Miracle-dz/UniFAR-FTUs huggingface dataset:
Health care service quality: a study of private hospitals

Service quality has been defined as the outcome of an evaluation process where the consumer compares his expectations with the service he has received or the difference between expected service and perceived service. In today's increasing competitive atmosphere providing service quality is important for any service industry. Here health care services have been studied as they have a distinct position amongst other services due to highly involving and risky nature of services and the general lack of expertise possessed by consumers. For comparative purposes, five service quality dimensions were used i.e. tangibility, reliability, assurance, responsiveness and empathy. The 22 items SERVQUAL scale based on gap model proposed by Parasuraman, Zeithmal and Berry was used. In this study a sample size of 100 was taken using quota sampling. Gap analysis was applied to find the gaps between expected and performed service in private hospitals of NCR and t-test was applied using SPSS to find difference between male and female perception and expectation. It was found that maximum gaps existed in dimensions of reliability and empathy. Also it was seen that though the males and females differed in their perception about service quality of hospitals they had similar views regarding expectations.
Upper gastrointestinal involvement in systemic sclerosis: Findings in a real-life setting

Gastrointestinal tract involvement is the most common visceral affectation in systemic sclerosis (SSc), but the manifestations may vary in extension and severity. Endoscopic and histopathological gastroesophageal findings were investigated in patients with SSc. A total of 79 consecutive patients with definite SSc were enrolled in a cross sectional study. Clinical data were collected, upper gastrointestinal endoscopy and biopsies from gastric mucosa were performed in all cases. Fifty-seven (72.1%) out of 79 SSc patients had gastroesophageal symptoms. The most frequent were dysphagia, present in 33 (41.7%) and gastroesophageal reflux symptoms in 23 (29.1%) patients. Out of the 79 patients, 22 were asymptomatic, but in 16 esophageal and gastric mucosa changes were endoscopically detected. Reflux esophagitis was found in 39 (49.3%) patients. The presence of esophageal manifestations was not related to the disease duration or with its other variables. Signs of gastritis were endoscopically described in 47 (59.4%) and confirmed on histopathologic examinations in 45 patients. In 31 patients without any endoscopic changes, 18 (22.7%) showed signs of gastritis on histopathologic examination. No significant statistical differences were found between symptomatic and asymptomatic patients or between those with limited cutaneous SSc and those with diffuse cutaneous SSc in terms of clinical, endoscopic or histopathological findings, except the higher proportion of hiatal hernia in symptomatic patients. The results of this study might suggest that upper gastrointestinal endoscopy should be performed during the early stage of the disease and then periodically in patients diagnosed with SSc, even in the absence of typical symptoms.
Cryptosporidium Infection: Epidemiology, Pathogenesis, and Differential Diagnosis

Cryptosporidium is a protozoan that infects a wide variety of vertebrates, including humans, causing acute gastroenteritis. The disease manifests with abdominal pain and diarrhea similar to that of choleric infection. In the immunocompromised hosts, the parasite causes prolonged infections that can also be fatal. For this reason, cryptosporidiosis is considered one of riskiest opportunistic infections for patients with acquired immunodeficiency syndrome. The best way to control the infection in these patients is setting up sensitive and specific diagnostic tests for epidemiological surveillance and morbidity reduction. Here, we summarized the general aspects of Cryptosporidium infection focusing on available diagnostic tools used for the diagnosis of cryptosporidiosis. Molecular methods currently available for its detection and progress in the development of new diagnostics for cryptosporidiosis are also discussed.
Successful vaginal delivery of spontaneously conceived twins in each horn of a bicornuate uterus with previous caesarean: a case report

Mullerian duct fusion anomalies resulting in uterine malformations have prevalence of 3-4%. Among this, bicornuate uterus has a rare incidence of 0.4%. Uterine malformations pose significant threat in terms of obstetric outcomes. We report an extremely rare case of spontaneous conception of twin pregnancy with the fetus occupying each horn of a bicornuate uterus (bicornis unicollis), in a woman with a history of previous caesarean section. She was booked at our hospital and the pregnancy remained uneventful. At 35 weeks she went into spontaneous labour and delivered vaginally without any maternal-fetal complications. The case is unique and the management is worth discussing as till date no protocols or guidelines have been proposed for the mode of delivery of bicornuate uterus with twins with previous cesarean. Only 12 cases of twins with bicornuate uterus have been reported till date. This is the first case in literature in which a successful VBAC has been conducted in a woman with bicornuate uterus with twins with previous caesarean.
Sensory restoration by epidural stimulation of dorsal spinal cord in upper-limb amputees

