Miracle-dz/UniFAR-FTUs huggingface dataset:
Nutritional status of adolescent girls in rural area of Varanasi.

In order to assess nutritional status of adolescent girls this community based cross-sectional study was done on 270 adolescent girls of a rural area of Varanasi selected by adopting appropriate sampling technique. Nutritional status of study subjects was assessed on the basis of clinical examination anthropometry and hemoglobin estimation. On clinical examination Vitamin A deficiency pallor dental caries and Iodine Deficiency Disorders were present in 13.70% 25.90% 13.33% and 4.44% adolescent girls respectively. As per proposed Asian and previous WHO criterias 68.52% adolescents girls were undernourished (BMI<18.5). As much as 19.63% 17.78% and 31.11% subjects suffered from chronic energy deficiency (CED) grade I II and III respectively. The average weight height and MAC were 73.63% 91.98% and 82.81% of the corresponding estimated reference values. Overall 30.74% girls were anaemic (Hb<12g%). Anaemia was significantly more in non-menstruating girls and subjects not using footwear during defecation. (authors)
Changing student learning preferences: what does this mean for the future of universities? Trish Andrews Teaching and Educational Development Institute (TEDI) The University of Queensland

Learner preferences appear to be changing and there is some evidence that students are seeking a different kind of learning experience than currently commonly available. This paper provides a brief discussion of changing student learning preferences and suggests that these are being driven by the accessibility and characteristics of available and emerging technologies, rather than by technological determinism. The paper also suggests that, in many ways, the majority of higher education institutions are ill-prepared for these changes and that a gap is emerging between student expectations and student experience. It is proposed that students are looking for more connected and mobile learning opportunities and that ‘loose networks’ are playing an increasingly important role in supporting learning. The paper discusses the implications these changes have for institutions and suggests that while universities face challenges they also have choices.
Surgical treatment of secondary hyperparathyroidism

Aim: Initial treatment of secondary hyperparathyroidism (sHPT), often seen as a result of end-stage renal failure, is medical treatment. Treatment-resistant patients require surgery. The aim of this study is to evaluate the diagnosis and treatment of patients who underwent sHPT. Material and Methods: Twenty-one patients who were operated for sHPT were included in the study. The demographic data of the patients and correlation of imaging results with correct localization and pathological diagnosis were evaluated. Results: The mean age of the patients was 45.80±1.10. While the number of patients with growth in a parathyroid gland was 7 (32%), the number of patients with multiple glands was 8 (39%). According to scintigraphy evaluation, the same values were 4 (19%) and 12 (57%) patients. 7 (34%) patients were underwent adenoma excision, 11 (52%) patients were underwent subtotal parathyroidectomy and 3 (14%) patients were underwent total parathyroidectomy + parathyroid auto-implantation. Persistent hyperparathyroidism was seen in 2 patients who underwent subtotal parathyroidectomy and 1 patient who underwent adenoma excision. Conclusion: Today, the treatment of sHPT is still the best treatment option, and as a treatment, subtotal parathyroidectomy and total parathyroidectomy + parathyroid autoimplantation surgery should be preferred.
Surgical Treatment of Complete Acromioclavicular Joint Dislocation

Seventy-eight of 95 consecutive patients who had been treated for complete acromioclavicular dislocation (Allman Type III) with either modified Phemister method (73 cases), Bosworth method (3), or Mumford procedure (2) were followed for an average of 4.2 years. The major cause of this injury was car accident. Using the Imatani evaluation system, the overall results were excellent and good in 41 and 25 patients respectively. The satisfactory result was 84.7% Although complicatoins were not uncommon (15.4%), but most were minors; lateral migration (5 cases), broken wires (3), and one screw loosening. Post-traumatic osteoarthritis were noted in 6 patients and subluxation in two. Our treatment for complete acromioclavicular dislocation (Allman Type III) is surgical intervention, especially in young and active patients, severely displaced patients, and overhead workers.
Tuberculosis in Foot and Ankle

Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months (6~24 months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months (6~36 months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Bröstrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.
EPIDEMIOLOGIC APPROACHES TO UNDERSTANDING GONORRHEA TRANSMISSION DYNAMICS AND THE DEVELOPMENT OF ANTIMICROBIAL RESISTANCE

Globally, the incidence of infection caused by Neisseria gonorrhoeae is the second highest among the bacterial sexually transmitted infections. In Canada, declining rates during the 1990s suggested progress toward curbing gonorrhea; however, those have been increasing since 1999, with rates in Saskatchewan among the highest in the country. Infection can cause serious complications in men and women, and reported resistance to third-generation cephalosporins could lead to potentially untreatable infections. Increased understanding of gonorrhea transmission dynamics, sexual networks, and predictors of antimicrobial resistance development is needed to inform the development of improved approaches to prevention and treatment. The research presented herein draws upon data from Shanghai, China, and Saskatchewan, Canada, to compare and contrast varying epidemiologic approaches to enhancing understanding of gonorrhea in the two settings. Using traditional statistical approaches, multi-level statistical modeling, social network analysis, and dynamic simulation modeling, questions related to sexual behavior, partner presentation, and antimicrobial resistance development are explored. Each technique is evaluated for its potential contribution to overall understanding of the issues related to the ongoing gonorrhea epidemic, globally, and in Saskatchewan. The relative strengths and limitations of the application of the analytical approaches in the different settings are described. Socio-demographic characteristics provided useful indicators of antimicrobial resistant infection among patients with gonorrhea from Shanghai. Further, socio-demographic characteristics were also useful for predicting presentation of a partner for testing and treatment and the use of condoms during intercourse, among this study population. In Saskatchewan, socio-demographic characteristics were useful in predicting coinfection with gonorrhea and chlamydia at the time of diagnosis as well as repeat infection with gonorrhea. Social network analysis of the Saskatchewan dataset provided little additional understanding of the gonorrhea epidemic in the province. This result was largely related to how STI data are collected and stored in the province. The utility of dynamic simulation modeling to investigate the potential impact of antimicrobial resistance in Saskatchewan was also limited due to the same data constraints. However, the insight gained from the model building process and findings from the working model did offer a starting point for conversations around the best ways to postpone the development of antimicrobial resistance in N. gonorrhoeae in Saskatchewan, as well as contribute additional information about how the ways in which STI data are collected and stored in the province considerably restrict the applicability of otherwise powerful epidemiologic tools. With persistently high rates of disease transmission, and the threat of untreatable infections due to antimicrobial resistance, N. gonorrhoeae remains a substantial public health threat…
CHRONIC MONTEGGIA FRACTURE-DISLOCATION IN CHILDREN SURGICAL STRATEGY AND RESULTS

ABSTRACT Objective: To report surgical techniques and results in the treatment of chronic Monteggia fracture-dislocation in children. Methods: Six pediatric patients who had undergone a procedure involving the following 6 crucial surgical steps were retrospectively evaluated: 1- extended lateral approach, 2- fibrotic removal, 3-proximal ulnar osteotomy, 4- reduction of the radial head and transcapitellar temporary fixation, 5- ulnar fixation with a straight plate shaped according to the deformity generated by temporary fixation, and 6- transcapitellar Kirschner wire removal. Results: Four patients were women, and four showed the right-sided compromise. The mean age of patients was 8 years, and the minimum follow-up period was 12 months. The mean time from the onset of fracture to treatment was 6 months. Six patients underwent complete flexo/extension, and one patient had a complete prono-supination. In four patients, we observed loss of pronation (by 10° in two, 15° in one, and 20° in one), and one patient had a 15° decrease in supination. We did not observe any redislocation of the radial head in the follow-up evaluation. No complications were observed; the only complaint was salience of the ulnar plate. Conclusions: Our results demonstrated an effective option for the treatment of chronic Monteggia fracture-dislocation in children, even with a small study sample, following the presented technical and surgical strategies. Level of evidence IV, Therapeutic Studies.
Effect of Age on Heart Rate Variability Analysis in Breast Cancer Patients

