Persius/hicric huggingface dataset:
Prevention of ST
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: 
There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us  to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

# Overview
The risk of stent thrombosis is reduced with the use of combined antiplatelet therapy.
- There are better outcomes noted with the use of aspirin plus ticlopidine or clopidogrel than with aspirin plus warfarin or aspirin alone.
- Preliminary evidence suggests prasugrel resulted in fewer ischaemic outcomes including stent thrombosis than with standard clopidogrel.

# Clinical trial data
- In STARS trial, studying 1653 patients showed superiority of aspirin and ticlopidine over combination of aspirin and warfarin or aspirin alone for reducing subacute stent thrombosis, although there were more hemorrhagic complications than with aspirin alone.
- A similar benefit for combined aspirin plus ticlopidine was noted in another randomized controlled trial.
- Results from double blinded randomized studies- PCI-CURE trial, analyzing 2658 patients and CREDO trial, analyzing 2116 patients, revealed the benefit of clopidogrel therapy increased with time and  provide evidence for at least one year therapy in patients with BMS. However both the studies did not evaluate DES.
- TRITON TIMI-38trial analyzing 12,844 patients who underwent stenting for ACS revealed intensive antiplatelet therapy with prasugrel resulted in fewer ischaemic outcomes including stent thrombosis than with standard clopidogrel.These findings were statistically robust irrespective of stent type, and the data affirm the importance of intensive platelet inhibition in patients with intracoronary stents.

# Coronary stent thrombosis prevention
The 2008 American College of Chest Physician illustrates the following guidelines for primary and secondary prevention of coronary artery disease.
Priyamvada Singh
Priyamvada Singh, M.D.

# Education
Maulana Azad Medical College, New Delhi, India- M.B.B.S.
Harvard Medical School- 'Principles and Practice of Clinical Research', Research Course

# Current Appointments
- Beth Israel Deaconess Medical Center, Harvard Medical School- Research fellow  (May 2011 to current)
- Harvard Medical School- Teaching assistant, Principles and Practice of Clinical Research (March 2011 to current)
- Wikidoc.org

# Past Appointments
- Children's Hospital Boston, Harvard Medical School - Research Assistant, Neurology (July 2010 - April 2011)

# Research
- Children's Hospital Boston- She has keen interest in research and was actively involved in research of, ' Spinal Muscular Atrophy ' a genetic neuro-muscular disorder seen in Pediatrics population. During her stint at Children's Hospital Boston she was actively involved in data analysis and interpretation of a study on Spinal muscular atrophy that later got funded. She was second author of the abstract that was based on these results. The abstract was presented in, '15th Spinal Muscular Atrophy Meeting' held in Orlando, Florida, 2011.
- Beth Israel Deaconess Medical Center- Currently she is working as a Research fellow and trialist at PERFUSE core laboratories and data coordinating center, where she is involved in the planning and conduction of three research trials.

# Teaching experience
She is currently acting as a teaching assistant for the 9 month intensive research course offered by Harvard Medical School called, 'Principles and Practice of Clinical Research' where she is responsible for 20 students from different countries (Japan, U.S.A., Brazil, Portugal, Iran and Australia)

# Accomplishments
- Topper of Delhi zone (North zone) in tenth grade examination held by, 'Central Board of Secondary Education', India
- She was among toppers of the Pre-Medical entrance examinations in India.
- She was among top ten students in the research course offered by ' Harvard Medical School',  'Principles and Practice of Clinical Research' .

# Publications
- Second author of review article,  'Spinal Muscular Atrophy : A Clinical and Research Update' submitted in the journal,  'Pediatric Neurology' .
- Second author of Abstract,  'Comparison of Clinician Perceived Care Given and Caregiver Perceived Care Received: Use of the SMA Clinical Assessment Tool (CAT) and a Comparative Family Survey' .

# Oral Presentation
Oral Presentation presented at: Principles and Practice of Clinical Research, for Harvard Medical School's Research course; Boston, MA on,  'Advanced search in PubMed and Google Scholar' .