Restoring somatosensory feedback to people with limb amputations is crucial for improving prosthesis acceptance and function. Epidural spinal cord stimulation is a commonly used clinical procedure that targets sensory neural pathways in the dorsal spinal cord to treat pain conditions. A similar approach could be developed as a clinically translatable means to restore somatosensation in amputees. We show that epidural stimulation of the dorsal spinal cord evoked sensory percepts, perceived as emanating from the amputated arm and hand, in four people with upper-limb amputation. After an initial caudal movement immediately following the implantation, the leads stabilized, exhibiting a median migration of <5 mm (each electrode contact is 3 mm long) over the remainder of the study in all the subjects. This was reflected in the consistent locations of evoked percepts in the hand across four subjects throughout the period of implantation, which lasted up to 29 days. The median change in the centroid location was 1.2 to 35.3 mm and the median change in percept area was 0 to 40%. While most of the evoked percepts were paresthetic in nature, a subset was described as naturalistic (e.g. touch or pressure) in three subjects. Modulating the stimulus amplitude affected the perceived intensity of the sensation in all subjects. A variety of sensory percepts were evoked in all subjects irrespective of the level of amputation or the time since amputation, suggesting the approach is amenable to a diverse population of amputees.
Hematological and nonhematological toxicities of imatinib mesylate in patients with chronic myeloid leukemia and gastrointestinal stromal tumor

Objectives : To determine the hematological and nonhematological toxicities of imatinib mesylate in patients with chronic myeloid leukemia (CML) and gastrointestinal stromal tumors (GIST) and to review the literature to compile a list of the etiologic agents responsible for these events. Materials and Methods : This was a prospective study conducted from May 2001 to February, 2007. Two hundred and thirty-two patients with CML and GIST treated with imatinib mesylate at the Aga Khan University Hospital were included in the study. Side effects were graded according to the common toxicity criteria of the National Cancer Institute version 3.0. Results : Ninety-seven patients experienced various side effects which, in decreasing order of frequency, were: generalized hypopigmentation, periorbital edema, nausea, and weight gain. Hematological toxicities included mainly grade I/II anemia and thrombocytopenia. Grade III/ IV hematological adverse events were rare in our group. The frequency of all events is equally distributed in all phases of CML and GIST. The side effects rarely lead to permanent discontinuation of therapy. Conclusion : Imatinib mesylate is a well-tolerated drug with some adverse events that are only rarely a permanent barrier to therapy.
Clinical characteristics, antibiotic resistance and molecular typing of methicillin-resistant Staphylococcus aureus in a teaching hospital at South Taiwan.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become an issue of public health worldwide. The clinical features, molecular epidemiology and antibiotic resistance of MRSA isolates from South Taiwan from January to December 2009 were collected and analyzed. Original Research Article Yang et al.; BMRJ, 8(4): 513-524, 2015; Article no.BMRJ. 2015.143 514 Methods: A total of 439 patients were invited to participate in this investigation. Antibiotic resistance was assessed by broth microdilution and pulsed-field gel electrophoresis (PFGE) was performed to identify the molecular genotypes. Results: Among 439 culture-proven S. aureus isolates, MRSA accounted for 47.8% (210/439). The remaining 52.2% (229/439) isolates were methicillin-susceptible Staphylococcus aureus (MSSA). MRSA isolated from intensive care unit (ICU) were significantly more than MSSA and the percentage of MRSA strains isolated from the respiratory tract was significantly higher than that of MSSA. The resistant rates of MRSA to penicillin, ampicillin/sulbactam, clindamycin and erythromycin were over 80% as no MRSA isolates were resistant to vancomycin, linezolid and teicoplanin. Antimicrobial data of MRSA strains were categorized into 10 patterns, of which 5 main patterns accounted for 95.7% (n=201). PFGE characterization of MRSA was grouped into 20 genotypes (A through T). Among 20 major pulsotypes, clusters A, E, J, and N of MRSA isolates were associated with clinical and antimicrobial importance. Conclusion: This study revealed crucial information of MRSA typing and essential connections among clinical characteristics, antimicrobial patterns and MRSA pulsotypes. The PFGE pulsotype may be coupled to distinct antibiotic-resistant patterns, special specimen sources and specific hospital department where MRSA isolated. The results can be regionally used in infection control and antibiotic stewardship of MRSA.
Factors Contributing to Delayed Extubation After Cervical Spine Surgery in Siriraj Hospital

