Miracle-dz/UniFAR-FTUs huggingface dataset:
Urinary tract infection in elderly: clinical profile and outcome study done at Kempegowda Institute of Medical Science and Hospital, Bengaluru, India

Background: Urinary tract infection (UTI) being the most common bacterial infection with considerable morbidity and mortality. In hospitalized geriatric patients, the risk is more attributable to differing characteristics such as anatomical and hormonal changes, presence of comorbidities such as neurological and urological abnormalities, diabetes mellitus and prolonged indwelling catheter use in hospitals and long-term care facilities.Methods: A retrospective study of patients admitted to medicine wards of age above 60 years with symptoms of urinary tract infection and positive urine culture spanning over a year were included. Demographic profile, clinical features, predisposing factors, laboratory features, urine culture reports, antimicrobial susceptibility patterns and outcome were noted and analysed.Results: Of the 120 patients included in our study, 58.2% were males and 41.8% were females. Dysuria was the most common major symptom (77.5%). Diabetes mellitus was the most common Predisposing factor observed in (63.3%) of the patients. Gram negative organism were responsible for (68.27%) of the uropathogen profile; Escherichia coli was the commonest isolate (31.66%) seen. Mortality rate was 29.16%. Significantly higher mortality was seen in patients with diabetes mellitus (p<0.001), complicated UTI (p<0.001), serum creatinine >1.4mg/dl (p<0.001) and increasing number of predisposing factors. Mortality was also associated with higher leucocyte count in the study population.Conclusions: Urinary tract infection in elderly increases the population mortality and morbidity; and the co morbid factors associated play a key role in the severity of the infection. Early management and appropriate antibiotic therapy will help in preventing antibiotic resistance and also in decreasing the overall geriatric population fatality.
The Changes of Plasma Amino Acids and Lipid Profiles in Patients with Cystic Fibrosis and Malnutrition induced by Immunonutrition

Background: According to the previous report immunonutrition leads to serum amyloid a decline in the cystic fibrosis patients with malnutrition. The goal of the current study was to evaluate the immunonutrition influence on nutrition parameters, plasma amino acid and lipid profiles in cystic fibrosis patients complicated with malnutrition. Methods: The changes of nutrition parameters and lipid and plasma amino acids profiles induced by immunonutrition and standard nutrition sipping were evaluated in 30 patients with cystic fibrosis in comparison with 55 control healthy subjects. Results: BMI, plasma prealbumin, transferrin were significantly deteriorated in patients with cystic fibrosis as well as plasma amino acids and lipid profiles in comparison with control subjects. Serum level of triacylgycerols significantly decreased in the cystic fibrosis patients after immunonutrion support. Immunonutrition lead to the elevation of glutamic acid, methionine, arginine and ornithine plasma concentration while the plasma concentration of glutamine, glycine, valine, threonine and tryptophan significantly decreased. Conclusion: Immunonutrition leads to the significant decrease of serum triacylglycerols and to the changes in plasma amino acids profile in the cystic fibrosis patients with malnutrition that may reflect an activation of immune system.
Simple Peripheral Markers for Inflammation in Drug-Naive, Comorbidity-Free Adolescents with Obsessive–Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder with recurrent obsessions and/or compulsions that cause distress, time-consuming and/or significant disruption (1). The prevalence of OCD is %1-3 (2). OCD is divided into 2 groups according to the age of onset; early onset (12-14 years) and late onset (20-22 years) (3,4). Childhood-onset OCD is suggested to be distinguished with late-onset OCD by different etiopathogenic mechanisms (4,5).
Periodontitis and rheumatoid arthritis: A neglected association in developing countries

1 Faculty of Dentistry, Semnan University of Medical Sciences, Semnan, Iran. 2 Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran. 3 Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran. 4 Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran. 5 Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
By Any Means Necessary? Modelling the Link Between Private Budgets and Public Projects Using Mental Accounting

