Miracle-dz/UniFAR-FTUs huggingface dataset:
Robotic implantation of intracerebral electrodes for deep brain stimulation and stereo-EEG

This master’s thesis focuses on the development of a robotic system able to assist neurosurgeons in minimally invasive stereotactic procedures, such as Deep Brain Stimulation (DBS) and Stereoelectroencephalography (Stereo-EEG or SEEG). The robot is expected to firmly hold the required surgical instruments, positioning them according to preoperative directives given by the medical team. The challenge is to use a real robotic system to perform as a passive assistant in stereotactic brain surgery procedures to guide and position the required surgical instrumentation. Information regarding stereotactic neurosurgery is gathered, and a study of equipment’s evolution used is made. Problems with the equipment currently used in traditional DBS and SEEG procedures are identified with a complete description of a stereotactic brain surgery procedure and, consequently, the role of a robotic system is recognized. A state of the art search on neurosurgery robots is elaborated, to get a picture of what is being done and what can be improved. Concepts of spatial transformations and formulation of robot kinematics are primarily learned using a simulation tool developed towards stereotactic neurosurgery. Revealed its advantages as a learning tool, an educational project based on experiential learning is created, suitable for teaching students of robotics courses. As an initial experimental approach, it is developed a method to register the robot’s to the surgery space based on contact. The robotic manipulator uses the computed transformation to position the required instrumentation according to the surgical trajectories of the preoperative plan. A middleware communication layer is used to connect the developed control application to the robot’s controller cabinet. The control application is developed with a intuitive user interface for positioning the robotic manipulator according to surgical trajectories for electrodes insertion. Implemented control routines are described, while emphasizing safety mechanisms. Robot’s performance is demonstrated when executing a full experimental procedure using the developed control application. It is followed a method for testing the robot’s flexibility in reaching stereotactic trajectories and visualizing robot postures assumed for each selected trajectory. Application accuracy is assessed with a phantom device that simulates surgical target coordinates.
Allodynia and Self-Efficacy in Migraineurs

ii LIST OF TABLES. iv LIST OF FIGURES. v INTRODUCTION. 1 METHODS. 17 RESULTS. 21 DISCUSSION. 26 REFERENCES. 34 APPENDICES. 53 CURRICULUM VITA. 70
Avoidable childhood death: A case of mismanagement and inappropriate medication use

Rational drug usage, clinical regulations and pharmaceutical care are important features of health practice. Thus; we have aimed case report to elaborate the clinical pharmaceutical services. A 3 year old girl, was presented in a hospital with minor burn that happened by spilt hot water on her wrist. She was in severe pain. The emergency ward staff applied an ointment. The doctor instructed injection Dormicum two times with short gape and then 3rd injection of Pavulon (Pancuronium). Patient went silent and started losing consciousness and eventually passed away. In view of the above facts and circumstances the inquiry board and judiciary took action against the negligence, mishandling. While; going through the investigation the inquiry board did not bothered the channel through which this injection came without proper check that is therapeutical drug monitoring, prescription reviewing, bio-safety and pharmaceutical evaluation. Furthermore, it is not a single death but representation of so many casualties because of the wrong medications. The medial practice needs some more legal, professional and principled restrictions to make sure the safe and correct therapy plans. The clinical legislation, drug rules and medical practice seriously need the attention of judiciary, society and leadership to assure the safety of precious live. Key words: Wrong medication, medical malpractice, professional negligence, pharmaceutical services, Suo-moto notice of chief justice of high court.
SERUM LEVELS OF IL-23, TNF-A AND OXIDATIVE STRESS MARKERS IN RHEUMATOID ARTHRITIS PATIENTS

