Miracle-dz/UniFAR-FTUs huggingface dataset:
Outline for setting up acute postoperative pain service for Indian Hospital

Majority of Indian hospitals still lack the provision of acute postoperative pain relief service. In other parts of the world, field of acute pain management strategy has witnessed a surge in its implementation. Today, acute pain has begun to be recognized not merely as a distressing symptom but also as a precursor of chronic, debilitating pain. This development warrants that we in India address this issue on an urgent basis through the use of analgesic/narcotic combination via parenteral/oral/rectal route as well as by performing regional blocks, to meet the interpatient variability and available facility. In this review article, we have provided the organization and function of acute pain service (APS) program that can be adapted to a wide spectrum of Indian hospitals. We have outlined the role of APS team including the use of easily available analgesic/narcotic drug combinations for various categories of Indian hospitals dealing with different grades of surgical conditions, including those hospitals that are not sufficient in resources and funding. This article has also tabulated possible regional block techniques with their indications for treating acute postoperative pain in combination with parenteral/oral/rectal analgesics/narcotics in the more developed Indian hospitals. Staffing and equipment requirements have also been outlined.
Early cleft lip and palate repair: Experience of the National Orthopedic Hospital Enugu, Southeast Nigeria

Background: Surgical treatment of clefts during infancy poses a challenge for the plastic surgeon and anesthetists. The timing of the procedures has been fraught with controversies with no consensus. Due to the many different treatment philosophies, the timing of treatment varies among cleft centers. Historically, anesthetic risk-related data suggest that the safe time period for surgery in this population of infants could be outlined by the rule of 10's. However, more sophisticated pediatric techniques and advances in intraoperative monitoring and pediatric anesthesia have resulted in the provision of safe general anesthesia for younger infants. This article attempts to provide an audit of the outcome and complications of cleft lip/palate repair performed earlier than the hitherto defined period. Aims/Objectives: The aims of the study were to evaluate the perioperative safety profile of early cleft lip and palate repairs and to evaluate early postoperative surgical complications. Materials and Methods: A retrospective audit of all patients that had early cleft lip and palate repair at the National Orthopedic Hospital Enugu, Nigeria, between May 2006 and May 2014. Early cleft lip and palate repairs were defined as repair done before 10 weeks and 9 months, respectively. Information was obtained from the folders of the patients and the smile train express database. The anesthetic technique was general anesthesia with endotracheal intubation and halothane as the inhalational agent. Armored tubes were used for palatal repairs. The Mohler's technique and Mulliken's technique were used for unilateral and bilateral lip repair, respectively. Intravelar veloplasty ± relaxing incisions/Bardach two-flap palatoplasty were used for palate repairs. All the procedures were carried out by one consultant plastic surgeon. Results: Four hundred and ninety-three cleft-related surgeries were performed in the period. Forty-one were early cleft lip/palate repairs. Thirty-one of these early procedures were done on the lip, whereas ten procedures were on the palate. There were no mortalities. One patient (2.4%) developed anesthetic complication (prolonged recovery time). There was neither need for intra- nor postoperative transfusion. One patient had a need for supplemental oxygen therapy beyond 1 h. There was no need to take any patient back to theater. The most common early complications following lip and palate repairs were wound dehiscence and palatal fistulae, respectively. Conclusion/Recommendation: These procedures can be safely carried out when performed early. The surgical complication rates appear to be few following early procedures. Further study on long-term cleft repair on facial growth and speech needed.
Gastropericardial fistula: a case report

Rationale: Gastropericardial fistula is a rare condition in which the patient presented with chest pain, dyspnea, tachycardia, pneumo/hydropericardium, or pericarditis. Alcohol intake or previous history of gastroesophageal surgery made the patient susceptible to fistula formation. Patient concerns: An 80-year-old male complained of sudden onset of dyspnea and respiratory distress. Nausea, hematemesis, and constipation were noted on clinical examination. Diagnosis: Herniation of the gastric fundus and massive pneumopericardium due to formation of fistula in the lesser curvature. Interventions: Urgent surgery was performed. Outcomes: The patient was discharged without any complication. Lessons: Although the lethal form of this condition is rare, gastroepicardial fistula should be included in the differential diagnosis workup of cases with stomach cardia and fundus ulceration.
Maternal factor effect on the infants with cleft lip and cleft palate: A case–control study

