Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparative analysis of immediate and delayed insertion of flexible cystoscope after application of topical anaesthetic lubricant on patient comfort

Background: The objective of the study was to compare the difference in pain scores during flexible cystoscopy between patients undergoing the procedure with insertion of the flexible cystoscope either immediately after topical lubrication with lignocaine gel or after a 3-minute delay.Methods: A total of 127 male patients with various indications for flexible cystoscopy were enrolled in this prospective study. Patients were randomized in two groups, immediate group and the delayed group depending on the retention time (immediate or after 3-minute delay) of the topical lignocaine gel. Pain scores were recorded immediately after the procedure using a visual analogue scale. The statistical analyses were performed using students “t” test.Results: Both the groups (immediate group and the delayed group) were comparable for variables including age, level of operating endoscopic surgeon and indication for the procedures. The most common indication for flexible cystoscopy was visible hematuria. There was no statistically significant difference in the mean pain scores between the two groups (p=0.98). However a small subset of patients (age less than 50 years), having flexible cystoscopy for the first time had less pain scores in the delayed group (p=0.003) but the sample size was very small.Conclusions: The study revealed that there appears to be no benefit in longer retention times of local anaesthetic during the outpatient flexible cystoscopy. However, there might be a possible advantage in men younger than 50 years of age who are having flexible cystoscopy for the first time.
Factors associated with human papillomavirus infection – findings from a cervical cancer screening program for female employees in Beijing

Background In 2018, the Beijing Federation of Trade Unions organized a cervical cancer screening program for female employees for the first time. This study aimed to investigate the screening results of this program and determine the factors associated with human papillomavirus (HPV) infection. Methods A total of 8297 female employees participating in the screening program between January 1, 2018, and December 31, 2018, were enrolled in this study. The methods for screening cervical cancer included ThinPrep cytology test (TCT) and HPV genotyping test. Single-factor analysis and multiple binary logistic regression analysis were used to identify the factors associated with HPV infection. Results Of the 8297 women (median age: 43.00 years), TCT was found to be abnormal in 116 patients (1.40%) and 1169 (14.09%) were positive for HPV genotyping test. Notably, HPV-52 was the most prevalent subtype (3.05%), followed by HPV-16 (2.82%), HPV-58 (2.01%), HPV-51 (1.58%) and HPV-56 (1.49%). Multivariate logistic regression analysis revealed that taxi drivers (OR =1.98; 95% CI =1.31–2.99) and single women with a history of sexual activity (OR =2.32; 95% CI =1.41–3.82) were significantly associated with an increased risk of HPV infection (P<0.05), whereas medical workers (OR =0.67; 95% CI =0.51–0.88) and factory workers (OR =0.36; 95% CI =0.17–0.77) were protective factors for HPV infection (P<0.05). Conclusion HPV-52, HPV-16 and HPV-58 are the most common types of high-risk HPV among female employees in Beijing. Being taxi drivers and single women with a history of sexual activity are significantly associated with the risk of HPV infection.
The early sociology of health and illness : selected readings

Volume One Kevin White Introduction I. Guy, W. A. Cholera Gossip [1849] II. Southwood-Smith, T. Contagion and Sanitary Laws Westminster Review [1825] III. Southwood-Smith, T. Plague-Typhus-Fever-Quarantine Westminster Review [1825] IV. Felkin, W. Moral Statistics of a District near Gray's Inn Journal Statistical Society [1839] V. Fripp, C. Report of an Inquiry into the Condition of the Working Classes of the City of Bristol Journal Statistical Society London [1839] VI. Sykes, M. , Guy, W. and F. Neison Report of a Committee of the Council of the Statistical Society of London to Investigate the State of the Inhabitants and their Dwellings in Church Lane, St. Giles's Journal Statistical Society London [1848] VII. Head, F. B. Report on the Sanitary Condition of the Labouring Classes Quarterly Review [1843] VIII. Alison, W. P. Observations on the Epidemic Fever of MDCCCXLIII in Scotland, and its Connection with the Destitute Condition of the Poor [1844] IX. Lawson, R. On the Hourly Distribution of Mortality Journal of the Institute of Actuaries and Assurance Magazine [1876] X. Eastwood, J.W. Life Insurance and Suicide Journal of the Institute of Actuaries [1878] XI, Neison, F. The Influence of Occupation upon Health as Shown by the Mortality Experience Journal of the Institute of Actuaries and Assurance Magazine [1873] Volume Two Rumsey, H.W. Essays on State Medicine [1856] Volume Three Roberton, J. Medical Police: or the Causes of Diseases with the Means of Prevention. Vol. 1 [1812] Volume Four Roberton, J. Medical Police: or the Causes of Diseases with the Means of Prevention. Vol. 2 [1812] Volume Five Gairdner, W. T. Public Health in Relation to Air and Water [1862] Volume Six Arlidge, J. T. The Hygiene, Diseases and Mortality of Occupations [1892]
Identifying candidate drugs for repositioning by graph based modeling techniques based on drug side-effects