Introduction: Rheumatoid arthritis (RA) is a chronic relapsing immuno- inflammatory multisystem disease with predominant synovial proliferation and destruction of the articular cartilage. Objective: To assess levels of IL-23, TNF-α, oxidative stress markers and antioxidant markers in RA patients. Methods: Patients with RA satisfying the revised 1987 ACR classification criteria were divided into two groups; remission group (n = 13). And active disease group (n = 17). In addition to a control group (n = 15) with matched age and sex. The serum levels of IL-23, TNF-α, MDA, total nitrite, nitrate, reduced glutathione and Catalase were determined in all groups. Results: we found that the levels of IL-23, TNF-α, MDA, total nitrite, and nitrate significantly higher in RA patients in comparison to the control. On the other hand, the levels of reduced glutathione and Catalase were significantly lower in RA patients than the controls. Moreover, their levels negatively correlated with the levels of IL-23 and TNF-α. Conclusion: The findings suggest that the inflammatory cytokines and the oxidative stress generated in an inflamed joint can contribute to autoimmune phenomenon and connective
Detection of Glaucoma and Diabetic Retinopathy using Image Processing Technique by Raspberry pi

Objectives: This study is centered on detection of eye diseases like glaucoma and diabetic retinopathy. Methods: This work proposes an Image processing based Embedded System to detect the diseases which cause blindness. At present, detection and tracing are performed physically, which can be a cause of poor repeatability. For feature extraction, hybrid algorithm is proposed for low cost automated glaucoma and retinopathy diagnosis. Artificial neural network classifier is used for classify the datasets. For hardware implementation Raspberry Pi 3 is used. Findings: The system disturbed with increasing automated techniques of producing measurable descriptions of the retinal images, used in diagnosis and assessment. About 90 images are used in datasets for classification. Application/Improvements: For low cost glaucoma and retinopathy diagnosis automatically. A camera module can be used in future.
Effect of Omega-3 Versus Omega-6 Fatty Acids on Induced Ulcerative Colitis in Male Albino Rat. Light and Electron Microscopic Study.

Introduction: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) well known by its exacerbated immune response. At present, a specific causal treatment for IBD is not available. The drugs currently used for management of IBD unfortunately are not devoid of potentially serious side effects. Polyunsaturated fatty acids (PUFAs) as omega-3 and omega-6 were reported to have immunomodulatory activities. Hence, may be of benefit in treating UC. Aim of the Work:The goal of this study was to illustrate the effect of omega-3 and omega-6 fatty acids on ulcerative colitis induced in male albino rat. Materials and Methods: Thirty adult male albino rats were used in the study. They were divided into four groups; Group I served as a control group. Group II was used as a model of ulcerative colitis. Rats of this group were subjected to intracolonic enema injection of 1 ml of 2% acetic acid for three consecutive days. Group III and group IV were subjected to colitis induction and on the fourth day, daily oral administration of omega-3 and omega-6 was done respectively for 14 days. All rats were sacrificed on day 17 from the beginning of the experiment. Colon specimens were collected and processed for light microscopic, scanning and transmission electron microscopic examination. Results: Ulcerative colitis induction showed mucosal injury. There were patchy areas with loss of crypt architecture, inflammatory cell infiltrate and ulcerated mucosa. Scanning electron microscopic study revealed areas of ulceration, whereas other areas showed alteration of the columnar absorptive cells. Transmission electron microscopic study revealed loss of apical microvilli of enterocytes with signs of degeneration. Administration of omega-3 completely treated the colonic structure, while omega-6 was by far less efficient in treating induced ulcerative colitis. Conclusion: Omega-6 fatty acids partially improved the colon against ulcer induction. Meanwhile, omega-3 fatty acid proved to be a more effective dietary management of ulcerative colitis without the adverse effects of either surgery or medications. Original Article
Virtual reality in the treatment of pain

