Persius/hicric huggingface dataset:
Menstrual disorder
A menstrual disorder is an irregular condition in a woman's menstrual cycle.

# Oligoovulation
Infrequent or irregular ovulation (usually defined as cycles of >/=36 days or <8 cycles a year) is called oligoovulation.

# Anovulation
Anovulation is absence of ovulation when it would be normally expected (in a post-menarchal, premenopausal woman).  Anovulation usually manifests itself as irregularity of menstrual periods, that is, unpredictable variability of intervals, duration, or bleeding. Anovulation can also cause cessation of periods (secondary amenorrhea) or excessive bleeding (dysfunctional uterine bleeding).

# Polymenorrhea
Polymenorrhea is the medical term for abnormally frequent menstruation that consists of a normal quantity and duration with cycle interval of less than 21 days.

## Differential Diagnosis
Causes
- Anovulatory cycle
- Bi-phasic cycle
- Hyperthyroidism

## Drug Causes
- Misoprostol
- Valdecoxib,

# Oligomenorrhea
Oligomenorrhea is the medical term for infrequent or light menstrual periods (frequency exceeding 35 days).

# Dysmenorrhea
Dysmenorrhea (or dysmenorrhoea), cramps or painful menstruation, involves menstrual periods that are accompanied by either sharp, intermittent pain or dull, aching pain, usually in the pelvis or lower abdomen.

# Amenorrhea
Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Physiologic states of amenorrhoea are seen during pregnancy and lactation (breastfeeding). Outside of the reproductive years there is absence of menses during childhood and after menopause.

# Menorrhagia
Menorrhagia is an abnormally heavy and prolonged menstrual period. Causes may be due to abnormal blood clotting, disruption of normal hormonal regulation of periods or disorders of the endometrial lining of the uterus. Depending upon the cause, it may be associated with abnormally painful periods (dysmenorrhoea).

# Related Problems
- Premenstrual syndrome (PMS)
- Stress and anxiety
- Pelvic inflammatory disease
- Adenomyosis
- History of sexual or physical abuse
- Fibroids
- Ovarian cysts
- Endometriosis
Kussmaul breathing
Synonyms and keywords: Kussmaul respiration

# Overview
Kussmaul breathing is the very deep and labored breathing with normal or reduced frequency, found among people with severe metabolic acidosis; it is a form of hyperventilation.

# Historical Perspective
Kussmaul breathing is named for Adolph Kussmaul, the 19th century German Physician who first noted it among patients with advanced diabetes (usually type I). He published his finding in a classic 1874 paper.

# Pathophysiology
The cause of Kussmaul breathing is respiratory compensation for a metabolic acidosis, most commonly occurring in diabetics in diabetic ketoacidosis. Blood gases on a patient with Kussmaul breathing will show a low pCO2 because of a forced increased respiration (blowing off the carbon dioxide). The patient feels an urge to breathe deeply, an "air hunger", and it appears almost involuntary.
A metabolic acidosis soon produces hyperventilation, but at first it will tend to be rapid and relatively shallow. Kussmaul breathing develops as the acidosis grows more severe. Indeed, Kussmaul originally indentified this type of breathing as a sign of coma and imminent death in diabetic patients.
Duration of fasting, presence or absence of hepatomegaly and Kussmaul breathing provide clues to the differential diagnosis of hypoglycemia in the inborn errors of metabolism.
Deep cervical vein
The deep cervical vein (posterior vertebral or posterior deep cervical vein) accompanies its artery between the Semispinales capitis and colli.
It begins in the suboccipital region by communicating branches from the occipital vein and by small veins from the deep muscles at the back of the neck.
It receives tributaries from the plexuses around the spinous processes of the cervical vertebr, and terminates in the lower part of the vertebral vein.
Defocus aberration
In optics, defocus is the one aberration familiar to nearly everyone who has ever needed eyeglasses or used a camera, videocamera, microscope, telescope, or binoculars, as it simply means out of focus.  Optically, defocus refers to a translation along the optical axis away from the plane or surface of best focus.  In general, defocus reduces the sharpness and contrast of the image.  What should be sharp, high-contrast edges in a scene become gradual transitions.  Fine detail in the scene is blurred or even becomes invisible.  Nearly all image-forming optical devices incorporate some form of focus adjustment to minimize defocus and maximize image quality.
The degree of image blurring for a given amount of focus shift depends inversely on the lens f-number.  Low f-numbers, such as Template:F/ to Template:F/2.8, are very sensitive to defocus and have very shallow depths of focus. High f-numbers, in the Template:F/16 to Template:F/32 range, are highly tolerant of defocus, and consequently have large depths of focus.  The limiting case in f-number is the pinhole camera, operating at perhaps Template:F/100 to Template:F/1000, in which case all objects are in focus almost regardless of their distance from the pinhole aperture.  The penalty for achieving this extreme depth of focus is very dim illumination at the imaging film or sensor, limited resolution due to diffraction, and very long exposure time, which introduces the potential for image degradation due to motion blur.
The amount of allowable defocus may be tied to the resolution of the imaging media.  High-resolution black-and-white (B&W) films can resolve image details down to 3 micrometers or smaller, with usable contrast at 150 cycles/millimeter or higher.  Modern digital imaging chips and color print films are not as sharp as high-resolution B&W films, but have resolution comparable to each other, and are slightly more tolerant of defocus.  If an imaging chip has 10 micrometer pixels, one cycle is therefore two pixels, equal to 20 micrometers or 0.020 millimeters, and the spatial cutoff frequency (limit of resolution) is thus 50 cycles/millimeter at focus.
Defocus is modeled in Zernike polynomial format as a(2 \rho^2-1), where a is the defocus coefficient in wavelengths of light.  This corresponds to the parabola-shaped optical path difference between two spherical wavefronts that are tangent at their vertices and have different radii of curvature.
Neurogenic bladder
For patient information page, click here

