Miracle-dz/UniFAR-FTUs huggingface dataset:
Focused Antenatal Care Service Utilization and Associated Factors in Dejen and Aneded Districts, Northwest Ethiopia

Background: Focused antenatal care considers every pregnant woman at high risk for developing pregnancyrelated complications. Hence, all pregnant women should receive at least four antenatal visits to early identify the complications and intervene accordingly. Therefore, this study attempted to assess focused antenatal care service utilization and associated factors among mothers who gave birth in the last 2 years prior to the study in Dejen and Aneded districts, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted on mothers who gave birth in the last 2 years in 2013. Multistage sampling was used to get the total sample size of 521. Pre-tested structured questionnaires were used to collect the data. The data were entered and cleaned by using Epi info version 6 and exported to SPSS version 16.0 software package for analysis. Results: A total of 509 mothers who have history of antenatal care for their last birth in the last two years were included in the study from which 61 (12.0%, 95%CI: 11.87, 12.13) mothers attended focused antenatal care service. Marital status (single/divorce women) (AOR= 3.44, 95%CI: 1.43, 8.26), travelling more than one hour to obtain antenatal services (AOR=8.21, 95%CI: 1.28, 36.8) and abortion history (AOR= 3.57 and 95%CI: 1.62, 7.86) were significantly associated with focused antenatal care service utilization. Conclusion and recommendations: The majority of pregnant mothers did not attend focused antenatal care during their last pregnancy. Marital status, travel time to health facility, history of abortion and illness, plan of pregnancy and sources of information were identified as factors affecting focused antenatal care service utilization. Provision of focused antenatal care should be used as an opportunity for early detection of pregnancy related complications. Women health development army in the districts should be used to disseminate information regarding FANC for pregnant mothers.
Sobrevida em dez anos e fatores prognósticos em mulheres com câncer de mama em Joinville, Santa Catarina, Brasil

Breast cancer has the highest incidence among women, and reduces survival among female sufferers. This article aims to evaluate the survival and its prognostic factors in women with breast cancer, treated by public sector, in Joinville, Santa Catarina, Brazil. Retrospective cohort study nested in a case-control. The data has been obtained by a questionnaire, by the review of records and death certifications. In the analysis of survival it has been applied the Kaplan-Meier's statistical method and the Cox's method. 170 women have been evaluated. The survival in ten years was 83.1% (95% CI 74.1 to 89.3%), and 21 (12.4%) deaths were identified at the time period. The probability of being alive was smaller for those in advanced stages of cancer; the risk of death was higher among those who had another kinds of cancer associated, and among those unsatisfied with life. The death's ratio was 17.1 times bigger among women diagnosed in advanced stages. The variable staging presented higher association with the survival in evaluated women. Detecting the disease early minimizes the mortality by breast cancer.
Effect of educational intervention on water pipe behaviour of students in dormitories of Kerman Medical University: BASNEF Model

Introduction: Over past years water pipe smoking have been increased among teenagers in the world. Hence, implementing an intervention plan to reduce water pipe smoking is required. This study aimed to determine the effect of an educational intervention on water pipe behaviour of students in dormitories of Kerman Medical University based on BASNEF Model. Materials & Methods: This was a quasi-experimental study. In total 80 students who were resident in university’s dormitories and were eligible to enter to the study were divided in two groups of intervention and control using multi-stage random sampling. Data were collected using "Water Pipe Behavioural Intention Scale" which was designed according to BASNEF Model. Face and content validity were used to determine the validity, while test-retest method was applied to measure the reliability of the questionnaire (r = 0.99). Two-month educational intervention included two sessions of group discussion, one reminder session, educational compact disc and educational messages. To analyze the data SPSS/16 was used. Findings: The mean scores of attitude (P=0.66), subjective norms (P=0.103) and behavioural intention (P=0.13) showed no significant difference before the education in both intervention and control groups. However, the result showed compelling difference in mean scores of attitude, subjective norms and behavioural intention after the education (P<0.001). Enabling factors showed no important variation among intervention and control groups before and after the experiment. Conclusion: The educational intervention according the BASNEF Model was effective to decrease water pipe smoking behaviour among university students. In addition, the educational intervention influenced individuals’ attitude, subjective norms and behavioural intention. It is recommended to perform educational interventions based on the theory and models of health education to change high-risk behaviour.
Chronic pain and quality of life among older people.

