Miracle-dz/UniFAR-FTUs huggingface dataset:
Endometriosis Misdiagnosed as a Metastatic Ovarian Tumour

Endometriosis is a debilitating problem with pain in the short term and high risk of infertility later. It is an oestrogen-dependent condition found in about 10% of women of reproductive age, about 1/3 of infertile women and as high as 80% of women with chronic pelvic pain. The condition is not well understood and thus associated with misdiagnosis and delayed diagnosis. Higher rates of misdiagnosis occur in blacks and this is especially for pelvic tumors-fibroids and ovarian tumors. We present here the case of a 30-year-old nullipara, who had an umbilical nodule (Sister Mary Joseph’s) and was found on imaging to have a pelvic tumor which was suspected to be an ovarian cancer. Diagnostic laparoscopy during the menstrual phase however revealed endometriosis in early stage. Misdiagnosis of endometriosis has potential to distort the course of the disease and endanger fertility prospects; early laparoscopic evaluation of patients with unclear pelvic pathologies would help to prevent this occurrence.
BEHAVIORAL GAIT CHANGE CHARACTERIZATION AND DETECTION USING PRECISION DAIRY MONITORING TECHNOLOGIES

OF DISSERTATION BEHAVIORAL GAIT CHANGE CHARACTERIZATION AND DETECTION USING PRECISION DAIRY MONITORING TECHNOLOGIES Lameness is a painful disorder that decreases performance and is highly recognized as one of the most important health and welfare concerns for dairy cattle. Visual gait scoring is the most common way to detect gait change in dairy cattle. However, this is not only subjective, but is also time consuming and costly. A need to remove the subjective assessment of human observation exists. Therefore, automatic gait change detection for continuous monitoring by precision dairy monitoring technologies may be beneficial. The first objective of this research was to characterize behavior and production variables as cow gait changed to evaluate potential usefulness in gait change detection across two different studies. Weighted gait score was a significant (P < 0.05) predictor of rumination time for study 1. Rumination time decreased as weighted gait score increased. However, for study 2, numbers of steps and feeding time were significant predictors (P < 0.05). Number of steps increased as weighted gait score increased. Time at the feedbunk and feedbunk visits decreased as cows weighted gait score increased. The second objective was to compare behavior and production variables for each individual gait aspect in increasing gait scores to evaluate potential usefulness in gait change detection across two different studies. For study 1, milk yield, rumination, and neck activity decreased as cows as tracking score increased. For study 2, lying time decreased as cow’s general symmetry score increased. Feedbunk visits decreased as cows tracking score increased. Number of steps increased as cow’s spine curvature score increased. Time active increased as cows head bobbing score increased. Activity increased as cows speed score increased. Lying time decreased as cow’s abduction/adduction score increased. The third objective was to detect gait change utilizing multiple precision dairy monitoring technologies in two different studies. For study 1, 56% of predicted gait scores were within 0.25 points of the actual weighted gait score and for study 2, 41% of predicted gait scores were within 0.25 points of the actual weighted gait score. Pearson Correlation for study 1 and 2 was 0.43 and 0.46, respectively. For both studies, the Pearson Correlation yielded results in the low category, when evaluating goodness of fit.
Knowledge, Attitude and Practice about Breast Cancer among Saudi Women: A Cross-sectional Study in Riyadh

Background: Worldwide, breast cancer is the most common cancer in women. Breast cancer screening has been found effective in early diagnosis and decreasing mortality rates. Aim of the study: To assess Saudi Women’s knowledge, attitudes and practices towards breast cancer screening in Riyadh, Saudi Arabia, and investigate factors that influence these practices. Methods: This is a cross-sectional community-based survey; a self-administered questionnaire was used to collect data from a convenience sample of females with a wide spectrum of socio-demographic profiles. A scoring scheme was used to score women’s responses. Logistic regression analyses were conducted to identify factors associated with screening practices viz. breast self-examination (BSE), mammography and attitudes. Results: The study included 407 females, mean (± S.D) age of 28 years (± 8.5); 45% were married and 40.2% had a university degree. Only 30% of females practiced BSE and 25% had ever performed mammography. Stepwise logistic regression analysis revealed that inappropriate attitude is independently predictable by inadequate knowledge (p<0.0001). Factors independently associated with BSE practice in the stepwise logistic regression analysis were being married (p<0.05), appropriate attitude (p<0.05), adequate knowledge (p<0.05) and performing a mammography test (p<0.0001). Factors independently associated with performing mammography were age greater than 40 years (p<0.05), higher knowledge score (p<0.0001) and practicing BSE (p<0.0001). Conclusion: These study findings indicate significant inadequate knowledge, inappropriate attitude towards breast cancer as well as suboptimal screening practices among Saudi women. Therefore, preventive educational campaigns employing innovative strategies to increase population awareness, particularly targeting future generations through schools and university curricula, should be urgently implemented to reverse the course of the upward growing incidence of breast cancer disease in the Kingdom of Saudi Arabia.
Clozapine-induced massive hematemesis: A rare case report

