Miracle-dz/UniFAR-FTUs huggingface dataset:
Организация грудного вскармливания в отделениях реанимации и интенсивной терапии недоношенных детей: дискуссионные вопросы

The priority of breastfeeding in the care of premature infants is not in doubt. For preterm babies, breastfeeding provides a dual effect, reducing the risk of both immediate and long-term effects associated with prematurity. In this regard, extraordinary efforts are being made at the international level to promote and support breast-feeding of newborns, including in intensive care units. Mother’s own milk is the first choice for feeding a premature baby. In recent years, the problems of quality and safety of expressed breast milk — both pasteurized and fresh — for newborn patients of intensive care units are discussed. The authors point out that the treatment procedures and storage conditions of expressed breast milk differ significantly; there are no common criteria for its microbiological safety, which limits the use of this unique product, especially in premature infants. In addition to the risk of bacterial infection, the risk of infection with cytomegalovirus (CMV) when using fresh milk from a CMV — seropositive mother is discussed for premature infants. The review examines the criteria for the risk of CMV infection in children and indications for selective treatment of breast milk for inactivation of a probable pathogen.
Mastering the multitude of monocytoses

In this issue of the journal, Valent and coworkers report on diagnostic criteria for chronic myelomonocytic leukemia (CMML), CMML variants, and pre-CMML conditions. [1][1] These CMML disorders have always been like orphans, trying to find their place in a suitable environment. They are rare entities
A Survey of Venous Thromboembolism (VTE) Prophylaxis in Obstetrics Patients in Iran

Objective: The purpose of the present study was a survey of venous thromboembolism (VTE) prophylaxis in obstetrics patients in Iran. Materials and methods: A national, multicenter, non-interventional, prospective study was performed on 1000 women at 11 different parts of Iran. Primary outcome was to assess the situation of VTE prophylaxis in pregnant and postpartum women and the secondary outcome was risk stratification in obstetrics patients and to evaluate the guideline adherence in physician’s practice of VTE prophylaxis. Results: 1,036 women entered the final analysis. The three main VTE risk factors before hospitalization were BMI > 30 kg/m2, history of oral contraceptive (OCP) use, and the age over 35.VTE risk factors upon enrollment were detected in 780 (75.28%) patients. 219 women (28.07%) were deemed eligible for drug prophylaxis, however, only 37 women (17%) received it. A total of 113 (10.9%) patients received VTE prophylaxis, of which 76 (67.25%) women had no clear indications. Concordance between theory and practice was detected with a Cohen’s Kappa coefﬁcient to be 0.74 (p < 0.001), which fell within “good agreement”. Multivariate analysis for association between VTE prophylaxis and VTE risk factors showed that history of VTE [OR = 9.06 (CI 95% 1.16 – 70.8) p = 0.036] was the most frequent risk factor for receiving VTE prophylaxis followed by obesity (BMI > 30 Kg/m2); [OR = 3.74 (CI 95% 1.79 – 5.69), p = <0.001], multiple pregnancy [OR= 2.81 (CI 95% 1.70 – 4.64), p = < 0.001] and age > 35 years; [OR =1.09 (CI 95% 0.82 – 1.21), p = 0.026]. Varicose Veins [OR= 0.22 (CI 95% 0.56 – 0.87), p = 0.031], PROM / PPROM [OR= 0.33 (CI 95% 0.12 – 0.91), p = 0.032] and history of using OCP [OR= 0.36 (CI 95% 0.24 – 0.53), p = < 0.001] were the most missed risk factors for receiving VTE prophylaxis respectively. Conclusion: History of VTE, obesity, multiple pregnancy and age > 35 years were the most frequent risk factors for receiving VTE prophylaxis and varicose veins, PROM / PPROM and history of using OCP were the most missed risk factors for receiving VTE prophylaxis.
Laparoscopy in surgical management of gastric cancer: A single center experience

