Miracle-dz/UniFAR-FTUs huggingface dataset:
Medication adherence and treatment satisfaction in some Egyptian patients with chronic obstructive pulmonary disease and bronchial asthma

Background The degree of effectiveness in the management of asthma and chronic obstructive pulmonary disease (COPD) entails proper treatment adherence and satisfaction. In this study, medication adherence and treatment satisfaction were assessed among some Egyptian patients with asthma and COPD. Materials and methods Consecutive asthma and COPD patients were recruited from the outpatient clinic or inpatients admitted to the Chest Department at Ain Shams University Hospital, Abbassia, and Qena Chest Hospitals. Self-reported medication adherence and treatment satisfaction were tested using the Arabic versions of the eight-item Morisky Medication Adherence Scale and Treatment Satisfaction Questionnaire for Medication (TSQM 1.4), respectively. Results Totally, 474 asthmatic patients (mean: 34.41 years, 61.2% male and 38.8% female) and 509 COPD patients (mean: 60.39 years, 91.7% male and 8.3% female) were included. According to eight-item Morisky Medication Adherence Scale, mean adherence was 4.55±2.01 and 3.88±1.63 in asthma and COPD, respectively, with no significant difference. In asthma and COPD, low adherence was found in 71.7 and 79.4%, medium adherence in 19.8 and 13.6%, and high adherence in 8.4 and 7.1%, respectively. There was a significant difference in all domains of TSQM between asthma and COPD, with more effectiveness, convenience, and global satisfaction but less side effects among asthma patients compared with COPD. There was a significant correlation in asthmatic patients between adherence and all domains of TSQM, whereas in COPD only side effects and convenience correlated significantly with adherence. In COPD, adherence was better in male smokers, with low smoking index, living in urban areas, having severe small airway obstruction, and treated by pulmonologists. In asthma, adherence was mainly affected by treatment satisfaction. Conclusion Most of the asthma and COPD patients were nonadherent to their medications. Asthma patients were more satisfied with treatment compared with COPD patients.
Use of cognitive enhancers among medical students in Lithuania

Aims The purpose of this study is to analyse the use of cognitive enhancers among medical students in Lithuania, determine the reasons for usage and evaluate the contributing factors such as socio-demographic characteristics, stress levels, sleep quality and knowing somebody who has used a neuro-enhancing drug. Design A cross-sectional survey study was performed by analysing a convenience sample of n=579 in the two universities offering medical education in Lithuania, Vilnius University and the Lithuanian University of Health Sciences. In 2014, students were asked to fill in anonymous paper questionnaires consisting of 13 items on prevalence of substance use to enhance cognitive performance, and on reasons and correlates (response rate 95%) during lecture time. Results Of the respondents, 8.1% indicated that they had used cognitive enhancers. Among those who had used these drugs, nootropics were the most frequently mentioned (59.6%), while psychostimulants, such as modafinil, methylphenidate and amphetamine-derived drugs were mentioned less frequently (38.3%). Other substances were indicated by 23.4% of the respondents. Improvement of concentration and increased studying time were predominant purposes (55.3% and 48.9% of users, respectively). Male students reported three times higher prevalence rates than females (14.6% vs. 5.1%, p<0.05). Prevalence was also higher in students who knew someone using these substances than among those who did not know such persons (17.3% vs. 5.1%, p< 0.05). This was the most associated factor with cognitive-enhancing drug-taking behaviour. No correlation between cognitive enhancement usage and sleep quality or stress levels was found, nor between usage and belonging to a student organisation or having a job. Conclusions In Lithuania, 1 of 12 medical students admits to having used neuro-enhancing drugs. Our study results provide an overview of the actual situation on correlates and reasons for taking performance-enhancing substances.
Analysis of congenital heart surgery results: A comparison of four risk scoring systems.