Objectives: Oral clefts are the most common congenital abnormalities that have various causes. The aim of this study was to investigate maternal factors influencing the event of this disease among newborns. Methods: This study was a case–control research. To investigate the effects of maternal factors on cleft lip and palate, medical records of 26 infants with cleft lip and palate as well as those of 52 healthy infants without this abnormality born in Qamar Bani Hashem Hospital in Khoy during 2015–2017 were studied. The required data were collected through interviews and reviewing their medical records. Results: The odds ratio of having a baby with cleft lip and cleft palate among mothers with a history of using cosmetics, being at a high age, use of psychiatric drugs, passive smoking, family history of the disease, and use of analgesics were, respectively, 1/9 (confidence interval [CI] =1.03–4.2), 2/2 (CI = 1.01–4.1), 1/7 (CI = 1.1–4.8), 2/08 (CI = 1.2–5.1), 2/8 (CI = 1.3–5.2), and 1/5 (CI = 1.01–4.9) times as much as the mothers of healthy infants. Conclusion: Lifestyle modification is the important factor in the prevention of cleft lip and cleft palate. Inclusion of preventive programs in prenatal maternal care programs may prevent or reduce the incidence of this disease.
Anxiety, depression, and suicidal ideations among patients with dermatological problems

BACKGROUND: High comorbidity is seen in psychiatric illness and dermatological problems ranging between 21% and 43%, which could be due to cosmetic impact/body image perception/disfigurement due to disease per se; majority of the cases go undetected due to overshadowing of mental illness by physical ailment, stigma, or improper assessment. The present research attempted to evaluate the comorbidity of anxiety, depression, and suicidal ideations among dermatological conditions METHODS: A population-based cross-sectional study with consecutive sampling was conducted in the outpatient department of a dermatology clinic. The Primary Care Evaluation of Mental Disorders (Patient Health Questionnaire-9 and Generalized Anxiety Disorder- 7) was used to assess the presence of psychiatric symptoms in these patients. RESULTS: A total of 1076 patients were included in the study, with age ranging between 10 and 82 years. Females had significantly more depression, anxiety, and suicidal ideation among individuals suffering from dermatitis. Males had significantly more anxiety among individuals suffering from lichen simplex chronicus. Females had significantly more depression and suicidal ideation among individuals suffering from hair disorders. Overall, 22% of individuals had suicidal ideation, of which 4.2% had active suicidal ideations. CONCLUSION: Significant active suicidal ideations were observed among individual dermatological conditions. Female reported having more depressive symptoms with no gender difference in anxiety disorder.
Reflected images processing and the diseases of the brain

OBJECTIVES: The objective of the study reflected image processing defects in patients with dementia. PATIENTS AND METHODS: Patients with memory complaint with Hindi Mental Status Examination (HMSE) score of 20 seen in the last 5 years were evaluated for mirror agnosia and mirror‐image agnosia. Visual acuity was checked and corrected. A 45 cm × 45 cm plain mirror was used. It was kept at 30‐cm distance from the patient. Their ability to recognize the mirror was confirmed. They were asked to identify reflected objects, ornaments, dress, self‐image, image of caregiver, and two each of famous, smiling, crying, and novel faces. RESULTS: A total number of patients with memory complaint were 512 and vascular dementia were 211. Others = 301 patients who had features suggestive of apraxia and agnosias = 69. Among the 69 patients, 65.2% were male and 34.8% female, mean age was 62.5. Disease wise distribution is frontotemporal dementia: 24.64%. Vascular dementia: 21.84%. Alzheimer’s disease (AD): 20.29%. Unclassified: 14.49%. Mixed: 14.49%. diffuse Lewy body disease : 2.89%. Cortico basal degeneration syndrome (CBGD): 1.45%. The pattern of reflected image processing abnormality is mirror agnosia: 9 patients. Mirror‐image agnosia: 11 patients. CONCLUSIONS: Patients with AD showed wide variety of apraxias and mirror agnosia. Those with mirror‐image agnosia did not show apraxias. In both groups, females were dominated. There is a clear delineation of features in patients with mirror agnosia and mirror‐image agnosia. Mirror‐image and mirror agnosia in degenerative dementias are not reported in the literature.
Comparison of inhibitory effect between DL–tryptophan and lactoferrin on Pseudomonas aeruginosa biofilm formation in wound dressing

