Miracle-dz/UniFAR-FTUs huggingface dataset:
GERM CELL TUMOURS OF THE OVARY IN CHILDREN AND ADOLESCENTS: A CLINICAL STUDY OF 109 PATIENTS IN A SPECIALIZED CANCER CENTRE

Objective: Paediatric ovarian germ cell tumours (GCTs) are rare tumours withmalignant tumours extremely rare.Methods: All the paediatric patients who received treatment for histology proven ovarian GCT at Shaukat Khanum Memorial Cancer Hospital from January 2006 to December 2014 were retrospectively reviewed. Patients over the age of 18 years were excluded from the study. A total of 109 patients were included in the study. A set of parameters were identified to record initial clinical presentation and examination, imaging and laboratory investigations including tumour marker levels. Decisions of multidisciplinary team meetings, surgical treatment, neo adjuvant, adjuvant chemotherapy and radiation data retrieved. Data analysiscarried out using SPSS 20.Results: In total 109 girls presented to our hospital during the study period, most of them above the age of 5 years, with dysgerminoma being the most common followed by yolk sac tumour. Most of the patients received treatment outside our hospital and were referred here for chemoradiotherapy. Fertility preserving surgery was the most commonly performed surgical procedure with a mean follow-up of 50.4 months and >75% overall 5-year survival.Conclusion: Regardless of histologic types, the outcomes of GCT can be improved with a multidisciplinary approach.Key words: Dysgerminomas, germ cell tumours, ovarian tumours
Risk Factors and Etiologies of Ischemic Stroke in Young Adults: A Hospital-based Study in Bangladesh

Background: Stroke is an important cause of disability among adults and is one of the leading causes of death worldwide. Strokes in young adults can have a significant impact on the affected individuals, their families and societies in general as the affected patients are in the economically productive period of their lives.This study was aimed to find out the demographic profile and explore the associated risk factors of the first-ever ischemic stroke of young adults. Methods : This retrospective study reviewed the records of 64 patients, age 18-49 years, ischemic stroke patients consecutively admitted in the Neurology department, BIRDEM General Hospital during the period January 2016 to June 2017. Study variables included hematological and biochemistry investigations and radiological and imaging findings. Stroke sub-typing was done following to TOAST criteria. Data of follow-up data at 3 month were also included. Data were expressed as number (percent) and managed by SPSS for Windows Version 15. Results: Of the 634 patients diagnosed as acute ischemic stroke 64 (9.90%) were in the 18-49 (yr) age range and the majority (55.4%) were male. Stroke was more common (47 out of 54) among the 31-49 years category as compare with the <30 years category. Stroke patients presented with diabetes mellitus(87.03%),arterial hypertension (44.4%), dyslipidemia (23.5%) and cigarette smoking (31.48%). Family history of stroke was present in 33.5% cases. Ten (6.51%) patients showed hypercoagualable state.Small vessel occlusion (SVO) found in 48.40% cases followed by large artery atherosclerosis (21.86%). Patients with SVO stroke presented with lacunar syndromes and lesions in Basal ganglia(12.1%),Thalamus(6.6%), Subcortical region (0.9%),Internal capsule (20.0%)and brain stem(11.3%). Thrombolysis was not done in any of patients. Most of the patients were on an anti-platelet treatment and majority (85.4%) receiving aspirin alone. Strokes left 48(75.5%)patients with moderate to moderately severe disability on discharge from the hospital.Mortality was lower (6.3%) and had good recovery 35 (54.6%). Conclusion: Ischemic stroke in the young adults accounted for 9.90% of the hospital admission with stroke. Those suffered from ischemic stroke had presence of modifiable risk factors. Predominance of SVO among them not only indicated stroke etiology but also predicted good short term prognosis. Birdem Med J 2018; 8(2): 138-144
Mechanistic bases for the adverse interaction of nicotine and chronic pain