Background This study aims to evaluate the surgical results of our clinic according to presumption systems of Risk Adjustment in Congenital Heart Surgery, Aristotle Basic Complexity score, Aristotle Comprehensive Complexity score, and Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality categories and to compare the efficiency of these systems in predicting morbidity and mortality. Methods In the study, classification and the risk scoring were performed with the four different systems for 1,950 patients (1,038 males, 912 females; mean age 5.5 months; range, 1 day to 18 years) who were administered congenital heart surgery between 1 October 2012 and 31 December 2016. The hospital mortality and morbidity were calculated for each category from the four models. The discriminatory ability of the models was determined by calculating the area under the receiver operating characteristic curve and the receiver operating characteristic curves of the four models were compared. Results Median weight of the patients was 7.2 kg (range, 1.8-80 kg). Among the patients, 53% were males and 47.5% were younger than one year of age. Of totally 1,950 operations, mortality was observed in 149 (7.6%) and morbidity was observed in 541 (27.7%). Areas under the receiver operating characteristic curve for mortality were 0.803, 0.795, 0.729, and 0.712 for the Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality categories, Aristotle Comprehensive Complexity, Risk Adjustment in Congenital Heart Surgery, and Aristotle Basic Complexity scores, respectively. Areas under the receiver operating characteristic curve for morbidity were 0.732, 0.731, 0.730, and 0.685 for the Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality categories, Risk Adjustment in Congenital Heart Surgery, Aristotle Comprehensive Complexity, and Aristotle Basic Complexity scores, respectively. Conclusion Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality categories, Risk Adjustment in Congenital Heart Surgery, Aristotle Basic Complexity, and Aristotle Comprehensive Complexity score systems were effective in predicting the morbidities and mortalities of patients who underwent congenital heart surgery and evaluating the performance of the surgical centers. Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery mortality categories were on the forefront due to high feasibility and performance. Aristotle Basic Complexity score system had the lowest performance. Combinations of systems will provide the most benefit during evaluation of results.
Dissemination of ST101 blaOXA-48 producing Klebsiella pneumoniae at tertiary care setting.

INTRODUCTION The worldwide dissemination of the acquired carbapenemases in Gram-negative bacteria is a strongly expressed demand for the emergence of post antibiotic era. The aim of this study was to test the production of carbapenemase by Klebsiella pneumoniae strains isolated from hospitalized cancer patients and to investigate the genetic relationship of carbapenemase producing carbapenem resistant K. pneumoniae using multilocus sequence typing (MLST). METHODOLOGY Antibiotic susceptibility testing and phenotypic testing for extended spectrum b-lactamases (ESBL) and carbapenemases production were performed. PCR amplification of ESBL and carbapenemase genes was performed. MLST was done to detect the genetic relatedness of the isolates. RESULTS Our data showed all strains were sensitive to colistin. Carba NP test was positive in thirty-one carbapenem resistant K. pneumoniae isolates and 26 out of 34 K. pneumoniae isolates were metallo-beta-lactamases (MBL) positive. All carbapenemase-positive isolates were ESBL CTX-M-1-like positive. blaOXA-48 gene was detected in 25 isolates (80.65%) and 21 isolates (67.75%) produced blaNDM-1 like enzyme. VIM and KPC genes were not identified in this study. Association of blaOXA-48 like and blaNDM-1 like was found in 15 (48.39%) isolates, while the coproduction of OXA-48-like and IMP-1 was revealed in only one K. pneumoniae isolate. MLST revealed ten distinct sequence types (STs). CONCLUSION Here we have documented the coexistence of NDM-type and OXA-48-like, and the coproduction of OXA-48-like and IMP in carbapenem resistant K. pneumoniae in patients with cancer. The dominant clone of the OXA-48-like-producing K. pneumoniae isolates from Egypt was ST101 epidemic clone belonging to clonal complex 101, an association that has been reported worldwide. The second most frequent ST was ST383.ST11 was assigned to OXA-48-producing K. pneumoniae.
Hypothesis

A hypothesis is proposed on a potential role of protein dielectricity as an unfolding factor in protein-protein interactions. It is suggested that large protein complexes and aggregation seeds can unfold target proteins by virtue of their effect on the dielectric properties of water at the protein-solvent interface. Here, similar to the effect of membrane surfaces, protein surface can cause decrease in the local dielectric constant of solvent and thereby induce structural changes in a target protein approaching this surface. Some potential implementations of this hypothetical mechanism are also discussed.
Nanotoxicology

