Miracle-dz/UniFAR-FTUs huggingface dataset:
Pharmacological management of chronic obstructive pulmonary disease by low-dose theophylline: A prospective hospital-based study in East Godavari of Andhra Pradesh

Background: High therapeutic dose of theophylline is not tolerated well by some patients. As it is an effective and affordable drug, the effectiveness of low-dose theophylline in pharmacological management of chronic obstructive pulmonary disease (COPD) was assessed. Aim: The aim of this study was to detect the efficacy of low-dose theophylline in COPD patients. Patients and Methods: Patients with stable COPD were enrolled. The complete blood picture (CBP), pulmonary function tests (PFTs), and St. George's Respiratory Questionnaire (SGRQ) were performed at enrolment. Patients were categorized into two groups: subjects and controls. All the participants were given medication for COPD as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. However, subjects were kept on low-dose sustained-release oral drug theophylline (150 mg twice daily) as an add-on. At every follow-up, once every 10 days up to 30 days, their parameters were recorded. The difference between the prognostic biomarkers was analyzed using the Student's “t”-test. Results: The CBP, SGRQ, and PFTs showed improvement in COPD patients treated with low-dose theophylline, i.e., subject group. Even though the PFTs improved in subjects, evidence of COPD remained. Low-dose theophylline may help to improve the quality of life in COPD patients. Conclusion: As a Cost-effective medication, low-dose theophylline can be used as an add-on drug to GOLD guidelines for the treatment of COPD. The subjects may feel better and can lead their normal life even with COPD.
Pattern of malocclusion and caries experience in unrepaired cleft lip and palate patients in Enugu

Background: Clefts are common birth defects, usually accompanied by various malformations that include malocclusions, and may be associated with tooth decay. The aim of this study was to assess the malocclusion and caries status of the patients with unrepaired clefts who presented at the National Orthopaedic Hospital Enugu. Subjects and Methods: A cross-sectional, descriptive study was conducted among patients with unrepaired cleft lip and/or palate that presented at the National Orthopaedic Hospital, Enugu between January 2009 and December 2011. Detailed records of 140 patients with cleft deformities who presented to the hospital within the study period were analyzed for the cleft pattern, whereas those patients above 6 years of age (52 patients) were analyzed for malocclusion using the Angle's classification of malocclusion. Assessment for dental caries according to WHO guidelines was made for all the patients. Result: There were 74 males and 66 females. Cleft lip with or without alveolus involvement had equal prevalence (47.1%) (66 patients) with combined cleft lip and palate; eight patients had isolated cleft palate (4.71%). Angle's class 1 malocclusion was statistically significantly higher than other classes (P = 0.000). Class I malocclusion was seen in 38 patients (73.1%), whereas class 111 was seen in 8 patients (15.4%) and class 11 in 6 patients (11.5%). Eight patients (100%) who developed class 111 malocclusion all had a hard palatal defect. Proclining of maxillary anterior teeth (increased overjet) was the most common orthodontic anomalies, reported in 25 patients (48.1%) (P = 0.002). Caries prevalence of 12.9% was observed in this study. Caries experience was statistically significantly higher in deciduous than permanent teeth (P = 0.002). Conclusion: The high prevalence of malocclusion in these cleft patients emphasizes the need for an interdisciplinary team approach and early inclusion of dental care especially oral hygiene to prevent tooth decays.
Cervical cancer screening among urban Women in Lagos, Nigeria: Focus on barriers and motivators for screening