The adverse interaction between smoking and chronic pain has been known for decades. A variety of chronic pain conditions – ranging from headache to low back pain to fibromyalgia – markedly exacerbate smoking prevalence and intensity in packs per day among multiple patient populations. In patients seeking pain treatment, the prevalence of smoking approaches 50%, compared to less than 20% in the general population. Perhaps not surprisingly, the relationship is bidirectional: not only does persistent pain increase rates and intensity of smoking, but smoking also appears to exacerbate both the intensity and associated impairment of chronic pain. In fact, smoking appears to place individuals at risk for developing a chronic pain condition and may also facilitate the transition from acute to chronic pain. The growing body of literature documenting these associations has led to the proposition of a positive feedback loop: individuals smoke in part to cope with their pain, but smoking actually worsens the pain. Despite the strong evidence for the existence of this adverse interaction, the mechanisms responsible for it remain poorly understood. A number of preclinical and clinical studies have documented that nicotinic acetylcholine receptor (nAChR) agonists, e.g., nicotine, have analgesic efficacy in the acute pain setting, such as that produced experimentally in the research laboratory or experienced by patients postoperatively. In contrast, the role of nAChR activation in modulating chronic pain is less well characterized. The experiments described in this thesis determine whether persistent pain diminishes the antinociceptive (analgesic) efficacy of an α4β2 nAChR agonist in
DISPENSING ERRORS OBSERVED BY COMMUNITY PHARMACY DISPENSERS IN IBB - YEMEN

Objective: The objective of this study was to determine the dispensing errors, its types, and causes in community pharmacies in Ibb, Yemen.Methods: A prospective study was conducted among community pharmacies in the Ibb, Yemen, over 4 months’ period. Dispensing errors that were detected during the dispensing process were recorded by the pharmacy dispensers using a data collection form. Detecting and reporting of dispensing errors, types, and causes of dispensing errors were explained to the participated pharmacists before starting the study. The data were analyzed using the Statistical Package for the Social Sciences® (IBM SPSS) version 21 for Windows.Results: A total of 35 (0.80%) dispensing errors were reported in this study. Wrong dosage form was the most common dispensing error type reported in this study followed by wrong quantity, wrong strength, and wrong drug. Factors most commonly reported as contributing to dispensing errors in this study were prescriptions poor handwriting, similar medications packaging, more than one patient at the same time, and similar drug names.Conclusion: This study explored the type and causes of dispensing errors at five community pharmacies in the Ibb city, Yemen. Dispensing errors can be prevented by educational interventions about dispensing error’s and its potential causes. Effective collaboration and communication between community pharmacy dispensers and prescribers are an important key to minimize and prevent dispensing errors.
Of Vanishing Retinal Drusen and Oxysterols

Aim: Spontaneous resolution of retinal drusen is a common occurrence in ophthalmology, but little is understood about the mechanistic pathophysiology of this phenomenon. Small molecules, taken orally, such as resveratrol (RV) and zeaxanthin (Z), resolve retinal drusen and amyloid protein, yet few clinicians are aware of this molecular, biochemical progress against the major degenerative disease(s) of ageing. Published Data: We highlight the mechanistic role of resveratrol (RV) in the cytochrome P450 enzymatic pathways of liver detoxification, as well as dosing considerations. RV has demonstrated utility in age-related macular degeneration (AMD) and has application in disorders of cognition (Alzheimer's Disease) and age-related hearing loss. We highlight the clinical evidence for the use of an epigenetic RV nutraceutical matrix called Longevinex®, and the xanthophyll carotenoid zeaxanthin. Longevinex® has been employed against retinal drusen, with resulting normalisation of retinal anatomy, Amsler Grid field loss (scotomas) and distortions of the central visual field (metamorphopsia). Implications: The published evidence for RV and Z resolving structural and functional deficits in Mini-review Article Richer et al.; JAMMR, 27(9): 1-12, 2018; Article no.JAMMR. 43776 2 AMD is presented. The xanthophyll carotenoid zeaxanthin has now been demonstrated, in a larger population clinical trial, to resolve drusen beyond normal expectation. Both RV and Z have also both shown to induce denser macular pigment, and such small molecules likely play a role in multisensory degeneration(s) of ageing. Conclusion: Previously described “spontaneous resolution” of drusen may have an unappreciated biological mechanism(s). The adjunct and complimentary wound healing benefits of RV and Z remain clinically underutilised in age-related retinal and neuro-degeneration associated diseases of ageing, while the complications of chronic ophthalmologic anti-vascular endothelial growth factor intravitreal injections emerge as problematic.
Novel technique of diagnosing and reducing pain in cervical radiculopathy

