Miracle-dz/UniFAR-FTUs huggingface dataset:
Utilisation du test GeneXpert pour le diagnostic de la tuberculose au service des maladies infectieuses du CHNU de Fann

Introduction: Nous avons realise ce travail pour montrer notre experience d’utilisation du GeneXpert et evaluer son apport dans la confirmation du diagnostic de la tuberculose. Methodes: Etude prospective descriptive et analytique de janvier a Decembre 2013. Resultats: Quatre vingt quatorze patients ont beneficie du geneXpert pour le depistage de la tuberculose toute localisation confondue. Le geneXpert avait ete positif dans 62% des cas. Les images radiologiques fortement evocatrices de tuberculose etait associees a un geneXpert positif dans 25% des cas. La recherche de BAAR realisee chez 55 patients etait positive dans 9 cas (16%). Le geneXpert etait positif sur 46 frottis negatif (54%)et dans 89% sur les frottis positifs. La prevalence de la tuberculose extrapulmonaire etait de 34%. Le taux de positivite etait variable en fonction du type de prelevement. Deux cas de resistance a la rifampicine ont ete detectees. Conclusion: Le geneXpert a ete d’un grand apport pour le diagnostic de la tuberculose pulmonaire et extrapulmonaire mais la bacilloscopie reste incontournable. Pan African Medical Journal 2016; 23
How do Departmental Lead Educators Review the Quality of Postgraduate Medical Education and Training Provided within Their departments

Introduction: Good quality postgraduate medical education and training is linked to good quality patient care. Departmental Lead Educators (DLEs) are identifiable in Hospitals/Trusts and a useful resource to review and develop quality of education and training at the local level. There is little published data on how they undertake this role. In this qualitative study we investigated the tools/approaches used by DLEs to review education and training quality. Methods: We interviewed 12 DLEs about their role and analysed the scripts by using a standard content analysis approach. Results: Thematic analysis of the responses revealed that the tools used by DLEs could be categorised under informal communications, formal meetings and surveys. The sources of information were mainly the trainees but DLEs also reported relying on fellow Trainers, Deanery feedback and GMC national annual survey. All the DLEs we interviewed used multiple tools to source feedback. Conclusions: DLEs are a useful resource in the education and training quality review cycle. Their role should be formally recognised, included in job plans and supported by Deaneries and employing organisations. A synergistic local feedback system can be developed with local feedback led by the DLES and co-ordinated information on quality metrics by the Deanery. Practice points 1. DLEs are a useful resource for local reviews of the quality of junior doctors education and training 2. The DLE role deserves formal recognition and support 3. DLEs use multiple tools to monitor the quality of education and training with a focus on trainees’ feedback and informal approaches 4. A synergistic feedback system can be developed with local DLE tools and Deanery feedback
Trial Watch: Monoclonal antibodies in cancer therapy

Since the advent of hybridoma technology, dating back to 1975, monoclonal antibodies have become an irreplaceable diagnostic and therapeutic tool for a wide array of human diseases. During the last 15 years, several monoclonal antibodies (mAbs) have been approved by FDA for cancer therapy. These mAbs are designed to (1) activate the immune system against tumor cells, (2) inhibit cancer cell-intrinsic signaling pathways, (3) bring toxins in the close proximity of cancer cells, or (4) interfere with the tumor-stroma interaction. More recently, major efforts have been made for the development of immunostimulatory mAbs that either enhance cancer-directed immune responses or limit tumor- (or therapy-) driven immunosuppression. Some of these antibodies, which are thought to facilitate tumor eradication by initiating or sustaining a tumor-specific immune response, have already entered clinical trials. In this Trial Watch, we will review and discuss the clinical progress of the most important mAbs that are have entered clinical trials after January 2008.
CD133-positive Status Predicts Better Prognosis in Metastatic Colorectal Cancer Patients Treated with Cetuximab