Breast Cancer (BC) is the leading cause of death in women, worldwide. The Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of BC can be studied using HRV measures. The main purpose of this chapter is to give an insight to clinicians via HRV measures with respect to age to make them understand the PS of patients. Data from 114 BC patients was segregated into two age groups, G1 (20 to 40 years) and G2 (41 to 75 years). The 5-minute electrocardiogram of the subjects was taken and HRV measures were extracted. One-way ANOVA with Posthoc Tukeys’ HSD test was done. Triangular Index, Ratio of standard deviation of poincare plot perpendicular to the line of identity to the standard deviation along line of identity, Detrended Fluctuation Analysis descriptors, Approximate Entropy, Effect of Age on Heart Rate Variability Analysis in Breast Cancer Patients: Heart Rate Variability in Breast Cancer
OUTPATIENT REGISTRY OF CARDIOVASCULAR DISEASES (RECVASA): PROSPECTIVE FOLLOW-UP DATA, ESTIMATION OF RISKS AND OUTCOMES IN PATIENTS WITH ATRIAL FIBRILLATION

Aim. To evaluate outcomes and risk of their occurrence in patients with atrial fibrillation (AF) within 12 months of follow-up in actual outpatient practice. Material and methods. A total of 3690 patients with AF, arterial hypertension (HT), ischemic heart disease (IHD) and chronic heart failure (CHF) consulted by general practitioners and cardiologists of three outpatient clinics of Ryazan, were enrolled into the outpatient REgistry of CardioVAScular diseAses (RECVASA). 530 of 3690 (14.4%) patients had the diagnosis of "atrial fibrillation" in their outpatient charts. Estimation of the end points within 12 months after inclusion into the registry was performed based on the data received from the contacts with patients or a documented fact of death. Results. 39 (7.4%) patients had died during this period [30 (76.9%) of them due to cardiovascular causes], 18 (3.4%) – had undergone stroke, 3 (0.6%) – myocardial infarction, 2 (0.4%) patients had cardiovascular surgery. There were 63 hospitalizations due to cardiovascular diseases (CVD). AF did not lead to significant increase in cardiovascular death risk [odds ratio (OR)=1.31, p=0.21] and stroke risk (OR=1.64, р=0.09) within 12 months after inclusion into the registry, but the risk of hospitalization due to CVD was significantly higher(OR=2.88, р=0.0001). Permanent AF significantly increased the risk of stroke (OR=2.07, р=0.04). Such factors as diabetes, prior stroke, systolic blood pressure (SBP)<110 mm Hg and heart rate (HR)≥90 bpm significantly increased all-cause death risk (OR=2.49, р=0.008; OR=2.46, р=0.01; OR=7.6, р=0.003; OR=15.3, р=0.01, respectively). Patients treated with ACE inhibitors or angiotensin receptor blockers (ARB) had lower all-cause and cardiovascular death risks: OR=0.38, р=0.01 and OR=0.25, р=0.02, respectively. Other drugs revealed no significant influence on prognosis. Conclusion. According to the outpatient registry RECVASA data such factors as permanent type of AF, diabetes mellitus, prior stroke, SBP<110 mm Hg and HR≥90 bpm, ACE inhibitors/ARB prescription significantly influenced prognosis in patients with AF. Estimating outcomes in AF patients, combination with HT, IHD, CHF and non-cardiac comorbidities must be taken into account as well as peculiarities of these diseases drug treatment.
ANALISIS JALUR HUBUNGAN DURASI TIDUR DAN ASUPAN PROTEIN PADA IBU HAMIL ANEMIA DENGAN KEJADIAN BERAT BAYI LAHIR RENDAH

