Miracle-dz/UniFAR-FTUs huggingface dataset:
PROFILE OF PATIENTS OF GLAUCOMA IN JAMMU PROVINCE (A HOSPITAL BASED STUDY)

Background: Glaucoma comprises group of disorder which cause damage to the ganglion cells and optic nerve fibers resulting in permanent loss of vision. Glaucoma is a silent killer of vision, the only treatable factor is IOP which can be lowered by medical means, laser treatment or surgery. Objectives: The objective of the study was to see profile of patients of glaucoma in jammu province. Material and method: The present prospective study involved 200 patients was conducted in the out-patient department of ophthalmology at tertiary care hospital of North India. After meeting inclusion & exclusion crieteria the patients underwent detailed clinical history, general examination, complete ophthalmological examination including dilated fundus examination, intra ocular pressure measurement, gonioscopy etc was done to diagnose different types of glaucoma. Results: Maximum number of patients i.e.128 were seen in age group of ≥50yrs followed by 60 in 41-50 yrs. Males i.e. 127 outnumbered females in present study. Total of 139 were from rural area. Maximum patients complain of diminution of vision ie 180 followed by pain in 135. Vision of 6/24-6/18 i.e. 59 (R/E) & 57 (L/E) followed by PL to <6/60 in 48(R/E) & 47(L/E) patients whereas PL absent was seen in 12 patients. Gonioscopically angle was open in 172(R/E) & 174(L/E) patients. Total of 102 patients had POAG. Conclusion: From present study we may conclude that glaucoma problem was more common in elderly age group and in males. It can lead to loss of vision among patient who suffer extreme optic nerve damage without realizing it. Therefore, for everybody above the age of 40years, it is mandatory to have IOP checked once a year especially if there is any risk factor for glaucoma like diabetes mellitus, myopia, family history of glaucoma, prolonged use of topical steroids etc. Keywords: Glaucoma, Gonioscopy, Intraocular Pressure(IOP), Visual acuity.
Targeting Ovarian Cancer Cell Cytotoxic Drug Resistance Phenotype with Xanthium strumarium L. Extract

Emerging drugs aim at targeting the genomic integrity and replication machinery in ovarian cancer. While the antiproliferative activity of Xanthium strumarium L. extract (XFC), a traditional herbal medicine, is believed to alter the mitotic apparatus of Chinese hamster ovary epithelial cells, its capacity to target and overcome the chemoresistance phenotype in ovarian cancer is unknown. Among the cancer cell lines tested, we found that the best proliferation inhibitory effect for XFC was against ovarian cancer cells and ranged from 30 to 35 μg/mL. XFC efficiently targeted both the cytotoxic drug chemoresistance phenotype of SKOV-3 cells and of the chemosensitive ES-2 cells. Early apoptosis and late apoptosis were effectively induced by XFC extract in ES-2 cells, whereas late apoptosis and necrosis events were triggered in SKOV-3 cells. Cell cycling regulation was trapped by XFC extract in the G2/M phase in both the ES-2 and SKOV-3 cell models. This effect was, in part, attributable to increased dose-dependent tubulin polymerization, which was increased in SKOV-3 cells. Whereas XFC extract triggered poly (ADP-Ribose) polymerase (PARP) cleavage in both ES-2 and SKOV-3 cells, it only lowered Nrf2 in ES-2 cells and phosphorylated Akt levels in SKOV-3 cells. Interestingly, cell cycling regulators Cdk4, Cyclin D3, and p27 were all decreased in SKOV-3 cells. XFC extracts were effective in inhibiting in vitro migration in both ovarian cancer cell models. Our data support the potential anticancer targeting of chemoresistant human ovarian cancer cells phenotype by XFC extract.
Killing for purposes other than slaughter: poultry