Background: There are few evidence which kind of tumor is more benefit from cetuximab, more investigations of supplementary predictive factors are highly relevant. The purpose is to evaluate the prognostic significance of CD133 expression and to investigate the utility as biomarker of prognosis of metastatic colorectal cancer (mCRC) patients treated with cetuximab. Methods: We investigated progression-free survival (PFS) and overall survival (OS) of patients with mCRC about 5FU-based regimen as first line chemotherapy and cetuximab as salvage line retrospectively, and performed immunohistochemical staining to evaluate the CD133 status. Non-parametric statistics, univariate and multivariate analysis were used. Results: From October 2008 to June 2009, 46 patients with measurable mCRC had received cetuximab as salvage line, and all of them had treated with 5FU-based regimen as first line. In first line chemotherapy, the median OS was 33.1 months (95% CI, 25.6-40.4) in the CD133-positive patients as compared with 16.0 months (95% CI, 0.938-31.1) in the CD133-negative patients (P=0.004), but there were no statistically significant difference in PFS between both group. In salvage therapy with cetuximab, the median OS was 8.8 months (95% CI, 5.24-12.4) in the CD133-positive patients as compared with 5.1 months (95% CI, 3.23-6.90) in the CD133-negative patients (P=0.007). The median PFS was also significantly better in CD133-positive patients, with a median of 5.2 month (95% CI, 2.96-7.51) in the CD133-positive patients as compared with 2.8 month (95% CI, 1.48-4.06) in CD133- negative patients (P=0.046). Univariate and multivariate Cox proportional hazards regression was performed, and it is shown that CD133 predicted OS and PFS of cetuximab. Conclusions: CD133 status was correlated with the prognosis of patients
DiNa framework: supporting collaboration in the wild

Much of the available collaboration support tools focus on sharing of documents and managing projects that require planned activities. These tools tend to fall short in meeting “principle of least effort”, or take into account the reality of complex overlapping scheduling of professionals. I propose DiNa, a set of recommendations as a framework for a topiccentric, as opposed to the conventional document-centric, collaboration system utilizing readily available devices. A series of prototypes are used to demonstrate the novel interaction techniques that enable collaborators to define ‘topics’ and address them in their own terms. The framework aims to complement existing systems, and the evaluation reveals suggestions for improving such systems for effective collaboration in different modes.
Effect of oral magnesium supplementation on insulin receptor affinity in elderly rats with experimental type 2 diabetes mellitus

Objective To observe the effect of oral magnesium supplementation on insulin receptor affinity in elderly rats with type 2 diabetes mellitus(DM). Methods After oral magnesium was supplemented to type 2 DM model of elderly rats,liver cell insulin receptor affinity was assayed,serum levels of fasting glucose,insulin and magnesium,and stable glucose infusion rate were measured with the euglycaemic-hyperinsulinaemic clamp technique.Results The constant of high and low affinity insulin receptor banding was significantly higher while the capacity of high and low affinity insulin receptor banding was significantly lower in high dose magnesium(2g/kg) supplementation group than in DM control group[(4.83±0.09)×108/mol Pr vs(1.12±0.17)×106/mol Pr,(4.46±0.16)×1010/mg Pr vs(8.32±0.27)×1013/mg Pr,P0.05)]. The serum levels of fasting glucose and insulin,and insulin sensitivity index(HOMA-IR) were significantly lower while the stable glucose infusion rate was significantly higher in high dose magnesium(2g/kg) supplementation group than in DM control group.Conclusion Oral magnesium supplementation can improve the insulin receptor affinity and reduce the insulin resistance in elderly rats with type 2 DM.
THE EFFECTS OF PARENTS’ COLLEGE SAVINGS ON COLLEGE ATTENDANCE AMONG STUDENTS FROM FAMILIES WITH LOW-INCOMES: THE MEDIATING ROLE OF PARENT’S DISCUSSIONS ABOUT COLLEGE WITH THEIR CHILDREN