Overview One of the most substantial challenges facing practitioners of social cost-benefit analysis is in accurately measuring preferences over public goods. The use by many such studies of (implicit) trade-offs between private and public goods conflicts with research demonstrating gaps between the choices made by ‘consumers’ and ‘citizens’. We propose a new framework for conceptualizing these choices within a unified set of preferences, referred to as the cognitive budgeting model (CBM). The CBM uses well-established cognitive constraints to operationalize mental accounting in a modified utility tree; individuals adapt to the complexity of large choice sets by nesting items within a multi-tiered budget. However, this also leads to ‘imperfect fungibility’ (Hess et al., 2012) by restricting choices between items in different nests, with important implications for the use of CBA in transport projects.
Left Atrial Size and Atrial Fibrillation in Mitral Stenosis

In a series of 135 patients with mitral valvular stenosis, three groups were identified: those in sinus rhythm, those with intermittent atrial fibrillation, and those with longstanding, established atrial fibrillation. Examination of the relationships between atrial fibrillation, hemodynamic findings and radiologic data in mitral stenosis was undertaken. Analysis of clinical and hemodynamic factors in the three groups revealed that: 1) age is an etiological factor in the production of atrial fibrillation, as suggested by the age distribution among the three groups; 2) left atrial enlargement may be the result, rather than the cause, of atrial fibrillation; and 3) severity of mitral stenosis is not invariably related to the incidence of atrial fibrillation. Hemodynamic measurements were not significantly different among the three groups, with the single exception of lower cardiac outputs found in patients with established atrial fibrillation. Since no single consequence of mitral stenosis always produces a.
STUDY THE ROLE OF VITAMIN D IN THE PATHOPHYSIOLOGY OF SEVERE ASTHMA

Background: Vitamin D deficiency has been suggested to play a role in the pathophysiology of asthma. Several suggested mechanisms have been proposed including airway remodelling. The aim of our study was to investigate the role of vitamin D serum level in the pathophysiology of airway remodelling in severe refractory asthma. Subjects and methods: The present study was conducted on 20 severe, 10 non-severe asthma patients and 15 control subjects. Pulmonary function tests, sputum matrix metalloproteinase-9 (MMP-9) and serum vitamin D3 were measured in all subjects. Patients with airway obstruction (Forced expiratory volume in one second (FEV1 ) <80%) performed bronchodilator reversibility testing. Results:Vitamin D deficiency was prevalent among all our asthma patients. Although there was no significant difference in serum vitamin D levels between severe and non-severe asthmatic patients, serum vitamin D levels were positively correlated with the degree of current clinical control, as measured by Asthma Control Test (ACT). Serum vitamin D levels were negatively correlated with sputum MMP-9 levels in our asthma patients. The degree of bronchodilator reversibility was positively correlated with serum vitamin D and negatively correlated with sputum MMP-9 levels. Accordingly, we suggest that vitamin D may have a beneficial role in the prevention of airway remodelling in asthma patients. Key Words: Asthma - airway remodelling - matrix metalloproteinase - severe asthma - vitamin D.
Cicadas

Medical Genetics has long been a part of the undergraduate curriculum and is a rapidly increasing component of postgraduate training at all levels, in all specialities. Ian Young has provided a textbook which will delight both undergraduate and postgraduate readers. There are many textbooks which claim to cover essential medical genetic teaching, but many of these are too big, too detailed and too expensive. This text is presented in a clear, logical manner with well illustrated chapters and excellent use of colour for key points and boxes. The text is interspersed with case histories, landmark publications and the novel use of a " case célèbre " to illustrate many chapters – and what an excellent memory tool that is. Do you know why Dolly the sheep was called Dolly? Or that Frédéric Chopin may have had cystic fibrosis? There are fourteen chapters from the first " Gene structure and function " travelling through the realm of clinical genetics to end with chapters on " Clinical skills " (so you think you know how to interpret a laboratory report? ) and " Applied clinical genetics ". The useful appendices cover medical school core curriculum and teaching medical genetics to undergraduate medical students. Each chapter ends with a few MCQs, the answers having succinct explanations. Ian Young is respected worldwide as a clinician, author and teacher of medical genetics. From Northern Ireland originally, he has not lost the art of communication. This is a text clinicians at any level will enjoy either for serious study or occasional casual reading (it is just about the right size and has enough flexibility for reading in bed). My one criticism is that it was not available when I needed it as a student (far too many years ago). An Irish-American medic called Gus McWilliams returns home to Northern Ireland, his urgent mission to find a donor kidney for his ill son – whose renal function is deteriorating – at all costs. His own kidney problems suggest hereditary renal disease and other modern (and old) ethical and genetic dilemmas feature in this novel where in the quiet village of Rostrevor, his genealogy research uncovers a mysterious crime committed in the last century against his ancestors. He uncovers evidence of a 19th century rogue scientist called Diogenes who has discovered the secrets of human cloning. Sinister elements from both sides of the local terrorist divide mix with some …
Ketamina-Propofol vs Propofol para sedación en endoscopia digestiva superior