Objective: To compare the inhibitory effect between DL-tryptophan and bovine lactoferrin on biofilm formed by isolated Pseudomonas aeruginosa strains. Methods: The study was carried out on 40 patients suffering from surgical site infection. Wound pus was collected using sterile swabs after isolation, and identified by common bacteriological methods. Isolated Pseudomonas aeruginosa strains were grown on biofilm enhancing materials, and then the inhibitory effects of different concentrations of DL-tryptophan and lactoferrin were tested using scanning electron microscopy and microtitre plate methods. Results: There was no significant difference in the inhibitory effect between DL-tryptophan and lactoferrin at 0.5 mg/mL. While in concentration of 1 mg/mL and 2 mg/mL, tryptophan showed more significant inhibitory effect than lactoferrin. Conclusions: Both DL-tryptophan and bovine lactoferrin have inhibitory effect on Pseudomonas aeruginosa biofilm formation in a dose dependent manner, and the inhibitory effect of DL- tryptophan is stronger.
High Internet awareness and proficiency among medical undergraduates in Nigeria: A likely tool to enhance e-learning/instruction in Internal Medicine

Background/Objective: The emergence of the Internet several decades ago has brought global revolution in a lot of processes even among developing nations, including educational processes. We assessed the familiarity of the medical students with Internet tools and their preparedness with integrating e-learning into Internal Medicine teaching methods. Materials and Methods: A cross-sectional survey of two graduating medical classes of College of Medicine, using structured self-administered questionnaire, was carried out. The survey assessed the knowledge, utility, and application of Internet tools in medical education using five-point Likert scale. Results: A total of 227 (75%) of the cohort of 292 students responded, comprising 150 (66.1%) males and 77 (33.9%) females. The median age was 24 years (Interquartile range, 23–26 years). Of these, 219 (96.5%) owned Internet-enabled devices, whereas 104 (46.2%) had formal training on the use of computers. Two hundred and twenty-two (97.8%) could access the Internet, with Google and Twitter accounts being the highest and the least used tools, respectively. Two hundred and twenty five (99%; mean rating 4.5 on a scale of 5) indicated that Internet tools were useful in teaching Internal Medicine, specifically in the areas of lectures, assignments, and interaction with experts globally. The key benefits were utility as a regular self-assessment tool and flexible learning schedule (mean rating, 4.0, respectively). Overall, 213 (93.8%) suggested that the use of Internet tools and e-learning should be incorporated into the traditional method of teaching. Challenges with its use included cost of accessing the Internet (n = 126; 55.5%), lack of facility with adequate technology (n = 115; 50.7%), and availability of Internet (n = 96; 42.3%). Conclusion: Undergraduate medical students in our setting are familiar with the Internet and its potential utility for learning and undergraduate teaching of Internal Medicine.
Internet addiction and its associated factors: Study among the students of a public health school of Kolkata