# Overview
Neurogenic bladder refers to dysfunction of the urinary bladder due to disease of the central nervous system or peripheral nerves involved in the control of micturition.

# Causes
Neurogenic bladder is often associated with spinal cord diseases, injuries, and neural tube defects including spina bifida. It may also be caused by brain tumors and other diseases of the brain, and by peripheral nerve diseases.  It is a common complication of major surgery in the pelvis, such as for removal of sacrococcygeal teratoma and other tumors.

# Diagnosis

# Treatments
Neurogenic bladder usually causes difficulty or full inability to pass urine without use of a catheter or other method.  Consequently most treatments involve creation of a  stoma that is continent and readily accepts a catheter.  These are  known as Mitrofanoff mechanisms.  Anticholinergic medication may also be used.
Function of the stoma may be augmented by periodic injections of botulinum toxin to relax one of the two sphincters involved in normal urination.  The effect is longer lasting with botulinum toxin type A than with type B.  This use of botulinum toxin is discussed at length in the French medical literature.
Tracheal deviation
Synonyms and keywords: Windpipe shift; deviated windpipe; windpipe deviation

# Overview
Tracheal deviation is defined as the position of the trachea away from its normal position in the midline to one side.

# Causes
The causes can be divided into two main groups: Deviation toward the cause of the problem, and deviation away from the cause of the problem.

## Tracheal Deviation Toward the Lung Problem
This scenario occurs when the pressure in the lung and pleural cavity is less than the other side, and the trachea shifts toward the side with reduced pressure expanding it:
- Atelectasis
- Pleural fibrosis
- Pneumonectomy
- Lung agenesis

## Tracheal Deviation Away From the Lung Problem
- Tension pneumothorax
Diethylcarbamazine
Synonyms and keywords: DEC

# Overview
Diethylcarbamazine is an anthelmintic drug that does not resemble other antiparasitic compounds. It is a synthetic organic compound which is highly specific for several parasites and does not contain any toxic metallic elements.

# Category
Antiparasitic

# US Brand Names
HETRAZAN

# FDA Package Insert
Description

# Mechanism of Action
Diethylcarbamazine is an inhibitor of arachidonic acid metabolism in filaria. This makes the filaria more susceptible to immune attack.

