg) were traced (McNamara method). The correlation of mandibular growth variables with hand wrist parameters and cervical vertebrae maturation were assessed separately in male and female. Pearson's correlation was used for analysis (Statistical Package for Social Sciences version 17). Results: Only 80 subjects were included in final analysis. A highly significant correlation was found among hand wrist parameters, and mandibular growth variables (P < 0.001) in both genders. Among males, there was a highly significant correlation between cervical vertebral maturation and mandibular growth variables (P < 0.001), whereas Co-Go has a significant correlation with C2Conc, C3Conc, and C4Conc (P < 0.05). In females, Co-Gn, Co-Go, Go-Gn, and Fg-Pg were significantly correlated with C3Conc and C4Conc (P < 0.001). Conclusion: Both the cervical vertebral maturation and mandibular growth variables can be accessed on the lateral ephalogram itself for the evaluation of the skeletal maturity, as effective as a hand wrist radiograph in males and females.
Epidemiology, screening and management of Chlamydia trachomatis infection in New Zealand

ii Acknowledgements . iv Co-Authorship Forms . v List of Figures . xvii List of Tables . xviii Abbreviations . xix Research Outcomes . xx Chapter 1: Genital Chlamydia trachomatis infection . 1 Overview . 1 Terminology . 1 History . 1 Biology . 2 Life cycle . 2 Taxonomy . 3 Serovars . 4 Clinical syndromes . 4 Pelvic inflammatory disease (PID) . 5 Ectopic pregnancy. 8 Female infertility . 10 Adverse pregnancy outcomes . 11 Epididymitis . 11 Male infertility . 12 Diagnosis . 12 Culture and other non-NAAT tests . 13 Nucleic acid amplification tests (NAATs) . 14 Genital C. trachomatis NAAT samples . 15 Treatment of C. trachomatis infections . 16 Management of sexual partners . 19 Chlamydia prevalence in New Zealand . 20 Chlamydia prevalence internationally . 25 New Zealand’s health care system . 28 STI surveillance. 31 STI surveillance in New Zealand . 31 Sentinel clinic STI surveillance . 31 Laboratory-based surveillance . 33 Reported chlamydia cases in New Zealand. 36 Recent trends in New Zealand . 38 Comparison with internationally-reported chlamydia cases . 40 Approaches to chlamydia control . 42 Duration of C. trachomatis infection . 42 Transmissibility of C. trachomatis infection . 42
EFFICACY AND SIDE EFFECTS OF HYDROXYUREA IN PATIENTS WITH THALASEMIA INTERMEDIA

: Introduction: The β-thalassaemias represent a heterogenous group of diseases resulting from decreased β-globin mRNA expression and imbalanced alpha/betaglobin chain synthesis which are clinically manifested by ineffective erythropoiesis and excessive hemolysis. Increasing levels of hemoglobin F (HbF) by improving the balance in globin chain synthesis. Hydroxyurea (HU), as an effective with low toxicity for activating y-globin gene, has been shown to enhance HbF synthesis. Methods: To analyze the clinical presentation and possible side effects of HU treatment 80 thalassemia intermedia patients were selected and followed-up for one year regularly. All of them started their regular blood transfusion beyond of 2 years of age and were being treated with 10-12 mg/kg/d HU orally. Results: The study group consist of 38 men and 42 women. The average age was 16.8(±6.9) years and thalassemia was diagnosed according to the RBC indexes and Hb electrophoresis. An improvement of erythropoiesis was reflected by an increase in hemoglobin concentration, the state of energy, fatigability, and mood. About 83% (69) of the patients tolerated the HU well and showed a dramatic response to the drug. Thirty of 80 transfusion-dependent patients became completely transfusion-free and 23 cases had one or two transfusions throughout the study. Vomiting and thrombocytopenia were seen in two patients. Conclusion: During this close observation, no malignant change was seen in our patients. HU therapy appears to be safe and effective when administered in thalassemic patients.
Comparison of Perforated Necrotizing Enterocolitis in Full-Term and Preterm Infants