The overall aim was to investigate chronic pain, quality of life and factors associated with pain as well as with quality of life among older people, aged 75 years and above. Further, the aim was to investigate the use of methods for pain management and their effects for those with pain and in need of help for daily living. Data were collected from a larger population study and in the first study 4093 people aged 75–105 years were studied regarding the prevalence of chronic pain, factors associated with pain and quality of life (QoL). Those who reported pain (n=1654) were compared with those who did not (n=2439). The aim of the second study was to study (n=1622) the oldest old (aged 85+) in pain in comparison with those not in pain regarding QoL and related factors. In the third study (n=532; aged 75–102 years) QoL and factors associated with QoL were investigated among those in pain and in need of help for daily living. In the fourth and last study those in pain and in need of help for daily living (n=294; aged 76–100 years) were investigated regarding the use of methods for pain management and comparisons were made between different living conditions. The results showed that chronic pain is common and often a major problem among older people. With higher age the prevalence of pain tended to be more prevalent, as did other complaints, such as functional limitations, fatigue, depressed mood, that were related to both age and pain. Those in chronic pain were most likely to suffer more from other complaints than those without pain, because the prevalence as well as the severity of these related complaints was even higher. Also QoL was significantly lower in the higher age groups and even lower among those in pain. Besides the fact that functional limitations (e.g. walking problems/mobility problems) were more common, also the need for help with IADL and PADL was higher in higher ages and among those in pain. High degree of pain, related complaints and low QoL were above all identified among the oldest old (85+) and among those in need of help to manage daily living. The use of various methods for pain management was found in this thesis to be sparse and tend to be unsystematic among those in need of help to manage daily living. A cluster analysis revealed above all two main clusters. The first cluster represented those using few (md: 2) and the most common methods used (prescribed medicine, rest, distraction). This first cluster included those who were significantly older than the second cluster that represented those that used more methods (md: 6) but reported significantly more pain severity and interference in daily life. Among the oldest old (in pain) functional limitations, fatigue and depressed mood were areas to be intervened against to improve their QoL. Also living alone and living in sheltered housing that was associated with low QoL, as well as the economic situation must be considered. For those in pain and in need of help in daily living, functional limitations, fatigue, sleeping problems, depressed mood and living in special accommodations were associated with low QoL.
Influence of different kind of clothing material on selected cardiovascular, respiratory and psychomotor parameters during moderate physical exercise.

OBJECTIVES The aim of the experiment was to analyze the influence that the clothing material may have on human physiology and thermal comfort both at rest and physical effort to answer the question which fabric is better, a natural or a synthetic one. MATERIALS AND METHODS We measured some psychomotor parameters: critical flicker frequency (CFF), reaction time to auditory/visual stimuli (RT), concentration of attention (CA); cardiovascular parameters: blood pressure (BP), heart rate (HR) and respiratory parameters: tidal volume (VT), minute ventilation (VE), oxygen consumption (VO2), carbon dioxide output (VCO2), respiratory exchange ratio (RER) in human volunteers before, during and after physical effort. The subjects performed a 15-min treadmill test on treadmill wearing clothes made of two different materials: 100% coarse wool and 100% acrylic. An interview was conducted directly before the exercise test to assess the subjects' general mood and wellbeing on that day. Besides, before and after the test, the subjects in their own words described the sensation they felt with respect to the physiological comfort of particular clothing. RESULTS The results showed that wearing clothes made of different fabrics had some influence on the cardiovascular and respiratory parameters during physical effort but it did not have any effect on the psychomotor skills. The perception of physiological comfort by the subjects wearing coarse wool or acrylic depended on their physiological state and differed at rest and after the physical effort. CONCLUSIONS The course of physiological processes depends on the kind of clothing a given person is wearing. It is not possible to clearly define which of the two clothing materials: natural - wool, or synthetic - acrylic is better. Each of them exerts a different effect on the human organism. The usefulness of a given type of clothing material seems to depend on the human physiological state and the related thermoregulatory processes.
Endocrine changes after experimental showjumping.