# Uses
Diethylcarbamazine is indicated for treatment of individual patients with certain filarial diseases. These diseases include: lymphatic filariasis caused by infection with Wuchereria bancrofti, Brugia malayi, or Brugia timori; tropical pulmonary eosinophilia, and loiasis.
In cases of onchocerciasis, another common filarial parasite, the drug is not used. This is because the itching associated with the dead subcutaneous parasites causes intense and unbearable itching.
Diethylcarbamazine continues to be the mainstay for treatment of patients with lymphatic filariasis and loiasis. Diethylcarbamazine is also used in the prevention of dogheartworm Dirofilaria immitis.
Dieulafoy's lesion

# Overview
Dieulafoy's lesion is an uncommon cause of gastric bleeding thought to cause less than 5% of all gastrointestinal bleeds in adults. It was named after French surgeon Paul Georges Dieulafoy, who described this condition in his paper "Exulceratio simplex: Lecons 1-3" in 1898. It is also called "Caliber-persistent artery" or "Aneurysm" of gastric vessels. However unlike most other aneurysms these are thought to be developmental malformations rather than degenerative changes.

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Dieulafoy's lesion from Other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications, and Prognosis

## Natural History

## Complications

## Prognosis
The mortality rate for Dieulafoy's was much higher before the era of endoscopy, where open surgery was the only treatment option.

# Diagnosis

## Diagnostic Criteria

## History and Symptoms
The symptoms due to bleeding are hematemesis and/or melena, possibly with shock.

## Physical Examination
Dieulafoy's Lesions is characterized by a single large tortuous arteriole in the submucosa which does not undergo normal branching,  or one of the branches retain high calibre of about 1-5 mm which is more than 10 times the normal diameter of mucosal capillaries. The lesion bleeds into the gastrointestinal tract through a minute defect in the mucosa which is not a primary ulcer of the mucosa but an erosion probably caused from the submucosal surface by the pulsatile arteriole protruding into the mucosa.
95% of Dieulafoy's lesions occur in the upper part of the stomach, within 6 cm of the gastroesophageal junction commonly in the lesser curvature, however they can occur anywhere in the GI tract.
Interestingly and in contrast to peptic ulcer disease, a history of alcohol abuse or NSAID use is usually absent in Dieulafoy's.

## Laboratory Findings

## Imaging Findings

## Other Diagnostic Studies

# Treatment

## Medical Therapy
It is diagnosed and treated endoscopically, however endoscopic ultrasound or angiography can be of benefit.
Endoscopic techniques used in the treatment include epinephrine injection followed by bipolar electrocoagulation, monopolar electrocoagulation, injection sclerotherapy, heater probe, laser photocoagulation, hemoclipping or banding.

## Surgery

## Prevention
Schilder's disease

# Overview
Schilder's disease or diffuse myelinoclastic sclerosis is a a very infrequent neurodegenerative disease that presents clinically as pseudotumoural demyelinating lesions, that make its diagnosis difficult. The disease presents with both adrenal atrophy and diffuse cerebral demyelination.

# Historical Perspective
It was first described by Paul Ferdinand Schilder in 1912, and for a hundred years the term was used to describe also the other white matter pathologies described by him. In 1986 Poser restricted its use to the disease described here.

# Epidemiology and Demographics
The disorder usually begins in childhood with an age of onset between 5 and 14 years old.

# Natrual History, Complication and Prognosis
The prognosis of this disease is very variable and can take three different courses: a monofasic, not remitting;
remitting;
and finally, progressive, with increase in deficits.

# Disorders to Differentiate Shilder's Disease From
This disease is considered one of the borderline forms of multiple sclerosis because some authors consider them different diseases and others MS variants. Other diseases in this group are neuromyelitis optica (NMO), Balo concentric sclerosis and Marburg multiple sclerosis.

# Diagnosis

## Symptoms
Symptoms are similar to those in multiple sclerosis and may include dementia, aphasia, seizures, personality changes, poor attention, tremors, instability, incontinence, muscle weakness, headache, vomiting, and vision and speech impairment.

## Diagnostic Criteria
The Poser criteria for diagnosis are:
- One or two roughly symmetrical large plaques. Plaques are greater than 2 cm diameter.
- No other lesions are present and there are no abnormalities of the peripheral nervous system.
- Results of adrenal function studies and serum very long chain fatty acids are normal.
- Pathological analysis is consistent with subacute or chronic myelinoclastic diffuse sclerosis.