Implication for health policy/practice/research/medical education: Provide scientific knowledge regarding handling and application of Nano particles in medicine. which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In recent years Nano-structure materials have been attractive to the world of science and technology for their wide spread possibilities in creating new shape and structure associated with materials. The impact of nanotechnology in medicine can mainly be seen in diagnostic methods, drug-release techniques and regen-erative medicine. Diagnostic techniques based on the use of nanoparticles offer higher sensitivity and assist the early detection of disease, offering a better prognosis and greater possibilities of successful treatment. The particulate drug delivery system is pharmacokinetic and pharmacodynamics properties of active pharmaceutical ingredient (API). Nanoparticles have attracted a lot of attention of the pharmaceutical scientists in the drug delivery system due to versatility in targeting tissues, ac-cessing deep molecular targets and controlling drug release. Due to its social and economic impacts, nanotech-nology has become a focus of public interest. Understanding the toxicity of Nano-materials is important for human and environmental health. Evaluation the state of knowledge about Nano toxicology is an important step in promoting comprehensive understanding of the health and environmental implications of these new materials. There have been several reviews, reports, and assessments on the current state and/or challenges of determining the toxicology of Nano-materials (1-8). However, despite the rapid development of nanotech-nology, information about the exposure of humans and the environment to Nano-sized particles is very few and the answer of questions about implications of the exposure to nanoparticles for humans and the environment have not yet been sufficiently explained. Therefore the development of technology should be accompanied by a corresponding risk assessment in order to identify and subsequently avoid potential damage. The important questions that should be answered include the following: How stable and persistent are these forms? Do they decompose or agglomerate? Are they soluble in water? Will they interact with other nanoparticles, chemicals, or surfaces? Are they degradable, and how their properties will change during degradation? Nanoparticles can penetrate into live cells. Therefore, they have a potential to accumulate in organisms and thus, also in the food chain and risks associated with this technology have to be paid attention to, thus there is a great need for further research about toxicity of Nano particles.
PREVALENCE AND BACTERIAL ETIOLOGY OF MASTITIS IN SMALL RUMINANTS IN TORO LOCAL GOVERNMENT AREA, BAUCHI STATE OF NIGERIA

A study was conducted at Toro Local Government Area of Bauchi State, north-eastern Nigeria to assess the prevalence of clinical and subclinical form of mastitis in lactating small ruminants – sheep and goat and identify causative agents. A total of 348 mammary gland secretion (milk) samples comprising 108 and 244 from sheep and goats, respectively, were screened for evidence of mastitis. The overall prevalence of subclinical mastitis was found to be 16.7% (18/108) and 24.6% (60/244) in sheep and goats, respectively. The overall prevalence of clinical mastitis was found to be 5.6% (6/108) and 5.7% (14/244) in sheep and goats, respectively. California mastitis test (CMT) positive milk samples were subjected to bacteriological examination and found to be that in both sheep and goats, the predominant organisms responsible for mastitis were Staphylococcus aureus, followed by Escherichia coli, Streptococcus spp. and coagulase negative Staphylococcus and the least isolated microorganisms of different species including Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumonia, Morganella morganii, Salmonella typhimurium, Proteus vulgaris, Citrobacter freundii and Bacillus cereus. Therefore, it can be concluded that mastitis is an important disease affecting the productivity of small ruminants and quality of their product (especially milk) for their kids and consumers, hence measures need to be taken to control the disease.
Topical Ciclopirox - Recalling a Forgotten Ally in the Fight against CutaneousMycoses