The study was designed in order to gain a better understanding of whether the lack of competition stress and/or sampling time had an influence on circulating β-endorphin, adrenocorticotrophin (ACTH) and cortisol modifications after experimental showjumping sessions and to study the effects of fence height on hormone changes. Hormone levels were recorded before exercise in basal conditions and after warm-up, then 5 and 30 min post-exercise. Using a randomized crossover study design, six horses were studied during three experimental showjumping sessions over fences of different heights: 1.00 m (session 1), 1.10 m (session 2) and 1.20 m (session 3). The showjumping exercise did not modify plasma β-endorphin and serum ACTH concentrations after session 1, and tended only to maintain higher values than basal after both session 2 and session 3. The interaction fence height/time was not statistically significant for either β-endorphin or ACTH changes. Sampling time significantly affected both β-endorphin ( F = 2.88; P F = 3.84; P F = 7.96; P
The inferior alveolar nerve's loop at the mental foramen and its implications for surgery.

BACKGROUND In this study, the authors aimed to identify and measure the anterior extension of the alveolar loop (aAL) and the caudal extension of the alveolar loop (cAL) of the inferior alveolar nerve by using cone-beam computed tomography (CBCT). They also aimed to provide recommendations for surgery in the anterior mandible. METHODS In this retrospective case study of the frequency and extension of aAL and cAL, the authors evaluated 1,384 mandibular sites in 694 CBCT scans of dentate and partly edentulous patients, performed mainly for further diagnosis before removal of the mandibular third molars between January 2009 and February 2013, by using multiplanar reconstructions. RESULTS The frequency of aAL was 69.73 percent and of cAL was 100 percent. The mean value for aAL was 1.16 millimeters, with a range of 0.3 to 5.6 mm; the mean value for cAL was 4.11 mm, with a range of 0.25 to 8.87 mm. For aAL, 95.81 percent of the sites showed values of 0 to 3 mm; for cAL, 93.78 percent of the sites showed values of 0.25 to 6 mm. Dentate patients showed statistically significantly higher values for cAL than did partly edentulous patients (P = .043). CBCT resolution had a statistically significant impact on cAL measurements (P = .001), with higher values at higher resolution. CONCLUSIONS This study showed a high frequency of and large variations in aAL and cAL. In contrast to panoramic radiography, CBCT has been shown to be a reliable tool for identifying and measuring the AL. Therefore, preoperative diagnosis with CBCT is recommended for planning three-dimensional tasks such as implant placement in the vicinity of the mental foramen. PRACTICAL IMPLICATIONS Owing to the variability of aAL and cAL measurements, it is difficult to recommend reliable safety margins for surgical procedures such as implant placement, bone harvesting or genioplasty Depending on the indication, the clinician should consider preoperative diagnosis by means of CBCT.
KIDNEY WEIGHT, BODY SIZE AND RENAL FUNCTION

In 1916, Addis1 introduced the determination of the ratiounder certain standard conditions as a measure ofthe amount of functioning renal tissue. The adequacy of this ratio as measured under the standard conditions for this purpose was demonstrated in a number of ways. It is a reasonable measure of renal function; 2 the variation in "experimental nephritis" was found 3 to agree well with the structural changes in the kidneys, and the compensatory renal hypertrophy as measured by the ratio coincided with the anatomic measurements. 4 Lastly, it was shown 5 that in rabbits there existed a linear relationship between the magnitude of the ratio and the weight of the kidneys, an observation since confirmed for the rat 6 and the dog. 7 Taylor, Drury and Addis 5 found that in rabbits the kidney weight varied directly in proportion to the body surface and bore a more constant relation to this figure than to any
Arterial hypertension in degenerative non-severe aortic stenosis