Clozapine (CLZ) is a drug of choice for the treatment of resistant schizophrenia. It is always blamed probably due to its life-threatening side effects, such as agranulocytosis, constipation, cardiomyopathies, and rarely hematemesis. We report the case of a 65-year-old patient diagnosed with resistant schizophrenia and treated with CLZ later he developed sudden massive hematemesis. The aim of our case report is to describe the rarely seen and potentially life-threatening side effect related to CLZ. Physician, particularly psychiatrists and medical specialists, should not ignore, be aware, and alert or always need to be watchful to the fatality of CLZ-induced hematemesis in the management of psychiatric disorders and should take appropriate therapeutic measures in such a case.
Gastrointestinal nematodes infections in ruminants: Prevalence and Anthelmintic efficacy

Ruminants are considered a major source of meat and milk productions for human consumption in Egypt. Egypt possesses large population of livestock which is managed by smallholder farmers.Gastrointestinal nematode infection was one of the most problems on health all over the world, it was affected the health of several people and animals causing huge economic loss in ruminants farming (Muluneh et al., 2014). Haemonchus was regarded as one of the most prevalent and highly pathogenic, possessed the highest biotic potential and had a prominent ability to develop resistance against most widely used anthelmintics and a unique survival strategy due to great biological and ecological plasticity. Hence compared to other gastrointestinal nematodes, Haemonchus was the most important parasite of domestic ruminants especially in sheep and goats (Kumsa et al., 2008). Abstract: This study investigates the prevalence of gastrointestinal nematodes in ruminants in Ismailia, Port-said and Damietta cities, during a period from October 2016 to September 2017. A total of 130 fecal samples were collected from sporadic cases and 60 abomasal samples and 36 small intestinal samples were collected from slaughtered animals in abattoirs to detect the adult nematode parasites. The results indicated that sheep was infected with 5 species of nematodes 3 in abomasum and 2 types in small intestine. The prevalence of the infection were 26.15%, 30% and 11.11% in faecal , abomasal. and small intestine samples respectively. The highest prevalence of the nematodes was in young animals (71.42% in ovine sp., 14.28% in bovine sp. and 0.0% in caprine sp). Higher prevalence was in male sheep 60% than ewe 30%. Damietta was the highest in prevalence (47.6%) then in Ismailia (29.16%) and 0.0% in Port-said. The most prevalent species of nematodes in abomasum was Haemonchus contortus (26.67%), Ostertagia sp. (10%) and Trichostrongylus axei (3.33%). In small intestine, were Cooperia sp. (11.11%) and Nematodirus sp. (5.56%). Faecal egg count reduction test was carried out on Ivomec super & Albendazole to demonstrate the efficacy of anthelmintics, and proved the Ivomec was more potent than Albendazole in treatment of GINs.
Comparative Study between Conventional and Custom Lasik Ablation in The Treatment of Myopic Astigmatism