# Other academic work
Major editor of English pages on WikiDoc. She has added content and edited numerous pages in Congenital Heart Disease and Spinal muscular atrophy. Added wikipatients pages on Infectious diseases and Endocrine diseases, and created site microchapter system. Due to her contributions she was awarded as,  'WikiDoc Scholars with Highest Distinction'
Proanthocyanidin
Proanthocyanidin (also known as oligomeric proanthocyanidin (OPC), pycnogenol, leukocyanidin and leucoanthocyanin) is a class of flavonoids. It was discovered in 1936 by Professor Jacques Masquelier and called Vitamin P, although this name did not gain official category status and has since fallen out of usage. It was Masquelier who first developed techniques for the extraction of Proanthocyanidins from certain plant species.
Proanthocyanidins have been sold as nutritional and therapeutic supplements in Europe since the 1980s, but their introduction to the United States market has been relatively recent.
Proanthocyanidins can be found in many plants, most notably pine bark, grape seed, grape skin, and red wines of Vitis vinifera. However, bilberry, cranberry, black currant, green tea, black tea, and other plants also contain these flavonoids. The berries of chokeberry, specifically black chokeberry, have the highest measured concentrations of proanthocyanidin found in any plant to date.
This information attracted the attention of public news media, describing that red wine consumption was associated with favorable intake of health-promoting flavonoids which correlate with oxygen radical absorbance capacity (ORAC).
In red wines, total oligomeric proanthocyanidin content, including catechins, was substantially higher (177.18 +/- 96.06 mg/L) than that in white wines (8.75 +/- 4.53 mg/L). A relative high correlation in red wines was found between ORAC values and malvidin compounds (r = 0.75, P < 0.10), and proanthocyanidins (r = 0.87, P < 0.05).
In white wines, a significant correlation was found between the trimeric proanthocyanidin fraction and peroxyl radical scavenging values (r = 0.86, P < 0.10).
A moderate drink (1 drink per day, about 140 mL) of red wine, or white wine, or wine made from highbush blueberry corresponded to an intake of 2.04 +/- 0.81 mmol of TE, 0.47 +/- 0.15 mmol of TE, and 2.42 +/- 0.88 mmol of TE of ORAC/day, respectively.
These studies provide data supporting the French Paradox which hypothesizes that intake of proanthocyanidins and other flavonoids from regular consumption of red wines prevents occurrence of a higher disease rate (cardiovascular diseases, diabetes) in French citizens on high-fat diets.

# Reference
-  Wu, X., Gu, L., Prior, R. L., & McKay, S. (2004). Characterization of anthocyanins and proanthocyanidins in some cultivars of Ribes, Aronia and Sambucus and their antioxidant capacity. J Agric Food Chem. 52 (26): 7846-7856.
-  Sanchez-Moreno, C., G. Cao, B. Ou & R.L. Prior 2003. Anthocyanin and proanthocyanidin content in selected white and red wines. Oxygen radical absorbance capacity comparison with nontraditional wines obtained from highbush blueberry. J Agric Food Chem. 2003 Aug 13;51(17):4889-96.
-  Corder, R., W. Mullen, N.Q. Khan, S.C. Marks, E. G. Wood, M.J. Carrier & A. Crozier 2006. Oenology: Red wine procyanidins and vascular health. Nature 444, 566 (30 November 2006).
Prosector's wart

# Overview
Tuberculosis verrucosa cutis (also known as "Lupus verrucosus," "Prosector's wart," and "Warty tuberculosis")is a rash of small, red papular nodules in the skin that may appear 24 weeks after inoculation by Mycobacterium tuberculosis in a previously infected and immunocompetent individual.
It is so called because it was a common occupational disease of prosectors, the preparers of dissections and autopsies. Reinfection by tuberculosis via the skin, therefore, can result from accidental exposure to human tuberculous tissue in physicians, pathologists and laboratory workers; or to tissues of other infected animals, in veterinarians, butchers, etc. Other names given to this form of skin tuberculosis are anatomist's wart and verruca necrogenica (literally, generated by corpses).
TVC is one of the many forms of cutaneous tuberculosis, such as the tuberculous chancre (which results from the inoculation in people without immunity, and the reactivation cutaneous tuberculosis (the most common one, which appears in previously infected patients). Other forms of cutaneous tuberculosis are: lupus vulgaris, scrofuloderma, lichen scrofulosorum, erythema induratum and the papulonecrotic tuberculid.
It was described by Rene Laennec in 1826.

# Presentation
Because the TVC's entry point usually is the site of a trauma, wound or puncture in the skin (during an autopsy, for example), the most frequent site for the wart are the hands. But it can occur anywhere in the skin, such as in the sole of the feet, in the anus, and, in the case of children from developing countries, in the buttocks and knees. This is because children from countries of high incidence of tuberculosis can contract the lesion after contact with tuberculous sputum, by walking barefoot, sitting or playing on the ground.
When recent, the skin lesion has the outside appearance of a wart or verruca, thus it can be confused with other kinds of warts. It evolves to an annular red-brown plaque with time, with central healing and gradual expansion in the periphery. In this phase, it can be confused with fungal infections such as blastomycosis and chromoblastomycosis.

# Diagnosis
The diagnosis is confirmed by a skin biopsy and a positive culture for acid-fast bacilli. A PPD test may also result positive.