Degenerative aortic stenosis (AS) is an active inflammatory process similar to that in atherosclerosis plaque. The aim was to evaluate the atherosclerotic risk factors, concomitant diseases and risk of cardiovascular death using the SCORE system in degenerative AS-patients aged 60 and over with preserved left ventricle ejection fraction related to severity of AS.MaterialThe database contains retrospectively consecutive series of 126 patients (mean age 69). Patients were analyzed related to severity of AS: severe AS with mean gradient of 64.6±8.7mmHg (n=79) and non-severe AS with mean gradient of 24.4±8.4mmHg (n=47). There were analyzed: age, gender, BMI, laboratory data, presence of hypertension (HA), diabetes, CAD, smoking cigarettes, positive family history, results of 12-lead ECG and coronary arteriography. There was estimated 10 year risk of cardiovascular death using the SCORE system.ResultsBoth studied populations presented high 10-year risk of cardiovascular death with higher SCORE in non-severe AS (5.64+/-3.3% vs. 6.95+/-3.13%, P=0.006). Multivariate analysis revealed that only HA was an independent parameter determining higher SCORE in non-severe AS (P<0.05). ConclusionsThe non-severe degenerative AS-population had higher 10 years risk of cardiovascular death based on SCORE system than severe AS-patients, what was probably resulted from arterial hypertension.
Correlation of selective serotonin re-uptake inhibitor use with weight gain and metabolic parameters -

Objective: Psychotropic drugs during the treatment period of psychiatric disorders can cause changes in metabolic parameters such as weight, lipid profile, fasting glucose level, and resting metabolic rate. The aim of this study is to investigate the correlation of selective serotonin re-uptake inhibitor (SSRI) use with weight gain and metabolic parameters. Methods: In this study, the resting metabolic rates (RMR) of 14 male patients intended to use selective serotonin re uptake inhibitor at least three months, were measured baseline, first and third month after SSRI use. Body weight, percentage body fat, body mass index and waist/hip ratio were measured before treatment, at the end of the first and second weeks and the first, second and third months. Laboratory tests including total cholesterol, LDL, HDL, VLDL, triglycerides and fasting blood glucose were performed before treatment and at the end of the third month. The correlation of body weight changes with RMR changes was also analyzed. Results: RMR did not differ in the beginning, first month and third month. No statistically significant difference was found in RMR between the beginning and the third month. RMR significantly decreased in the increased-dose group while it wasn’t changed in the constant-dose group. No correlation was found between RMR changes and body weight changes. The mean body weight decreased significantly between the beginning and the first week and the first month. Even though the mean body weight of all patients was higher in the third month than the beginning, no statistically significant difference was found. The total cholesterol levels, body lipid ratio, and waist/hip ratio increased significantly between initiation of treatment and the third month. Conclusion: As a result, we suggest that SSRI’s use did not cause body weight increase due to reduction in RMR. The waist/hip ratio, total cholesterol levels were increased in the third month. Further studies which look more closely to fat metabolism in patients under SSRI’s treatment are necessary.
Late Treatment-Related Morbidity in Breast Cancer Patients Randomized to Postmastectomy Radiotherapy and Systemic Treatment Versus Systemic Treatment Alone

Late treatment-related morbidity after mastectomy and adjuvant systemic treatment with and without postoperative irradiation was assessed in 84 patients randomized in the Danish Breast Cancer Cooperative Group Trials 82b and c. A structured interview and physical examination, using a standardized assessment sheet, constructed on the basis of the late effects normal tissues (LENT) scoring system, was used. The median length of follow-up from mastectomy was 9 years (range 6-13 years). Lymphedema was measured in 14% of the irradiated patients versus 3% of the non-irradiated patients (NS). Slightly decreased shoulder morbidity was measured in 45% of the irradiated women versus 15% of the non-irradiated patients, but moderate or more severe impairment was seen in only 5% of the irradiated patients and in none of the non-irradiated patients (p=0.004). Seventeen percent of the irradiated patients and 2% of the non-irradiated patients found that impairment of shoulder movement caused symptoms (p=0.001).
Recent advances in the management of epilepsy

