Medicine and Health Sciences Commons^™

Metastatic Choriocarcinoma In A Young Woman Presenting As Thyroid Storm: A Case Report, Muhammad Saleem, Sher Sethi, Abrar Ali, Zareen Kiran,

Department of Medicine

Background: Thyroid storm is an endocrine emergency and life-threatening condition discovered in 1926. There is no specific laboratory parameter that can differentiate or distinguish between thyroid storm and primary hyperthyroidism. Diagnosis is made on a clinical scoring system, including the Burch-Wartofsky point scale and Japanese Thyroid Association scoring system. The management is early diagnosis, immediate initiation of anti-thyroid medications, intensive care monitoring, and prevention of multiorgan failure.
Case presentation: A 30-year-old Pakistani female presented with complaint of headache, vomiting, and generalized weakness for 3 weeks. She had an episode of seizure-like activity at home, and so was rushed to the …

A Rare Case Of A Plurihormonal Pituitary Adenoma, Alisha Hossain Do, Lindor Gelin Do, Arjan Ahluwalia Md, Emily C. Skutnik Do, Sonum Singh Md, Gretchen A. Perilli Md, Sharmila C. Koshy Md

Department of Medicine

No abstract provided.

The Difficulty Of Post-Operative Surveillance Of Calcitonin Negative Medullary Thyroid Cancer, Emily C. Skutnik Do, Rachel Kinney Do, Rebecca A. Lopes Do, Chun Siu Do, Angela Magdaleno Do, Gretchen A. Perilli Md

Department of Medicine

No abstract provided.

Predictors Of Mortality In Hospitalized Patients With Influenza: A Five-Year Experience From A Tertiary Care Centre In Pakistan, Iffat Khanum, Amber Sabeen Ahmed, Safia Awan, Sabiha Banu, Bushra Jamil

Department of Medicine

Influenza outbreaks are associated with significant morbidity. Our aim was to determine the factors associated with increased mortality in hospitalized patients admitted with diagnosis of influenza, at a tertiary care center in Pakistan. This study included all adult patients with an influenza infection, confirmed by realtime reverse-transcriptase polymerase-chain-reaction (RT-PCR) at Aga Khan University Hospital Pakistan. In our study, 112 patients with laboratory-confirmed influenza virus infection were admittedat our hospital from the 1st of January 2013 to the 31st of December 2018. Eighty-nine patients (79.46%) were managed in ward or special care units and 23 patients (20.5%) received treatment in intensive …

High Dose Biotin And Its Effects On Thyroid Function Testing, Emily C. Skutnik Do, Rebecca A. Lopes A, Sandhya Venkataraman Do, Angela Magdaleno Do, Leslie A. Colip Md

Department of Medicine

No abstract provided.

Adult-Onset Hypophosphatasia: Before And After Treatment With Asfotase Alfa, Angela Magdaleno Do, Sonum Singh Md, Sandhya Venkataraman Do, Ya-Yu Lee Md

Department of Medicine

No abstract provided.

Primary Hyperparathyroidism As Initial Presentation Of Stage Iv Breast Cancer, Angela Magdaleno Do, Angel Lopez Md, Thomas A. Diven Md, Marc A. Vengrove Do, Facp

Department of Medicine

No abstract provided.

Management Of Pregestational Diabetes Insipidus In Pregnancy, Sandhya Venkataraman Do, Sharmila C. Koshy Md, Marc A. Vengrove Do, Facp

Department of Medicine

No abstract provided.

Immune Related Adverse Events: Isolated Acth Deficiency With Nivolumab/ Ipilimumab Combination Therapy, Joseph Scurozo Do, Angela Magdaleno Do, Sharmila C. Koshy Md

Department of Medicine

No abstract provided.

Web-Based Glucose Monitoring Using The Telcare® Wireless System For Management Of Pregnant Women With Pregestational Diabetes., Marc A. Vengrove Do, Facp, Emma Qureshey Md, Helai Hesham Md, Meredith Rochon Md, Joshua Cohen Bs, John C. Smulian Md, Mph

Department of Medicine

No abstract provided.