Background: Neck pain with upper limb pain is a common complaint of patients seen in Out Patient Department (OPD). Such pain may be because of a pinched nerve. There is inflammation in the nerve which causes radicular symptoms. The available clinical tests for cervical radiculopathy are provocative tests, difficult to perform and techniques vary from author to author. The reliability of these tests is only when done in clusters. We devised a novel non-provocative clinical sign to diagnose cervical radiculopathy and a method to reduce upper limb radicular pain and thereby improving the function of the upper limb. Method: Patient’s bilateral pronated wrists were palpated dorsomedially on the ulnar styloid. This elicited tenderness over the Dorsal Cutaneous branch of Ulnar Nerve (DCU). The painless active degree of movement at shoulder and elbow joints was noted. Nerve block at the palpated tender point was given using 2% lignocaine in 95 patients. We used Visual Analogue Scale score to measure radicular pain intensity before and 5 minutes after injection. Results: All patients had tenderness at the DCU on the symptomatic upper limb. All patients had reduction in VAS of radicular pain from 7.36±0.89 before injection to 1.89±0.98 after injection with improvement of shoulder and elbow active movement. Conclusion: We recommend palpation of DCU in both upper limbs in all cases of suspected cervical radiculopathy. Palpation to elicit tenderness over DCU in cervical radiculopathy, was documented as Pote’s sign positive. Injection of local anesthetic agent over DCU reduces pain and improves upper limb function and it was documented as Pote’s test positive. This test is of diagnostic and therapeutic significance. This test is minimally invasive and can be done in an OPD set-up.
Abstract 1157: The B-NDG mouse is a perfect tool for immune system humanization and patient derived xenograft transplantation

The B-NDG mice (NOD-Prkdcscid Il2rgtm1/Bcgen), independently developed by Biocytogen, display a severe immunodeficiency phenotype, with no mature T, B or functional NK cells, and deficient in cytokine signaling. The B-NDG mouse is one of the best models for reconstitution of human immune system using peripheral blood mononuclear cells (PBMC) or hematopoietic stem cells (CD34+). Human PBMC reconstituted well in B-NDG mice, with the percentage of hCD45+ cells was over 50% in five weeks. To further analyze the subsets of immune cell composition, we found the majority of human cells were CD8+ T lymphocytes. Other than PBMC, human CD34+ hematopoietic stem cells also demonstrated a high-engraftment efficacy in B-NDG mice. Successful engraftment of CD34+ cells develops all major cell types via myeloid and lymphoid lineage to reconstitute functional human immune system. At 10 weeks post CD34+ cell implantation, the percentage of hCD45+ cells is over 30% with detectable human T, B and NK cells. Therefore, the immuno-humanized B-NDG mice are useful tools for studying hematopoiesis, immunology, infectious disease, and ES/iPS cell research. With barely any rejection to human derived cells, the B-NDG mouse is an ideal host for transplantation of PDX (Patient-Derived Xenograft), and retains the high heterogeneity characteristics of tumor tissues. Each PDX model can be considered as a single tumor patient and fully embodies the patient group characteristics. We have a collection of various PDX models including leukemia, breast cancer, gastric, lung, pancreatic, and colon et al. The humanized PDX model by implantation of PDX on the immuno-humanized B-NDG mice will be a promising tool to evaluate the in vivo efficacy of immune checkpoint antibodies in monotherapy or in combination. Therefore, therapeutic efficacy studies using B-NDG based PDX models are more meaningful and predictive in preclinical drug development and discovery. Citation Format: Meiling Zhang, Chaoshe Guo, Yuelei Shen, Yanan Guo. The B-NDG mouse is a perfect tool for immune system humanization and patient derived xenograft transplantation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1157.
Scientific opinion on the safety of monacolins in red yeast rice