Background: Cervical cancer screening is known to be highly effective in reducing the incidence, morbidity, and mortality associated with cervical cancer. However, the provision and availability of these screening services have not resulted into increased uptake of cervical cancer screening in many developing countries due to the interplay of several factors which influence women's decision to undergo or not to undergo cervical cancer screening. Objective: The objective was to assess the factors that serve as barriers and motivators for cervical cancer screening among urban women in Lagos, Nigeria. Methods: A descriptive cross-sectional study conducted among women attending an urban General Hospital in Lagos, Nigeria, using a structured questionnaire to assess their barriers and motivators for cervical cancer screening. Results: Awareness and uptake of cervical cancer screening were low among women, accounting for 41.4% and 18.4%, respectively. The major factors motivating women to undergo cervical cancer screening were recommendation by doctor/nurse (53.3%), advice from friends/relatives (21.7%), and enlightenment by the media (20.7%). The major barriers to the uptake of cervical cancer screening were lack of awareness of screening methods (64.2%), lack of adequate information on screening methods (43.4%), and non-recommendation by doctors (41.4%). Conclusion: The uptake of cervical cancer screening is low among urban women in Lagos, Nigeria. The lack of awareness and adequate information on cervical cancer and its screening methods were the major barriers to the uptake of cervical cancer screening, while recommendation by doctors/nurses and advice from friends and relatives were the major motivators for cervical cancer screening.
Research in respiratory care

IntroductIon Conducting research and publishing has become a necessity of the day. Although this concept has been prevalent for a few years now in the developed countries, the concept is catching on in many places across India. Universities have now begun to insist on publications in an attempt to detect and improve our practice. Unless the research mindset is inculcated in the young minds, this becomes a herculean task for them to understand and execute. This editorial is being written precisely for such individuals who are interested in research in respiratory care but do not know how to go about doing it.
Target inhibition of caspase-8 alleviates brain damage after subarachnoid hemorrhage

Caspase-8 plays an important role in the mediation of inflammation and the effect of its role in subarachnoid hemorrhage remains elusive. The nucleotide-binding oligomerization domain-like receptor protein 3 inflammasome has been postulated to mediate inflammation during SAH. The aim of the present study was to investigate the effects of caspase-8 inhibition on SAH injury and further elucidate the molecular mechanisms. In this study, a subarachnoid hemorrhage model was established by endovascular perforation process in adult male Sprague-Dawley rats. Z-IETD-FMK (0.5, 1, 2 mg/kg; an inhibitor of caspase-8) was delivered via intravenous (tail vein) injection immediately after subarachnoid hemorrhage. After 12 hours of subarachnoid hemorrhage, western blot assay showed that the expression of cleaved caspase-8 was significantly increased at 12 hours, peaked at 24 hours, and then decreased at 72 hours after subarachnoid hemorrhage. Immunofluorescence staining demonstrated that caspase-8 was expressed in microglia after subarachnoid hemorrhage. Z-IETD-FMK significantly improved neurological deficits and reduced brain water content 24 hours after subarachnoid hemorrhage. The Morris water maze and rotarod test confirmed that Z-IETD-FMK significantly improved spatial learning and memory abilities and motor coordination at 21–27 days after subarachnoid hemorrhage. Furthermore, inhibition of caspase-8 activation reduced the expression of pyrin domain-containing 3, caspase-1, and interleukin-1β after subarachnoid hemorrhage. In conclusion, our findings suggest that caspase-8 inhibition alleviates subarachnoid hemorrhage-induced brain injuries by suppressing inflammation. The study was approved by the Institutional Animal Ethics Committee of the First Affiliated Hospital, School of Medicine, Zhejiang University, China (approval No. 2016-193) on February 25, 2016.
Bone mineral density in children with relapsing nephrotic syndrome: A hospital-based study

This cross-sectional analytical study was conducted from January 2012 to November 2014 in the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, to evaluate the bone mineral density (BMD) values in children with relapsing nephrotic syndrome (NS). Thirty relapsing nephrotic patients were enrolled in this study. They were divided into two groups: Group I – Frequent Relapse (FR) with 21 patients and Group II – Infrequent Relapse (IFR) with nine patients. Children included were both males and females aged between four and 15 years with relapsing NS with normal renal function. Steroid-resistant NS or those with abnormal renal functions or who were on cyclosporine and calcium supplement with Vitamin D or children with secondary NS were excluded from the study. All the study population underwent dual-energy X-ray absorptiometry scan to see the BMD value. Mean age of the patients of Group I (8.43 ± 2.61 years) was lower than that of Group II (9.41 ± 2.94 years (P = 0.4043). Mean BMD Z-scores of Group I was significantly lower than that of Group II (-2.70 ± 1.28 vs. -1.30 ± 1.54, respectively; P = 0.0317). A significantly higher cumulative dose of prednisolone was administered to Group I compared with Group II (P = 0.00003). On multivariate analysis, the total dose of prednisolone (P = 0.03693), body mass index (BMI) (P = 0.00703), and age of onset of disease (P = 0.03465) had a linear relationship with dependent variable BMD Z-score. On univariate regression analysis, statistically significant inverse relationship was observed between cumulative dose of prednisolone (in grams) (P = 0.049) and BMI (P = 0.00) with BMD Z-score, but no relation was observed with duration of illness. Children with relapsing NS, especially those receiving higher doses of steroids, were at risk for low BMD.
Continuous renal replacement therapy: Principles, modalities, and prescription