Accept Date 2019-10-15 ABSTRACT Background: Gastric cancer is the fourth most common cancer worldwide. Laparoscopic Gastrectomy is technically demanding surgery and its adequacy for lymph node clearance is controversial. The present work aims to evaluate feasibility and effectiveness of the laparoscopic method in treating gastric cancer. Methods: A total sample of 15 patients presenting with non-metastatic cancer stomach were included in the study. Ages less than 15 years or older than 70 were excluded. Laparoscopic total gastrectomy and esophagojejunostomy was performed for proximal types of cancer, while laparoscopic subtotal gastrectomy with gastrojejunostomy and entero-enterostomy was done for distal stomach cancer. Results: Mean age was 55.87+7.37 with male predominance (80%) and 26.7% were diabetics. Distal stomach cancer was the most prevalent type (73.3%). Total gastrectomy was done in 3 patients, subtotal gastrectomy in 11 patients, partial gastrectomy in 1 patient of Gist tumor. The mean operative time was 251.87+24.14 while average blood loss ranged from 150 to 310ml. Chest infection occurred in 2 patients, while wound infection and anastomotic leakage occurred in 1 patient each. Surgical margins were clear in 100% of patients (14.8+2.42 lymph node dissected). Adenocarcinoma was the commonest pathological type (60%). Mean hospital stay was 6.53 days while time to start oral feeding ranged from 2 to 5 days. Conclusion: Total laparoscopic gastrectomy is safe and effective, and offers some advantages as low intra-operative blood loss and overall complication rates; few wound-related complications; quick recovery of gastrointestinal motility and a short hospital stay, but with a long operating time.
Maternal prognosis of childbirth during augmentation of labour with oxytocin in Goma town, DR Congo

The use of synthetic oxytocin is now widespread in the stimulation of labor, almost substituting the normal physiology of childbirth and yet it remains a high-risk molecule. The objective of this study was to determine the maternal prognosis after augmentation of labour with oxytocin in our maternity wards. A case-control study of women who gave birth in three health reference facilities. The sample was of convenience consisting of 824 women in labor with a good prognosis of vaginal delivery at admission. We maintained 412 stimulated cases and 412 unstimulated controls, thus 1 case for 1 control. The software EPIINFO 2000, 7.2. 2.version and SPSS 20 version helped us to analyze the data. The results reveal a high labour stimulation rate in the city of Goma is 54%. The stimulation protocol was not respected: Bishop score was not evaluated in 56.8% of cases with 91.3% of cases stimulated by a high dose of 10 IU of oxytocin diluted in 500 ml. There were short intervals of increase ≤ 29 minutes in 18.5% of cases and 90.6% of the stimuli did not receive tococardiographic monitoring. The maternal prognosis was characterized by a high frequency of cesarean section (OR=1.95), artificial delivery (OR= 25.50), the post-partum hemorrhage (OR=2, 29) with (p < 0, 05). The resuscitation for disseminated intravascular coagulation (OR=1.29) and the maternal death characterized by (OR= 2.00). Unregulated augmentation of labor by oxytocin involves in increasing maternal morbi-mortality.
Inter-professional prescription safety workshop for non-medical prescribing and pharmacy students: A cross-sectional study.

This article reports on an evaluation of a prescribing workshop to increase ‘sharedlearning’ between registered practitioners undertaking a non-medicalprescribing (NMP) course (midwifery, nursing, physiotherapy, and podiatry) andundergraduate pharmacy students to increase awareness of, and understanding of theroles. The focus was on three domains ofsafe prescribing: Knowledge (of commonly prescribed medicines and theirsuitability for individual patients); Process (of legal requirements and supplyof medicines and associated patient information); and Relationships (betweenprescribers and pharmacists). A cross-sectional evaluation was utilized with6-point Likert-style items and a free text section, completed by 337participants. Participants reported positivelyabout the workshop content and their learning experience, although somedifferences between pharmacy and NMP participants were noted in the knowledgedomain. Quantitative analysis revealed significant differences (p<0.001) oflow-to-moderate magnitude (partial-2=0.146) between NMP and Pharmacy studenton all 3 domains, with NMP students reporting slightly more positive outcomes(between 0.4 and 1.5 points higher) in all cases. However, both groups scoredpositively; with mean domain scores of 15.6 to 16.5 on scales with maximumscores of 18.
Chief Student Affairs Officer’s Competencies: Perspectives from Community College Presidents in Illinois

Chief Student Affairs Officers (CSAO’s) within single campus community colleges are responsible for providing senior leadership and overall planning for all administrative areas as assigned by the college president. They work collectively to provide leadership for various functional areas to facilitate the development and maintenance of college campus environments and student success. While within single campus community colleges the CSAO are recognized by various administrative titles, but they serve in an executive capacity reporting directly to the college president and are responsible for the overall planning and leadership that supports the college’s mission. The purpose of this study was to identify the essential competencies that Single Campus Community College Presidents in Illinois consider to be important when hiring new Chief Student Affairs Officers. The primary data was collected by semi-structured interviews from four setting community college presidents in Illinois. The participants shared their perspectives on what essential competencies, functions, skills, and abilities, challenges, and leadership potential are needed by aspiring Chief Student Affairs Officers. Findings indicate the study participants believe that along with a fundamental understanding of student development theory and student engagement it is necessary that candidates convey trustworthiness, problem solving skills, and a good understanding of assessment. Furthermore, the study found that identifying a new CSAO must be intentional. It is not enough to update the current CSAO job descriptions to identify new skills and responsibilities; this process must be direct, time sensitive, and robust.
Central Symptoms Predict Posttreatment Outcomes and Clinical Impairment in Anorexia Nervosa: A Network Analysis