Abstract The Panel on Food Additives and Nutrient Sources added to Food (ANS) was asked to deliver a scientific opinion on the safety of monacolins in red yeast rice (RYR) and to provide advice on a dietary intake of monacolins that does not give rise to concerns about harmful effects to health. The Panel reviewed the scientific evidences available as well as the information provided by interested parties in response of a public ‘Call for data’ launched by EFSA. The Panel considered that monacolin K in lactone form is identical to lovastatin, the active ingredient of several medicinal products authorised for the treatment of hypercholesterolaemia in the EU. On the basis of the information available, the Panel concluded that intake of monacolins from RYR via food supplements, could lead to estimated exposure to monacolin K within the range of the therapeutic doses of lovastatin. The Panel considered that the available information on the adverse effects reported in humans were judged to be sufficient to conclude that monacolins from RYR when used as food supplements were of significant safety concern at the use level of 10 mg/day. The Panel further considered that individual cases of severe adverse reactions have been reported for monacolins from RYR at intake levels as low as 3 mg/day. The Panel concluded that exposure to monacolin K from RYR could lead to severe adverse effects on musculoskeletal system, including rhabdomyolysis, and on the liver. In the reported cases, the product contained other ingredients in addition to RYR. However, these reported effects in particular musculoskeletal effects, have both occurred after ingestion of monacolin K and lovastatin independently. On the basis of the information available and several uncertainties highlighted in this opinion, the Panel was unable to identify a dietary intake of monacolins from RYR that does not give rise to concerns about harmful effects to health, for the general population, and as appropriate, for vulnerable subgroups of the population.
Influence of Insulin Resistance and TSH on the Risk of Malignancy of Thyroid Nodule

Objective: The incidence of thyroid cancer has increased in recent years. This increase may be due to the change of metabolic parameters in patients. This study was designed to clarify the association of malignancy of thyroid nodules with metabolic parameters. Materials and methods: This study designed as a cross-sectional study between January 2018 and May 2018. Samples were collected from the patients by thyroid fine needle biopsy and patients who had thyroid surgery. Group 1 patients were pathologically benign patients; Group 2 patients were pathologically malignant. In both groups, preoperative TSH, fasting insulin were measured and HOMA-IR calculated. Statistical analysis was performed. Results: A total of 84 patients were included in the study. The benign group was 41 (F/M: 33/8) and the malignant group was 43 (F/M: 36/7). TSH levels (1.44 (0.0-9.4) versus 0.41 (0.0-8.9); p < 0.01), fasting insulin levels (13.0 (5.040.0) versus 9.4 (3.2-25); p < 0.05) and HOMA-IR levels (2.75 (1.06-13.19) versus 2.24 (0.68-6.3); p < 0.05) were significantly higher in the malignant group. Conclusion: TSH elevation and insulin resistance may be associated with a risk of malignancyof thyroid nodule.
Caracterización del riesgo de presentar pie diabético. Servicio Provincial de Angiología de Matanzas. 2014-2015

Introduction: the identification of the foot at risk of people with diabetes allows its stratification as a preliminary step for the establishment of future preventive strategies to prevent the onset of the diabetic foot ulcer. Objective: to characterize the risk of developing diabetic foot in patients who entered the Provincial Service of Angiology and Vascular Surgery of Matanzas with this affection from September 2014 until May 2015. Material and method: a descriptive, retrospective, cross-sectional research was carried out. The studied sample was constituted by 111 hospitalized patients diagnosed with diabetic foot in the Provincial Service of Angiology and Vascular Surgery of Matanzas, in the period from September 2014 to May 2015. Results: in the stratification of risk, diabetic patients with risk 4 foot prevailed; the use of inadequate footwear and deficient feet care were the predominant risk factors related to the education of the diabetic patients; diabetic neuropathy was the most frequent condition in patients with compromised foot; however, podalic deformities and the absence of peripheral pulses were also present in a high percentage of patients. Conclusions: neuropathy, the antecedent of ulcer and / or amputation, the use of inadequate footwear and deficient care of the feet represent risk to develop a diabetic foot:
The Potential for Menstrually-Derived Stem Cell Banking in the UK