INTRODUCTION: The Internet has brought a wealth of information and has turned to be an important tool for education, entertainment, and communication. However, aspects such as ease of access and social networking have led to addictive behavior. MATERIALS AND METHODS: An institution-based study was conducted among 147 students of a public health school in Kolkata from October to November 2017. A self-administered questionnaire was used to collect the data on demographic characteristics and the pattern of Internet use, and the assessment of Internet addiction (IA) was done using the validated Young's IA Test. Data entry and analysis was done using SPSS version 16.0. All those who scored more than 30 were considered as IA. RESULTS: Of 147 students, 44.2% were found to have some degree of IA. Mean age (standard deviation) of the students was 27.9 (5.9) years and 74.8% of the respondents were females. Most students (92.5%) accessed the Internet from their mobile phones and 33.3% have reported to have permanently online login status. Majority (82.3%) have reported social networking as a reason for Internet use. It was found that students with factors such as age group of 27–33 years, male sex, single status, residing away from home, low physical activity, permanently online status, social networking, and accessing the Internet for entertainment were more addicted to the use of Internet. CONCLUSION: The findings suggest a need for students to indulge in outdoor activities. Interacting with people socially rather than being active on social networking sites and involvement in other recreational activities will help alleviate their dependence on the Internet.
An Investigator Unearths Illegal Behavior via a Subliminal Channel

With the rapid development of the Internet, the number of criminal cases has greatly increased. Therefore, determining how to avoid and reduce illegal behaviors has become an important issue. For example: illegal insider trading of enterprises, commercial spying, etc. Illegal insider trading occurs when somebody in an enterprise trades based on non-public information obtained during the performance of the insider’s duties at the corporation, or in breach of a fiduciary or other relationship of trust and confidence, or where the nonpublic information was misappropriated from the company. In this paper, we propose a novel scheme to protect investigators’ safety and ensure the security of the collected evidence via a subliminal channel. We use a cryptographic mechanism to solve the replay attack, forgery attack, non-repudiation, untraceable and authentication issues. Our scheme not only protects investigators’ identity and safety but also constitutes a fair arbitration mechanism.
Marine Collagen as A Promising Biomaterial for Biomedical Applications

This review focuses on the expanding role of marine collagen (MC)-based scaffolds for biomedical applications. A scaffold—a three-dimensional (3D) structure fabricated from biomaterials—is a key supporting element for cell attachment, growth, and maintenance in 3D cell culture and tissue engineering. The mechanical and biological properties of the scaffolds influence cell morphology, behavior, and function. MC, collagen derived from marine organisms, offers advantages over mammalian collagen due to its biocompatibility, biodegradability, easy extractability, water solubility, safety, low immunogenicity, and low production costs. In recent years, the use of MC as an increasingly valuable scaffold biomaterial has drawn considerable attention from biomedical researchers. The characteristics, isolation, physical, and biochemical properties of MC are discussed as an understanding of MC in optimizing the subsequent modification and the chemistries behind important tissue engineering applications. The latest technologies behind scaffold processing are assessed and the biomedical applications of MC and MC-based scaffolds, including tissue engineering and regeneration, wound dressing, drug delivery, and therapeutic approach for diseases, especially those associated with metabolic disturbances such as obesity and diabetes, are discussed. Despite all the challenges, MC holds great promise as a biomaterial for developing medical products and therapeutics.
Comparative Transcriptomic Analysis Reveals Molecular Profiles of Central Nervous System in Maternal Diapause Induction of Locusta migratoria