College savings are a promising strategy to pay for higher education, given the high college costs and inadequate financial aid available to students today. Asset theory suggests college savings have financial as well as psychological and social effects on children’s educational outcomes. This dissertation study focuses on the role of parent-child discussions about college as a potential mediator in the relationship between savings and college attendance. Also, the direct association between these discussions about attending college and children’s college expectations was examined. The Wisconsin Model of status attainment provides the organizing framework for this study as it encompasses the most important factors at key moments in an individual’s trajectory to educational attainment. The Education Longitudinal Study (2002) was utilized with the sample restricted to families with incomes at or below 185 percent of federal poverty guidelines. The total number of sample students is 3,997. Depending on the pattern of missing data, the deductive and multiple imputation approaches were applied. Since the outcome variable is polytomous, multinomial logistic regression analysis was used. To test mediation effects, both the Baron and Kenny approach and multiple mediation bootstrapping were employed. Results of this study suggest college savings are significantly and positively associated with parental college expectations, parent-child discussions about college, and two-year college attendance. Both parental expectations and college discussions mediate the relationship between savings and college attendance. These findings suggest college savings programs could be a promising strategy to help students access a post-secondary education. Social workers in school settings need to encourage families to develop college savings accounts by providing relevant information and connecting these families to financial service institutions. Another key finding is that discussions about attending college are associated with children’s own expectations and ultimate college attendance. Not all parents are comfortable talking with their children about going to college, especially without direct college experiences themselves. Developing programs to facilitate parent-child discussions about attending college is suggested so that social workers can help families to engage in productive discussions by providing communication guidelines and teaching parents’ ways to encourage their children without pressuring them.
Passive Prescription of Secondary Prevention Medical Therapy during Index Hospitalization for Acute Myocardial Infarction Is Prevalent and Associated with Adverse Clinical Outcomes

Secondary prevention therapy reduces death and reinfarction after acute myocardial infarction (AMI), but it is underutilized in clinical practice. Mechanisms for this therapeutic gap are not well established. In this study, we have explored and evaluated the impact of passive continuation compared to active initiation of secondary prevention therapy for AMI during the index hospitalization. For this purpose, we have analyzed 1083 consecutive patients with AMI to a tertiary referral hospital in Hong Kong and assessed discharge prescription rates of secondary prevention therapies (aspirin, beta-blockers, statins, and ACEI/ARBs). Multivariate analysis was used to identify independent predictors of discharge medication, and Kaplan–Meier survival curve was used to evaluate 12-month survival. Overall, prescription rates of aspirin, beta-blocker, statin, and ACEI/ARBs on discharge were 94.8%, 64.5%, 83.5%, and 61.4%, respectively. Multivariate analysis showed that prior use of each therapy was an independent predictor of prescription of the same therapy on discharge: aspirin (odds ratio (OR) = 4.8, 95% CI = 1.9–12.3, P < 0.01), beta-blocker (OR = 2.5, 95% CI = 1.8–3.4, P < 0.01); statin (OR = 8.3, 95% CI = 0.4–15.7, P < 0.01), and ACEI/ARBs (OR = 2.9, 95% CI = 2.0–4.3, P < 0.01). Passive continuation of prior medication was associated with higher 1-year mortality rates than active initiation in treatment-naïve patients (aspirin (13.7% vs. 5.7%), beta-blockers (12.9% vs. 5.6%), and statins (11.0% vs. 4.6%); all P < 0.01). Overall, the use of secondary prevention medication for AMI was suboptimal. Our findings suggested that the practice of passive continuation of prior medication was prevalent and associated with adverse clinical outcomes compared to active initiation of secondary preventive therapies for acute myocardial infarction during the index hospitalization.
The Impact of Early Childhood Nutritional Status on Cognitive Development: Does the Timing of Malnutrition Matter?

This article uses longitudinal data from the Philippines to examine whether the timing of malnutrition in early childhood is a critical factor in determining subsequent cognitive development. Although some observers have argued that the first six months of life are the most critical in the sense that malnutrition during that time period harms cognitive development more than malnutrition later in life, analysis of the Philippines data does not support this claim. To the contrary, the data suggest that malnutrition in the second year of life may have a larger negative impact than malnutrition in the first year of life.
Small Bowel Transplantation: Current Clinical Status

With recent refinements in immunosuppression techniques, the first successful reports of small bowel transplantation in humans have now been made, increasing interest in bowel transplantation among clinicians and patients alike. This article reviews recent developments in understanding of the functional capabilities and requirements for effective immune suppression in bowel transplantation. Both experimental and clinical experience with transplantation are discussed, as are the areas which appear to offer the most promise for future developments. Finally guidelines for consideration of patient selection for this procedure are reviewed.
Validación y estandarización de valores normales de la prueba de caja y cubos en niños