Pituitary Apoplexy Mimicking A Meningoencephalitis., Chun Chu Md, Gretchen A. Perilli Md, Rachel Kinney Do, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Using Mobile Health (Mhealth) Technology In The Management Of Diabetes Mellitus, Physical Inactivity, And Smoking, Hasan Rehman, Ayeesha Kamran Kamal, Saleem Sayani, Pamela B. Morris, Anwar T. Merchant, Salim S. Virani

Department of Medicine

Purpose of Review: Cardiovascular mortality remains high due to insufficient progress made in managing cardiovascular risk factors such as diabetes mellitus, physical inactivity, and smoking. Healthy lifestyle choices play an important role in the management of these modifiable risk factors. Mobile health or mHealth is defined as the use of mobile computing and communication technologies (i.e., mobile phones, wearable sensors) for the delivery of health services and healthrelated information. In this review, we examine some recent studies that utilized mHealth tools to improve management of these risk factors, with examples from developing countries where available.
Recent Findings: The mHealth …

Incidental Metastatic Mediastinal Atypical Carcinoid In A Patient With Parathyroid Adenoma: A Case Report., Zareen Kiran,, Asma Ahmed, Owais Rashid, Saira Fatima, Faizan Malik, Saulat H. Fatimi, Mubasher Ikram

Department of Medicine

Background: Atypical carcinoid arising from the mediastinal tissue is a rare neuroendocrine tumor and an association with parathyroid adenoma is very unusual. We report an unusual case of atypical carcinoid of mediastinum with metastasis in a patient presenting with parathyroid adenoma, which is the first case to be reported from Pakistan.

Case presentation: A 51-year-old Pakistani man was seen in postoperative intensive care after right parathyroidectomy and mediastinal mass resection for the management of postoperative hypocalcaemia. He had a background history of dyspnea. Examination was unremarkable. Preoperative laboratory evaluation revealed a calcium level of 12.7 mg/dl, phosphate of 1.9 mg/dl, …

An Unusual Pathogen Causing Native Valve Endocarditis., Aneela Hussain, Nosheen Nasir, Bushra Jamil

Department of Medicine

No abstract provided.

Glucose Monitoring In Pregnancy Complicated By Diabetes., Aisha Sheikh, Abdul Jabbar

Department of Medicine

Diabetes in pregnancy is associated with adverse maternal and neonatal outcomes. Due to variations in insulin resistance throughout pregnancy there is a continuous need to implement Medical Nutrition Therapy (MNT), exercise and pharmacological treatments which have to be escalated. Self-monitoring of blood glucose (SMBG) is integral to the management of diabetes in pregnancy. Proper implementation of SMBG in pregnant women with diabetes requires patient education and understanding of its applications and limitations. Real-time results enable individuals to make informed daily self-care decisions regarding diet, exercise, and insulin. Retrospective analysis of SMBG data enables clinicians to develop individualized care plans, informing …

Unusual Presentation With Polymenorrhagia And Markedly High 17-Hydroxy Progesterone Levels In A Lady With Non-Classic Congenital Adrenal Hyperplasia., Azra Rizwan, Marium Hayat

Department of Medicine

Congenital adrenal hyperplasia is generally associated with oligo-amenorrhea, and its presentation with polymenorrhagia is rare. Here we present a case of an Asian female who presented with polymenorrhagia since menarche, increased body hair growth and enlargement of clitoris for 7-8 years. Examination revealed a normal Body Mass Index, moderate hirsutism, Tanner 5 breasts and significant clitoromegaly. Serum testosterone and 17-hydroxyprogesterone levels were elevated. Ultrasonography revealed normal adrenal glands and polycystic ovaries. adrenocorticotropic hormone stimulation test uncovered borderline cortisol deficiency. Oral dexamethasone was commenced and six months later, she showed improvement though there was no change in hirsutism or clitoromegaly. The …

Ectopic Cushing Syndrome And Pancreatic Cancer: A Case Report, Mira Mitry Md, Nicole M. Agostino Do, Stacey Smith Md, Facp, Vasudev G. Magaji Md, Ms

Department of Medicine

No abstract provided.