Anemia is highly prevalent among Indonesian community, especially in pregnant women. Sleep duration and poor sleep patterns when someone is pregnant mayincrease therisk factors that affect the outcome of pregnancy. Protein requirements for pregnant women will increase as increasing gestational age. Lack of protein intake maycause low birth weight.The purpose of this study was to analyze the correlationof sleeping duration and protein intake in anemic pregnant women with the incidence of low birth weight babies.The study used a case control design. The subject of the study was anemic pregnant women in Sukoharjo who have been gaving birth from 2016 to 2018. Subjects wereselected using purposive sampling. Case was those who delivered normal baby’s weight and case was those who delivered low bird weight baby. 74 subjcts were in control group and 37 subjects were in case group.Sleeping duration was measured during sleep at night per hour and the quality of sleeping using PSQI from. Path analysiswasused to evaluate the association.The results showed that the association of sleeping duration of anemic pregnant women with incidence of LBW was not significant (p=0,285); protein intake withincidence of LBW was significant (p=0,019), and sleep quality anemic pregnant women with incidence of LBW was not significant (p=0,379). There is no significant direct and indirect associations (through sleep quality) of sleeping duration among anemic pregnant women withincidence of LBW, there is a significant associationof protein intake in anemic pregnant women with incidence of LBW, and there is no significant indirect association (through sleep quality) of protein intake in anemic pregnant women with incidence of LBW babies.
Adolescent motherhood: problems and consequences.

An estimated 13 million female adolescents under age 18 years in India are married especially in the 4 larger northern states of the country. The widespread existence of the phenomenon of early marriage throughout much of India reflects the cultural norm encouraging married couples to bear and raise many sons to provide for the security and well-being of parents throughout their later years; parents can maximize the production of offspring by starting early. Not only are these young women subject to this traditional outlook on child wealth they are also overwhelmingly ignorant about family planning methods. The authors recommend providing young women in India with educational and economic alternatives and incentives to bearing children early in the course of their reproductive lives. In so doing fertility will decrease and with it the rate of maternal mortality. Improvements in child survival will also result. Since early marriage is strongly related to the schooling of girls especially those aged 10-14 years it is further suggested that the education of girls be made compulsory up to the 10th standard.
Quimioterapia intensiva con cuatro farmacos y trasplante autogenico de celulas progenitoras de sangre periferica en el cancer diseminado de mama

OBJECTIVE To evaluate the therapeutic efficacy (in terms of overall survival [OS] and progression-free survival [PFS]) of a high-dose chemotherapy protocol including four drugs and peripheral stem cell rescue (PSCR) plus posttransplant G-CSF (filgrastim) in disseminated breast cancer patients. PATIENTS AND METHODS Fifty-three metastatic breast cancer patients were treated with a four-drug program of high-dose chemotherapy including cyclophosphamide (6 g/m2), thiotepa (500 mg/m2), carboplatin (800-1,600 mg/m2) and mitoxantrone (20-60 mg/m2) with autologous peripheral blood progenitor cell support followed by filgrastim. Most cases (92%) had previously received conventional induction chemotherapy with anthracycline-containing combinations. RESULTS After a median follow-up of 27 months (range 12-43 months) from transplant, the median survival of the overall group was 25 months, with an OS projected at 43 months of 31%. Patients in complete remission after induction chemotherapy or status NED (no evidence of disease: surgical resection of metastases) presented the best outcome, with a projected PFS of 50% at 43 months. Patients intensified without complete response had a poor outcome. The most important extramedullary toxicity was mucositis. Four patients (7.5%) died as a consequence of treatment (2 with sepsis-associated ARDS, one with venooclussive disease of the liver, one with congestive cardiac failure). CONCLUSIONS The outcome of metastatic breast cancer patients in complete remission after induction chemotherapy or NED status seems to be good with our high-dose chemotherapy including four drug and PSCR. On the other hand, patients intensified without complete response presented a bad outcome and do not seem candidates for future trials with this therapeutic approach.
Oral Propranolol: A Corner Stonein the Therapeutic Strategy ofInfantile Haemangiomas