The mortality rate of critically ill patients with severe acute kidney injury (AKI) remains high. The associated sepsis and septic shock, as well as the presence of multiorgan failure, further increase the risk of death. Renal replacement therapy (RRT) represents the cornerstone of the management of severe AKI. Continuous RRT (CRRT) has been considered the predominant form of dialysis in the intensive care unit due to its accurate volume control, steady acid-base, and electrolyte correction and achievement of hemodynamic stability. This narrative review covers an introduction to CRRT, its physiologic principles, modalities, requirements, indications, and different elements of adequate prescription.
Cognitive impairment and its effect on chronic obstructive pulmonary disease: An underestimated phenomenon

Background: To assess the ability of the Rowland Universal Dementia Assessment Scale (RUDAS) to predict inhaler technique and determine the prevalence of cognitive impairment in chronic obstructive pulmonary disease (COPD). Patients and Methods: This cross-sectional study included 98 participants, and we recorded age, education, locality, occupation, COPD stage, comorbidities, duration of inhaler use, and smoking history. Inhaler technique was assessed using an internationally accepted schedule (nine steps). RUDAS, a multicultural cognitive assessment scale, was used to assess cognitive function. Results: The study included 92 males and 6 females with the mean age of 63.9 years. At a cutoff of 24, RUDAS had 93.6% sensitivity and 88.2% specificity in screening incorrect inhaler technique. Those having a RUDAS score <24 were 272 times more likely to perform incorrect inhaler technique. On comparison of incorrect and correct inhaler technique groups on various parameters in univariate analysis, it was found that the groups were significantly different in terms of education, locality, occupation, COPD stage, comorbidities, and smoking history. However, in logistic regression, only RUDAS score <24 was found to be a predictor of incorrect inhaler technique. At the original cutoff of 23, RUDAS screened 42.9% (n = 42) of the patients as having cognitive impairment. Conclusions: High prevalence of cognitive impairment among COPD patients and its untoward impact on inhaler technique is an important but underestimated clinical issue. RUDAS is an effective tool to predict incorrect inhaler technique and cognitive impairment in COPD.
Clinical measurement of angular profile of the knee and correlation with intermalleolar distance in children in Enugu metropolis

Background: Angular deformities of the lower limbs are commonly encountered deformities in pediatric orthopedic clinics. The values of the tibiofemoral angle undergoes changes as the child grows and these changes are self-limiting. The aim of the study is to establish the normal variation of knee angles of children between 2 and 12 years of age in Enugu metropolis and to establish any correlation between the knee angles and the intermalleolar distances (IMDs). Subjects and Methods: This study was done on 630 school children in Enugu metropolis between the age groups of 2 and 12 years. Multistage sampling was used in the study. The tibiofemoral angles and intermalleolar/intercondylar distances were measured. Results: The maximum tibiofemoral angle from this study was 7.6° ± 2.4° and the age corresponding to this value was 4 years. Only 23 subjects (3.5%) had varus knee angle. The values of the mean tibiofemoral angle and IMDs plateaued from 8 to 12 years. There was a significant positive correlation between average knee angle and IMD (r = 0.785, P < 0.001). Conclusion: The physiological changes in the knee angle (tibiofemoral) follow a similar pattern as established in the literature and there was positive correlation between IMD and the tibiofemoral angle.
Efficacy of auto-PAP titration in obstructive sleep apnea: Single-center experience