Although necrotizing enterocolitis (NEC) is a primary disease of prematurity, full-term infants account for approximately 10% of cases. We retrospectively reviewed the medical records of infants with perforated NEC at two tertiary medical centers over the past fifteen years. Nine full-term and 29 pre-term infants with perforated NEC were enrolled in our study. Among the full-term cases, 4 were older than one month. Perforated NEC was male predominant in pre-term cases and female predominant in full-term cases. Abdominal distention, abdominal wall discoloration and muscle guarding were the most common manifestations in preterm cases, and abdominal distension and bloody stool were most common in full-term cases. The most common abnormal laboratory findings were anemia and metabolic acidosis in preterm cases, and leucocytosis and metabolic acidosis in full-term cases. In pre-term infants, the most common related factors were prenatal problems and maternal disease (19/29, 65.5%), patent ductus arteriosus with indomethacin use (14/29, 48.3%), and sepsis (11/29, 37.9%). In full-term cases, congenital anomaly (5/9, 55.6%) and sepsis (3/9, 33.3%) were the most common related factors, especially in full-term infants older than 1 month. The most common pathogen cultured from patients' blood or ascites was Klebsiella pneumoniae, followed by E. coli, in both pre-term and full-term infants. In conclusion, perforated NEC should be considered in both preterm and full-term babies if infants present with signs of surgical abdomen. To reduce NEC mortality and morbidity in both preterm and full-term infants, early diagnosis and treatment are vitally important, especially in cases with predisposing factors.
PHYSIOLOGIC INDICES OF PATIENTS BEFORE, DURING AND AFTER VISIT IN CORONARY CARE UNIT AT IMAM KHOMEINI HOSPITAL IN ARDEBIL

Physiologic indices of patients before, during and after visit in coronary care unit at Imam Khomeini hospital in Ardebil Kamrani, F. 1 * (MSN); Seyedjavadi, M. 2 (MSN); Abedsaeedi, Zh. 3 (PhD); Ezzati, Zh. 4 (MSN); Alavimajd, H. 5 (PhD); Hosseinian, A. 6 (MD) 1. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Alumnus, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran 3. Assistant Professor, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran. 4. Lecture, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 5. Associate Professor, Dept. of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 6. Cardiologist, Faculty of Medicine, Ardebil University of Medical Sciences, Ardebil, Iran. Abstract Background and aim Visit is an essential issue in hospitals and of patients' basic needs in coronary care units (CCUs). However, there is no evidence regarding its physiologic effects on them. The aim of this was to determine the physiologic indexes of patients before, during and after visit at CCU of Imam Khomeini Hospital in Ardebil. Materials and methods In this descriptive study, 50 patients with acute myocardial infarction were selected through convenience sampling method. A questionnaire and a cardiac monitoring device were used for data collection. Content method and calibration the device were used for validity and reliability of the tools respectively. ANOVA with repeated measurements was used for data analysis. Findings %72 of patients was male and %28 was female. Their mean age was 59.8. Significant differences were found between s ystolic, diastolic and mean arterial pressures; heart as well as respiratory rates; temperature; and oxygen saturation before, during and after the visits. Accordingly, the indexes increased significantly by the start of visits and turned back to the previous state after them with no significant difference in before-after amounts. Conclusion It seems that the physiologic indices of patients change in normal range during visits and return to their primary state after 30 minutes from the end of visits with no clinical importance. Keywords: Visit, Coronary Care Unit (CCU), Physiologic indexes. * Corresponding Author: Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: comruni1338@yahoo.com
Clearance of corticosteroids following intra‐articular administration of clinical doses to racehorses

Summary Over the last few years there has been a nationwide cooperative effort to establish threshold concentrations and withdrawal time guidelines for corticosteroid use in racehorses. As dosing regimens are specific to individual horses and highly variable, it is not possible to establish regulatory guidelines for every dosing scenario and therefore they are often based on single dose administration studies. The goal of the study described here was to assess the applicability of current regulatory recommendations for intra-articular corticosteroids based on clinical protocols used by practitioners. A total of 58 Thoroughbred and 82 Quarter Horse racehorses received varying doses of triamcinolone acetonide, methylprednisolone acetate, isoflupredone or betamethasone intra-articularly in various joints by the treating practitioner. Blood samples were collected at 0, 7, 10, 14, 21, 28 and 35 days post drug administration and serum samples analysed by liquid chromatography mass spectrometry for quantitation of drug concentrations. Serum elimination varied depending upon the dose and the number and specific joints treated. Serum concentrations fell below the ARCI threshold guidance by Day 7 (100 pg/ml) for both triamcinolone acetonide (2–40 mg dose) and isoflupredone acetate (4–30 mg dose) and Day 21 (100 pg/ml) for methylprednisolone acetate (20–600 mg dose). Betamethasone fell below the regulatory threshold (10 pg/ml) by 7 days for all Quarter Horses and for 7/10 Thoroughbreds studied. Drug concentrations were below the regulatory threshold by Day 10 in the remaining 3 horses receiving betamethasone.
Association Between Standing and Lying Behavior and Udder Health in Free-stall Housed, Lactating Dairy Cows