Abstract Poultry of different ages may have to be killed on‐farm for purposes other than slaughter (in which slaughtering is defined as being for human consumption) either individually or on a large scale (e.g. because unproductive, for disease control, etc.). The processes of on‐farm killing that were assessed are handling and stunning and/or killing methods (including restraint). The latter were grouped into four categories: electrical methods, modified atmosphere, mechanical methods and lethal injection. In total, 29 hazards were identified and characterised, most of these regard stunning and/or killing. Staff were identified as origin for 26 hazards and 24 hazards were attributed to lack of appropriate skill sets needed to perform tasks or due to fatigue. Specific hazards were identified for day‐old chicks killed via maceration. Corrective and preventive measures were assessed: measures to correct hazards were identified for 13 hazards, and management showed to have a crucial role in prevention. Eight welfare consequences, the birds can be exposed to during on‐farm killing, were identified: not dead, consciousness, heat stress, cold stress, pain, fear, distress and respiratory distress. Welfare consequences and relevant animal‐based measures were described. Outcome tables linking hazards, welfare consequences, animal‐based measures, origins, preventive and corrective measures were developed for each process. Mitigation measures to minimise welfare consequences were also proposed.
Lipid profile of type 2 diabetics in Almajmaah, Saudi Arabia

This research evaluated the lipid profile of type 2 diabetics in Almajmaah, Saudi Arabia. There is scarcity of literature about the assessment of lipid profile of type 2 diabetics in Saudi Arabia with very few studies addressing this issue. The data was collected from 350 diabetic patients visiting the primary healthcare centres in Almajmaah, Saudi Arabia. The questionnaire comprised of socio-demographic and clinical data information. Systematic random sampling technique was used to collect the data from available sample frame of type 2 diabetics. The median age of the patients was 45 (40 – 51) years. Majority of the patients were males as compared to females (57.7% vs 42.3%). A significant dyslipidaemia was observed in diabetics. Patients had significantly high LDL, and TG level (p < 0.001) respectively. HDL-C of males was significantly high, whereas, for females, it was at borderline (p < 0.001) respectively. However, TC was not statistically significant (p = 0.405). The prime focus when treating diabetics is to introduce preventive and therapeutic lifestyle changes measures into a comprehensive treatment programme. The treating doctor must keep an eye on the lipid profile of diabetics that can be useful for the patients to reduce the morbidity from macrovascular complications.
Efficacy and Safety of CAR-T Therapy with Safety Switch Targeting Bcma for Patients with Relapsed/Refractory Multiple Myeloma in a Phase 1 Clinical Study

Background: Encouraging results are seen from several early phase clinical trials on the cellular immunotherapy based on chimeric antigen receptor (CAR)-engineered T (CAR-T) targeting B cell maturation antigen (BCMA) for the treatment of relapsed/refractory (RR) multiple myeloma (MM). We developed an anti-BCMA CAR-T cell product manufactured via gamma-retrovirus-mediated transduction of activated T cells to express a second-generation CAR with the 4-1BB costimulatory domain along with a truncated epidermal growth factor receptor (tEGFR) as a safety switch. The preclinical study confirmed its high reactivity against MM cells. Methods: A phase 1 clinical trial (NCT03093168) has been launched to evaluate the safety and feasibility of this BCMA CAR-T cell product for treating RRMM. The enrolled RRMM patients had received at least 2 prior treatment regimens, including a proteasome inhibitor and an immunomodulatory agent, or are double-refractory, and have over 5% BCMA expression on plasma cells (Nine patient with extramedullary plasmacytoma does not express BCMA). Patients were subjected to a lymphodepleting regimen with Cy (300 mg/m2, d-5 to d-3) and Flu daily for 3 days (25 mg/m2, d-5 to d-3) prior to the CAR-T infusion (d0) at a dose of 9×106CAR+ cells/kg. The efficacy was assessed by the International Uniform Response Criteria for Multiple Myeloma, and the toxicity is graded by CTCAE 4.03. Results: As of March 1th, 2019, 46 patients had been infused with this intended dose of the autologous BCMA CAR-T cells, and 44 patients had reached at least 1 month of follow-up. As of this data cut-off, the overall response rate (ORR) for the 44 evaluable patients was 79.6%, including 2sCRs, 16CRs, 8VGPRs and 8PRs, and 16 patients reached MRD-negative response. The CAR-T cell expansion and persistence were consistently observed throughout these patients. The medianPFS is 15mon, and the median OS result has not been reached (49.16% progression-free survival, and 53.95% overall survival at 24 months). Among the 44 infused patients, 22.7% had grade 1-2 Cytokine release syndrome (CRS ) and 6.8% (3 patients) had grade 3 CRS. No grade 4 CRS reactions developed and all toxicities were fully reversible. Conclusions: Our result demonstrates the high potential of this single CAR-T infusion therapy for RRMM, including 2sCRs, 16CRs and ongoing clinical responses for more than 26 months, with manageable CRS to date. These initial data provide strong evidence to support the further development of this anti-myeloma cellular immunotherapy. No relevant conflicts of interest to declare.
Pathologic tearfulness after limbic encephalitis