La sedacion con ketamina/propofol (ketofol) para endoscopia digestiva facilita dicho procedimiento. Ketamina/propofol poseen efectos clinicos deseables para este proposito. La combinacion de ketamina/propofol produce sedacion mas profunda y disminucion de los eventos respiratorios indeseables producidos por el propofol. Material y metodo: Se efectuo un estudio piloto experimental, longitudinal, comparativo, prospectivo. Se estudiados 22 pacientes divididos en dos grupos. Programados electivamente para endoscopia digestiva alta. Se comparo el nivel de sedacion, dosis y efectos adversos respiratorios y cambios en la presion arterial, con ketamina/propofol vs propofol. Resultados: Las dosis de ketamina/propofol fue 2.8 versus 3.6 para propofol. Los valores de presion arterial media fueron mas estables en el grupo de ketamina/propofol. Las complicaciones respiratorias fueron menos severas en el mismo grupo. Tambien se encontro una correlacion negativa del propofol con la presion sistolica a los 5 y 10 minutos en el grupo B. Conclusiones: La dosis utilizada en el grupo de ketamina/Propofol presenta una mayor estabilidad hemodinamica, con nulos efectos respiratorios y buena analgesia postoperatoria
Defining Student Success in Academic Medicine

Background: The U.S. healthcare delivery system must increase the number of physicians who will deliver health care, as well as increase the number of scientists who will analyze and address the ailments that challenge diverse populations. Because medical schools are responsible for the education and preparation of diverse professionals, medical school administrators are working to create and maintain programs that recruit and retain students from underrepresented groups in medicine. Methods: This study follows A Student Success Ad-hoc Committee (SSAC) charged with a) defining student success, b) exploring the success of underrepresented students in medicine based on this definition, and c) drafting recommendations based on data and evidence collected. This self-study evaluates and assesses medical student experiences, their educational attainment, and outcomes at Indiana University School of Medicine. This aim is explored through the application of higher education theories to undergraduate medical education. Results: This paper demonstrates how an interdisciplinary team of academic medicine professionals endeavored to critically study the perceptions of student success in medicine. The study showcases the institution’s progress towards defining student success informed by literature on student retention and persistence, learning environments, and student outcomes. The paper includes recommendations based on a reflexive process about three areas: admissions and pre-matriculation, academic promotion, and the educational environment. Conclusion: The authors challenge professional schools in conducting self-studies that expand the utilization of theoretical and conceptual frameworks external to medicine, and reinforce the application of higher education research into professional school settings. Keywords: STUDENT SUCCESS, ACADEMIC MEDICINE, MEDICAL EDUCATION
Atypical Presentation of Ocular Toxoplasmosiswith Exudative Retinal Detachment

A 54 year old female presented with complains of gradual and progressive diminution of vision in left eye for last 5 days. She had no history of uveitis or tuberculosis or contact with pets. She was hypertensive for last 4 year controlled on regular medications. On examination her best corrected visual acuity was 6/9 in right eye Abstract Subretinal fluid, a common clinical pathological entity, is seen in a variety of ocular disorders. Though inflammation is associated with the development of subretinal fluid, toxoplasmosis is an unusual causative agent. A 54 year old lady presented with atypical ocular findings of exudative retinal detachment due to toxoplasmosis. The diagnosis was misinterpreted first as sarcoidosis based on HRCT chest picture, later on diagnosed as ocular toxoplasmosis on correlating clinical presentation, fundus fluorescein angiography (FFA), optical coherence tomography (OCT) findings and serology. Patient was managed with a combination of oral anti Toxoplasma drugs, and oral corticosteroids.
Impact of epicatechin gallate on the structural integrity of the PBP2/PBP2a complex in methicillin resistant Staphylococcus aureus