Drug development is a lengthy and highly costly endeavor, often with limited success and high risk. The objective of drug repositioning is to apply existing drugs to different diseases or medical conditions than the original target, and thus alleviate to a certain extent the time and cost expended. The area of drug repositioning is a suitable application area for computational intelligence because numerous online databases containing technical information on drug targets, protein interactions, side-effects and biological knowledge are freely available. Thus {\it in-silico} analysis can be used as a useful first stage to screen potential candidate drugs for possible redeployment. We take the position that drugs with side-effects are potential candidates for use elsewhere, it is a case of identifying potential diseases that may benefit from this re-deployment. The system we are refining uses graph based computational techniques to analyze drugs with known side-effects and compares the proteins involved in these side-effects with proteins known to be identified with other diseases. Our intention is to find potential candidates for treating Alzheimer's disease.
Downregulation of Wnt3 Suppresses Colorectal Cancer Development Through Inhibiting Cell Proliferation and Migration

The aberrant expression of Wnt3 has linked to several types of human malignancies. However, it is not known for its role in tumorigenesis of colorectal cancer (CRC). Herein, we show that Wnt3 is upregulated in human CRC tissues and is essential for the CRC progression. Knockdown of Wnt3 in human CRC cells delayed tumor formation in nude mouse xenografts through silencing of canonical Wnt pathway and glycolysis. We further found that silencing of Wnt3 enhanced the sensitivity of CRC cells to cisplatin through inducing apoptotic cell death. Taken together, it demonstrates that Wnt3 is a novel clinical biomarker for the detection of CRC and plays an important role in colorectal tumorigenesis. Therefore, downregulation of Wnt3 will be a valuable strategy in CRC treatment.
ELECTROCARDIOGRAM CHANGES IN ADDISON DISEASE: POTENTIAL CLINICAL MARKER FOR ADRENAL CRISIS.

Objective To present a unique phenomenon of a patient in addisonian crisis with electrocardiogram (ECG) anomalies that resolved following glucocorticoid therapy. Methods We present the case report followed by discussion with literature review. Results A 25-year-old male with Addison disease (AD) presented with a 1-week history of lightheadedness, shortness of breath, chest pain, abdominal pain, postural hypotension, and tachycardia. The patient was diagnosed with addisonian crisis and started on intravenous, high-dose glucocorticoids. An ECG showed right-heart axis deviation and T-wave inversions. In the context of ongoing chest pain, there was concern for myocardial ischemic attack and the patient underwent an extensive cardiac evaluation. Cardiac workup was negative and an echocardiogram showed an ejection fraction of 50 to 55%. The ECG abnormalities resolved 1 day into his hospital admission and his other symptoms resolved 2 days following treatment with steroids. Conclusion AD is a rare, potentially lethal, and commonly misdiagnosed disease often first encountered clinically amidst an incident episode of adrenal crisis. Our AD patient was undergoing an adrenal crisis with ECG changes positive for probable cardiac ischemia. Glucocorticoid deficiency has been previously linked with decreased cardiac function and myocardial ischemia, though the underlying mechanisms are not fully clear. This patient recovered within 2 days after receiving corticosteroid supplementation. There have been similar cases previously reported. In each of these, patients underwent extensive and costly workup to evaluate cardiac function, yet all patients fully recovered with corticosteroids. Understanding the physiology and clinical presentation of adrenal crisis will be useful in establishing an earlier diagnosis, thus preventing mortality and avoiding unnecessary, expensive evaluations.
PROspective evaluation of coronary FLOW reserve and molecular biomarkers in patients with established coronary artery disease the PROFLOW-trial: cross-sectional evaluation of coronary flow reserve