Oral Propranolol: A Corner Stone in the Therapeutic Strategy of Infantile Haemangiomas Infantile hemangiomas are the most common tumors of childhood. Despite their benign and self-limited nature, some hemangiomas can cause complications such as ulceration or life-altering disfigurement. In addition, they may compromise vital organ function, or herald underlying developmental anomalies of the central nervous system or spine [1]. Until recently, high-dose steroid therapy was the mainstay treatment for problematic proliferating infantile hemangioma [2]. Whilst corticosteroids are effective, they are associated with significant adverse effects as cushing syndrome, growth retardation, hirsutism, hypertension, and immunosuppression [3]. Interferon alpha is a potent inhibitor of angiogenesis that can be used in the treatment of infantile hemangiomas [4]. However, its reported severe neurotoxicity, including spastic diplegia, limits its use to cases with life-threatening hemangiomas that have not responded to other forms of treatment [5]. Vincristine was initially used in the treatment of the Kasabach-Merritt phenomenon [6]. Moreover,it is used as an alternative therapy for glucocorticoid-unresponsive, lifethreatening, or severely life-altering hemangiomas[7]. Pulsed dye laser therapyis another treatment option that was found to be beneficial for select infantile hemangiomas including those with small superficial, ulcerated, or involuting lesions [8,9]. In 2008, a French group accidently observed accelerated involution of large facial hemangiomas in two infants following treatment with propranolol for heart failure [10]. These favorable results led to the initiation of some case reports and observational studies to evaluate the efficacy of propranolol in the treatment of proliferating infantile hemangioma [11-14]. To date, the mechanism of action of propranolol on infantile hemangioma is not clear [15]. Moreover, there are some concerns about the potential complications with propranolol usage. The most frequently reported serious side effects were asymptomatic hypotension, asymptomatic bradycardia[16], pulmonary symptoms related to blockade of adrenergic bronchodilation [17], hypoglycemia [17], and hyperkalemia [18]. The most commonly reported non potentially life-threatening side effects were sleep disturbances including nightmares, somnolence, cool or mottled extremities, diarrhea, and gastroesophageal reflux/upset [19].
Implementation of a rehabilitation nursing homecare program in patients with chronic obstructive pulmonary disease

5 INTRODUCTION AND BACKGROUND OVERVIEW . 5 1. AIMS AND WORKING HYPOTHESES . 6 1.1. SPECIFIC OBJECTIVES . 6 1.2. MAIN EVENT AND HYPOTHESES SECONDARY . 7 2. METHODOLOGY . 7 2.1. DESIGN . 7 2.2. POPULATION . 7 2.3. VARIABLES . 7 2.4. INSTRUMENTS . 8 2.5. METHODS . 8 2.6. STATISTICAL PROCEDURES . 9 3. RESULTS . 9 3.1. CHARACTERIZATION OF THE POPULATION . 10 3.2. DIFFERENT EVALUATION MOMENTS . 13 4. DISCUSSION . 18 5. CONCLUSIONS . 21 6. REFERENCES . 22 7. ANNEX I – DATA COLLECTION INSTRUMENT . 24 8. ANNEX II – INFORMED CONSENT . 28 9. ANNEX III – OPINION OF THE ETHICS COMMITTEE . 30 10. ANNEX IV – LEAFLET ON THERAPEUTIC EXERCISES . 31 11. POSSIBILITIES OF CONTINUATION OF DESIGN AND CLINICAL APPLICATION . 32 12. PUBLICATIONS OF THE PROJECT . 32 IMPLEMENTATION OF A REHABILITATION NURSING HOMECARE PROGRAM IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE | 5
Hyperlipidemia in Coronary Heart Disease

A B S T R A C T Plasma cholesterol and triglyceride levels were measured after an overnight fast in 500 consecutively studied 3-mo survivors of myocardial infarction. Virtually all patients under 60 yr of age (95% ascertainment) and a randomly chosen group of older survivors admitted to 13 Seattle hospitals during an 11 mo period were included. A comparison of their lipid values with those of 950 controls demonstrated that 31% had hyperlipidemia. These lipid abnormalities were most commonly found in males under 40 yr of age (60% frequency) and in females under 50 yr of age (60% frequency). Elevation in triglyceride levels with (7.8%) or without (15.6%) an associated elevation in cholesterol levels was three times more common in survivors than a high cholesterol level alone (7.6% ). These results raise the possibility that hypertriglyceridemia may be as an important a risk factor for coronary atherosclerosis