Objetivo La evaluacion de las destrezas motoras gruesas forma parte del examen funcional del nino. La prueba de caja y cubos es un metodo sencillo y util en la valoracion de la funcionalidad del miembro superior. El objetivo del estudio fue validar y estandarizar los valores normales de la prueba en ninos de 6 a 11 anos. Metodos Se aplico la prueba a 411 ninos de dos colegios de diferentes clases socioeconomicas en Bogota. Para la validacion de constructo se utilizo un cuestionario dirigido a padres y profesores evaluando el desempeno en actividades de la vida diaria y actividades escolares relacionadas y se establecio la correlacion con la prueba. Resultados En total se analizaron los datos de 386 ninos (55.4% de genero masculino), de los cuales 67.9 % pertenecian a colegio publico. 90.2% tenian dominancia derecha. La puntuacion promedio de la prueba con la mano derecha fue 60.9 y con la mano izquierda 57.8. Discusion Los valores de las puntuaciones promedio de las ninas fueron significativamente mas altos. Se construyo una tabla con los valores promedio, desviacion estandar y rango de normalidad. Se encontro una correlacion positiva del resultado de la prueba con la edad y con las actividades de la vida diaria y la apreciacion de las habilidades escolares del nino por parte del profesor. La prueba fue confiable con una correlacion intraclase de 0.84 y 0.83 para la mano derecha e izquierda, respectivamente.
Physicians' knowledge and practice with regard to acute kidney injury at Omdurman Military Hospital: A cross-sectional survey

INTRODUCTION: The fact that the incidence of acute kidney injury (AKI) is increasing globally, and that data from low- and middle-income countries are scarce and inadequate, necessitates that health-care professionals being knowledgeable and aware of all aspects of this underestimated disease. This study aimed to assess the knowledge and practice of physicians working in different specialties about AKI. MATERIALS AND METHODS: This was a cross-sectional study; 169 physicians from Omdurman Military Hospital, practicing in different specialties, who were available at the time of the study, were included. Participants were assessed using a self-administered questionnaire. Data were analyzed using the Statistical Package for the Social Sciences. RESULTS: The majority of the respondents were aged 29 years or less (74.1%), and 81.7% were female. Most of the respondents (63.9%) had <3 years of experience. About 62.1% of the samples were medical officers mainly from the department of emergency, internal medicine, and surgery. Nearly 56.8% of the participants were found to have moderate knowledge, whereas 23.7% had a good knowledge; there was a significant association between knowledge and professional level. Regarding AKI management practice, 56.6% of the respondents were found to have poor practice, whereas 5.7% found to conduct good practice. The practice was found to be not associated with years of experience, profession level, or specialty. There was a significant association between knowledge and practice scores (P < 0.001). CONCLUSION: This study demonstrated knowledge and practice gaps as only one-fifth of the participants had a good knowledge and only 5% had a good practice.
Monilethrix: A Report of Three Cases in Children Confirmed with Dermoscopy

Monilethrix is a rare hereditary disorder affecting hair resulting in hair fragility and alopecia. We report three patients of monilethrix who presented with complaints of sparse and brittle hair from early childhood. All three patients had multiple discrete hyperkeratotic papules over the scalp. Dermoscopy revealed beaded appearance of hair with the presence of elliptical nodes and intermittent constrictions on the hair shafts as well as broken hairs, which were confirmed with routine microscopic examination of hair. Dermoscopy helps in easier and faster diagnosis of monilethrix.
Teledermatology and its Current Perspective

Teledermatology is one of the most important and commonly employed subsets of telemedicine, a special alternative to face-to-face (FTF) doctor--patient consultation that refers to the use of electronic telecommunication tools to facilitate the provision of healthcare between the “seeker” and “provider. ” It is used for consultation, education, second opinion, and monitoring medical conditions. This article will review basic concepts, the integration of noninvasive imaging technique images, artificial intelligence, and the current ethical and legal issues.
Anxiety disorders in Late Life