Background: Obstructive sleep apnea (OSA) is a sleep-associated breathing disorder, which left untreated can cause severe morbidities or even mortality. The recommended treatment strategy for moderate-to-severe OSA is continuous positive airway pressure (CPAP). The optimal pressure required for OSA can be measured by either manual CPAP titration or auto-CPAP titration study. Objective: To assess the efficacy of auto-PAP titration for OSA patients. Methodology: This was a cross-sectional study conducted on Pulmonary Medicine Sleep Lab at Amrita Institute of Medical Sciences, Kochi. Fifty patients who have undergone full-night polysomnography and followed with auto-PAP titration are included in the study. The research was approved by the institutional ethics committee. Results: In the study cohort, 50% showed optimal titration, 40% good titration, 10% adequate titration and none in unacceptable category. The results showed that auto-PAP usage has good result in moderate-to-severe OSA. Conclusion: Unattended auto-PAP titration seems to be highly effective modality which can be considered as an alternative to attended CPAP titration, thus reducing labor intensiveness and cost.
The N-formyl peptide receptors: contemporary roles in neuronal function and dysfunction

N-formyl peptide receptors (FPRs) were first identified upon phagocytic leukocytes, but more than four decades of research has unearthed a plethora of non-myeloid roles for this receptor family. FPRs are expressed within neuronal tissues and markedly in the central nervous system, where FPR interactions with endogenous ligands have been implicated in the pathophysiology of several neurodegenerative diseases including Alzheimer’s disease and Parkinson’s disease, as well as neurological cancers such as neuroblastoma. Whilst the homeostatic function of FPRs in the nervous system is currently undefined, a variety of novel physiological roles for this receptor family in the neuronal context have been posited in both human and animal settings. Rapid developments in recent years have implicated FPRs in the process of neurogenesis and neuronal differentiation which, upon greater characterisation, could represent a novel pharmacological target for neuronal regeneration therapies that may be used in the treatment of brain/spinal cord injury, stroke and neurodegeneration. This review aims to summarize the recent progress made to determine the physiological role of FPRs in a neuronal setting, and to put forward a case for FPRs as a novel pharmacological target for conditions of the nervous system, and for their potential to open the door to novel neuronal regeneration therapies.
Effect of laser application on microtensile bond strength of an orthodontic adhesive to water-aged composite

Aim: This study evaluated the microtensile bond strength (MTBS) of an orthodontic adhesive to water-aged composite surfaces using different surface treatments. Subjects and Methods: Twelve composite blocks (10 mm × 10 mm × 5 mm) were fabricated and randomly divided into two groups. Half of the specimens were stored in distilled water for 1 day, and the other specimens were stored for 30 days. The specimens were randomly assigned to six groups according to surface treatments (n = 15): Group 1, control (no treatment); Group 2, phosphoric acid; Group 3, diamond bur; Group 4, diamond bur + phosphoric acid; Group 5, laser; and Group 6, laser + phosphoric acid. One coat of orthodontic adhesive was bonded to one surface of composite blocks, and a microhybrid composite resin was bonded to the surfaces via a Teflon mold. Bond strength was evaluated using an MTBS test. Surface topography was evaluated using scanning electron microscopy (SEM) analysis. The data were analyzed using one-way analysis of variance, Tamhane post-hoc test, and independent sample t-tests (P < 0.05). Results: Bond strength values tended to decrease in all groups (with the exception of Group 2) after storage in water for 30 days (P < 0.05). Laser and diamond bur application (with or without phosphoric acid) enhanced the bond strength. Conclusions: An Er,Cr:YSGG laser application may be a feasible alternative to diamond bur for enhancing the bond strength of orthodontic adhesive to composite resin.
Psychiatric morbidity in violent and nonviolent offenders: A cross-sectional comparative study