Background Survivors of myocardial infarction (MI) are at high risk of new major adverse cardiovascular events (MACE). Coronary flow reserve (CFR) is a strong and independent predictor of MACE. Understanding the prevalence of impaired CFR in this patient group and identifying risk markers for impaired CFR are important steps in the development of personalized and targeted treatment for high-risk individuals with prior MI. Methods PROFLOW is a prospective, exploratory, cross-sectional open study. We used information from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) to identify high-risk patients with a history of type-1 MI. We measured CFR non-invasively in a left anterior descending artery (LAD) using transthoracic Doppler echocardiography. Coronary flow velocity was measured at rest and at maximal flow after induction of hyperemia by intravenous infusion of adenosine (140 μg/kg/min). Independent predictors of CFR were assessed with multiple linear regression. Results We included 619 patients. The median age was 69 (IQR 65–73), and 114 (18.4%) were women. Almost one-half of the patients, 285 (46.0%) had the multi-vessel disease, and 147 (23.7%) were incompletely revascularized. The majority were on optimal standard treatment eg ASA (93.1%), statins (90.0%), ACEI/ARB (82.6%) and beta-blockers (80.8%). The majority, 547 (88.4%) had no angina pectoris, and 572 (92.2%) were in NYHA class I. Evaluation of CFR was possible in 611 (98.7%) patients. Mean CFR was 2.74 (±0.79 (mean ± SD)). A substantial number of patients (39.7%) had CFR ≤2.5. In a multiple linear regression model age, dyslipidemia, smoking, hypertension, body mass index, incomplete revascularization, and treatment with angiotensin receptor blockers were independent predictors of CFR. Conclusion In this high-risk group of patients with prior MI, the prevalence of impaired CFR was high. Further risk stratification with CFR in addition to traditional cardiovascular risk factors may improve predictive accuracy for future MACE in this patient population.
Phototherapy and photochemotherapy in dermatology. Recommendations of the Polish Dermatological Society

Light is a component of the electromagnetic waves. The electromagnetic wave consists of mutually inducible electrical and magnetic components that generate variable electric field. This then turns into magnetic field, causing alternating current to flow. Electromagnetic waves include radio waves, microwaves, infrared light, visible light, ultraviolet light, X-rays and gamma radiation. The length of these waves determines their properties. An increase in wavelength is accompanied by a decrease in its radiation energy. Dermatological phototherapy uses the following types of light: broadband UVB, narrow-band monochromatic UVB, laser UVB, UVA in combination with psoralens – PUVA, UVA1, visible light, monochromatic light within the visible spectrum: violet, yellow, red, deep red and infrared. Phototherapy and photochemotherapy nowadays uses equipment emitting radiation at the following lengths: UVB 311, UVB 313, UVB 308, UVA 320–400 nm with a peek at 365 nm and 340–400 nm UVA1. In Poland, the most commonly used radiation is UVB 311 and UVA 320–400 mm (mainly with psoralens). Photochemotherapy is a form of treatment by light, in which the effect of ultraviolet in combination with chemical substances acting as photosensitizers (psoralens) is utilized. The term PUVA was introduced in 1974 by Parrish et al. in a publication assessing the results of psoriasis treatment with orally administered 8-methoxypsoralen and wholebody exposure to long-wave UVA radiation. This article contains the recommendations of the Polish Dermatological Society for photoherapy and photochemoterapy in dermatology. Special article/praca Specjalna cORReSPONDiNg AuTHOR/ ADReS DO KOReSPONDecJi: prof. dr hab. n. med. Waldemar Placek Katedra i Klinika Dermatologii, Chorób Przenoszonych Drogą Płciową i Immunologii Klinicznej Collegium Medicum Uniwersytet Warmińsko-Mazurski Olsztyn tel. : +48 601 915 419 e-mail: w.placek@wp.pl
Overweight in 5-year-old Children: Assessment and Risk Factors (The Be Active, Eat Right Study)