In the United States, anxiety disorders are the most prevalent group of psychiatric disorders [1]. They cause significant social and functional impairments in individuals who are affected by these disorders [2]. Current data indicates that the prevalence of anxiety disorders in greater in the older adults than previously acknowledged [3]. The rates of anxiety symptoms that did meet the criteria for a psychiatric diagnosis in older adults were 15% to 20% in the general community and primary care samples [4]. The National Comorbidity Survey Replication (NCS-R) found that among adults older than 60 years in age, the prevalence of any anxiety disorder was 15.3%. Among the anxiety disorders, specific phobia was the most prevalent (7.5%) followed by social phobia (6.6%), generalized anxiety disorder (GAD) (3.6%), posttraumatic stress disorders (PTSD) (2.5%), panic disorder (2%), agoraphobia without panic (1%) and obsessive compulsive disorder (OCD) (0.7%) [1].
Exploration Of Technology Use Pattern Among Teenagers And Its Relationship With Psychological Variables

Objectives : Technology use is common among adolescents. It is due to availability, curiosity and as a coping method to manage boredom, fill up free time and for having pleasant experience. The present study aims to explore the pattern of information technology usage among 200 adolescents in the age group of 13-17 years and its impact on psychological distress. Methods: Semi structured interview schedule, Technology addiction survey and Strength and difficulty questionnaire on 200 randomly selected participants. Results: Addictive use of gaming was present for 39 adolescents (19.5%); addictive use of mobile/cell phone was present in 31 adolescents (15.5%) and addictive usage of Internet was present among 36 (18%) of them. It was associated with difficulties in various daily activities such as academics, sports, meeting friends, socializing and emotional difficulties. Conclusions : This study found addictive use of technology devices and social media among adolescents. This Study has implications for screening technology usage pattern among adolescents; its relation with psychological distress and need for development of intervention programme for technology addiction. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.
S36 Weekly audiograms pre-emptively identify amikacin related ototoxicity in MDR-TB

Introduction and objectives Updated WHO guidance recommends at least 8 months of aminoglycoside (AG) for MDR-TB but provides no definitions or monitoring strategies for otoxocity. Most UK centres perform 2–4 weekly audiograms; we perform weekly audiograms. We retrospectively investigated whether this strategy pre-emptively identifies ototoxicity before significant hearing loss (HL) is evident. Methods Patients we treated with amikacin for MDR-TB from 2002–2015, with at ≥4 weekly pure tone audiograms, were included. Audiograms, treatment duration, symptoms, creatinine clearance and outcome were obtained from clinical records. All patients received amikacin at 15 mg/kg per day and had weekly amikacin levels and renal function. Definition of HL was defined as per the ASHA as >20 dB loss of pure tone threshold from baseline at one frequency or >10 dB at two adjacent frequencies. Results 31 MDR-TB patients fulfilled selection criteria; 15 female, median age 36 years (IQR: 24–43) and median weight 61.5 kg (IQR: 52–65.) 22/31 (70.9%) patients had their first audiogram within 10 days; median 5.5 (IQR:4–7.) The median duration of amikacin treatment was 79.5 days (IQR: 61.75–94) and median total dose of 70.8 g (IQR:44.4–97.75.) 4/31 (12.9%) had moderate-severe baseline hearing loss (HL). A total of 17 (54.8%) patients met the ASHA definition of HL: 7 at 4 kHz, 10 at 6 kHz and 17 at 8 kHZ. The median time to meeting ASHA definition of HL among these patients was 59 days (IQR: 41–84.75). 16/31 (51.6%) patients stopped amikacin earlier than planned and 1 continued; 2 (6.5%) due to symptoms of deafness, 2 (6.5%) due to tinnitus and 12 (38.7%) due to asymptomatic high frequency HL on audiograms. Creatinine clearance and trough amikacin levels remained within range for all patients. Regarding outcomes, 17 (54.8%) completed TB treatment, 5 (16.1%) remain on treatment, 4 (12.9%) transferred, 3 (9.7%) were lost to follow up and 1 (3.2%) died. Conclusions AGs are important in the treatment strategy of MDR-TB but this must be balanced with the long-term side effects. The ototoxicity of AG is unrelated to elevated drug levels or contributing factors and is a common adverse effect. Weekly audiograms led to earlier detection of pre-symptomatic amikacin ototoxicity and cessation in 38.7% of patients.