# Treatment
Management Corticosteroids may be effective in some patients. Otherwise management in supportive and includes physiotherapy, occupational therapy and nutritional support in the later stages
Rectal examination
A rectal examination or rectal exam is an internal examination of the rectum by a physician or other healthcare professional.
The digital rectal examination (DRE, Latin palpatio per anum or PPA) is a relatively simple procedure.  The patient is placed in a position where the anus is accessible and relaxed (lying on the side, squatting on the examination table, bent over the examination table, etc). The physician inserts a gloved and lubricated finger into the rectum through the anus and palpates the insides.
The DRE is inadequate as a screening tool for colorectal cancer because it examines less than 10% of the colorectal mucosa; colonoscopy is preferred. However, it's an important part of a general examination, as many tumors or other diseases manifest themselves in the distal part of the rectum.
This examination may be used:
- for the diagnosis of rectal tumors and other forms of cancer;
- in males, for the diagnosis of prostatic disorders, notably tumors and benign prostatic hyperplasia;
- for the diagnosis of appendicitis or other examples of an acute abdomen (i.e. acute abdominal symptoms indicating a serious underlying disease);
- for the estimation of the tonicity of the anal sphincter, which may be useful  in case of fecal incontinence or neurologic diseases;
- in females, for gynecological palpations of internal organs
- for examination of the hardness and color of the feces (ie. in cases of constipation, and fecal impaction);
- prior to a colonoscopy or proctoscopy.
- to evaluate haemorrhoids
The DRE is frequently combined with a FOBT (fecal occult blood test), which may be useful for diagnosing the etiology of an anemia and/or confirming a gastrointestinal bleed.
Sometimes proctoscopy may also be part of a rectal examination.

# Veterinary medicine
In veterinary medicine rectal examination is useful in dogs for analysis of the prostate (as in man), pelvic urethra, sublumbar lymph nodes, and anal glands.  In horses it is a vital component of the clinical examination for colic, to determine the presence or absence of bowel torsion, impaction, or displacement.  Horses undergoing a rectal exam are at relatively high risk of a rectal tear, which can be a life-threatening event, rapidly leading to peritonitis and septic shock.
The procedure in dogs and cats is similar to humans.  For the horse, the patient stands in a stock cage and may be sedated.  The examiner puts on a long glove that extends to the shoulder. The examiner inserts the hand and arm into the rectum as far as necessary.
Diloxanide furoate

# Overview
Diloxanide furoate is a luminal amebicide used in the treatment of Amebiasis. It is considered the luminal agent of choice for mild intestinal amebiasis or asymptomatic cyst carriers.It can also be added to metronidazole(active drug in luminal and extraintestinal amebiasis) in acute amebic dysentery as well as hepatic abscess(In hepatic abscess it is for the control of cysts in the lumen which may cause relapse). The drug was discovered by The Boots Company Plc in 1956 and introduced as Furamide. The Furamide brand is now owned by Abbott Laboratories. It is not available in the US. In India it is available as Amicline by Franco-Indian.
It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.

# Safety and effectiveness
A 13-year study conducted by the United States Center for Disease Control between 1977 and 1990 found that this drug had a low incidence of side effects and was successful in treatment of 86% of asymptomatic carriers of Entamoeba histolytica.
Diploma in Nursing
Assistant Editor-In-Chief: Michelle Lew

# Overview
A Diploma in Nursing or Nursing Diploma is an entry-level tertiary education nursing degree.
In the United States, this type of degree is usually awarded by hospital-based nursing schools.  Students awarded a Diploma in Nursing are qualified to sit for the NCLEX-RN and apply for licensure as a Registered Nurse.
At one time, all nurses in the United States were diploma-prepared.  The Cherry Ames series of children's books was created to encourage girls to go into the nursing profession during World War II.  She was a "hospital diploma" nurse.
Although the number of hospital-based nursing schools continues to decrease, many still exist.  Some require that non-nursing prerequisite courses be completed at another school prior to admission or coordinate their program with classes at a nearby school, though many are still self-contained.
Dipropyltryptamine
Dipropyltryptamine (DPT) is a psychedelic drug belonging to the tryptamine family.  It is found either as its crystalline hydrochloride salt or as an oily or crystalline base.  It has not been found to occur naturally.
Frequent physical effects are nausea, numbness of the tongue or throat, and pupil dilation.