Background: The popularity of laser-assisted in situ keratomileusis (LASIK) stems from its ability to treat a wide range of refractive errors with rapid visual recovery and minimal patient discomfort. The conventional treatment is a Munnerlyn based spherocylindrical ablation, Customized Ablation is a topography and wavefront guided ablation treating corneal high-order aberrations Objective: to evaluate the visual and refractive outcomes of customized ablation and conventional ablation in the treatment of myopic astigmatism. Patients and Methods: This randomized prospective comparative study was carried out on 60 eyes of 34 patients with compound myopic astigmatism (myopic sphere ≤ -10.0 D and myopic cylinder ≤ - 4.0D) with age range between 18 and 50 years at Al-Azhar University Hospital, Assuit and Al-Nahar Eye Centre, Assuit, between April 2018 and October 2018. These patients were divided into two groups: Group (1) included 30 eyes of 18 patients who had Standard LASIK ablation. Group (2) included 30 eyes of 16 patients who had WFG (Custom) LASIK ablation. Results: Regarding the refractive safety, both procedures were highly safe (all the patients maintained the preoperative BSCVA in the 6th month). It was obvious that the WFG LASIK was superior to the conventional LASIK in the visual outcome and this can be approved by applying the efficacy index for the procedures (mean postoperative UCVA/mean preoperative BSCVA), and it was 1.14 in the custom group and 0.97 in the conventional group in the 1st month. Improving the visual acuity after custom LASIK, in spite of similar refractive results (predictability) indicates that not only the defocus, but also the high order aberrations affect the final visual acuity level. Conclusion: the two procedures have high degree of safety, refractive stability and predictability but the custom LASIK is superior to the conventional LASIK.
Recurrent Meta-Structure for Robust Similarity Measure in Heterogeneous Information Networks

Similarity measure is one of the fundamental task in heterogeneous information network (HIN) analysis. It has been applied to many areas, such as product recommendation, clustering, and Web search. Most of the existing metrics can provide personalized services for users by taking a meta-path or meta-structure as input. However, these metrics may highly depend on the user-specified meta-path or meta-structure. In addition, users must know how to select an appropriate meta-path or meta-structure. In this article, we propose a novel similarity measure in HINs, called Recurrent Meta-Structure (RecurMS)-based Similarity (RMSS). The RecurMS as a schematic structure in HINs provides a unified framework for integrating all of the meta-paths and meta-structures, and can be constructed automatically by means of repetitively traversing the network schema. In order to formalize the semantics, the RecurMS is decomposed into several recurrent meta-paths and recurrent meta-trees, and we then define the commuting matrices of the recurrent meta-paths and meta-trees. All of these commuting matrices are combined together according to different weights. We propose two kinds of weighting strategies to determine the weights. The first is called the local weighting strategy that depends on the sparsity of the commuting matrices, and the second is called the global weighting strategy that depends on the strength of the commuting matrices. As a result, RMSS is defined by means of the weighted summation of the commuting matrices. Note that RMSS can also provide personalized services for users by means of the weights of the recurrent meta-paths and meta-trees. Experimental evaluations show that the proposed RMSS is robust and outperforms the existing metrics in terms of ranking and clustering task.
Diagnostic value of initial s-100b and neuron- specific enolase levels in diabetic patients with ischemic stroke

Diabetics have a high risk of ischemic stroke. The present study aimed at evaluating the diagnostic validity of immediate measurements of serum S-100B and NeuronSpecific Enolase (NSE) in comparison with neurological examinations and cerebral computed tomography (CT) findings in diabetic ischemic stroke patients. It also aimed at determining the possible influence of type 2 diabetes mellitus, either or not complicated with stroke, on serum levels of S-100B and NSE. Another objective of the current study was the determination of serum malondialdehyde (MDA) as an indicator of lipid peroxidation (LPO) to detect any possible correlation between LPO and S-100B or NSE. This cross sectional study included 66 subjects; 46 diabetic patients and 20 healthy subjects. Participants were classified into the following groups: Group I: 25 diabetic patients (type 2) with acute stroke. Group II: 21 uncomplicated controlled type 2 diabetic patients. Group III: 20 apparently healthy age and sex matched control subjects. Serum levels of S-100B and NSE were assessed by ELIZA technique. MDA levels were measured using a chemical method. Results of this work showed that the mean levels of serum S-100B and NSE in diabetic patients with cerebrovascular stroke were significantly higher than the corresponding mean values in uncomplicated diabetic patients and in control subjects (P < 0.001). Serum S-100 B levels in diabetic stroke patients showed significant positive correlation with the infarct size as assessed by the CT brain ( r = 0.9816 , P < 0.001 ). Similarly, serum levels of NSE correlated positively with infarct size (r = 0.9384, P < 0.001). No significant correlation was observed between levels of S-100B and NSE on one hand and glycemic control and duration of diabetes on the other. Also, MDA showed statistically significant elevation in diabetics with stroke compared to its corresponding values in uncomplicated diabetics and control groups (P < 0.001). In conclusion: Serum levels of S-100B and NSE correlated with the neurological clinical findings, as well as the infarct size as assessed by brain CT. So, S-100B and NSE measurements immediately after admission might help to reduce serial CT scans of the brain of ischemic stroke in diabetic patients. Future studies are recommended to follow the S-100B and NSE serum levels after thrombolytic therapy. Elevation of MDA in diabetic patients, which was significantly higher in diabetic patients complicated with stroke compared to uncomplicated diabetics, might direct the attention to further studies on the role of antioxidants in such patients.
Diagnostic Value and Prognostic Use of Presepsin Versus Procalcitonin in Sepsis