Introduction: The selective pressure imposed by the misuse and overuse of antibiotics has led to the emergence and dissemination of methicillin resistant Staphylococcus aureus (MRSA), forcing a re-evaluation of therapeutic approaches to the treatment of MRSA infections. Epicatechin gallate (ECg), a constituent of the tea plant Camellia sinensis, has the capacity to abrogate the resistance of MRSA to β-lactam antibiotics and may be useful as an adjunct to conventional chemotherapy. Current evidence suggests that ECg sensitises resistant strains to β-lactam agents by disruption of the penicillin binding protein (PBP) complex PBP2/PBP2a at the septal site of cell division following its intercalation into the cytoplasmic membrane (CM) bilayer. Methods: Styrene maleic acid lipid co-polymer (SMALP) was used to solubilise and extract PBP2/PBP2a membrane complexes from the CM of EMRSA-16 and ECg-exposed cells. Cell walls were partially digested and membrane proteins excised and solubilised with hydrolysed styrene maleic acid (SMA). SMALP particles were visualised by TEM and size distribution determined by dynamic light scattering. Membrane protein complexes were cross-linked within SMALPs, protein complexes recovered by co-immunoprecipitation and the constituents determined by Western blotting and flow cytometry. Results: PBP2/PBP2a complexes were identified in both ECg-exposed and control EMRSA-16 cells when SMALPs were pulled down with anti-PBP2 and anti-PBP2a antibodies. Fewer complexes were recovered from ECg exposed cells. Co-immunoprecipitation of SMALPs with antibody against the division scaffold protein FtsZ led to the identification of FtsZ/PBP2/PBP2a complexes. ECg displaced PBP2a from this complex. The PBP2/PBP4 complex was also identified, however there was no difference observed following ECg exposure. Conclusion: Intercalation of ECg into the MRSA phospholipid palisade led to partial disruption of PBP2a from PBP2/PBP2a and FtsZ/PBP2/PBP2a complexes. The data suggest that ECg-mediated conversion of MRSA to β-lactam susceptibility may in part be related to loss of functional integrity of the cellular replication machinery. The therapeutic approach with the use of antibiotic resistance modifying agent, such as ECg, in combination with a previously ineffective β-lactam antibiotic, presents a novel therapy to combat antibiotic resistance in MRSA.
4 The Family Desulfobacteraceae

Desulfobacteraceae, a family within the order Desulfobacterales, embraces 21 genera Desulfobacter, Desulfatibacillum, Desulfatiferula, Desulfatirhabdium, Desulfatitalea, Desulfobacterium, Desulfobacula, Desulfobotulus, Desulfocella, Desulfococcus, Desulfoconvexum,Desulfofaba,Desulfofrigus,Desulfoluna,Desulfonatronobacter, Desulfonema, Desulforegula, Desulfosalsimonas, Desulfosarcina, Desulfospira, and Desulfotignum. The family is primarily defined by their 16S rRNA gene sequence phylogeny. Morphological and chemotaxonomic properties are highly variable for the delineation of genera and species. Strictly anaerobic, having a respiratory type of metabolism. Fermentative metabolism might occur. Members are either mesophilic or psychrophilic sulfate-reducing bacteria. Members of the family are mainly found in freshwater, brackish water, marine, and haloalkaline habitats. Most described species are chemoorganoheterotroph; some are chemolithoheterotroph or chemolithoautotroph. Most members oxidize organic substrates completely to carbon dioxide, whereas some perform an incomplete oxidation of organic substrates to acetate. This contribution is a modified and an updated version of a previous family description (Kuever et al. 2005a).
Acute exercise increases prostate tumor blood flow in rats