The theory by Melzack and Wall (1965) constituted a revolution in the understanding of pain. They proposed the concept of modulation. From this perspective, a pain signal does not follow a fixed pathway from the pain receptor (e.g. in the skin) to the brain. The pain signal can be controlled, modified or inhibited on its way to the brain by messages coming from other sources in the brain. Higher order thought processes can change the way incoming pain signals are interpreted as they are processed by the brain, and can even change the intensity of incoming pain signals that make it into the brain (like a gate). According to Melzack and Wall, pain perception involves a balance of activity within the whole system. Pain involves the interaction of several neural networks, including parts of the nervous system involved in the sensory component of pain, but also parts involved in other processes like attention, emotion or memory. Psychological factors such as stress, depression and anxiety can alter the central and autonomic nervous systems and increase the amount of pain experienced. Other psychological factors like relaxation or distraction can diminish the experience of pain.
P1516Novel cardiotropic AAV variant C102 vectors show superior gene delivery & reduced immunogenicity in non-human primates, transduction of human cardiomyocytes, & correction of Fabry disease phenotype

Cardiac-targeted gene therapy vectors are needed. Fabry disease is a rare, X-linked disorder caused by mutations in the GLA gene, which encodes α-galactosidase A (GLA). Storage and accumulation of glycolipid substrates of GLA leads to organ damage. Cardiovascular disease is the most common cause of mortality in Fabry disease (75% of deaths). Enzyme replacement therapy (ERT; first line treatment for most patients) demonstrates clearance of Gb3 from capillary endothelial cells. However, Gb3 accumulation in podocytes, cardiomyocytes, and vascular smooth muscle cells persists. Gene replacement strategies leveraging adeno-associated virus (AAV) vectors with high tropism for affected organs (namely the heart) may directly address the underlying pathophysiology of Fabry disease. To unlock the full potential of cardiac gene therapy, novel targeted vectors are needed with enhanced tropism for specific target tissues when delivered in vivo. An industrialized “directed evolution” approach (Therapeutic Vector Evolution) was applied in the most relevant animal species (non-human primate; NHP) which led to the discovery of C102, a novel AAV variant capable of efficient gene delivery throughout the primate heart following a single intravenous (IV) administration. C102 biodistribution using a ubiquitous promoter was evaluated in mice and NHP at doses at least 10-fold lower than current AAV-based clinical trials for neuromuscular gene therapy. Animal studies conformed to the NIH Principles of Laboratory Animal Care. To evaluate the ability of the C102 capsid to transduce human target cells relevant to Fabry disease, human pluripotent stem cell-derived cardiomyocytes were transduced. To evaluate the ability of C102 to correct Fabry disease, cultured patient fibroblasts were transduced with the C102.GLA product. Following a single IV administration in mice, the onset of C102.luciferase expression was rapid (14 days) and durable. Dose-dependent luciferase activity was observed in Fabry disease target tissues, including heart and liver. Following a single IV administration in NHP, superior delivery to heart was demonstrated and immunogenicity was markedly reduced compared to first generation wild-type vectors (AAV8,9), and genomes were present throughout the heart and skeletal muscle groups. In human cardiomyocytes in vitro, C102.EGFP demonstrated significantly higher transduction compared to wild-type AAV1 and 9 vectors (immunofluorescence imaging and quantification by flow cytometry) at all doses. Following transduction with increasing doses of the C102.GLA product in Fabry patient fibroblasts, dose-dependent GLA expression and function was observed. C102 Genome Delivery in NHP The data generated using the novel C102 capsid and the C102.GLA Fabry product validate the Therapeutic Vector Evolution approach for cardiac tissue targeting in vivo and provide a strong preclinical data package to enable clinical translation.
PAW21 Rewarding visual cues increase dopamine neurotransmission in Parkinson's patients with impulse control disorders: a PET study

Background Current evidence connects impulse control disorders (ICDs) to dopaminergic replacement therapy used for the treatment of Parkinson's disease (PD). Common ICDs include hypersexuality, pathological gambling, compulsive shopping and binge eating. The underlying neuropathology is thought to be due to sensitisation of the dopaminergic system in the striatum and related neurocircuitry. Aim To investigate the effect of rewarding visual cues on dopamine neurotransmission in PD patients with ICDs. Methods Ten ICD PD patients and five PD controls underwent two randomised positron emission tomography (PET) scans with 11C-raclopride (RAC) after a medication challenge with levodopa while observing neutral or rewarding (gambling, sex, food and money) images. Scans were analysed using region-of-interest approach. Results The ICD PD group showed a significant decrease of RAC binding in ventral striatum (p=0.001) and caudate nucleus (p=0.015) in response to rewarding images (compared to neutral images), where in PD controls there was no difference. Discussion Our PET results suggest a significant increase in the release of endogenous dopamine in ventral striatum and caudate nucleus in PD patients with ICDs and further support the role of dopaminergic pathways in mediating ICDs. The response to visual stimuli alone may be of relevance to new treatment strategies.
An Open Clinical Trial on Hingwadichoorna in the Management of Tamakaswasa W.S.R to Bronchial Asthma in Children