Background: Cervical spine surgery brings up great concerns about post-operative severe complications and morbidities. Anesthesiologists should know contributing factors for the delayed extubation which includes patient factors, surgical factors, and anesthetic factors. Objective: To study the factors related to delayed extubation for the benefit of anesthetists future decision making and the patients safety. Methods: Case-controlled study in a retrospective fashion. Patients who undertook cervical spine surgery during 2002-2007 without previous intubation, tracheostomy, and ones with data available to be collected; were identified for the study. Data included age, sex, BMI, ASA classification, smoking history, pre-operative neurological deficit, history of previous C-spine surgery, steroid administration, number of cervical spine surgeries, upper cervical level including, surgical approach, instruments, intubation technique, duration of the operation, total blood loss, and total fluid replacement. All 16 factors were studied and analyzed for their relationship to extubation difficulty. Results: Of all 140 patients identified in the study, 70 were patients with immediate extubation and 70 were patients with de- layed extubation. Factors that are statistically significant in delayed extubation are: advancing age >60 years, ASA classification > class 2, pre-operative neurological deficit, surgery >2 levels of spines, duration of the operation >180 minutes, fiberoptic intubation technique, total fluid administration >4,000 ml during surgery and total blood loss >250 ml. When analyzed with multivariate analysis, factors that related to delayed extubation are advancing age >60 years (odds ratio 4.077, 95% CI 1.562-10.641), neurological deficit (odds ratio 5.719, 95% CI 1.312-24.927), surgery >2 levels of spines (odds ratio 4.108, 95% CI 1.672-10.095), duration of operation >180 minutes (odds ratio 4.538, 95% CI 1.687-12.205), and fiberoptic intubation technique (odds ratio 4.131, 95% CI 1.636-10.433). Conclusion: There are 5 contributively factors that are related to delayed extubation in patients receiving cervical spine surgery at Siriraj Hospital: advancing age >60 years, neurological deficit, surgery >2 levels of cervical spines, duration of the operation >180 minutes, and fiberoptic intubation technique.
A Review of Wound Healing Activity on Different Wound Models

Wound is an injury of living tissue or break in the epithelial integrity of the upper layer of skin.which may lead to disturbance of skin anatomical structure and their function. The normal wounds are starts to healing immediately after an injury. Healing process are involved a series of coordinated events (inflammatory response, proliferation, maturation phase). Wound healing remains a challenging clinical problem therefore correct and efficient wound management is essential. The screening models are important biological tools to understand basic process of tissue repair and treatment of wounds. Wide varieties of in-vitro, ex-vivo and in-vivo models have been developed for evaluation of wound healing activity. The in-vitro models includes Chick chorioallantoic membrane assay, Fibroblast assay, Collagen assay, Scratch assay, Endothelial cell in vitro tube formation assay, Keratinocytes assay. ex-vivo models includes organotypic culture, human ex vivo skin culture, porcine model, Human organotypic skin explanted culture And the in-vivo models includes Excision wound model, Incision wound Model, Burn wound model, Dead space wound model, Skin wound induction.the aim of this review is detailed study on different types of in-vitro, ex-vivo and in-vivo models for evaluation of wound healing activity.
The Quality of Data Collection by an Interview on the Prevalence of Elder Mistreatment

ABSTRACT The aim of the present study was to investigate the quality of the interview process that was used to obtain data on the prevalence of elder mistreatment in order to improve the quality of this process in future research studies. Audiotapes of interviews with 143 victims of elder mistreatment were transcribed into verbatim protocols that were subsequently coded and analyzed. The results of the present study show that despite the fact that all interviewers were carefully selected, intensively trained, and supervised during the interview period, 4.2% of the questions were skipped, and in 4.4% of the interactions no usable answer was obtained. However, in all of these cases the interviewer did register an answer, the validity of which is questionable. Considerable differences were found between interviewers with respect to their performance and also between the various questions. Finally, suggestions are made to improve interviewer behavior.
Caractérisation d'une lignée cellulaire humaine provenant d'un carcinome anaplasique de la thyroïde.

: A new cell line derived from a thyroid anaplastic carcinoma, CAL 62, has been established in culture. This line is constituted by highly tumorigenic cells. Their epithelial phenotype is stable in culture. Immunochemical staining for human thyroglobulin is negative. Cytogenetic analysis showed a gain of chromosome 20, the translocation i (14q), and breakpoints of centrometric chromatine. These results are similar to those previously reported by other investigators. CAL 62 radiosensibility has been studied. The survival curve of the in vitro irradiated cells has been adjusted with a linear-quadratic model. This cell line is thus showed to be radioresistant. Cell line CAL 62 constitutes an appropriate model for in vitro studies of thyroid anaplastic carcinoma.
Clinical Management of Chronic Atopic Dermatitis in a Goat: A Case Report