During exercise there is a redistribution of blood flow within the body based upon the functional vascular compliance of a given tissue. Given the altered vasculature morphology within tumors (e.g., less smooth muscle), there may be a profound increase in tumor blood flow during exercise. We utilized vehicle control (CON; n=5) or tumor bearing (TB; n=6) Copenhagen rats to test whether prostate tumor perfusion increases during moderate intensity exercise. Dunning R‐3327 MatLyLu tumor cells were injected (104cells) into the ventral lobe of the prostate of TB animals and blood flow experiments performed 21 days later. Blood flow and vascular conductance to the tumor and prostate tissue was measured using radiolabelled microspheres at rest and during exercise (treadmill; 5 min @ 15 m/min, 10° incline). There was a marked increase in tumor blood flow during exercise (rest, 17 ± 2; exercise, 52 ± 5 ml/min/100 g; p<0.001). Tumor vascular conductance increased by ~ 270% from rest to exercise. Blood flow to the surrounding prostate tissue (TB) or the prostate (CON) did not change with exercise. This is the first investigation to demonstrate that tumor perfusion is significantly increased with exercise. The precise mechanisms for the increase perfusion (e.g., blunted vasoconstriction), and whether increase in blood flow during exercise affect tumor growth, remains to be determined. Support: NIH (AG‐31317); FBRP (1BN‐02).
Feasibility and Safety of Combining Therapeutic Hypothermia with Magnesium Sulfate Administration, in the Management of Neonates with Hypoxic Ischemic Encephalopathy - Randomized Control Trial

Objective: The aim of the study was to confirm the therapeutic effectiveness and no significant side effects of therapeutic hypothermia plus magnesium sulfate in the group of newborns with HIE. Materials and methods: Neonates born at ≥36 GA, with perinatal asphyxia and confirmed moderate or severe HIE were randomized to study (TH+Mg) or control (TH) groups. Neonates in study group received three doses of MgSO4 (250 mg/kg) as intravenous infusion on three consecutive days in addition to therapeutic hypothermia. Newborns in control group were treated only with therapeutic hypothermia. Primary outcome was risk of death during initial hospitalization, secondary outcome: short-term neurological status. Additionally the circulatory, respiratory and hematological parameters were assessed. Results: 75 patients were included in this study. There were no statistically significant differences in the rate of death (OD 1.053; 95% CI 0.26-4.25; p=0.943). Neonates in study group had better neurological outcome after cooling procedure, their neurological assessment at 5 days of age (by Thompson scale) improved (4.75 vs. 7.03; p=0.032). They had shorter time to full oral feeding 14.5 vs. 16.5 days; p=0.006 and shorter hospitalization time 23.55 (±8.0) vs. 27.77 (±14.1); p=0.003. Coagulation parameters, number of blood products transfusions and incidence of intracranial bleedings were not affected by the magnesium administration. Risk of PPHN incidences was lower (OD 4.5; 95% CI 0.90-22.38; p=0.049, NNT=7). Conclusion: Applied therapy was not associated with increased risk of death or other significant adverse effects. Faster normalization of short-term neurological functions in study (TH+Mg) group was observed.
Causes of Elevated Levels of Serum CA 19.9 in Patients without Prior Diagnosis of Malignant Disease

Results: Overall, 226 patients with benign disorders and 59 patients with malignant disease had elevated CA 19-9 levels. One hundred ten (39%) patients with increased CA 19-9 levels did not have any significant clinical condition associated with high CA 19-9 values. Median CA 19-9 levels were significantly higher in patients with malignancies than in patients with benign disorders (67.3 vs. 47.9; p<0.001). Receiver operating characteristic curve analysis identified a cut-off value of 66.3 U/mL for discrimination of malignant from benign gastrointestinal diseases (sensitivity 58.3% and specificity 82.7%; p<0.001).
SURVEY OF CLAM AND OYSTER RESOURCES OF SOME KARNATAKA ESTUARIES

Of an estimated standing stock of about 6700 tonnes of clams and oysters in the estuaries on the southwest coast of India between Mangalore and Honavar 80% were clams and 20% were oysters. Among clams Meretrix casta was the chief species, followed by Villorita cyprinoides, Paphia malabarica, Meretrix meretrix and Katelysia opiina. The important oyster was Crassostrea madrasensis. Mulky, Udyavara and Coondapur were the more productive estuaries, among which Mulky topped with a production rate of 18 t/ha of clams and oysters.