## Physical Examination

### Skin
- Tuberculosis verrucosa cutis. Adapted from Dermatology Atlas.
- Tuberculosis verrucosa cutis. Adapted from Dermatology Atlas.
- Tuberculosis verrucosa cutis. Adapted from Dermatology Atlas.
- Tuberculosis verrucosa cutis. Adapted from Dermatology Atlas.
- Tuberculosis verrucosa cutis. Adapted from Dermatology Atlas.
- Tuberculosis verrucosa cutis. Adapted from Dermatology Atlas.

# Treatment
Therapy for cutaneous tuberculosis is the same as for systemic tuberculosis, and usually consists of a 4-drug regimen, i.e., isoniazid, rifampin, pyrazinamide, and ethambutol or streptomycin.
Protein toxicity
Protein toxicity with proteinuria can result in those with preexisting kidney disease, or those who have lost kidney function due to advanced age.  For otherwise healthy people, consuming over 2.0 g/kg/d, the extra protein can become a stressful stimulus for the kidney.
Those with kidney disease are advised to avoid consumption of protein if possible, as consuming them accelerates the problems (see Chronic renal failure#Signs and symptoms).  Most of the problems stem from the accumulation of toxins and wastes from protein metabolism that aren't getting filtered out.
It must be noted that kidney function (along with everything else) naturally declines with age due to the gradual loss of nephrons (filters) in the kidney.  Therefore, a 90 year old cannot safely consume the same amount of protein as a 20 year old.
The first sign of kidney problems begins with microalbuminuria.
Severe illness including death can occur with chronic renal failure.
Common causes of kidney disease include diabetes, heart disease and long term untreated high blood pressure, as well as abuse of aspirin.
Pulled hamstring
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: 
There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us  to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Straining of the hamstring, also known as a pulled hamstring, is defined as an excessive stretch or tear of muscle fibers and related tissues.

# Grades

## Grade A
With a grade one hamstring strain the signs may not be present until after the activity is over. There may be a sensation of cramp or tightness and a slight feeling of pain when the muscles are stretched or contracted.

## Grade B
With a grade two hamstring strain there is immediate pain which is more severe than the pain of a grade one injury. It is confirmed by pain on stretch and contraction of the muscle.

## Grade C
A grade three hamstring strain is a severe injury. There is an immediate burning or stabbing pain and the athlete is unable to walk without pain. The muscle is completely torn and there may be a large lump of muscle tissue above a depression where the tear is. After a few days with grade two and three injuries a large bruise may appear below the injury site caused by the bleeding within the tissues.

# Treatment
The immediate treatment of any muscle injury consists of the RICE protocol - rest, ice,compression,  and elevation (never apply ice directly to the skin). This is aimed at reducing the bleeding and damage within the muscle tissue. Resting may be the common sense approach, but it is one that is often ignored by competitive athletes. This is unwise, since it does not take much to turn a grade one strain into a grade two, or a grade two strain into a grade three. As a general rule, grade one hamstring strains should be rested from sporting activity for about 3 weeks and grade two injuries for about 4 to 6 weeks. In the case of a complete rupture, the muscle will have to be repaired surgically and the rehabilitation afterwards will take about 3 months.
Regardless of the level of the injury the treatment in the first five days is the same. The hamstring should be rested in an elevated position with an ice pack applied for twenty minutes every two hours, if practical (never apply ice directly to the skin). A compression bandage should be applied to limit bleeding and swelling in the tissues. After the first five days have been spent resting, more active rehabilitation can be started.
Crutches would be necessary for any period time that you will be walking long distances or many steps. You should use it but not over use it. Short distances such as around the house you should not use the crutches however going places you should strongly consider the crutches. If over-using occurs it could result in a raise of the grade of strain.
Pulmonary toilet
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: 
There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us  to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Pulmonary toilet, also called pulmonary hygiene, is a set of methods used to clear mucus and secretions from the airways.  The word pulmonary refers to the lungs.  The word toilet is related to the French toilette, refers to body care and hygiene; this root is used in words such as toiletry that also relate to cleansing.
Pulmonary toilet prevents atelectasis (the collapse of the alveoli of the lungs) and rids the respiratory system of secretions, which could cause respiratory infections.  It can also decrease pulmonary shunting, increase the functional reserve capacity of the lungs, and prevent respiratory infection after chest trauma.  Methods include using suction to remove fluids and placing the patient in a position that allows secretions to drain by gravity.

# Methods
Methods used for pulmonary toilet include suctioning of the airways, chest physiotherapy, blow bottles, and nasotracheal suction.  Bronchoscopy, in which a tube is inserted into the airways so that an examiner can view them, can be used therapeutically as part of pulmonary toilet. Incentive spirometry and use of analgesics (pain medications) that do not inhibit breathing are also parts of pulmonary toilet.  Coughing is also important for ridding the airways of secretions, so healthcare providers are careful not to oversedate patients, because that could inhibit coughing.  Tracheotomy facilitates pulmonary toilet. Percussion, another method, loosens secretions and allows the cilia of the airways to remove material.  Positioning is another method for promoting drainage of secretions; sometimes patients are placed in a prone position to aid in this purpose.