An open clinical trial was conducted to evaluate the efficacy of Hingwadichoorna on acute attack of Bronchial Asthma in children at SDM College of Ayurveda & Hospital, Kuthpady, Udupi. The trial was conducted on 34 patients, Hingwadichoorna was given in children of age group of 5years to 9yrs 11 months.The medicine was given 6 hourly in a 4 divided dose per day for 7 days and with a follow up of 14 days. The response was assessed using various clinical, quantitative parameters and analyzed statistically using paired‘t’ test and Wilcoxon Signed Rank Test. Statistically significant results obtained in subjective parameter and peak expiratory flow rate and hemoglobin, AEC. Study showed Hingwadichoorna is effective in combating the signs and symptoms of Tamakaswasa.
A Plant-Based Dietary Intervention for Preoperative Glucose Optimization in Diabetic Patients Undergoing Total Joint Arthroplasty

Purpose. The purpose of this study was to assess the feasibility and effectiveness of a whole food plant-based diet (WFPBD) to improve day of surgery fasting blood glucose (FBG) among patients with type 2 diabetes (T2D). Patients and Methods. Ten patients with T2D scheduled for a total hip or total knee replacement were recruited. For 3 weeks preceding their surgeries, subjects were asked to consume an entirely WFPBD. Frozen WFPBD meals were professionally prepared and delivered to each participant for the 3 weeks prior to surgery. FBG was reassessed on the morning of surgery and compared with preintervention values. Compliance with the diet was assessed. Results. Mean age of subjects and reported duration of diabetes was 65 and 8 years, respectively, average hemoglobin A1c (HbA1c) was 6.6%, and 6 were women. Mean FBG decreased from 127 to 116 mg/dL (P = .2). Five of the subjects experienced improvement in glycemic control, with an average decline of 11 mg/dL. Conclusion. A WFPBD is a potentially effective intervention to improve glycemic control among patients with T2D during the period leading up to surgery. Future controlled trials on a larger sample of patients to assess the impact of a WFPBD on glycemic control and surgical outcomes are warranted.
Immunosuppressive properties of Wharton's jelly derived mesenchymal stromal cells in the treatment of graft versus host disease in rat model

Graft Versus Host Disease (GVHD) is the major complication following hematopoietic stem cell transplantation. GVHD is activated by immunocompetent T cells presented in the donor grafted tissue. Due to the increased use of bone marrow transplantation to treat diverse malignancies, the incidence of GVHD has shown a notable increase. Depending of the degree of immunological mismatch between donor and host, 50-70 % of patients develop GVHD after allogeneic Bone Marrow Transplantation (BMT). Once GVHD develops, mortality reaches up to 50% in humans. Several studies using Mesenchymal Stromal Cells (MSCs) to prevent and treat GVHD have produced controversial results. It is thought that distinct MSCs sources used in those studies might be an important factor that produces different outcomes. For cellular therapy, the most attractive characteristics of MSCs are their reduced immunogenic potential, and their abilities to modulate immune responses. This dissertation addressed the hypothesis that Wharton‘s jelly cells (WJCs) would prevent the pathology and death associated with GVHD after BMT. To accomplish this, I created a clinically relevant model of GVHD by transplanting allogeneic bone marrow across minor histocompatibility antigen (HA) barriers in the rat. To enhance alloreactive T-cell stimulation, bone marrow (BM) was co-administered with a fraction of CD8 + cells magnetically selected from spleen to induce GVHD. Bone marrow tissue was isolated from a donor rat Fischer 344 (F344, RT1lv) and transplanted into lethally irradiated (10 Gray) Lewis rat (LEW, RT1l). Once GVHD was induced, MSCs derived from umbilical cord WJCs were either co-transplanted at day 0 with bone marrow, or given on day 2 post-BMT intravenously. The prophylactic potential of WJCs in an in vivo GVHD model was assessed as survival time, clinical symptomatology occurrence, and histopathology injuries in target tissues. Results indicate that while co-administration of WJCs with hematopoietic cells on day 0 failed to alleviate GVHD associated symptomatology and mortality. WJCs administered on day 2 postinduction ameliorated GVHD-associated symptomatology, improved engraftment and survival.
MRI-Based Proton Treatment Planning for Base of Skull Tumors.