The injudicious use of antifungals, indiscriminate use of corticosteroids for instant relief, persistence of predisposing factors like sweat retention, and uncontrolled diabetes, and emerging resistance to antifungals across the globe have rendered the management of an erstwhile simple infection, the superficial cutaneous mycoses highly complicated and tricky. Ciclopirox is an old yet efficacious, versatile, and safe topical antifungal of the hydroxypyridone family. Despite its numerous beneficial properties over majority of other topical antifungals, it is being under-utilized owing to aggressive focus and tactics of the pharmaceutical industry on promoting ‘newer azoles’. The antifungal spectrum of ciclopirox is one of the broadest and includes nearly all clinically relevant fungi (dermatophytes, yeasts and moulds). It is also effective against many azole-resistant dermatophytes and Candida albicans and Non-albicans Candida spp. like C. glabrata and C. krusei. The mechanism of action of ciclopirox, a fungicidal agent, is different from that of other topical antifungals that usually inhibit ergosterol synthesis. The drug chelates trivalent metal cations especially iron resulting in inhibition of metal-dependent enzymes that protect the fungal cell by scavenging reactive oxygen species, disrupts cellular activities such as mitochondrial electron transport processes, blocks intracellular transport of precursors by cell membrane alteration, and disrupts DNA repair. This set of multilevel fungicidal mechanisms being unique to ciclopirox minimizes the possibility of development of drug resistance, which till date has never been reported clinically. The drug also has potent anti-bacterial activity (against Gram Positive as well as Gram Negative bacteria) and bears anti-inflammatory effects comparable to 2.5% hydrocortisone. Ciclopirox olamine 1% cream, equivalent to 0.77% ciclopirox penetrates into the deep layers of the skin and mucosae. It is indicated for dermatophytosis, pityriasis versicolor, seborrheic dermatitis, vulvovaginal and cutaneous candidiasis, usually as twice-a-day application for 2 4 weeks. For onychomycosis, 8% nail lacquer formulation is used. The topical drug is devoid of systemic adverse effects. Only mild transient local reactions have been reported in less than 5% of treated patients. It is perhaps one of the best and most versatile topical antifungal with potential of being instrumental in the management of current epidemic of rampant antifungal therapy failure.
Drug prescribing pattern in surgical wards of a tertiary care hospital in Western part of India

Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, etc. A growing number of pharmaceutical products are available in present era. Irrational prescribing of drugs is prevalent worldwide. Drug utilization study can be used to assess prescribing patterns. Authors undertook this study to determine current practice of prescribing in surgical wards of the hospital.Methods: Authors conducted observational, noninterventional, descriptive study among patients admitted in surgical wards for one year. Authors have analysed collected data of 604 patients using descriptive statistics to determine utilization pattern of drugs and drug use indicators.Results: Appendicitis (14.9%) followed by hernia (10.6%) were leading diseases for admission. Mean duration of stay was 7.44. Average number of drugs in a prescription was 8.94. Antibiotics (32.07 %), analgesics (17.11 %) and antacids (16.09 %) were leading drug groups prescribed. Amikacin (5.81 %) followed by metronidazole (5.30 %) and ciprofloxacin (5.19 %) were commonly prescribed antimicrobial drugs. Tramadol (5.31 %) and pantoprazole (7.17 %) were leading drugs prescribed from analgesics and antacids respectively. All prescriptions had at least one injectable drug. At least one antibiotic was present in 92.05 % prescriptions. Majority of drugs (87.27 %) were prescribed by generic names. Proportion of drugs prescribed from essential medicine list was 84.22 %. Conclusions: Polypharmacy and injectable drug prescribing were common in practice. There is a scope for improving such prescribing practices among practitioners. Use of multiple antibiotics should be avoided whenever possible and usage should be evidence based.
Influence of Atorvastatin Treatment on l-Arginine Cerebrovascular Reactivity and Flow-Mediated Dilatation in Patients With Lacunar Infarctions