Objective We investigated the nature and neural foundations of pathologic tearfulness in a uniquely large cohort of patients who had presented with autoimmune limbic encephalitis (aLE). Methods We recruited 38 patients (26 men, 12 women; median age 63.06 years; interquartile range [IQR] 16.06 years) in the postacute phase of aLE who completed questionnaires probing emotion regulation. All patients underwent structural/functional MRI postacutely, along with 67 age- and sex-matched healthy controls (40 men, 27 women; median age 64.70 years; IQR 19.87 years). We investigated correlations of questionnaire scores with demographic, clinical, neuropsychological, and brain imaging data across patients. We also compared patients diagnosed with pathologic tearfulness and those without, along with healthy controls, on gray matter volume, resting-state functional connectivity, and activity. Results Pathologic tearfulness was reported by 50% of the patients, while no patient reported pathologic laughing. It was not associated with depression, impulsiveness, memory impairment, executive dysfunction in the postacute phase, or amygdalar abnormalities in the acute phase. It correlated with changes in specific emotional brain networks: volume reduction in the right anterior hippocampus, left fusiform gyrus, and cerebellum, abnormal hippocampal resting-state functional connectivity with the posteromedial cortex and right middle frontal gyrus, and abnormal hemodynamic activity in the left fusiform gyrus, right inferior parietal lobule, and ventral pons. Conclusions Pathologic tearfulness is common following aLE, is not a manifestation of other neuropsychiatric features, and reflects abnormalities in networks of emotion regulation beyond the acute hippocampal focus. The condition, which may also be present in other neurologic disorders, provides novel insights into the neural basis of affective control and its dysfunction in disease.
Prospective audit of complications after ultrasonography-guided percutaneous nephrostomy for upper urinary tract obstruction using modified Clavien classification system

Introduction: Percutaneous nephrostomy (PCN) is a commonly performed intervention in urology for various benign and malignant conditions causing upper urinary tract obstruction. We present a prospective audit of complications of ultrasonography (USG) guided PCN using modified Clavien classification system (mCCS). Methods: The data were prospectively collected for 368 PCN performed in 344 patients from June 2015 to January 2017, for various benign and malignant diseases causing upper urinary tract obstruction. Patients were followed for 1 month, and complications arisen of PCN were noted. Results: PCN was successful in 356 renal units. The 12 patients in which PCN failed was due to minimal pelvicalyceal dilatation and PCN was successfully performed after 48 h by a senior urologist. 207 patients had malignant disease and 161 patients had benign condition. Most common malignant disease was carcinoma cervix. 238 were noninfected while 130 had infected renal units. 62 (16.84%) patients had Grade I (self-limiting hematuria/cot/debris/fever). 37 (10.0%) patients had Grade II (7 - transfusion and 30 - urinary tract infection). 34 (9.2%) had Grade III a (repositioning/change/reinsertion of PCN tube under local anesthesia) and 4 (1.1%) had Grade III b (repositioning under anesthesia). 8 (2.2%) Grade IV a (Sepsis), 0 Grade IV b, and 0 Grade V complications were observed. Conclusion: USG-guided PCN is a safe, minimally invasive, and effective procedure for upper urinary tract diversion with a low rate of morbidity. Individual complications are within the threshold limits set by the American College of Radiology, the Society of Interventional Radiology. mCCS is well applicable and easily reproducible tool for reporting the complications of PCN.
Outside-in: Rethinking the etiology of autism spectrum disorders

A role for peripheral sensory neurons in autism pathogenesis Autism spectrum disorders (ASDs) are thought to arise exclusively from aberrant brain function. Our research proposes a surprising revision of this view. We have discovered that peripheral sensory neurons—neurons outside the brain—are key sites at which ASD-related gene mutations have a critical impact. Dysfunction of peripheral neurons in mouse models disrupts central nervous system development and causes ASD-related phenotypes, including sensory overreactivity, social impairments, and anxiety-like behaviors. These unexpected findings have led us to propose and demonstrate that peripheral neurons are a tractable and effective therapeutic target to improve some ASD-related behaviors.
Thyroid Cytopathology: Evaluation of a Thyroid Nodule

