Persius/hicric huggingface dataset:
Rimantadine indications and usage

# Indications And Usage
Flumadine is indicated for the prophylaxis and treatment of illness caused by various strains of influenza A virus in adults.
Flumadine is indicated for prophylaxis against influenza A virus in children.
PROPHYLAXIS: In controlled studies of children over the age of 1 year, healthy adults and elderly patients, Flumadine has been shown to be safe and effective in preventing signs and symptoms of infection caused by various strains of influenza A virus. Early vaccination on an annual basis as recommended by the Centers for Disease Control's Immunization Practices Advisory Committee is the method of choice in the prophylaxis of influenza unless vaccination is contraindicated, not available or not feasible. Since Flumadine does not completely prevent the host immune response to influenza A infection, individuals who take this drug may still develop immune responses to natural disease or vaccination and may be protected when later exposed to antigenically-related viruses. Following vaccination during an influenza outbreak, Flumadine prophylaxis should be considered for the 2 to 4 week time period required to develop an antibody response. However, the safety and effectiveness of Flumadine prophylaxis have not been demonstrated for longer than 6 weeks.
TREATMENT: Flumadine therapy should be considered for adults who develop an influenza-like illness during known or suspected influenza A infection in the community. When administered within 48 hours after onset of signs and symptoms of infection caused by influenza A virus strains, Flumadine has been shown to reduce the duration of fever and systemic symptoms.
Risk Factors compartment syndrome

# Overview
Various risk factors are known to be related to CS.

# Risk Factors
Totally there can be several risk factors for the occurrence and progression of CS:
- Age: Younger patients are more prone to get CS than elderly cases.
- Gender: Males are ten times more prone to develop CS than females.
- Type  of injury
- Site of injury
- Burns to the limb
- Blunt to the limb
- Crushing trauma to the limb
- Excessive exercise or nonroutine physical activity
- Nonaccidental causes like medical conditions include
- Nephrotic syndrome
- Viral myositis
- Hypothyroidism
- Bleeding disorders
- Malignancies
- Diabetes mellitus
On the other hand in there can be another classification for the risk factor of CS:
The primary risk factors of Acute Compartment Syndrome:
- A crushing injury to the extremity
- Wearing too tight, a bandage or cast
- Participation in any rough or high-impact sport
- Consumption of anticoagulants, which increases the risk of bleeding within a compartment
- Individuals with a bleeding disorder, such as hemophilia
The primary risk factors of Chronic (Exertional) Compartment Syndrome:
- Athletes, younger than 30 years
- Consumption of anabolic steroids or the supplement creatine
- Any sport or physical activity that involves repetitive motions, such as running or fast-walking
Rizatriptan indications and usage

# Indications and Usage
MAXALT and MAXALT-MLT are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old.

### Limitations of Use
MAXALT should only be used where a clear diagnosis of migraine has been established. If a patient has no response for the first migraine attack treated with MAXALT, the diagnosis of migraine should be reconsidered before MAXALT is administered to treat any subsequent attacks.
MAXALT is not indicated for use in the management of hemiplegic or basilar migraine .
MAXALT is not indicated for the prevention of migraine attacks.
Safety and effectiveness of MAXALT have not been established for cluster headache.
Sodium-glucose transport proteins
Sodium-dependent glucose cotransporters (or sodium-glucose linked transporter, SGLT) are a family of glucose transporter found in the intestinal mucosa (enterocytes) of the small intestine (SGLT1) and the proximal tubule of the nephron (SGLT2 in PCT and SGLT1 in PST). They contribute to renal glucose reabsorption. In the kidneys, 100% of the filtered glucose in the glomerulus has to be reabsorbed along the nephron (98% in PCT, via SGLT2). If the plasma glucose concentration is too high (hyperglycemia), glucose is excreted in urine (glucosuria) because SGLT are saturated with the filtered glucose. Glucose is never secreted by a healthy nephron.

# Types
The two most well known members of SGLT family are SGLT1 and SGLT2, which are members of the SLC5A gene family.  In addition to SGLT1 and SGLT2, there are five other members in the human protein family SLC5A, several of which may also be sodium-glucose transporters.