Egg diapause in Locusta migratoria L. (Orthoptera: Acridoidea) is believed to be influenced by maternal photoperiod. However, the molecular mechanism regulating the phenomenon of maternal diapause induction is unclear. Here we performed transcriptomic analyses from the central nervous system (CNS) of migratory locusts under long and short photoperiods to identify differentially expressed genes (DEGs) related to diapause induction. There were total of 165750 unigenes from 569491 transcripts, and 610 DEGs were obtained in S_CNS (CNS of short photoperiod treated locusts) vs. L_CNS (CNS of long photoperiod treated locusts). Of these, 360 were up-regulated, 250 were down-regulated, and 84 DEGs were found to be related to FOXO signaling pathways, including citrate cycle/TCA cycle, glycolysis/ gluconeogenesis, oxidative phosphorylation, and PI3K-Akt. The qRT-PCR validation of mRNA expression of 12 randomly selected DEGs showed consistency with transcriptome analysis. Furthermore, the takeout gene thought to be involved in circadian rhythm was cloned and used for RNAi to observe its function in maternal diapause induction. We found that the mRNA level of Lm-takeout was significantly lower in dstakeout treatments as compared to the control under both long and short photoperiods. Similarly, the offspring diapause rate was significantly higher in dstakeout treatment as compared to the control only in short photoperiod. This shows that the Lm-takeout gene might be involved in the inhibition of maternal diapause induction of L. migratoria under short photoperiods. The present study provides extensive data of the CNS transcriptome and particular insights into the molecular mechanisms of maternal effects on egg diapause of L. migratoria. As well for the future, the researchers can explore other factors and genes that may promote diapause in insect species.
Clostridium difficile Infection in the Emergency Department

Introduction: Clostridioides difficile infection (CDI) is associated with substantial emergency department (ED) and inpatient burden. To date, few studies have evaluated the ED burden of CDI. Using the Nationwide Emergency Department Sample, we evaluated trends in ED use, ED and inpatient charges, admission and mortality rates, length of stay, and independent risk factors for hospital admission and mortality after an ED visit. Methods: Using Nationwide Emergency Department Sample for 2006 through 2014, we identified all patients with the primary diagnosis of CDI (using diagnostic codes). We determined the trends in ED visits and used survey logistic regression analysis to identify factors associated with hospital admission. Results: Overall, 909,236 ED visits for CDI resulted in 817,935 admissions (90%) to the hospital. The number of visits increased from 76,709 in 2006 to 106,869 in 2014, and the admission rate decreased from 92.4% to 84.4%. ED charges adjusted for inflation went up from US$1433.0 to 2900, a significant rise even accounting for inflation. The overall length of hospital stay decreased from 7 to 5.8 days. Independent predictors of admission after ED visits included smoking, use of alcohol, and presence of multiple comorbidities. Independent risk factors for mortality in admitted patients include increasing age and presence of comorbidities. Conclusions: Although ED use for CDI increased, rates of hospital admission decreased over 9 years. Identification of predictors of admission and in-hospital mortality will help guide policies and interventions to reduce the burden on health care resources.
Detection and Molecular Identification of Salmonella Virulence Genes in Livestock Production Systems in South Africa

Livestock are an important source of protein and food for humans, however opportunistic pathogens such as Salmonella spp. turn livestock into vehicles of foodborne diseases. This study investigated the prevalence of virulence genes in Salmonella spp. isolated from livestock production systems in two provinces of South Africa. During the period from May to August, 2018, a total of 361 faecal (189), oral (100), environmental (soil (36) and water (27)) and feed (9) samples were randomly collected from different animals (cattle, sheep, goats, pigs, ducks and chickens) that were housed in small-scale livestock production systems from Eastern Cape and KwaZulu-Natal Provinces in South Africa. Salmonella spp. were isolated and identified using microbiological and DNA molecular methods. Salmonella spp. were present in 29.0% of the samples of which 30.2% belonged to the Salmonella enterica species as confirmed by the positive amplification of the species specific iroB gene. Virulence genes that were screened from livestock-associated Salmonella were invA, iroB, spiC, pipD and int1. Statistically significant associations (p < 0.05) were established between the virulence genes, sampling location, animal host as well as the season when samples were collected. Furthermore, statistically significant (p < 0.05) positive correlations were observed between most of the virulence genes investigated. This is one of the recent studies to detect and investigate livestock-associated Salmonella spp. in South Africa. This study highlights the importance of continuous monitoring and surveillance for pathogenic salmonellae. It also demonstrated the detection and prevalence of virulent Salmonella spp. harbored by livestock in South Africa. This study demonstrated the potential risks of pathogenic Salmonella enterica to cause foodborne diseases and zoonotic infections from farm-to-fork continuum using the global one-health approach.