# Applications
Pulmonary toilet is used for preventing infections such as pneumonia.  It is also used in the management of conditions such as pneumonia and cystic fibrosis.  For people with chronic lung diseases, pulmonary toilet is used to prevent infections and lung abscesses.  Pulmonary toilet is also used to prevent acute respiratory distress syndrome after chest trauma.
Pulsus alternans

# Overview
Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis.

# Pathophysiology
The mechanism of pulsus alternans was referred to Starling's law of the heart.  The ejection fraction will decrease significantly in cases of left ventricular dysfunction, which is the most important cause of pulsus alternans, causing reduction in stroke volume, and this reduction results in an increase in the end-diastolic volume.  As explained by Starling's law, during the next cycle of systolic phase, the myocardial muscle will be stretched more than usual and causes an increase in myocardial contraction, this in turn results in a stronger systolic pulse.

# Causes

## Overview
The presence of pulsus alternans almost indicate severe left ventricular failure, and patients should undergo further investigations for proper management.

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Pulsus alternans in itself is not a life threatening condition, but in most of cases it indicate sever left ventricular failure and further investigations should be done.

## Common Causes
The most common cause of pulsus alternans is Left ventricular failure, other causes include:
- Asthma
- Cardiac tamponade
- Meadows syndrome
- Premature ventricular contraction
- Severe aortic regurgitation

## Causes by Organ System

## Causes in Alphabetical Order
- Asthma
- Cardiac tamponade
- Left ventricular failure
- Meadows syndrome
- Premature ventricular contraction
- Severe aortic regurgitation
Pulsus bigeminus

# Overview
Pulsus bigeminus is a cardiovascular phenomenon, in which two heartbeats occur close to each other followed by a long pause.  The second pulse is weaker than the first, and it is caused by premature contractions after every other beat, usually of the ventricles.

# Causes

## Overview
Pulsus bigeminus may be innocent and a temporary phenomenon, but mostly seen in cases of hypertrophic obstructive cardiomyopathy.

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Pulsus bigeminus in itself is not a life threatening condition.

## Common Causes
The most common cause of pulsus bigeminus is hypertrophic obstructive cardiomyopathy, other causes include:
- Beta blocker
- Calcium channel blocker
- Digoxin
- Hyperkalemia
- Hypothyroidism
- Myocardial infarction

## Causes by Organ System

## Causes in Alphabetical Order
- Beta blocker
- Calcium channel blocker
- Digoxin
- Hypertrophic obstructive cardiomyopathy
- Hyperkalemia
- Hypothyroidism
- Myocardial Infarction
Pupillary reflex
Pupillary reflex refers to one of the reflexes associated with pupillary function.
Types include:
- Pupillary light reflex
- Accommodation reflex
Although pupillary dilation is not usually called a "reflex", it is still usually considered a part of this topic.
Accommodation and vergence are also known as the "near response", while inhibition of the ciliary muscle is also known as the "far response".
Radioimmunoassay
Radioimmunoassay (RIA) is a scientific method used to test antigens (for example, hormone levels in the blood) without the need to use a bioassay. It involves mixing known quantities of radioactive antigen (frequently labeled with gamma-radioactive isotopes of iodine attached to tyrosine) with antibody to that antigen, then adding unlabeled or "cold" antigen and measuring the amount of labeled antigen displaced.
Initially, the radioactive antigen is bound to the antibodies. When "cold" (unlabeled, quest) antigen is added, the two compete for antibody binding sites - at higher concentrations of "cold" antigen, more of it binds to the antibody, displacing the radioactive variant. The bound antigens are separated from the unbound ones.
One method of separation used initially was the use of a second antibody directed against the first for precipitation and centrifugation. The use of charcoal suspension for precipitation was extended but replaced later by Drs. Werner and Acebedo at Columbia University for RIA of T3 and T4. An ultramicro RIA for human TSH was published in BBRC (1975) by Drs. Acebedo, Hayek et al.  The free hormone  stays in the supernatant, the radioactivity of which is measured and a binding curve is plotted.
The technique is both extremely sensitive and  specific, but it requires special precautions (because radioactive substances are used), sophisticated apparatus, and is expensive. The technique has been largely replaced by the ELISA method where instead of a radioactive signal, the antigen-antibody reaction is measured by colorometric signals.
The RIA was developed by Rosalyn Yalow and Solomon Aaron Berson in the 1950s.  Rosalyn Sussman Yalow received the 1977 Nobel Prize in Medicine for the development of the RIA for insulin. The precise measurement of minute amounts of such a hormone was a key event in endocrinology.