Background: Sepsis is a medical problem beyond belief despite the use of modern antibiotics and frequently updated guidelines on resuscitation therapies. It is at this crucial juncture where inflammatory biomarkers have been providing an incredible and easy way to detect sepsis. Various biomarkers have been used over the past decades in medicine to evaluate sepsis, each one better than the previous and having its own pros and cons. In this study, we assess the role of presepsin, which is a CD-14 polypeptide, and procalcitonin which has for some time been the inflammatory marker of choice in sepsis. This is the first study of presepsin as a sepsis biomarker in Indian adults. Methods: A prospective observational study was conducted in 48 patients who were diagnosed to have sepsis either on admission to the hospital or during their stay in hospital according to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) guidelines during the period from October 2015 to January 2017, after fulfilling all inclusion and exclusion criteria. Efficacy of both inflammatory markers was studied from blood drawn from the patient at the same time, with the same prick. Results: A total of 48 patients were included in this study. The superiority of presepsin over procalcitonin was evident with presepsin having a sensitivity of 46.2 and specificity of 100 and procalcitonin having a sensitivity of 46.2 and specificity of 31.8. The P value of the presepsin results was significant at <0.001. Along with it, presepsin also proved to be a very reliable marker for 28-day mortality with all 12 patients in the presepsin positive group expiring (P value: <0.001). Receiver operating characteristic (ROC) curve was plotted to try and define an optimal normal value for presepsin in an Indian population and the value calculated was 93.71 with a sensitivity of 65.4 and a specificity of 68.2. Conclusion: This study shows the superiority of presepsin over procalcitonin as it has much better specificity and a similar sensitivity than procalcitonin and is a better indicator of 28-day mortality. The new cut off that we have postulated here for presepsin improves the efficiency of the inflammatory marker by increasing its sensitivity at the cost of decreasing its specificity slightly.
Evaluation of the concurrent use of lidocaine and ketamine infusions as adjunctive analgesia in the intensive care unit

The purpose of this study was to determine the safety and effectiveness of ketamine and lidocaine infusions for the management of pain in surgical critically ill patients. This is a retrospective case series with a total of seven patients aged 18 years or older, had ICU stay at least 24 hours, and received concurrent use of systemic lidocaine and ketamine infusions as an adjunct therapy for pain management were enrolled between March 2014 to August 2015. The primary outcomes included the time measurement to achieve a 20% reduction in pain scores after the initiation of lidocaine and ketamine and the difference in opioid requirements pre and post concurrent pain therapies. Secondary outcomes include development of adverse events while on dual therapy. The median time to achieve a 20% pain score reduction was 2 hours. The median opioid requirements was reduced comparing prior to the ketamine and lidocaine infusions and 24 hours while on dual therapy (morphine dose equivalent 90.33 mg vs. 56 mg). Two neurological adverse events were noted. The results of this study suggest that low-dose lidocaine and ketamine infusions can be a safe and effective adjunctive treatment option for selected ICU patients with severe pain. However, future studies need to be conducted to determine the safety and effectiveness of concurrent use of lidocaine and ketamine infusions aside from surgical ICU patients.
Unintentional injuries and socio-psychological correlates among school-going adolescents in four ASEAN countries