In the UK, there is a growing demand for the NHS to provide cost-effective medical treatment for the ever-increasing, ever-aging population, suffering from chronic non-communicable diseases such as heart disease, diabetes, cancer, and chronic degenerative diseases, such as Alzheimer’s disease, Huntington’s disease, and multiple sclerosis. Well-established stem cell treatment includes that for blood and immune system diseases and conditions, such as treating leukaemia with a bone marrow transplant. Skin grafts are grown from stem cells for severe burns cases; and cornea damage (surface of the eye) can be repaired with stem cells. However, stem cell treatment is currently limited by the painful, invasive, expensive harvesting procedures required. Stem cells have been found in menstrual blood: harvesting menstrually-derived stem cells does not require an invasive procedure, can be donated monthly, and can be collected within the donor’s home using a menstrual cup. This new source of stem cells could lead to greater accessibility to stem cell therapy, and increase the rate of stem cell therapy research. This paper explores the potential for a menstrually-derived banking system in the UK from a scientific, ethical, and human factor standpoint. The scientific community views menstrually-derived stem cells as having potential for application in stem cell therapy. However, the proposed stem cell donation must also be evaluated from an ethical standpoint. The potential for menstrually-derived banking in the UK is driven by the willingness for women to donate their menstrual blood: without the support from women, the entire system is void. The study looks to explore women’s initial thoughts, concerns, and inclination to donate, in addition to their first experiences with a menstrual cup. With potential from a scientific, ethical, and human factor perspective, the scientific and medical community can anticipate and prepare for the potential for banking menstrually-derived stem cells in the UK.
Envejecimiento y memoria: efectos de la restricción calórica

Introduccion. El conocimiento de los mecanismos cerebrales involucrados en el proceso de envejecimiento y el deterioro mental podria ser clave para el desarrollo de pautas de conducta que garanticen alcanzar edades avanzadas con la maxima calidad de vida posible y reducir la perdida cognitiva asociada a la senectud. Objetivo. Describir y analizar diferentes investigaciones con animales y humanos que demuestran que una dieta con restriccion calorica aminora el envejecimiento cerebral y el declive cognitivo asociados a la edad. Desarrollo. Desde hace mas de 100 anos se conoce que la restriccion calorica incrementa la longevidad de los animales de laboratorio. Este efecto parece derivar de la disminucion de algunos sintomas que acompanan al envejecimiento, como la obesidad, la aparicion de tumores cancerigenos y algunas enfermedades metabolicas. Sin embargo, mientras las consecuencias de la restriccion calorica sobre la salud estan bien determinadas, su capacidad para frenar el declive cognitivo que acompana al envejecimiento sigue siendo un tema controvertido. La investigacion de los efectos de la restriccion calorica en animales de laboratorio proporciona los primeros avances para la comprension de sus efectos beneficiosos en la neurobiologia de los procesos cognitivos durante el envejecimiento. Conclusiones. La restriccion calorica atenua el envejecimiento normal o patologico del cerebro y reduce los problemas de memoria asociados a la vejez. La intervencion dietetica podria convertirse en un metodo muy eficaz para fomentar una mejor calidad de vida y prevenir el deficit cognitivo que acompana a la ancianidad.
Intra-abdominal packing does not increase infection risk or mandate longer presumptive antibiotic therapy

ABSTRACT BACKGROUND: Damage control laparotomy allows for resuscitation and reversal of coagulopathy with improved mortality. Intra-abdominal packing is often used to limit hemorrhage. Temporary abdominal closure is associated with increased rates of subsequent intra-abdominal infection. The effect of increased duration of antibiotics is unknown on these infection rates. We sought to determine the role of antibiotics in damage control surgery. METHODS: A retrospective analysis of all trauma patients requiring damage control laparotomy on admission to an ACS verified level one trauma center from 2011 to 2016 was performed. Demographic and clinical data including ability and time to attain primary fascial closure, as well as complication rates, were recorded. The primary outcome measure was intra-abdominal abscess formation following damage control laparotomy. RESULTS: Two-hundred and thirty-nine patients underwent DCS during the study period. A majority were packed (141/239, 59.0%). No differences existed in demographics or injury severity between groups, and infection rates were similar (30.5% vs. 38.8%, P=0.18). Patients with infection were more likely to have suffered gastric injury (23.3% vs. 6.1%, P=0.003) than those without complication. There was no significant association between gram negative and anaerobic (Odds Radio [OR] 0.96, 95% confidence interval [CI] 0.87–1.05) or antifungal therapy (OR 0.98, 95% CI 0.74–1.31) and infection rate, regardless of duration on multivariate regression CONCLUSION: Our study offers the first review of the effect of antibiotic duration on intra-abdominal complications following DCS. Gastric injury was more commonly identified in patients who developed intra-abdominal infection. Duration of antimicrobial therapy does not affect infection rate in patients who are packed following DCS.