Network analysis can be used to identify central symptoms of eating disorders such as anorexia nervosa (AN), but the validity of this approach has been questioned. Using network analysis, in the present study we identify central symptoms of adult AN, identify key bridge symptoms between AN and anxiety/depression, and examine whether central symptoms at baseline are important predictors of treatment outcomes. We conducted network analyses for AN and comorbid depression and anxiety using longitudinal data (N = 142) with measurements at baseline, and at 6-month, 12-month, and 24-month postrandomization follow-ups. We identified central symptoms and bridge symptoms and tested whether centrality values calculated at baseline were related to the prognostic utility of symptoms longitudinally. Feeling fat and fear of weight gain were among the most central symptoms of AN. Feelings of worthlessness had the highest bridge centrality connecting depression to AN. Symptom centrality at baseline was strongly related to prognostic utility (r2 = .52, .55). The finding that symptom centrality was strongly related to prognostic utility supports the validity of network theory in that central symptoms may have a particularly strong influence on clinical impairment and recovery. These analyses generate useful hypotheses about the etiology and maintenance of AN and related comorbidities and may inform future treatment development.
Next-generation sequencing for better treatment strategy of cancer of unknown primary (CUP)

Abstract Background Cancer of unknown primary (CUP) consists of diverse histology types of cancer and have shown poor prognosis. In the era of precision medicine, next-generation sequencing (NGS) may contribute new therapeutic target which could improve treatment outcomes of CUP. Methods Patients who were diagnosed with CUP and underwent NGS exam between August 2017 and August 2018 at Samsung medical center were included for the study. NGS data were analyzed, and medical records were reviewed retrospectively to evaluate clinical characteristics and response to various treatments. Results A total of 21 patients with CUP who had NGS data were analyzed. The median age was 58 (range, 35-78 years). Male was dominant (57.1%) and most of the patients were ECOG 1 (90.5%). Among the patients, 14 (66.7%) were poorly differentiated carcinoma, 6 (28.6%) patients were adenocarcinoma, and one patient was squamous cell carcinoma. Most common metastatic site was lymph node (57.1%), followed by bone (38.1%), lung (19.0%), pleura (19.0%). Paclitaxel combined with carboplatin was most frequently used regimen for the first-line treatment (57.1%). Cisplatin-based chemotherapy was used second most (28.6%). One patient showed complete remission during the first-line treatment whereas 7 patients and 5 patients achieved the best response of partial response and stable disease, respectively. Median progression-free survival was 4 months (95% CI: 0.316-7.684), and median overall survival was not reached. Except four patients, 17 (81.0%) patients showed 25 gene alterations on the NGS results. TP53 mutation was observed most commonly (n = 6, 25.6%), followed by ERBB2 alterations (n = 3, mutations [n = 2], amplification [n = 1]), KRAS mutation (n = 2), MET amplification (n = 2), CDKN2A deletion (n = 2), and MYC amplification (n = 2). One patient harbored ERBB2 amplification was treated with trastuzumab combined with paclitaxel, and the patient demonstrated sustained partial response at 9 months, until the data cut-off date. Conclusions Most of CUP patients had variety actionable gene alterations. Precision medicine based on molecular analysis with NGS will improve the prognosis of the patients with CUP. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.
Diagnostik und Therapie der Osteoporose bei Diabetes mellitus

Zusammenfassung Ein Diabetes mellitus beeinträchtigt das Skelettsystem und ist ein starker Risikofaktor für die Entwicklung einer Osteoporose mit Fragilitätsfrakturen. Die zugrundeliegenden Mechanismen für die erhöhte Fragilität des Knochens sind unzureichend bekannt, umfassen jedoch direkte und indirekte Effekte einer chronischen Hyperglykämie auf den Knochenstoffwechsel. Beim Typ-1-Diabetes mellitus (T1DM) ist das Skelett deutlich stärker betroffen als beim Typ-2-Diabetes mellitus (T2DM), insbesondere durch diabetische Komplikationen. Die Knochendichte kann bei Patienten mit T2DM sogar erhöht sein, schützt aber offenbar aufgrund einer eingeschränkten Qualität weniger gut gegen Frakturen. Orale Antidiabetika vom Typ der Glitazone fördern den Knochenverlust und sollten daher bei Osteoporose vermieden werden. Ein körperlich aktiver und gesunder Lebensstil, eine konsequente Prävention und Therapie diabetischer Komplikationen sind zusammen mit einer Basistherapie bestehend aus Kalzium und Vitamin D die Säulen der Behandlung der Osteoporose bei T1DM und T2DM. Die Messung der Knochendichte und die Bestimmung anderer Risikofaktoren dienen der Festlegung einer risikoadaptierten spezifischen Therapie. Auch wenn sie nicht spezifisch bei Diabetikern untersucht wurden, scheinen sämtliche etablierte Osteo porosetherapien bei Patienten mit Diabetes mellitus wirksam zu sein.
pectoralis major tendon rupture in a rugby player clinical case