Objectives: The study aimed to report the prevalence and socio-psychological correlates of non-fatal injury among school adolescents in four ASEAN countries. Materials and methods: Cross-sectional research data from the 2015 “Global School-based Health Survey (GSHS)” included 29,480 school adolescents (mean age 14.5 years, standard deviation=1.6) that were representative of all students in secondary school. Results: The proportion of participants with one or multiple serious past-year injuries was 36.9% (21.4% once and 15.4% multiple times). The most frequent cause of the reported injury was “I fell” (10.2%) and motor vehicle (5.8%) and the most common form of injury was “a broken bone or dislocated joint” (8.1%) and “cut, puncture or stab wound” (3.4%). In adjusted multinomial logistic regression analysis, male sex, experiencing hunger, substance use (alcohol, tobacco, cannabis, amphetamine and soft drinks), school truancy, participating in physical education classes and psychological distress were associated with one and/or multiple injuries. Parental or guardian support decreased the odds of one annual injury. Compared to students from Indonesia, students from Laos had a lower odd for injury and students from the Philippines and Thailand had higher odds for injury. Conclusion: Several variables, such as male sex, food insecurity, substance use, truancy, physical education and psychological distress, were identified that could be targeted in injury prevention programs in this school population.
Mikrobielle Einflüsse in der Tumorentwicklung und Tumortherapie

Zusammenfassung Viren und Bakterien spielen eine zentrale Rolle in der Entstehung von Malignomen im Gastrointestinaltrakt. So konnte bereits vor Dekaden eine Assoziation von Helicobacter pylori und dem Magenkarzinom sowie MALT-Lymphomen, und von Hepatitis-B- und C-Virus-Infektionen und dem hepatozellulären Karzinom nachgewiesen werden. Faszinierende Daten der letzten Jahre deuten jedoch einen weit über diese Zusammenhänge hinausgehenden Beitrag mikrobieller Erreger zur Karzinogenese im Gastrointestinaltrakt und der Leber an. So konnte gezeigt werden, dass Barriere-Defekte sowie Veränderungen in der Komposition der intestinalen Mikrobiota die kolorektale und hepatozelluläre Karzinogenese fördern. Darüber hinaus konnte die überraschende Beobachtung gemacht werden, dass die Mikrobiota nicht nur in lokaler Weise die Tumorentwicklung reguliert, sondern auch maßgeblichen Einfluss auf die Wirksamkeit systemischer Tumortherapien hat. Im vorliegenden Artikel sollen aktuelle Daten zur mikrobiellen Regulation der Tumorentstehung und der Beeinflussung systemischer Tumortherapien dargestellt werden und Implikationen für die klinische Diagnostik und Therapie diskutiert werden.
Fatores determinantes da anemia ferropriva no sexto mês de vida com ênfase na reserva de ferro ao nascer e tempo de clampeamento do cordão umbilical: um estudo de coorte

xix I INTRODUÇÃO . 1 II REVISÃO DA LITERATURA. 4 Panorama atual da anemia ferropriva . 4 Avaliação do estado nutricional de ferro . 8 Anemia ferropriva na infância e fatores associados . 12 III OBJETIVOS . 19 Geral . 19 Específicos . 19 IV CASUÍSTICA, MATERIAIS E MÉTODOS . 20 1) Casuística . 20 Desenho do estudo . 20 Seleção da amostra . 20 Caracterização da população . 22 2) Materiais e métodos . 22 Coleta de dados . 22 Avaliação antropométrica . 26 Avaliação bioquímica . 28 Avaliação dietética . 30 Análise dos dados . 31 Aspectos éticos . 32 VI RESULTADOS . 34
A Study on the Images Used in Sandplay Therapy by Children Who Experienced the Gyeongju Earthquake

The purpose of this study was to investigate the themes and images in the sandplay scenes of children who experienced the 2016 Gyeongju earthquake. The subjects of this study were children aged 3 to 6 years, and a total of four sessions of individual sandplay therapy was conducted once a week for 40 minutes per session. The children’s stories were collected and their behaviors were categorized into themes and symbols commonly expressed. We identified a total of seven themes: attack, confusion, protection, precious things, mourning, emptiness, and energy to change. Individual sandplay therapy with the children was found to have a positive effect on their psychological recovery. We observed a decreasing tendency to use figures of soldiers, weapons, and religious spiritual images as they stabilized and their need for protection diminished, while images of construction, building facilities, and treasure increased over time.