RELATIONSHIP BETWEEN STANDING AND LYING BEHAVIOR AND UDDER HEALTH IN FREE-STALL HOUSED LACTATING DAIRY COWS Mary Ellen Alexandrea Watters Advisor: University of Guelph, 2013 Dr. Trevor DeVries This thesis investigates the relationship between cow lying behavior and udder health in free-stall housed dairy cows milked 3x/d. Two longitudinal studies were undertaken; in the first, associations with risk of elevated somatic cell count (eSCC) were determined and, in the second, associations between management practices, post-milking standing duration (PMSD), and risk of intramammary infection (IMI) were determined. A PMSD of >90 min was associated with reduced odds of eSCC. A PMSD of 90 to 120 min was associated with reduced odds of CNS IMI, as was provision of feed around time of milking. Providing ample feed bunk space, having lower free-stall stocking densities, and providing feed around the time of milking promoted PMSD. Overall, these results suggest that management practices which promote PMSD may help to improve udder health in free-stall cows milked 3x/d.
Designing an assessment tool for professional attributes of medical graduates from a new medical school in Nepal

Introduction: Background: Methods: Results: Discussion: The final assessment document requires only a ‘meets expectations’ or ‘below expectations’ tick from the tutor across 11 attributes. The efficacy and practical value of this tool will only be determined with use, and further research to determine how effective it is. The definitions of required attributes together with the presence or absence of their corresponding behaviour would be indicated in a simple table that could be used in a wide variety of educational settings. An initial faculty-wide consultation meeting in 2007 produced a list of 29 attributes for PAHS graduates. In 2008, the newly formed Medical Education Unit was given the task of refining them into a workable list that could be realistically assessed. This produced a list of 12 attributes together with their operational definitions. Professionalism is an increasingly important topic in medical education today and a number of studies have described ways of defining and measuring professional attributes in Western medical graduates. No such studies can be found in any Asian medical schools. Patan Academy of Health Sciences (PAHS) is a new medical school that specialises in specifically training doctors for service in the rural areas of Nepal. The trainee doctors’ values are consistent with sustainable improvements in the health of poor and marginalized people. This new faculty is engaged in a collaborative exercise to define professional attributes that are required of new graduates and to design a simple assessment tool to measure themselves.
Comparison of Temporary Interruption of Warfarin Therapy for 3 and 5 days before Surgery in Thailand: A Randomized Controlled Trial

Objective: The ACCP guideline 2008 recommended cessation of warfarin five days before surgery. However, based on the observation of the clinical practice at Siriraj Hospital, we suggested a shorter period of three days before surgery. Prior studies have shown multiple factors had effected warfarin dosage, but few studies have shown factors that influenced normalization of prothrombin time after discontinuation of warfarin. Previous studies have shown the genetics factors, vitamin K epoxide reductase (VKORC1) and cytochrome P450 2C9 (CYP2C9) enzyme conjointly determine the warfarin maintenance dose. We wanted to find out the proper timing of warfarin cessation before surgery and relationhip to genetic factors. Methods: Sixty-eight patients on warfarin were randomized to stop warfarin for three or five days. Blood samples were acquired at three or five days after interruption of warfarin in each group and assayed for INR, VKORC1 and CYP2C9. We started bridging therapy when INR was less than 2.0 and accepted an INR value of 1.5 or less on the day of surgery. Results: A total of 68 patients were enrolled in the study. Thirty-three patients (48.5%) were male. The mean age was 50.8 ± 6.6 years (range 16-88 years). The mean BMI was 22.5 ± 3.6 kg. All patients had mechanical heart valve replacement, and 22 (32.4%) patients had AF. The mean cumulative weekly dose of warfarin was 27 ± 11.3 mg and baseline INR was 2.4 ± 0.3. Thirty (88.2%) patients in the three days group had INR ≤ 1.5 and thirty-three (97.3%) patients in the five days group had INR ≤ 1.5. There was no significant difference between interruption of warfarin for three and five days (p =0.16). Female sex, BMI and weekly warfarin dosage were associated to the longer cessation of warfarin. Only weekly warfarin dosage was a significant factor after multivariate analysis. From 68 patients, CYP2C9 *1/*1 was found in 93% and CYP2C9 *1/*3 was found in 7%. Neither mutant CYP2C9*2 allele nor individuals homozygous for CYP2C9*3 were observed. Regarding VKORC1, haplotype AB was found in 32% and haplotype AA was found in 63%. Haplotype BB (wild type) was found in 4%. Five patients who had INR > 1.5 after interruption of warfarin had VKORC1 haplotype AA, four patients had CYP2C9*1/*1 and one patient had CYP2C9 *1/*3. Neither VKORC1 nor CYP2C9 was related to normalization of INR (p=0.10, p=0.17). Conclusion: Temporary interruption of the warfarin therapy between three days and five days with bridging therapy before surgery is not significantly different in the Thai population. This study recommends discontinuing warfarin three days before surgery. The proper timing of interruption for warfarin does not only depend on the half-life of warfarin but also depends on age, co morbidity, sex, BMI, lower maintenance warfarin dose, and concomitant drugs. If patients have cardiac or liver disease, they may spend longer time to discontinue warfarin before surgery.
Yield of colonoscopy with special reference to lower gastrointestinal bleeding in a tertiary referral center in Eastern India