Epilepsy is a complex disorder affecting brain function having a variety of contributing factors. The genetic predisposition plays a key role in the genesis of epilepsy. Antiepileptic drugs (AEDs) provide effective control in majority of patients with different seizure types. But some refractory cases and those who cannot tolerate the conventional AEDs, it is difficult to control the seizures adequately. On the basis of different mechanisms of action and considering the side effects of drugs, various newer approaches have been evolved during the recent years in the rational management of epilepsy. A brief account of these newer treatment modalities has been focused and incorporated in this review in order to enlighten the readers with the possible beneficial effect of this regimen and their limitations as well. Northern International Medical College Journal Vol.5(2) 2014: 353-356
Screening for hepatocellular carcinoma in a cohort with cirrhosis mainly of alcoholic origin

Patients and methods — 293 patients with cirrhosis, among them 186 (63.5%) from alcoholic origin, were included in a surveillance programme for hepatocarcinoma by carrying out liver ultrasonography and α-fœtoprotein dosage every 6 months. Results were analyzed with a mean follow-up of 60 months. Seventeen hepatocarcinoma discovered through the surveillance programme (“screened HCC”) were compared with 40 hepatocarcinoma discovered outside the surveillance programme during the same period (“incidental HCC”).
Hospital volume and patient outcomes in pulmonary embolism

Background: In numerous high-risk medical and surgical conditions, a greater volume of patients undergoing treatment in a given setting or facility is associated with better survival. For patients with pulmonary embolism, the relation between the number of patients treated in a hospital (volume) and patient outcome is unknown. Methods: We studied discharge records from 186 acute care hospitals in Pennsylvania for a total of 15 531 patients for whom the primary diagnosis was pulmonary embolism. The study outcomes were all-cause mortality in hospital and within 30 days after presentation for pulmonary embolism and the length of hospital stay. We used logistic models to study the association between hospital volume and 30-day mortality and discrete survival models to study the association between in-hospital mortality and time to hospital discharge. Results: The median annual hospital volume for pulmonary embolism was 20 patients (interquartile range 10–42). Overall in-hospital mortality was 6.0%, whereas 30-day mortality was 9.3%. In multivariable analysis, very-high-volume hospitals (≥ 42 cases per year) had a significantly lower odds of in-hospital death (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.51–0.99) and of 30-day death (OR 0.71, 95% CI 0.54–0.92) than very-low-volume hospitals (< 10 cases per year). Although patients in the very-high-volume hospitals had a slightly longer length of stay than those in the very-low-volume hospitals (mean difference 0.7 days), there was no association between volume and length of stay. Interpretation: In hospitals with a high volume of cases, pulmonary embolism was associated with lower short-term mortality. Further research is required to determine the causes of the relation between volume and outcome for patients with pulmonary embolism.
The Fibromyalgia Syndrome: Translating Science into Clinical Practice

Objectives: The first objective is to present the arguments in favor of considering the biological component of the fibromyalgia syndrome [FMS], a disease of the nociceptive nervous system. The second aim is to present reliable methods for diagnosing such a disease. Findings: Studies confirm that there is long-standing or permanent pain hypersensitivity in FMS. The main causes of the pain amplification are central and peripheral sensitization of pain transmission neurons and/or pain disinhibition due to a disturbed endogenous pain modulation. The manual palpation method for determining the number of tender points is a measure of pressure-pain thresholds and degree of pain perception. Pain perception is influenced by psychological factors. More objective measures of pain thresholds are available and are presented in the article. Conclusions: The biological part of FMS reflects a long-standing or permanent change in the function of the nociceptive nervous system, that can be equated with a disease. It is hoped that upgrading FMS from illness to disease will increase the awareness of FMS among health personnel. This will in turn help patients with FMS to get correct diagnosis and treatment.