# SGLT2 inhibitors for diabetes
SGLT2 inhibitors, also called gliflozins, are used in the treatment of type 2 diabetes. Examples include dapagliflozin (Farxiga in US, Forxiga in EU), canagliflozin (Invokana) and empagliflozin (Jardiance).

# Function
Firstly, an Na+/K+ ATPase pump on the basolateral membrane of the proximal tubule cell uses ATP molecules to move 3 sodium ions outward into the blood, while bringing in 2 potassium ions. This action creates a downhill sodium ion gradient from the outside to the inside of the proximal tubule cell (that is, in comparison to both the blood and the tubule itself).
The SGLT proteins use the energy from this downhill sodium ion gradient created by the ATPase pump to transport glucose across the apical membrane, against an uphill glucose gradient. These co-transporters are an example of secondary active transport. Members of the GLUT family of glucose uniporters then transport the glucose across the basolateral membrane, and into the peritubular capillaries. Because sodium and glucose are moved in the same direction across the membrane, SGLT1 and SGLT2 are known as symporters.

# History
In August 1960, in Prague, Robert K. Crane presented for the first time his discovery of the sodium-glucose cotransport as the mechanism for intestinal glucose absorption.
Crane's discovery of cotransport was the first-ever proposal of flux coupling in biology.
SREBP cleavage-activating protein
Sterol regulatory element-binding protein cleavage-activating protein, also known as SREBP cleavage-activating protein or SCAP is a protein that in humans is encoded by the SCAP gene.
SCAP contains a sterol-sensing domain (SSD) and seven WD domains. In cholesterol-depleted cells, this protein binds to sterol regulatory element binding proteins (SREBPs) and mediates their transport from the ER to the Golgi apparatus. The SREBPs are then proteolytically cleaved and stimulate sterol biosynthesis.

# Function
SCAP is a regulatory protein that is required for the proteolytic cleavage of the sterol regulatory element-binding protein (SREBP). SCAP is an integral membrane protein located in the endoplasmic reticulum (ER).  One of the cytosolic regions of SCAP contains a hexapeptide amino acid sequence, MELADL, that functions to detect cellular cholesterol. When cholesterol is present, SCAP undergoes a conformational change that prevents it from activating SREBP and cholesterol synthesis does not occur.

# Structure
Scap has 8 transmembrane domains and both the N-terminal and C-terminal face the cytoplasm. Also, it binds SREBP by a series of consecutive WD repeats on its C-terminus.
Sample mean and sample covariance

# Overview
Sample mean and sample covariance are statistics computed from a collection of data, thought of as being random.

# Sample mean and covariance
Given a random sample \textstyle \mathbf{x}_{1},\ldots,\mathbf{x}_{N} from an \textstyle n-dimensional random variable \textstyle \mathbf{X} (i.e., (realizations of \textstyle N independent random variables with the same distribution as \textstyle \mathbf{X}), the sample mean is
In coordinates, writing the vectors as columns,
the entries of the sample mean are
The sample covariance of \textstyle \mathbf{x}_{1},\ldots,\mathbf{x}_{N} is the \textstyle n by \textstyle n matrix \textstyle \mathbf{Q}=\left   with the entries given by
The sample mean and the sample covariance matrix are unbiased estimates of the mean and the covariance matrix of the random variable \textstyle \mathbf{X}. The reason why the sample covariance matrix has \textstyle N-1 in the denominator rather than \textstyle N is essentially that the mean is not known and is replaced by the sample mean \textstyle\bar{x}. If the mean \textstyle\bar{X} is known, the analogous unbiased estimate
with the exact mean indeed does have \textstyle N. This is an example why in probability and statistics it is essential to distinguish between upper case letters (random variables) and lower case letters (realizations of the random variables).
The maximum likelihood  estimate of the covariance
for the Gaussian distribution case has \textstyle N as well. The difference of course diminishes for large \textstyle N.