A 4 years old Jamnapari cross buck weighing 50 kg was presented to the Veterinary Teaching Hospital, Universiti Putra Malaysia, with a primary complaint of dry crusty and alopecic skin lesions on the ventral neck, thoracic, abdominal, scrotal, perianal, and interdigital regions. The animal was physically sound with normal appetite and was managed intensively for breeding purposes. Hematological analysis showed a marked leucocytosis characterized by eosinophilia and netrophilia with degenerative left shift. Skin scrappings taken showed no ectoparasites and the vital parameters were within the normal range. Other systems appeared normal except the integumentary system which showed crusty and alopecic skin lesions on different parts of the body. The case was first tentatively diagnosed as dermatitis and effectively managed following a gradual change of feed and the administration of a single intradermal injection of 50 mg (10 mg/kg) chlorpheniramine maleate, 50 mg of long acting oxytetracycline hydroxide (20 mg/kg, I.M) repeated four days later and multivitamin injection, 10 mg/kg for five days. This report highlights the significance of atopic dermatitis among goats and the need for its early and effective management in breeder farms and to provide a simple systematic approach for veterinarians and animal scientists in diagnosing and managing the condition.
Short communication MOLECULAR ANALYSIS OF MYCOBACTERIAL DNA IN SOME CASES OF SARCOIDOSIS: CORRELATION WITH CLINICAL COURSE AND 10 YEARS' OBSERVATION

We present six patients with sarcoidosis whose transbronchial biopsy specimens had been investigated, the gene of immunogenic protein MPB64 for Mycobacterium tuberculosis by polymerase chain reaction analysis. M. tuberculosis DNA was detected in three of them by PCR. We followed patients with sarcoidosis for ten years. We discussed tuberculin test results and clinical course of M. tuberculosis positive and negative patients with polymerase chain reaction. we cannot make a conclusion about a relationship between clinical course and mycobacterial DNA positivity.
Health and Lifestyle Assessment among Medical Students of El Kasr El Aini, Faculty of Medicine, Cairo University

Medical students represent a significant community investment and promoting their health preserves this investment. The study aim is to assess health status and detect life style risky behaviors among Egyptians' medical students in order to contribute to the development of health promotion programs designed specifically for them. A cross-sectional study was conducted among medical students at Faculty of medicine, Cairo University, from February to May, 2011. The study sample was stratified according to undergraduate grades of education a random sample of 440 students was chosen. Data was collected via a self-administered anonymous questionnaire consisted of students' demographic characteristics and three main domains used to assess health of the study participants. The index of adiposity used in the study was the body mass index (BMI). A scoring mechanism was built for every question and a mean of the total scores was calculated for each domain. The computer package SPSS version 16 was used for statistical analysis. The results indicated that, out of the 440 university students studied, 151 (34.3%) were males and 289 (65.7%) were females. The mean age of males was (19.8+1.25) years, while that of females was (19.2+1.17) years. Mean BMI for male was 25.5 kg/m2, compared with 23.8 kg/m2 for female students. Students in the fifth year were more likely to be obese than students in other years of graduation (13.3% vs 11.7%). Male were almost likely to be more obese than female students (59.5% vs 40.5%). The majority believed their activity levels were insufficient (78.6%) and (62.9%) had poor sleep behavior. Fifth year students were significantly less likely to eat meals regularly (p 0.03). Consumption of fatty food > 5 times/week was significantly associated with being over weight and obese, as compared to those who consumed fatty food less than 5 times per week (p 0.007). Frequencies revealed that anxiety and depression was significantly higher among 1 st year students as compared to the 3 rd and 5 th years (p 0.05). Most of them (68.9%) suffered from poor time management affecting their academic performance. Examination and academic related stresses constituted the highest percentage (91.8%) among the causes of stress. The over all total score of the three health domains was significantly higher among fifth year students (p<0.01). Health risk behaviors score (life style and dietary habits) and the mental social well-being mean score did not show any statistical significant difference between medical students in the three years of education. This study identified significant health promotion opportunities for these students that can be carried out during medical school in order to establish a healthier physician population. It is recommended to develop health and nutritional education, behavioral modifications and intervention studies for better health promotion of medical students.
Depression among primary health care physicians in Makkah Al- Mukarramah

Background The practice of Medicine is stressful, as the pressure of work is unavoidable. The stressful event goes hand-in-hand with physician's job and such events may start as early as Medical school days. Objectives The main objective being the determination of prevalence depression among primary Health Care physicians in Makkah Al Mukarramah city. The second objective was to evaluate factor associated with depression among them. Subjects and methods This was a across – sectional epidemiological study among primary Health Care physicians in Makkah Al Mukarramah city. A sample of 90 physicians was included, (64%) males and (26%) females. The tool of the study was self administered questionnaire, which consist of two main parts, each part consist of instructions. First part was consisted of personal data. Second part included 21 questions of Beck Depression Inventory Scale. Results Main result showed that the prevalence of depression among Primary Health Care Physicians 28.9 %, mild form 18.9 %, moderate form 10 %, and no severe form. Female physicians reported depression more significantly than males.