Background: Several studies have found that mental illnesses are very commonly seen in the prison population when compared to the normal population and they are a major public health concern. In most of the cases, it is very difficult to differentiate between abnormal personality and criminal behavior and their influence on psychopathology. In the literature, there were many studies done on the entire prison population. However, there were very few studies that compared the characteristics and psychopathology of both violent and nonviolent offenders which are distinct in many ways. Hence, the current study focussed on how the violent differ from the non-violent offenders. Aim: This study aims to study the various sociodemographic factors, crime characteristics, and psychiatric morbidity in violent offenders and nonviolent offenders. Study Design: It is a cross-sectional comparative study conducted at central prison Cherlapalli, Hyderabad. Materials and Methods: Study sample includes 61 violent offenders involved in serious crimes like murder (IPC SEC 302), attempt to murder (IPC SEC 307) and 34 nonviolent offenders (involved in other crimes like theft, check bounce, etc.) The characteristics are analyzed using semi-structured intake pro forma, and psychopathology is analyzed using International Classification of Diseases 10 criteria and MINI scale. Results and Conclusions: In our study, significant differences between the two groups were found in domicile, employment status, marital status, and duration of stay in prison. History of psychiatric illness before and after the crime is most commonly seen in violent offenders when compared to nonviolent offenders. Significant previous incarcerations were high in nonviolent offenders when compared to nonviolent offenders. In both the groups, more than half of the individuals had either alcohol abuse or dependence pattern, and high rates of substance intoxication at the time of the commission of the crime were found in violent offenders. Less than one-fourth of both groups were found to have psychiatric illness apart from alcohol. Hence, more awareness programs and campaigns regarding the influence of alcohol on the crimes can be conducted with the help of police, government, private organizations, and media, especially directed at vulnerable and at-risk population for crime, would indirectly decrease crime rate by decreasing alcohol consumption. There are a lot of studies in Indian literature regarding the psychopathology in the whole of the prison population and also in violent offenders; but, there are very few studies comparing both violent and nonviolent offenders which are a distinct population.
Relationship Between Spinal-Pelvic Sagittal Balance and Pelvic-Femoral Injuries in Professional Soccer Players

Background: Pelvic-femoral injuries are a common problem in football (soccer) players. However, the risk factors for these injuries are unclear. Our knowledge of spinal-pelvic sagittal balance has increased considerably over the past few years, notably as a result of new radiographic techniques such the EOS radiographic imaging system. Purpose: To investigate the link between spinal-pelvic sagittal balance on EOS imaging and the incidence of pelvic-femoral injuries. Study Design: Cohort study; Level of evidence, 2. Methods: Players in a League 1 professional soccer team were observed for 5 consecutive seasons. All players included in the study underwent EOS radiographic imaging. All acute and microtraumatic injuries to the pelvic-femoral complex were recorded prospectively: hamstrings, psoas, quadriceps, adductors, obturators, and pubic symphysis. We analyzed the relationship between injury incidence and key radiographic parameters involved in pelvic balance. Results: A total of 61 players were included (mean age, 24.5 years; n = 149 injuries; mean pelvic tilt, 9.08° ± 5.6°). A significant link was observed between the incidence of pelvic-femoral injuries and pelvic tilt (P = .02). A significant link was also observed between the incidence of acute pelvic-femoral injuries and pelvic tilt (P = .05). In both cases, a high pelvic tilt was associated with a low incidence of injuries. Conclusion: In professional soccer players, a low pelvic tilt was associated with a high incidence of all pelvic-femoral injuries as well as acute pelvic-femoral injuries. These results could lead to new preventive methods for these musculotendinous injuries through physical therapy.
Cardiovascular Risk in Essential Thrombocythemia and Polycythemia Vera: Thrombotic Risk and Survival

Thromboembolic and bleeding events pose a severe risk for patients with Polycythemia Vera (PV) and Essential Thrombocythemia (ET). Many factors can contribute to promoting the thrombotic event due to the interaction between platelets, leukocytes, and endothelium alterations. Moreover, a significant role can be played by cardiovascular risk factors (CV.R) such as cigarette smoking habits, hypertension, diabetes, obesity and dyslipidemia. In this study, we evaluated the impact that CV.R plays on thrombotic risk and survival in patients with PV and ET.