# Hallucinogenic Properties
While dipropyltryptamine is chemically similar to dimethyltryptamine, the effects are markedly different.
The most prominent features of the DPT experience are increased significance or intensity of music, colors take on a new intensity or appearance, the body may have a buzz or vibratory feeling, a pleasant sensation of warmth, complete ego loss, apparitions of faces, and visions of bizarre creatures and alien lands.
While seeing other beings under the influence of DPT is not uncommon, the perspective is more as an observer or watcher, as contrasted to the more personal real-feeling entity contact reported with DMT.
Also reported is a loss of ego boundary; for example, the boundary between the self and a table may not be easy to distinguish.  Difficulty distinguishing other boundaries is common as well. For example, different colors may be difficult to distinguish.  Other sensory input may also become blended.  This is distinct from synaesthesia.
A user may also encounter the feeling of experiencing the life of someone else, or having had all possible experiences simultaneously. One may have the experience of seeing the universe from different locations in space and time.
Visuals are often geometric, wavy, and/or spiraled. Other visual distortions and hallucinations tend to be experienced in the peripheral vision. The self or the environment may take on a stylized cartoon-like look or feel. Pleasant flashes of light and sparkles are also common.

## Dose
Smoked: When smoked, the effects of DPT have an onset in minutes and a duration of less than one hour. Dosage ranges from 30-100 mg.
Insufflation: Average onset for insufflation of DPT is five to fifteen minutes, and typical dosage ranges from 45-225 mg, but the most popular dose is around 100 mg.
Intramuscular: When injected into the muscle, onset ranges from one minute to fifteen minutes. Typical dosage ranges from 20-110 mg.
Intravenous: When injected intravenously, onset ranges from five to fifteen seconds. Typical dosage ranges from 10-75 mg.
Oral Ingestion: DPT is metabolized by the enzyme monoamine oxidase.  While DPT is orally active on its own, the combination with a monoamine oxidase inhibitor (MAOI) can increase the length and intensity of the experience. Oral dosages of 150 - 250 mg are commonly reported, with an onset of 20-60 minutes (depending on stomach content).

# Religious use
DPT is used as a religious sacrament by the Temple of the True Inner Light, a New York City offshoot of the Native American Church.  The Temple believes DPT and other entheogens are physical manifestations of God.
Dipylidium caninum
Dipylidium caninum, also called the cucumber tapeworm or the double-pore tapeworm, is a cyclophyllid cestode that infects organisms afflicted with fleas, including canids, felids, and pet-owners, especially children.  Adult worms are about 18 inches long.  Eggs (or egg clusters or egg balls) are passed in the host's feces and ingested by fleas, which are in turn ingested by another mammal after the tapeworm larvae partially develop.  Examples of fleas that can spread D. caninum include Ctenocephalides canis and Ctenocephalides felis.
As in all members of family Dipylidiidae, proglottids of the adult have genital pores on both sides (hence the name double-pore tapeworm).  Each side has a set of male and female reproductive organs.  The scolex has a rostellum with four rows of hooks, along with the four suckers that all cyclophyllid cestodes have.  In cats, sometimes proglottids are visible hanging out of a cat's anus.
Inside fleas, eggs hatch and form oncosphere larvae that move through the wall of the flea intestine into the body cavity where they become cysticercoid larvae, which are infective to mammal hosts.
In children, infection causes diarrhea and restlessness.  As with most tapeworm infections, the drugs of choice are niclosamide or praziquantel.  The best way to prevent human infection is to treat infected animals and to kill fleas.
Dislocation of hip
A dislocated hip is a condition that can be congenital or acquired. Congenital hip dislocations are much more common in girls than in boys.

# Posterior vs. anterior
Nine out of ten hip dislocations are posterior. The affected limb will be shortened and internally rotated in this case.
In an anterior dislocation the limb will not be lengthened as noticeably and will be externally rotated.

# Congenital vs. acquired
Congenital hip dislocation must be detected early when it can be easily treated by a few weeks of traction. If it is not detected the child's hip may develop incorrectly seen when the child begins to walk. If one hip is affected the child will be have a limp and lurch and with bilateral dislocation there will be a waddling gait.
Acquired hip dislocations can be extremely painful and commonly occur during car accidents. They may be treated by surgical realignment and traction.