Clinical, Lifestyle, Socioeconomic Determinants And Rate Of Asymptomatic Intracranial Atherosclerosis In Stroke Free Pakistanis., Ayeesha Kamran Kamal, Farzin Majeed, Omrana Pasha, Hasan Rehman, Muhammad Islam, Iqbal Azam Syed, Muhammad Saleem Ilyas, Munawar Hussain, Kamran Masood, Bilal Ahmed, Sumaira Nazir, Zafar Sajjad, Scott E. Kasner

Department of Medicine

Background: Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region.

Methods: The study is an analytical prospective cross-sectional study of 200 adults from Radiology Departments of two diagnostic centers in Karachi. Eligible participants confirmed the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS) and underwent an interview covering medical, socio demographic, lifestyle and anthropometric evaluation using locally validated and standardized definitions. Magnetic Resonance Images (MRI) were centrally reviewed to detect ICAD using the criterion used …

Case Report: Nocardia Infection Associated With Ectopic Cushings., Azra Rizwan, Aqiba Sarfaraz, Abdul Jabbar, J. Akhter, Najmul Islam

Department of Medicine

Background: Cushing's syndrome results from exposure to excess glucocorticoids. Ectopic Cushings is endogenous ACTH dependant form of Cushing's associated with markedly raised ACTH and cortisol levels. This leads to an impaired immune response, setting the stage for occurrence of opportunistic infections. Nocardiosis is a gram positive bacterial infection caused by aerobic actinomycetes in genus Nocardia. We report a series of patients diagnosed with ectopic Cushings, having pneumonia with Nocardia spp. In one of these cases, the manifestations of Cushing's disappeared with treatment for Nocardia.

Case Presentation: Two middle aged men of Asian descent presented to the Endocrine clinic: the first …

Diabetes Insipidus In Patient With Bodydysmorphic And Eating Disorder, Vasudev G. Magaji Md, Ms, Gretchen Perilli Md

Department of Medicine

No abstract provided.

Unique Diagnostic Challenges Of Cushings From Large Bilateral Adrenal Adenoma And Mifepristone Utilization For Hypercortisolism Prior To Surgery, Vasudev G. Magaji Md, Ms, Sarah Park Do, Maura Bucciarelli Do, Katie Mastoris Do, Scott Beman Md

Department of Medicine

No abstract provided.

Rare Case Of Klinefelters Syndrome With 48xxyy, Vasudev G. Magaji Md, Ms, Deborah Feden Crnp, Gretchen Perilli Md

Department of Medicine

No abstract provided.

1,25 Oh Vitamin D Mediated Hypercalcemia In A Patient With Malignancy Without Lymphoma (Poster), Katie Mastoris Do, Sarah Park Do, Vasudev G. Magaji Md, Ms

Department of Medicine

No abstract provided.

Congenital Pituitary Stalk Deformity, Maura Bucciarelli Do, Gretchen Perilli Md

Department of Medicine

No abstract provided.

Cushing’S Storm Secondary To Ectopic Acth Secreting Metastatic Breast Cancer, Maura Bucciarelli Do, Ya-Yu Lee Md, Vasudev G. Magaji Md, Ms

Department of Medicine

No abstract provided.

Importance Of Measuring Non-Hdl Cholesterol In Type 2 Diabetes Patients., Nanik Ram, Bilal Ahmed, Fauzan Hashmi,, Abdul Jabbar

Department of Medicine

OBJECTIVE:

To study the correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol in patients with Type 2diabetes mellitus and the proportion of patients achieving Adult Treatment Panel III recommended goals.

METHODS:

The cross sectional study was conducted at the Diabetic Clinic, Aga Khan University Hospital, Karachi. Data of Type 2 diabetesmellitus patients who attended the clinic bewteen 2007 and 2011 was reviewed. All Type 2 diabetic patients of either gender with fasting lipid profile irrespective of taking lipid lowering therapy were included.Type-1 DM, gestational diabetes, type 2 diabetes patients with pregnancy and those with incomplete data were excluded. Correlation between …

Diabetes Related Knowledge Among Residents And Nurses: A Multicenter Study In Karachi, Pakistan., Asma Ahmed, Abdul Jabbar, Lubna Zuberi, