Miracle-dz/UniFAR-FTUs huggingface dataset:
A cross-sectional study of risk factors and preventive measures among patients presenting to a cardiac center

Objective: Cardiovascular disease (CVD) is highly prevalent and more so in patients with diabetes mellitus (DM). Although many treatment advances have been made, the patient outcomes do not reflect the progress. With improved knowledge about the prevention of risk factors and the availability of educational material, the expectation was that patients would become more knowledgeable. Materials and Methods: The design was a cross-sectional study with patients presenting at a cardiac center in Jeddah, Saudi Arabia. Results: In total, 350 participants were included, both diabetic and nondiabetic patients. Just more than half of the sample (51%) was male, with a mean age of 49 years. There was a high incidence of metabolic syndrome components: 30% of the sample was hypertensive, 24% aware of being hyperlipidemic, and 40% overweight. From an educational perspective, 45% of the sample received no previous education regarding DM, 34% were unaware of the complications of diabetes, 41% reported that physicians did not provide appropriate education, and half of the sample indicated that the media did not provide appropriate education. This lack of education and patient-related factors resulted in 56% not following a diet, 52% did not control their diabetes to avoid complications, and 47% was not physically active. Conclusion: There is a significant gap in the public knowledge of diabetic risk factors, how to control diabetes and appropriate lifestyle changes. Information received from physicians or the media is below the patients' expectations. A combined strategy to raise awareness and improve knowledge between primary health care and media, starting at school age and continued through all admissions, is mandatory. Governmental support is required in all the different levels of education to decrease the burden due to CVD in Saudi Arabia.
Profile of substance use and health risk due to substance use in subjects attending outpatient departments of a tertiary care hospital, South India

Background: The pattern and prevalence of substance use change from region to region and differ from country to country. Most of the people who abuse the drugs do not know the ill effects of their habit. Objective: This study aimed to assess the profile and health risk involved in each subject who used substances. Materials and Methods: The study was conducted in the outpatient departments of Medicine and Pulmonary Medicine of a tertiary care hospital using cross-sectional descriptive design. A screening questionnaire, “Alcohol, Smoking, and Substance Involvement Screening Test” (ASSIST) was administered to assess the type of substances that had been used and the level of health risk associated with them based on the ASSIST score. Statistical Analysis: Sociodemographic variables and the level of risk were presented as frequency and percentage. Chi-square test and Fisher's exact test were used to assess the relationship between categorical variables and ASSIST scores. Results: Most of the participants participated in the present study came under moderate health-risk category. Majority of the participants 114 (53.53%) had a family history of substance use. There was a strong association for gender with alcohol and tobacco use. Conclusion: The most widely abused substances in the present setup were alcohol and tobacco.
Prevalence and Causes of Visual Impairment Among Nigerian Children Aged 3 to 5 Years

Objectives: This article determines the prevalence and causes of visual impairment (VI) in children aged 3 to 5 years in Ilorin East Local Government Area of Kwara State, Nigeria. Methods: The study was a descriptive, cross-sectional, school-based study of 464 children enrolled by multistage sampling. The sample size was calculated based on the prevalence of ocular morbidity of 19.9% found in a previous Ilorin study by Ayanniyi et al. (Causes and prevalence of ocular morbidity among primary school children in Ilorin, Nigeria. Niger J Clin Pract 2010;13:248-53) using the Fisher’s formula. Visual acuity (VA) of selected children was assessed using the Lea symbols chart. Children meeting the referral criteria of VA worse than 20/30 (6/9.5), two lines difference in VA between the eyes, visible anterior and posterior segment anomalies, and untestable children with the Lea symbols thereafter had a comprehensive eye examination. Results: Seventy (15.1%) of the children screened were 3 years’ old, 176 (37.9%) were 4 years, whereas 218 (47%) were 5 years’ old. Nine hundred twenty-eight eyes of 464 children were screened; 707 (76.2%) eyes in 332 (71.6%) children had VA 6/9.5 or better, whereas 184 (19.8%) eyes in 112 children (24.1%) had VA worse than 6/9.5 and 37 (4%) eyes in 20 children (4.3%) were untestable. An identifiable cause of VI was found in 36 eyes of 23 children, giving a prevalence of 5%. The causes of VI were myopia (2.5%), astigmatism (1.8%), hypermetropia (0.2%), anisometropic amblyopia (0.2%), and strabismus (0.2%). Conclusion: The prevalence of vision impairing conditions in this age group underscores the importance of preschool vision screening to ensure early detection and treatment to prevent the permanent damage of amblyopia.
Causes of root canal treatment failure: A prospective study in Makkah City, Saudi Arabia

Aim: The aim of the study is to identify the causes of root canal treatment (RCT) failures in Makkah City. Materials and Methods: The study used a prospective cohort study design, using a clinical examination, treatment, and follow-up. The study summarized the data of 131 patients presented to the Endodontic Department in King Faisal Hospital, Makkah, in the Western region of Saudi Arabia and included patients with failed RCT aged 16 years or older without any systemic disorder. Results: Of the 131 patients, the most common factor for root canal failure was underfilling (71.0%), followed by coronal leakage (42.7%), overfilling (16.8%), missed canal (16.0%), iatrogenic (6.1%), leaked canal and anatomic (1.5%), and 3.1% for unknown causes. Fifty-two (39.7%) were female and 79 (60.3%) were male. One hundred and three (78.6%) were 18–40 years old, whereas 28 (21.4%) were 40 years old and older. For tooth type, 34 (26.0%) had an anterior root canal, 39 (29.8%) had a molar root canal, and 58 (44.3%) had a premolar root canal. Conclusion: Considering the limitations of the present study, it was determined that endodontic treatment failures mostly occurred in underfilled root canals, followed in number by coronal leakage. Premolars had a higher failure rate than did anterior and molar teeth.
An evaluation of the relation between the maxillary third molars and facial proportions using cephalometric image

Objective: The aim of this study was to evaluate the position of the third molars and their relationship with pterygomaxillary fissure vertical dimension patterns and on panoramic and cephalometric images. Materials and Methods: In the present retrospective study, the third molar position classifications, third molar positions of patients with cephalometric and panoramic radiographs, and their relationship with vertical skeletal growth and pterygomaxillary fissure were thoroughly investigated in the light of the preoperative clinical and radiologic records from 200 patients with an indication of third molar extraction, who were admitted to İstanbul Aydın University Faculty of Dentistry Oral, Dental and Maxillofacial Radiology Clinic and Department of Orthodontics due to various reasons. Results: The obtained data were evaluated using SPSS (22.0) package program. Regarding the data analysis, Mann–Whitney U-test statistics was used for the analysis of two-variable data. The vertical facial length's relation with the maxillary third molars, which had been examined on cephalometric and panoramic images, was identified as 50.3% for skeletal Class I, 42.1% for skeletal Class II, 7.6% for skeletal Class III, 70.2% for unilateral, and 29.8% for bilateral. The upper impacted wisdom tooth being unilateral or bilateral does not affect the vertical facial length (P = 0.386). The upper wisdom tooth being impacted unilaterally or bilaterally did not exhibit any statistical difference with the parameters of upper-lower and total anterior facial height and posterior facial height. According to the Chi-square analysis, the correlation between gender and pterygomaxillary fissure variable was found to be statistically insignificant (P > 0.05). According to Mann–Whitney U-test results, no variable was found to be statistically significant based on the molar status (P > 0.05). Conclusion: In the light of this study, prior to treatment planning, if the relationship between the third molars and anatomical formations is determined on cephalometric and panoramic radiographs and it is determined whether the impact of upper wisdom teeth remains effective, consider the therapeutic mechanics used in orthodontic treatments and the complications that may arise during surgical operations. It is emphasized that the necessary measures should be considered beforehand in order to prevent these problems.
“Tracheomalacia after Thyroidectomy,” Does it Truly Exist?

Aim: Tracheomalacia is a potentially life-threatening, but a rare complication of thyroidectomy. In previous studies, the incidence rate was very different. Considering the relatively high prevalence of goiter and thyroidectomy in the West Azerbaijan region, we designed this study to determine the tracheomalacia incidence in patients who underwent thyroidectomy within a 10-year interval. Materials and Methods: This retrospective study was done in Urmia Imam Khomeini Hospital in West Azarbayjan Province. Demographic characteristics including the age and sex of patients who underwent thyroidectomy between 2007 and 2017 and also the incidence of tracheomalacia after surgery were recorded. Results: From 2007 to 2017, total 1236 thyroidectomy were performed. The patients' age ranged from 15 to 83-year-old with a mean age of patients was 44.5 ± 13.81 years old. Two hundred and twenty-nine patients (19%) were male and 1007 (81%) were female. We did not find any cases of tracheomalacia after thyroidectomy in our study population. Conclusion: Based on the results of this study, it seems that with the necessary precautions, the incidence of tracheomalacia can reach zero.
Long-term survival in a patient with bilateral metachronous triple negative breast cancer: A case report and literature review

The incidence of bilateral metachronous breast cancer is rare in our environment. We report the rare case of a 44-year-old woman who has survived for 12 years after she was first diagnosed with stage 3B medullary right breast cancer. She had a positive family history of breast cancer in her paternal grandmother. She was treated with mastectomy and axillary clearance, six cycles of combination chemotherapy and external beam radiotherapy. She was also placed on tamoxifen. She developed a second primary breast cancer in the contralateral breast; triple negative, 10 years after her first diagnosis. She was treated with modified radical mastectomy and six cycles of Docetaxel with excellent response. She completed her chemotherapy about 2 years ago and has been on follow-up with no evidence of loco-regional recurrence.
Aerobic exercises along with resisted training to prevent postrenal transplant complications in renal transplant recipient: A single-subject design

Background: Renal transplantation has become moderately accepted and successful due to advancement in overall management. However, long-term complications of renal transplantation still post new challenges. Pharmacologic treatment along with “appropriate level” of exercise helps to prevent long-term complications. This study reports the efficacy of appropriate level of aerobic exercises along with resisted training to prevent post-renal transplant complications in a single case of renal transplant recipient. Methods: This single- subject experimental study design consist of A1, B1, A2, B2 and A3 phases which include either of aerobic exercise, aerobic exercise with resisted training or home programme. Visual analysis and 2SD- band method was used to analyze serum creatinine, postprandial blood sugar, blood pressure, VO2 max and amount of medicines required to renal transplant recipient. Results: A favorable changes were noted among the specific variables even after longtime, when combined aerobic exercises with resisted training were given. Conclusion: This case study shows that Aerobic exercises with resisted training are effective to prevent post renal transplant complications among renal transplant recipient within two years of transplantation, which could not be generalized but provides impetus to further research.
Tobacco Cessation: Are Oral Cancer Patients Ready for It

Abstract Aims: The objective was to examine the predictors of readiness to quit tobacco among oral potentially malignant disorder (OPMD) and oral cancer (OC) patients in dental health care setting. Settings and Design: Two hundred and seven patients diagnosed with OC or OPMDs comprising 153 males and 54 females, with mean age being 52.2 years, with varying levels of addiction formed the study group. Subjects and Methods: Readiness to quit tobacco as measured by the ladder of change and the single-item readiness question was significantly correlated with measures of perceived risk. Statistical Analysis Used and Results: Pearson’s correlations showed that readiness to quit tobacco was significantly correlated with the participant’s perception of his or her health compared with other tobacco users of the same age (P < 0.005). Readiness to quit was positively correlated with the degree to which participants felt that their oral condition is related to their tobacco use (P < 0.001), how much their general health is affected by tobacco use (P < 0.01), and how much quitting tobacco could influence their health positively (P < 0.001). Post hoc analyses showed that readiness to quit was also significantly and negatively correlated with nicotine addiction (P < 0.001) and decisional balance scores (P < 0.01). Conclusions: There is an urgent need for tobacco risk assessment, intervention, and education with this population of patients, and hence, health professionals can play a significant role in motivating and assisting to quit.
Effect of galantamine on verbal repetition in AD

Objectives: To understand how commonly diminution of verbal repetition was a goal of treatment in patients with Alzheimer disease (AD), how commonly that goal was achieved, whether goal attainment might be attributable to galantamine treatment, and whether change in verbal repetition is a marker of the overall treatment response. Methods: This is a secondary analysis of the Video-Imaging Synthesis of Treating Alzheimer’s Disease study, a 4-month, double-blind, randomized, placebo-controlled trial of galantamine in 130 community-dwelling patients with mild to moderate AD. The primary outcome was Goal Attainment Scaling, in which individualized problems identified by patients/caregivers and treating physicians were assessed bimonthly. Results: Reduction of verbal repetition was set as a treatment goal in 44% (n = 57) of randomized patients. More patients/caregivers (32%) set repetition goals than did physicians (18%). After 4 months, more galantamine-treated patients showed diminution of verbal repetition (58%) than did placebo-treated patients (24%; p < 0.01). Reduction of verbal repetition correlated with improvement in clinical measures, but not in standardized ones. Conclusions: Reduction of verbal repetition is a common goal of Alzheimer disease treatment. After 4 months, patients treated with galantamine were more likely to experience a reduction of verbal repetition than those treated with placebo. Diminution of verbal repetition was associated with other improvements, suggesting it might be a clinical marker of a positive treatment response.
Quantifying influence of epidural analgesia on entropy guided general anaesthesia using sevoflurane – A randomised controlled trial

Background and Aims: Minimum alveolar concentration (MAC) of inhalational agent denotes the requirement of it to maintain adequate plane of general anaesthesia. The precision to the maintenance of anaesthesia can be further guided by use of entropy to titrate the depth of anaesthesia. Regional anaesthesia and the concomitant deafferentation will decrease the need of general anaesthetics. We conducted a randomised double-blind trial to quantify the effect of addition of regional anaesthesia to sevoflurane based general anaesthesia technique guided by entropy to achieve satisfactory depth of anaesthesia. Methods: Forty patients posted for elective laparotomies were randomised to two groups. All patients received a bolus followed by an epidural infusion. Group GE (general anaesthesia + epidural bupivacaine) received 0.25% epidural bupivacaine and Group GS received epidural saline. Both groups received narcotic, relaxant and sevoflurane anaesthesia guided by entropy monitoring. The state entropy (SE) was maintained at 40–60 by titrating end tidal sevoflurane concentration (ETsevo). Heart rate, blood pressure, SpO2, end tidal carbon dioxide (ETCO2) and sevoflurane were recorded. Results: Both groups were similar in heart rate and mean blood pressure during anaesthesia maintenance. The minimum ETSevorequired to maintain entropy between 40 and 60 in group GE was 0.53% compared to 0.95% in group GS the epidural saline group (P < 0.001). The end-tidal sevoflurane requirement to maintain adequate depth of anaesthesia dropped by 44.2% in group GE.Conclusion: Lower concentrations of volatile anaesthetic are required when entropy-guided general anaesthesia is combined with regional blockade.
Comparison Efficiency of Posteroanterior Cephalometry and Cone-beam Computed Tomography in Detecting Craniofacial Asymmetry: A Systematic Review

Objectives: The aim of this systematic review is to compare cone-beam computed tomography (CBCT) and two-dimensional radiography in the assessment of facial asymmetry. Methods: Three valid electronic databases (PubMed, Scopus, and Web of Science) were searched for articles published from 1973 to February 2017. Hand searching was done through references of selected articles, internal thesis, and national and international conferences. The titles and abstracts obtained from the search were evaluated by reviewers according to the inclusion and exclusion criteria. Results: The established search strategy identified 2137 articles. A total of 2079 articles were from electronic search in three international databases and 58 articles from hand searching. After eliminating duplicate articles and on the basis of inclusion and exclusion criteria, 13 articles and 1 thesis entered the final analysis. Bayesian meta-analysis was done due to the heterogeneity of articles and the differences related to the methodology of the studies. According to this method, analyzing J-J landmark in two studies showed that there were no statistical differences between posteroanterior (PA) radiography and three-dimensional method with reference standard. Conclusion: The results of the study showed that there was no preference between the two techniques in measuring and diagnosing the landmarks and evaluating asymmetry. It can be concluded that in patients having problems other than asymmetry and need more information for the treatment plan, CBCT is more helpful than PA cephalometry.
A study of effect of lateral position on oropharyngeal seal pressure of i-gel® and ProSeal™ LMA in children

Background and Aims: Supraglottic airways (SGAs) should have good oropharyngeal seal pressures (OSP) for adequate ventilation and prevention of aspiration. Our aim was to study the effect of lateral position on OSP and thereby on ventilatory parameters for i-gel® and ProSeal™ laryngeal mask airway (PLMA) in children. Methods: In this prospective observational study, 86 children of ASA I-II, aged 1 month to 12 years, scheduled for elective surgery under general anaesthesia using i-gel® or PLMA and requiring lateral position either for surgery or regional blocks were included. In both supine and lateral position OSP (constant flow method), expired tidal volume, fractional volume loss (%), and end-tidal carbon dioxide (ETCO2) were noted. Intragroup and intergroup difference in OSP from supine to lateral position was analyzed using paired and unpaired t-test respectively. Results: In lateral position, there was a significant decrease in the OSP (cm H2O) in both i-gel® (supine: 21.94 ± 5.82, lateral: 15.54 ± 5.37) and PLMA (supine: 17.53 ± 5.05, lateral: 12.76 ± 3.37) groups (P = 0.000). Percentage reduction in OSP from supine to lateral with i-gel® (28.14 ± 18.86) and PLMA (24.06 ± 19.75) were comparable (P = 0.339). With both i-gel® and PLMA significant increase in fractional volume loss and ETCO2were noted in lateral position. I-gel® group had higher OSP compared to PLMA in supine (P = 0.001) and lateral position (P = 0.009). Conclusion: In lateral position there was significant reduction in OSP compared to supine position with both i-gel® and PLMA.
Management of vernal keratoconjunctivitis in children in Saudi Arabia

Vernal keratoconjunctivitis is a chronic inflammatory disease of the ocular surface and one of the worst types of allergic conjunctival diseases. Because of its chronic nature, it can damage the cornea, resulting in sight-threatening complications if left untreated. The disease affects mainly young children starting around the age of 7 years. We used keywords to search for published English articles in PUBMED, Google Scholar, EMBASE, and Cochrane Database of Systematic Reviews. Most of the published literature is focusing on general management of the disease and few publications focusing on treatment in the pediatric age group. We highlight the importance of how is the topical management differs between age groups. We focused on the importance of doing cycloplegic refraction for each child as the risk of keratoconus and oblique astigmatism is high in these cases. Furthermore, we highlight the importance of using eye lubricants as a therapeutic and preventive tool for the attacks of the disease. We highlight that most of the recent effective medications (especially the off-label ones) are not available in Saudi Arabia, such as tacrolimus, and some are only available to be prepared in tertiary center pharmacies as Cyclosporine A with higher concentrations.
Renal transplant in a child with Alport syndrome

Alport syndrome is a rare inheritable renal disease characterized by renal, cochlear, and ocular involvement. Patients commonly require renal replacement therapy in the second or third decade of life. Renal transplantation in pediatric patients has become a routinely successful procedure, with 1- and 5-year patient survival rates of 98%, the range takes into account the differences between living and deceased donors. These good outcomes represent the cumulative effect of improvements in pre- and post-transplant patient care, operative techniques, immunosuppression, and infection prophylaxis, diagnosis, and treatment. We report the case of a male child with Alport syndrome who underwent preemptive live renal transplant and his mother was the donor.