The thyroid specialist frequently evaluates thyroid nodules because they may represent malignancy. Nodules are typically found on physical exam or incidentally when other imaging studies are performed. Malignant or symptomatic nodules that compress nearby structures warrant surgical excision. Yet, the majority of thyroid nodules are asymptomatic and benign, so the thyroid surgeon must rely on diagnostic studies to determine when surgery is indicated. Ultrasound is the preferred imaging modality for thyroid nodules, and the ultrasound guided fine needle aspiration biopsy (FNAB) is the preferred method of tissue sampling. Nodules one centimeter or larger, or nodules with suspicious sonographic appearance warrant cytologic analysis to better quantify the risk of malignancy. Molecular biomarkers are a powerful adjunct to cytology, as detecting malignancy pre-operatively allows total thyroidectomy in a single operation without the need for frozen section or a second operation for completion thyroidectomy if malignancy is found during the initial thyroid lobectomy.
The Effectiveness of The Use of Cervical Cancer Prevention Guideline Book on Women Participation in Visual Inspection with Acetic acid (VIA)

Cervical cancer is the second leading cause of death for women in the world after breast cancer. It is estimated that every 40-45 new cases occur and around 20-25 people die due to cervical cancer. In Kudus , the coverage of early detection of cervical cancer by the VIA method is only 2% of the number of women aged 30-50 years. This study aims to determine the effectiveness of health promotion and guidebook on the early detection of cervical cancer as an effort to increase the participation in women's VIA examination. This study was quasiexperimental with the design of the pretest posttest non equvialent control, The samples as many as 66 respondents were divided into two groups selected taken using consecutive sampling technique. Later on, the data were analyzed using McNemar and Chi Square tests. The results showed McNemar test results in the intervention group found there was an increase in knowledge and participation in the VIA examination compared to the control group. Obtained differences between the intervention group and the control group using the Chi Square test with the p value of 0.003. Providing health promotion and guidebooks for early detection of cervical cancer are very effective in increasing the knowledge and women participation of VIA examinations in Mejobo Subdistrict, Kudus Regency. Keywords—Guideline book, VIA Participation
A Distance-Learning Course to Improve Drug-Dispensing Behaviors Among Brazilian Community Pharmacists

Objective. To evaluate the effectiveness of a distance-learning course in the training of pharmacists in drug dispensing. Methods. This interventional study was carried out with community pharmacists throughout Brazil. A 12-week distance-learning course was conducted. Pharmacists’ knowledge and performance during drug dispensing were evaluated before and after completion of the course. Results. Community pharmacists’ knowledge of drug dispensing was greater after completing the distance-learning course than before (mean=5.7, SD=2.8 points vs mean=3.8, SD=1.9 points, respectively). However, no improvement was observed in pharmacists’ drug-dispensing practice. Almost all participants (96.5%) considered that they were more qualified to perform the drug dispensing after the course. There were 1492 pharmacists enrolled in the course, of which 1061 were included in the study, and 472 completed the surveys. Only pharmacists from Ribeirão Preto, Brazil, were invited to take the mytery shopper evaluation (n=26). However, 10 pharmacists completed the mystery shopper encounter. Conclusion. A distance-learning course was effective in improving community pharmacists’ knowledge. However, the course did not seem to improve overall drug-dispensing performance. Additional educational strategies should be adopted in future studies to address this gap.
P133 Does spirometry alone capture all respiratory abnormalities associated with abnormal lung function?