Pectoralis Major (PM) is a muscle-tendon unit that connects the anterior chest wall with the upper member. Indirect trauma is the most common mechanism of injury in athletes. We present a case of acute failure of PM 1 week of evolution and review the literature on the most appropriate treatment of such injuries. Full injury MP in osteotendinous junction is primarily surgical treatment, through the reinsertion of the tendon, allowing a morphological restoration of the thoracic region, and a full functional recovery of the affected upper limb.
Diabetes Mellitus Hastalarının Diyet Alışkanlıklarının Değerlendirilmesi

Giris: Diabetes Mellitus (DM); genetik, yasam tarzi degisiklikleri ve cevresel faktorlerin etkilesimi nedeniyle insulin etkisi, insulin salinimi veya her ikisinin de birlikte oldugu defektlerden koken alan hiperglisemi ile karakterize bir metabolik hastaliktir. Diabetli hastalarda yasam kalitesinin degerlendirilmesi tedavi etkinliginin gostergesi olarak kabul edilir. Bu calismada amacimiz; birinci ve ucuncu basamak saglik sunucularina basvuran DM hastalarinin yasam tarzi degisikliklerini degerlendirmek ve DM tedavisinde, tedavi hedeflerine ulasma oranlarini belirlemektir. Materyal ve Metot: Calismamiza Universite Hastanesi Ic Hastaliklari Poliklinikleri’ne ve Eskisehir Halk Sagligi Mudurlugu’ne bagli Aile Sagligi Merkezleri’ne 1 Haziran 2017 ile 15 Ocak 2018 tarihleri arasinda basvuran 631 DM hastasi dahil edildi. Arastirmacilar tarafindan olusturulan anket formu DM hastalarina yuz yuze gorusme yontemi ile uygulanmistir. Bulgular: Olgularin 337’si (% 53,40) Universite Hastanesi Ic Hastaliklari polikliniklerinde (Ucuncu Basamak Saglik Hizmetleri), 294’u ( % 46,60) Eskisehir Halk Sagligi Mudurlugu’ne bagli Aile Sagligi Merkezleri’nde (Birinci Basamak Saglik Hizmetleri) takipli olan hastalardir. Katilimcilarin % 92,23’u (n=582) takip edildikleri birimlerde diyetisyene yonlendirildigini ve diyet onerileri aldiklarini belirtirken, diyetisyene yonlendirilenlerin % 49,31’i (n=287) diyet uyumlarinin oldugunu belirtmistir. Katilimcilara egzersiz bilgileri soruldugunda ise % 18,85’i (n=119) daha onceden hekimleri tarafindan egzersiz konusunda bilgi aldiklarini belirtirken, % 81,14’u (n=512) egzersiz hakkinda bilgilendirilmediklerini belirtmistir. Sonuc: DM hastalarinin takibi sirasinda hedeflere ulasmak icin, hastalar her kontrolde yasam tarzi degisiklikleri icin motive edilmeli ve hastalarin bu degisiklikleri benimseyerek uygulamalari saglanmalidir.
Studies On The Transmission Dynamics Of Leishmania Donovani In Gadarif State Eastern Sudan