# Weighted samples
In a weighted sample, each vector \textstyle \textbf{x}_{k} is assigned a weight \textstyle w_{k}\geq0. Without loss of generality, assume that the weights are normalized:
(If they are not, divide the weights by their sum.)
Then the weighted mean \textstyle \mathbf{\bar{x}} and the weighted covariance matrix \textstyle \mathbf{Q}=\left   are given by
and 
If all weights are the same, \textstyle w_{k}=1/N, the weighted mean and covariance reduce to the sample mean and covariance above.
Sandbox:Parotitis medical therapy

# Overview
Parotitis therapy is primarily supportive and symptomatic. Common therapies include analgesics, such as paracetemol and diclofenac, and other measures to relieve pain, including heat massages and warm saltwater mouth rinses. Therapy that increases saliva flow is also used, including extra fluids and foods that stimulate saliva flow, including lemon drops and vitamin C lozenges. Other therapies are used to target the potential cause of the parotitis, including antiretroviral medication, antimicrobial therapy, anti-tuberculosis therapy, and sialendoscopy and parotid gland surgery.

# Medical Therapy

## Viral Parotitis
- Viral parotitis treatment is primarily symptomatic and supportive, including the following:
Analgesics:
Paracetamol
Diclofenac
Massaging the parotid gland with heat.
Rinsing the mouth with warm salt water.
Increasing saliva flow with extra fluids or foods that stimulate saliva flow:
Lemon drops
Vitamin C lozenges
- Analgesics:
Paracetamol
Diclofenac
- Paracetamol
- Diclofenac
- Massaging the parotid gland with heat.
- Rinsing the mouth with warm salt water.
- Increasing saliva flow with extra fluids or foods that stimulate saliva flow:
Lemon drops
Vitamin C lozenges
- Lemon drops
- Vitamin C lozenges
- Viral parotitis from HIV should also be treated with antiretroviral medication .

## Recurrent Parotitis
In addition to supportive care, chronic recurrent parotitis treatment includes the following:
- Sialendoscopy: Used to relieve parotitis in patients with parotid gland obstruction
- Surgical removal of the parotid gland if the cause is neoplasmic or symptomatic treatment does not work.

## Bacterial Parotitis
- Antibiotic therapy is used to treat parotitis resulting from Staphylococcus aureus infection, depending on whether the strain is suspected to be methicillin-susceptible staphylococcus aureus (MSSA) or methicillin-resistant staphylococcus aureus (MRSA).
Preferred regimen (MSSA suspected): Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h
Preferred regimen (MRSA suspected): Vancomycin 1 g IV q12h
- Preferred regimen (MSSA suspected): Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h
- Preferred regimen (MRSA suspected): Vancomycin 1 g IV q12h
- If an abscess forms then surgical drainage will be required.
- Parotitis from extrapulmonary tuberculosis will require anti-tuberculosis therapy:
Isoniazid
Rifampin
Ethambutol
Pyrazinamide
- Isoniazid
- Rifampin
- Ethambutol
- Pyrazinamide
Sandbox: Peritonitis landing page
For more information related to Primary peritonitis click here
For more information related to Secondary peritonitis click here

# Overview
Peritonitis defined as inflammation of peritoneum (a serosal membrane lining the abdominal cavity and abdominal viscera) is associated with a higher mortality rate secondary to bacteremia and sepsis syndrome. Most common cause of peritonitis in approximately 80% adults is perforation of the gastrointestinal or biliary tract. Other less common causes include liver cirrhosis (result of alcoholism), and peritoneal dialysis associated peritonitis. Peritonitis is an emergency medical/surgical condition that requires prompt medical attention and treatment.
Peritonitis may be classified according to the etiology into 3 subtypes: primary, secondary, and tertiary peritonitis.

## Classification Based on Etiology
Peritonitis is classified based on the cause of the inflammatory process and the character of microbial contamination as follows:

## Causes

# Risk Factors
The following factors may increase the risk of peritonitis:
- Penetrating trauma to the intestine
- Twisted intestine
- Inflammation of the hollow viscera of the abdomen
- Surgical injuries to the abdominal viscera
- Liver disease (Cirrhosis)
- Pelvic inflammatory disease
- Leakage of sterile body fluids into the peritoneum, such as blood (endometriosis), gastric acid (peptic ulcer), bile( liver biopsy), urine(pelvic trauma), menstruum( salpingitis),pancreatic juice (pancreatitis).
- Peritoneal dialysis
- Extra peritoneal tuberculous infection
Common risk factors for peritonitis are described as follows:

# Approach to peritonitis
Approach to the diagnosis and management of peritonitis.
Saphenous Vein Graft Nomenclature

# Overview
The terms single bypass, double bypass, triple bypass, quadruple bypass and quintuple bypass refer to the number of coronary arteries bypassed in the procedure.
In other words, a double bypass means two coronary arteries are bypassed (e.g. the left anterior descending (LAD) coronary artery and right coronary artery (RCA)); a triple bypass means three vessels are bypassed (e.g. LAD, RCA, left circumflex artery (LCX)); a quadruple bypass means four vessels are bypassed (e.g. LAD, RCA, LCX, first diagonal artery of the LAD) while quintuple means five.  Less commonly more than four coronary arteries may be bypassed.
A greater number of bypasses does not imply a person is "sicker," nor does a lesser number imply a person is "healthier."  A person with a large amount of coronary artery disease (CAD) may receive fewer bypass grafts owing to the lack of suitable "target" vessels.
Signal-averaged electrocardiogram
Signal-averaged electrocardiography (SAECG) is a special electrocardiographic technique, in which multiple electric signals from the heart are averaged to remove interference and reveal small variations in the QRS complex, usually the so-called "late potentials". These may represent a predisposition towards potentially dangerous ventricular tachyarrhythmias.

# Technique

## Procedure
A resting electrocardiogram (ECG) is recorded in the supine position using an ECG machine equipped with SAECG software; this can be done by a physician, nurse, or medical technician. Unlike standard basal ECG recording, which requires only a few seconds, SAECG recording requires a few minutes (usually about 7-10 minutes), as the machine must record multiple subsequent QRS potentials to remove interference due to skeletal muscle and to obtain a statistically significant average trace. For this reason, it is important for the patient to lie as still as possible during the recording.

## Results
SAECG recording yields a single, averaged QRS potential, usually printed in a much larger scale than standard ECGs, upon which the SAECG software performs calculations to reveal small variations (typically 1-25 mV) in the final portion of the QRS complex (the so-called "late potentials, or more accurately, "late ventricular potentials"). These can be immediately interpreted by comparing results with cut-off values.

# Significance
Late potentials are taken to represent delayed and fragmented depolarisation of the ventricular myocardium, which may be the substrate for a micro-re-entry mechanism, implying a higher risk of potentially dangerous ventricular tachyarrhythmias. This has been used for the risk stratification of sudden cardiac death in people who have had a myocardial infarction, as well as in people with known coronary heart disease, cardiomyopathies, or unexplained syncope.
Still, the real predictive value of these findings is questioned. Late potentials may be found in 0-10% of normal volunteers. When used as a prognostic factor for the development of ventricular tachycardia, they have a sensitivity of 72% and a specificity of 75%, yielding a positive predictive value of 20% and a negative predictive value of 20%.
Simethicone (patient information)

# Why is this medication prescribed
Simethicone is used to treat the symptoms of gas such as uncomfortable or painful pressure, fullness, and bloating.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# How should this medicine be used
Simethicone comes as regular tablets, chewable tablets, capsules, and liquid to take by mouth. It usually is taken four times a day, after meals and at bedtime. Follow the directions on the package or on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take simethicone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the regular tablets and capsules whole. Chewable tablets should be chewed thoroughly before being swallowed; do not swallow them whole. Do not take more than six simethicone tablets or eight simethicone capsules each day unless your doctor tells you to. The liquid may be mixed with 1 ounce of cool water or infant formula.

# What special precautions should I follow
Before taking simethicone:
- tell your doctor and pharmacist if you are allergic to simethicone or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including vitamins.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking simethicone, call your doctor.

# What should I do if I forget a dose
If you are taking simethicone on a regular schedule, take the missed dose as soon you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects
When taken as directed, simethicone usually has no side effects.

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# What other information should I know
Ask your doctor or pharmacist any questions you have about taking this medicine.