Abstract Background: Little data exist on the yield of colonoscopy in its different indications, especially gastrointestinal (GI) bleeding. Furthermore, there are no formal guidelines regarding the timing of its performance in the work up for lower GI bleeding. Methods: In a retrospective study, spanning from January 2007 to December 2013, the clinical data of all the patients undergoing colonoscopy were retrieved from the hospital records including the predominant symptom which mandated colonoscopy and results of the other tests done before colonoscopy including upper GI endoscopy (esophagogastroduodenoscopy [EGD]). The type of GI bleed (overt or occult) along with the presence or absence of iron deficiency anemia (IDA) was noted. The yield of EGD in the corresponding years in those having a presentation with lower GI bleed and/or IDA was also noted for comparison. Results: Overall yield of colonoscopy was low (25.7%) like for all its indications except lower GI bleed where its yield was highest (45.2%). 81.2% of the cases with a diagnosis presented with lower GI bleed, highest for colon cancer (90%), and polyps (86.1%). Cases of occult bleed more often had a positive diagnosis than overt bleed (P = 0.02). EGD yielded positive findings in more cases (43.2%, P = 0.00) than colonoscopy (except piles). Colonic cancers and polyps were presented with hematochezia when compared to gastric cancer which presented more often with occult bleed and other clinical symptoms. Conclusion: EGD should be done first in lower GI bleeding to exclude upper GI source and select subsequent colonoscopy. For hematochezia and occult bleed, colonoscopy is important whether IDA is present or not.
Use of Bone Marrow-Derived Culture-Expanded Mesenchymal Stem Cells to Augment Healing of Chondral Defects Treated With Microfracture

Intra-articular injection of autogenous bone marrow–derived stem cells provided long-term improvement in repair tissue firmness and aggrecan staining in cartilage defects. Authors’ addresses: Gail Holmes Equine Orthopaedic Research Center, Colorado State University, 300 West Drake, Fort Collins, Colorado 80523-0912 (McIlwraith, Frisbie, Kisiday, Kawcak, Werpy); and Steadman Philippon Research Institute, 181 W. Meadow Drive, Suite 1000, Vail, Colorado 81657 (Rodkey, Steadman); e-mail: wayne.mcilwraith@colostate.edu. © 2010 AAEP.
Comparison of Desflurane-induced Circulatory Responses by the Rate of Increase in Inhaled Desflurane Concentration

Background: A rapid increase in desflurane concentration induces tachycardia and hypertension and increases plasma catecholamine concentration. No clinical study is available as to whether the desflurane-induced circulatory responses is blunted by the rate of increase in inhaled desflurane concentration although there were many studies about methods to blunt the circulatory responses. The current study examined to compare desflurane-induced circulatory responses by the rate of increase in inhaled desflurane concentration. Methods: Unpremedicated sixty ASA physical status 1 patients, aged 20-60 years, scheduled for elective surgery under general anesthesia were randomly allocated into one of two groups. The inspired concentration of desflurane via mask was increased to 12.0 vol% abruptly (group 1), or during 120 seconds (group 2). The target was to produce an end-tidal concentration of desflurane (ETdesf) of 10.0 vol% which was maintained until the end of the study by adjusting the vaporizer setting, when necessary. Heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance (SVR), ETdesf, end-tidal concentration of carbon dioxide, and peripheral oxygen saturation were measured at baseline and every 30 seconds for 5 minutes after inhalation of desflurane and for 2 minutes after intubation. Results: HR, blood pressure, and CI were significantly increased in two groups compared with baseline, but significant differences in maximum values were not observed between two groups. There were no significant differences between groups of the ETdesf at the maximal HR and MAP. Incidences of hypertension and tachycardia were lesser in slowly increased inhaled desflurane concentration (group 2) than abruptly increased group (group 1). Conclusions: The present study demonstrates that increasing inhaled desflurane concentration slowly for mask ventilation is partially effective in attenuating desflurane-induced circulatory responses.