This study was carried out in eastern Sudan by introducing dogs from non endemic area to VL endemic area to elucidate the natural L. donovani infection in dogs(Canis familiaris, Linnaeus, 1758) and then to determine their role in transmission of visceral leishmaniasis as reservoir hosts. This study comprised 3 groups of dogs, the first one was the natural L. donovani , infection test group, consisted of 35 dogs selected with the age of less than 6 months, from non endemic area of V.L. ( Khartoum) transferred to the VL. endemic area (17 dogs in Tabarak Alla and 18 in Barber el fugara). The second group was healthy controls consisted of five dogs kept at Khartoum State, in the Police Dogs Directorate. The third group consisted of 25 local dogs sampled randomly during a survey done in December 2008 – Feb. 2009. All dogs from group 1&2 were checked free from Leishmania donovani . They were vaccinated with routine vaccines (Distemper, canine adenovirus type 2, canine parvovirus and rabies). The field study was continued for more than 2 years (32 months) (June 2006 – February 2009). Trips for sampling and data collection were regulated every (1-2) months. Dogs were tested for the development of symptoms and signs of CVL on monthly basis. Venous blood and lymph node, bone marrow aspirates were collected for the detection of infection using the PCR, DAT, microscopy and culture. The results showed that, the transferred dogs group (1) had developed typical clinical signs of CVL like, lymphadenomegaly, long nails, weight loss, & different skin lesions. Parasitological examination showed the presence of the distinctive promastgote forms in cultures of BM& LN in (18.2%) of transferred dogs, which also showed (55.6%) and (100%) of PCR & DAT positive results respectively. In the other hand, the local dogs, although they showed no clinical symptoms, they were (84%) & (96%) positive by PCR& DAT respectively. In addition to these results, questionnaires designed to know the relation of keeping domestic animals including dogs & the VL infections in human. Showed a positive contribution of them to VL risk factors. It was concluded that dogs can acquire natural infection with Leishmania donovani, and thus may be considered as a potential reservoir of leishmaniasis that can play a significant role in VL transmission in that endemic area.
Chronicles of Alzheimer’s Disease: A Medicinal & Therapeutic Overview in Bangladeshi Aspect

Nervous system and Neurological disorder sounds like a deep-sea of neurobiological harmony, reflecting a glorious bond and symbolizing a deep sign of interrelated linkages. Neurodegenerative diseases especially; Alzheimer’s disease is a widely renowned disorder with a larger scope of research opportunities. Nowadays, there are an abundance of research activities been carried out on this specific topic. It’s quite frightening to witness the ultimate outcome of Alzheimer’s disease sometimes which can turn out to be the deaths of the patients. In our data analytical program, we have emphasized on Alzheimer’s disease present therapeutic condition in Bangladesh, where in recent times this disorder has transformed into a household scenario. A handful number of patients been analysed through the regular observations based on their previous therapeutic history, expert opinions of scientists and physicians, as well as a smartly organized collection of medicinal and therapeutic information’s been used in order to estimate and indicate an up to dated circumstance of Alzheimer’s disease in Bangladesh. However, it’s a matter of concern that even with the development of modern technology, this age-old innocence of the inability to treat such a class of apocalypse has raised a finger at the capability of civilized human beings. Here, we have also focused on the in-general medical therapeutics of Alzheimer’s disease from which we are able to formulate a portfolio on the medicinal agents used in Bangladesh. Additionally, a data graphic is provided to figure out an estimated analysis of the approximate number of Alzheimer’s disease affected patients in Bangladesh.
Enterografia peroral por tomografia computorizada: avaliação da patologia do intestino delgado por tomografia computorizada multicorte com contraste oral de goma de alfarroba-sorbitol

Introducao: O estudo do intestino delgado tem evoluido extraordinariamente, mas ainda nao esta definido um metodo referencial. Descreve-se a utilizacao em Tomografia Computorizada de um contraste oral usado em Ressonância Magnetica. Objectivos: Avaliacao da Enterografia Peroral por Tomografia Computorizada com goma de alfarroba-sorbitol no estudo do intestino delgado. Material e Metodos: Doze doentes realizaram Enterografia Peroral por Tomografia Computorizada: 7 por suspeita de doenca de Crohn, 2 para estudo de doenca de Crohn conhecida e 3 por hemorragia digestiva e/ou anemia. Efectuouse o estudo num aparelho multicorte, apos admnistracao endovenosa de contraste iodado, com distensao previa do intestino com solucao oral hiperosmolar (goma de alfarroba-sorbitol). Avaliou-se: tolerância, distensibilidade intestinal e acuidade diagnostica deste metodo. Resultados: O exame foi bem tolerado em todos os doentes. Confirmou o diagnostico de doenca de Crohn em 4, avaliou complicacoes desta doenca em 2, diagnosticou tumores no delgado em 1 e no colon em 1. A distensibilidade intestinal foi boa ou optima em todos. Registaram-se apenas complicacoes minor do contraste oral: desconforto abdominal em 1 e diarreia em 3. Conclusoes: A Enterografia Peroral por Tomografia Computorizada com goma de alfarroba-sorbitol revelou-se uma tecnica simples, bem tolerada e util no estudo do intestino delgado. Summary