Purpose To introduce a novel, deep-learning method to generate synthetic computed tomography (SCT) scans for proton treatment planning and evaluate its efficacy. Materials and Methods 50 Patients with base of skull tumors were divided into 2 nonoverlapping training and study cohorts. Computed tomography and magnetic resonance imaging pairs for patients in the training cohort were used for training our novel 3-dimensional generative adversarial network (cycleGAN) algorithm. Upon completion of the training phase, SCT scans for patients in the study cohort were predicted based on their magnetic resonance images only. The SCT scans obtained were compared against the corresponding original planning computed tomography scans as the ground truth, and mean absolute errors (in Hounsfield units [HU]) and normalized cross-correlations were calculated. Proton plans of 45 Gy in 25 fractions with 2 beams per plan were generated for the patients based on their planning computed tomographies and recalculated on SCT scans. Dose-volume histogram endpoints were compared. A γ-index analysis along 3 cardinal planes intercepting at the isocenter was performed. Proton distal range along each beam was calculated. Results Image quality metrics show agreement between the generated SCT scans and the ground truth with mean absolute error values ranging from 38.65 to 65.12 HU and an average of 54.55 ± 6.81 HU and a normalized cross-correlation average of 0.96 ± 0.01. The dosimetric evaluation showed no statistically significant differences (p > 0.05) within planning target volumes for dose-volume histogram endpoints and other metrics studied, with the exception of the dose covering 95% of the target volume, with a relative difference of 0.47%. The γ-index analysis showed an average passing rate of 98% with a 10% threshold and 2% and 2-mm criteria. Proton ranges of 48 of 50 beams (96%) in this study were within clinical tolerance adopted by 4 institutions. Conclusions This study shows our method is capable of generating SCT scans with acceptable image quality, dose distribution agreement, and proton distal range compared with the ground truth. Our results set a promising approach for magnetic resonance imaging-based proton treatment planning.
Clinical management of aggressive fibromatosis/desmoid tumour

Introduction: Aggressive fibromatosis (AF) is a rare benign monoclonal fibroblastic proliferation which accounts for 0.03% of all neoplasms and 3% of all soft tissue sarcomas. It can occur sporadically or within the context of Gardner’s syndrome and at any age, although it is more common among young patients. Areas covered: AF is characterised by a natural history that is highly unpredictable; these tumours are benign, in the sense that they do not metastasize, but are locally aggressive, with a high risk of recurrence. Therefore, the management of patients with fibromatosis is challenging and controversial. Surgery, radiotherapy, medical treatment and chemotherapy have been used for AF. Here, the management of AF is reviewed, considering all the known and possible new therapeutic options, in a view of a multidisciplinary management of the patient. Expert opinion: An upfront watchful waiting policy is largely accepted as an initial strategy for management of this disease. Medical treatments should be considered for all the patients who progressed clinically and/or radiologically. The first step should be a hormonal and/or NSAID treatment, followed by systemic chemotherapy or targeted agents. Surgery does play a role where feasible and without undue morbidity, or after other treatment failure. For abdominal wall AF, surgery should be the recommended first-line treatment. As for other rare cancers, careful counselling at a referral centre is mandatory, as well as a multidisciplinary management of the patient.