# Brand names
- Alka-Seltzer Gas Relief Maximum Strength Softgels
- Flatulex Drops
- GasAid Maximum Strength Softgels
- Gas-X
- Gas-X Extra Strength
- Gas-X Extra Strength Liquid
- Gas-X Extra Strength Softgels
- Genasyme
- Genasyme Drops
- Maalox Anti-Gas Extra Strength
- Maalox Anti-Gas Regular Strength
- Mylanta Gas Relief
- Mylanta Gas Relief Gelcaps
- Mylanta Gas Relief Maximum Strength
- Mylicon Infant's Drops
- Phazyme Infant Drops
- Phazyme-125 Softgels
- Phazyme-166 Maximum Strength
- Phazyme-166 Maximum Strength Softgels

# Brand names of combination products
- Imodium Advanced Caplets containing Simethicone and Loperamide Hydrochloride
- Imodium Advanced Chewable Tablets containing Simethicone and Loperamide Hydrochloride
Stroke diagnostic study of choice

# Overview
There is no single diagnostic study of choice for the diagnosis of stroke. But stroke can be diagnosed based on clinical presentation, CT scan, MRI findings.

# Diagnostic Study of Choice

## Study of choice
There is no single diagnostic study of choice for the diagnosis of stroke. But stroke can be diagnosed based on clinical presentation, CT scan, MRI findings.
- Non-contrast CT scan is fast, widely-available and inexpensive. It can rule in hemorrhagic stroke (intracerebral or subarachnoid hemorrhage) with over 95% accuracy. CT scan also has the ability to rule in massive ischemic stroke in two third of cases, but is is not sensitive for minor ischemic stroke.
- MRI is the most sensitive and specific test for diagnosing ischemic stroke, specially minor ischemic stroke with limited deficits, and may help detect presence of infarction in few minutes of onset of symptoms.

## Sequence of Diagnostic studies
- History and physical exam
- Non-contrast CT scan
- MRI

# Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

## Head and Neck Imaging
Suicidal ideation medical therapy

# Overview
Treatment of suicidal thoughts and behavior depends on specific situation, such as level of severity of suicidal ideation, underlying mental and physical problems that might be contributing to suicidal thoughts/behavior. Treatment varies based on whether it is an emergency situation that requires active intervention or just a passive suicidal ideation that can be addressed by follow up as an outpatient or psychotherapy or other life style interventions.

# Treatment

## Emergency
- If you have active suicidal ideation and acted on those thoughts,
Call 911 or local ER number, or take help from people around you to call.
- If the subject is at immediate risk of hurting themselves:
Call 911 or local ER number
Call a suicide hot line number -in the U.S., " National suicide prevention lifeline at 800-273-8255 to reach out to a counselor.
- Call 911 or local ER number
- Call a suicide hot line number -in the U.S., " National suicide prevention lifeline at 800-273-8255 to reach out to a counselor.
In the ER, the patient will be treated as per the underlying condition. Doctor will interview and assess the risk of suicide and will decide on further plan. The patient may be given medications to alleviate the symptoms of any underlying mental illness such as major depressive disorder or if needed the patient may require in-patient hospitalization for ensuring safety of the patient and assess response to therapeutic interventions that have been initiated.
- In the state of Massachusetts, patients with active suicidal ideation are sometimes involuntarily admitted under section-12, if the patient refuses admission to a psychiatric unit voluntarily( the names for involuntary admissions may vary from state to state across United States)

## Non-emergency situation
- If a patient has suicidal ideation, but are not in an imminent danger of harming themselves, outpatient treatment with a mental health professional is recommended and they can be on a medication regimen or seek help in the form of psychotherapy

## Medical therapy
- Antidepressants
- Anti psychotics
- Anti anxiety medications

## Psychotherapy
The therapist explores various issues in a patient's life, that might have triggered the suicidal thoughts and helps the patient learn skills that enable them to manage their emotions more effectively. Meets up with the patient in various sessions and there by develops a therapeutic alliance.

## Addiction treatment
Patients who actively use substances like alcohol, and drugs have an increased risk of suicidal thoughts as compared to the general population. These patient's might need enrollment in "Detox", and other self help groups such as "Alcoholic anonymous", "Narcotic anonymous".

## Family therapy
There is an emphasis on educating family members understand the patient's situation and to equip them with better coping skills and improve communication and relationship and there by making a positive impact on the patient's life.