Background and Purpose— In our study we hypothesized that statins improve endothelial function in patients with lacunar infarctions (LI). Cerebral and systemic endothelial function was determined before and after 3-months treatment with atorvastatin. Methods— Cerebral endothelial function was determined by l-arginine reactivity and systemic endothelial function by flow-mediated dilatation (FMD) in patients with LI (18 patients, aged 61.1±7.6 years), 20 age- and gender-matched patients with similar risk factors (SR) and 19 age- and gender-matched healthy controls. The mean arterial velocity (vm) in both middle cerebral arteries was measured by transcranial Doppler sonography before, during and after a 30-minute intravenous infusion of l-arginine. FMD of the brachial artery after hyperaemia was determined. The measurements were repeated after 3-months treatment with 40 mg of atorvastatin per day. Results— l-arginine reactivity was decreased in LI patients (13.1±8.4%) and in patients with SR compared with he.
Clinico-hematological manifestations of malaria in children in Western Uttar Pradesh, India

Background: Globally, malaria is one of the important causes of mortality in pediatric age group. We describe here the clinico-hematological manifestations of malaria in children in Western Uttar Pradesh. Methods: A Retrospective study was done over 8 months in pediatric ward and pediatric intensive care unit of a tertiary care centre in Greater Noida. Children below 18 years admitted with acute febrile illness with peripheral smear and / or rapid malaria antigen test positive were included in the study. Detailed clinical, biochemical and hematological characteristics of children hospitalized with severe malaria were recorded and patients were managed according to National Vector Born Disease Control Programme Guidelines for malaria treatment. Results: Out of 115 children admitted with malaria, majority of cases were due to P. vivax (88.7%) compared to P. falciparum (5%) and Mixed infection (6%). Malaria was more common in males and in 1 to 5 years age group. Out of 115 patients, severe malaria was present in 27 (23.4%) patients, all infected with P. vivax. Among them, bleeding was present in 13.04 %, shock in 9.56%, acidosis in 9.56%, jaundice in 5.21%, seizures in 3.47%, severe anemia in 5.21%, renal impairment in 3.47%, impaired sensorium in 1.73% and pulmonary edema was present in 0.86% patients respectively. Case fatality Rate was 1.73%, all due to severe vivax malaria. Conclusions: The study highlights that P. vivax is a common cause of malaria in Western UP and can result in a severe disease with potential mortality.
Amniotic membrane transplantation - which side up?

Purpose: Amniotic membrane shows efficiency in treatment of corneal epithelial defects, bullous keratopathy and other ocular surface diseases. Most of the cytokines (BFF, TGF-β ) that are secreted from the amniotic membrane are located in the epithelium. Till now, common way for the amniotic membrane transplantation was with the epithelial side "UP". In this study we compared first results of the amniotic membrane transplantation with the epithelial side "DOWN" with results from the classical approach. Methods: Patients with the persistent epithelial defect PED (n=34), corneal ulcer CU (n=19), bullous keratopathy BK (n=40), acute corneal combustion ACC (n=3), post-keratitic HS (n=2) were randomly divided in two groups. In first group of patients amniotic membrane was transplanted with the epithelial side "UP" (PED=17, CU=10, BK=20, ACC=1). In second group amniotic membrane was transplanted with the epithelial side "DOWN" (PED=17, CU=9, BK=20, ACC=2, HS =2). Transplantation was repeated in the "UP" group in 9/48 eyes and in the "DOWN" group in 8/50 eyes. Amniotic membranes were prepared in Lions Croatian Eye Bank and stored at -20 oC. Results: Outcome success criteria included re-epitelisation, reduction of pain, healing of punctiform lesions and reduction of inflammation. Re-epitelisation was achieved in 82% (14/17) of patients from the "UP" group and 94% (16/17) from the "DOWN" group. 70% (7/10) of corneal ulcers healed in the "UP" group while 55% (5/9) healed in the "DOWN" group. In patients with bullous keratopathy reduction of pain was achieved in 90% (18/20) "UP" and 90% (18/20) "DOWN" " so pain reduction didn't depend on the transplant orientation. In patients with ACC complete healing without symblepharon formation was achieved. Decrease of vascularisation and stromal haze was achieved in HS. Conclusion: We achieved better results with epithelium "DOWN" in case of PED while better results with the epithelium "UP" were achieved in CU. The difference was not statistically significant thou. The orientation of the amniotic membrane didn't effect pain reduction in patients with BK.