markdownabstract__Abstract__ The World Health Organization defines overweight and obesity as “abnormal or excessive fat accumulation that may impair health”. Worldwide, about one in ten children at the age of 5 to 17 years have overweight (obesity included). In the last decades there has been a dramatic increase in the prevalence of childhood overweight and obesity in many countries. This increase over a relatively short period of time and within a relatively stable population indicates that genetic factors can not be the primary reason for the increase. The fundamental cause of overweight and obesity is an imbalance between energy intake and energy expenditure, and the increase in prevalence has been ascribed to changes in society that increase the energy intake and decrease the physical activity of the population. An environment with factors that facilitate the development of overweight and obesity is also referred to as an obesogenic environment. Children with overweight are at risk of developing obesity, and childhood obesity is associated with an increased risk of health problems already during childhood (e.g. cardiovascular risk factors, type 2 diabetes, asthma and psychosocial problems). However, the greatest health problems will be seen in next generations as overweight and obesity track from childhood into adulthood quite strong. Childhood overweight and obesity have been associated with higher morbidity and mortality later in life. Further, once childhood obesity is established, it is difficult to reverse. Childhood overweight and obesity are therefore a major burden on health care, and prevention of childhood overweight and obesity is an international public health priority. In the Netherlands, the prevention of overweight in children appeared as a priority on the political and public health agenda at the beginning of this century. As a result, the overweight prevention protocol for use in the setting of youth healthcare was developed in 2005. This thesis reports on a number of studies examining overweight assessment and risk factors for overweight in young children. These studies are embedded in the ‘Be active, eat right’ study. The ‘Be active, eat right’ study was initiated to implement the overweight prevention protocol in the youth healthcare setting, and to assess its effects on the prevalence of overweight and health behavior of children.
Drug utilization pattern and analysis of quality of life in Indian patients of Parkinson’s disease

Background: Parkinson's disease (PD) is a highly debilitating disease characterized by tremors, bradykinesia and rigidity. It leads to lowered self-esteem and psychological consequences which affect quality of life. The aim of this study is to study the drug utilization pattern and assess the quality of life in patients of Parkinson’s Disease.Methods: 40 patients of PD at least 1 month duration and 20 age-based controls were analyzed for quality of life using Parkinson’s Disease Questionnaire-39 (PDQ-39). Drug prescriptions were analyzed.Results: Mean number of anti-Parkinson drugs prescribed is 2.65±1.21. Of 106 anti-Parkinson drugs prescribed, 45% were levodopa and carbidopa combinations, followed by dopamine agonists (18%), anticholinergic drugs (15%), amantadine (12%), MAO inhibitors (5%) and COMT inhibitors (5%). There were significant problems in speech, performance of daily chores and daytime somnolence (p<0.0001). Depression, isolation, cognitive decline and memory loss were noteworthy in the patients as compared to controls (p<0.05). 25% patients felt embarrassed due to their disease; 59% felt affected by others’ opinion, 60% felt difficulty in communicating with others (p<0.05). Almost 2/3rd patients needed help in personal care as compared to the control group (p<0.0001). Conclusions: Quality of life of parkinsonian patients is severely affected in spite of them receiving a large number of drugs. This may be both due to disease progression as well as medication. Levodopa-carbidopa combination is the most prescribed medication. Use of levodopa and carbidopa combination must be evaluated properly. Newer guidelines and interventions are the need of the hour which may provide a better outcome on the quality of life of parkinsonian patients.
Facial Paralysis as Initial Manifestation of Light-chain Amyloidosis