Introduction and objectives Respiratory disease is the third biggest cause of death in the UK,1 and for the first time, NHS England (NHSE) has designated respiratory disease as a clinical priority. The NHSE Long Term Plan highlights earlier and more accurate diagnosis as an objective. To identify respiratory disease earlier, the plan relies on quality performance of spirometry within the primary care setting. However, lung gas exchange abnormalities can be present in lung disease despite normal spirometry.2 Therefore, some diagnoses may be missed. Our aim was to investigate within a cohort of our patients, the proportion of those with abnormal gas exchange yet normal spirometry, and whose time to first diagnoses may be protracted due to the reliance of spirometry measurement alone. Methods A retrospective review of all patients attending the lung function laboratory from July 1995–July 2018 was undertaken. Spirometry and Single Breath Gas Transfer were performed to ERS/ATS standards, with ±1.64 standardised residual FEV1%VC Max used to identify normal spirometry and <-1.64 standardised residual used to identify abnormal TLCOc. Results Of 41,480 visits, 5759 (13.9%) were identified on first presentation as having normal spirometry, yet abnormal gas transfer, once corrected for Hb. Within the cohort of 5759 patients, 3270 were female and 2489 male, with a median (IQR) age of 63 (24) years. TLCOc median (IQR) standardised residual -2.23 (0.86). FEV1%VC Max median (IQR) standardised residual -0.25 (1.4). Conclusions We have demonstrated that a large proportion of patients referred to secondary care with symptoms suggestive of respiratory disease have normal spirometry, yet abnormal gas transfer. These results have implications when solely utilising spirometry in order to detect respiratory disease earlier and will ultimately result in a continued protraction of patient diagnosis. References GOV.UK. ( 2019). Respiratory disease: applying All Our Health. [online]Available at: https://www.gov. uk/government/publications/respiratory-disease-applying-all-our-health/respiratory-disease-applying-all-our-health [Accessed 27 May 2019]. Pellegrino R, Viegi G, Brusasco V, Crapo R, Burgos F, Casaburi R, Coates A, Van Der Grinten C, Gustafsson P, Hankinson J, Jensen R. Interpretative strategies for lung function tests. European Respiratory Journal 2005;26(5):948–968.
THE EFFECTS OF BALNEOTHERAPY IN ELDERLY PATIENTS WITH CHRONIC LOW BACK PAIN TREATED WITH PHYSICAL THERAPY: A PILOT STUDY

Amac: Bu calismanin amaci, balneoterapinin kronik bel agrisi nedeniyle fizik tedavi alan yasli bireylerde tedavi etkinligine katkisini arastirmaktir. Gerec ve Yontem: Toplam 244 hasta iki gruba randomize edildi. Grup I’e fizik tedavi ve Grup II’ye fizik tedavi ve balneoterapi uygulandi. Tedavinin baslangicinda (T0) ve tedavinin sonunda (T1) Agri (VAS), Quebec Bel Agrisi Engellilik Olcegi (Quebec) ve Saglik Degerlendirme Anketi (HAQ) kullanilarak degerlendirmeler yapildi. Bulgular: Tum gruplar VAS-agri, Quebec ve HAQ skorlarindaki dusus istatistiksel olarak anlamliydi (p<0,001). VAS-agri gruplar arasi kiyaslandiginda VAS-agri T0, BT + PT grubunda PT grubunda anlamli dusukluk saptandi (p=0,001). HAQ ve Quebec degerleri gruplar arasinda karsilastirildiginda, T0 degeri BT + PT ve PT grubu arasinda benzerken (HAQ p= 0,068, Quebec p=0,495), T1 degerleri BT + PT grubunda PT grubundan anlamli sekilde dusuktu (p<0,001). Gruplar karsilastirildiginda BT + PT grubunda tum puanlarin ortalama degisiklikleri (T1-T0) istatistiksel olarak daha anlamli degisiklik gosterdi (p<0,001). Sonuc: Calismanin sonuclari, kronik bel agrisi olan yasli hastalarda kombine tedavi uygulamalarinin daha etkili olabilecegini gostermektedir. Uygun kosullarda, tum vucuda uygulanan balneoterapi tedavinin etkinligini artirabilir.
Existing and emerging smoking cessation options for people with schizophrenia spectrum disorders

Abstract Tobacco cigarette addiction is a deeply entrenched behavior among people with Schizophrenia Spectrum Disorders, and consequently these individuals die an average of 25 years earlier than the general population. The aim of this review was to evaluate the state-of-the-science focused on cessation and reduction interventions for people with SSD. We searched peer-reviewed articles from medline, psycinfo, web of science, scopus, and cochrane library, about cessation interventions for people with SSD. The search was carried out by combining an exhaustive list of terms denoting schizophrenic disorder and smoking cessation treatment. The review search period was limited from January 2000–November 2018, 260 studies were identified and a total of 24 of studies were included in the final review. This review demonstrates the vulnerability of smokers with SSD and underscores the need for research in these areas with large enough sample sizes to detect treatment effects: 1) outcomes using and comparing standard treatments 2) long-term cessation/reduction outcomes 3) flexible treatment options 4) more research to develop the evidence-base for e-cigarettes intervention.