Light-chain (AL) amyloidosis is a systemic disease capable of damaging virtually all body tissues. Neurologic involvement is commonly manifested by dysautonomia and peripheral nervous system affection. However, from 1970 to 2018, only 12 cases of cranial nerve injury associated with AL amyloidosis were identified. Eight months before hospital admission, a previously healthy 61-year-old man complained to his general practitioner of episodes of lipotimia while walking and, three months later, he developed a left facial nerve paralysis assumed, at that time, to be idiopathic. After two months, he started complaining of dyspnea and lower limb edema. Physical examination at admission revealed hypotension, exuberant peripheral edema, jugular venous distention, periorbital purpura and left peripheral facial paralysis. He had elevated troponin and brain natriuretic peptide, mild proteinuria and a monoclonal gammopathy IgG/lambda. Bone marrow biopsy revealed 20% plasmocytes and cardiac ultrasound showed diffuse hypokinesia and restrictive filling pattern. AL amyloidosis with major cardiac involvement was considered and a rectal biopsy revealed amyloid protein. Chemotherapy protocol to AL amyloidosis was initiated but cardiac disease progressed leading to death. Persistent facial nerve paralysis should be considered as a rare initial manifestation of AL amyloidosis allowing an earlier diagnosis.
Pathoradiological association between depth of invasion and neck node metastasis in oral cavity tumours

<p class="abstract"><strong>Background:</strong> The aims of the study were to know whether the increase in the depth of invasion in oral cavity carcinoma assessed histopathologically and radiologically co-relates with neck node metastasis and to accurately co-relate the radiological thickness at which neck dissection is required. </p><p class="abstract"><strong>Methods:</strong> A retrospective study has been conducted over thirty patients with oral cavity carcinoma (buccal mucosa and tongue) in the time period of April 2018 to December 2018 who were operated in our tertiary care hospital. </p><p class="abstract"><strong>Results:</strong> Depth of invasion is relatable histopathologically and radiologically, is directly proportional to neck node metastasis. Pre-operative radiology is a reliable modality to rule out the need of neck node dissection. </p><p><strong>Conclusions:</strong> Depth of invasion is directly proportional to the incidence of neck node metastasis and pre-operative radiology has been reliable to rule out the need of neck dissection and reduce its morbidity. </p>
Afecções colônicas detectadas à colonoscopia em adultos sem sintomasdigestórios

O câncer colorretal e uma afeccao cuja incidencia vem aumentandoprogressivamente e apresenta grande impacto no sistema de saude. O rastreamento dessa doenca tem como finalidade avaliar se ha necessidade de submeter os individuos a exames especificos em busca de molestias ainda assintomaticas e, eventualmente, trata-las em seu estadio pre-clinico. Objetivos: Avaliar a prevalencia de afeccoes da mucosa colonica detectadas em colonoscopias de pacientes adultos sem sintomas ou sinais abdominais, ou digestorios, asssociando-as a possiveis fatores predisponentes. Metodo: Foram estudados prospectivamente 50 individuos consecutivos assintomaticos submetidos a colonoscopia. Avaliaram-se sexo, idade, indice de massa corporal (IMC), dieta, historia familiar positiva para câncer colorretal, etilismo e tabagismo. Com relacao a colonoscopia, foram estudados osachados do exame e suas complicacoes. Nao foram incluidos individuos com sinais e sintomas abdominais ou digestorios. Resultados: Quanto ao sexo, 70% dos individuos estudados eram do sexo feminino e 30% do sexo masculino. Verificou-se historia familiar decâncer colorretal em 42% da amostra. Como alteracoes colonoscopicas, encontraram-se polipos hiperplasicos em 12%, adenomas em 16% e neoplasia de colon sigmoide em 2% dos individuos. Houve presenca de polipose colonica em 4% deles. A analise mostrou que apenaso tabagismo estava associado a presenca de polipos colonicos (p=0,02). Conclusoes: Existem muitas afeccoes da mucosa colonica em pessoas acima dos 50 anos de idade sem sintomas ou sinais abdominais ou digestorios, que sao detectadas por colonoscopia, destacando-se entre elas polipos e cancer. Dentre os fatores predisponentes analisados neste estudo, somente o tabagismo associou-se a ocorrencia de polipos colorretais.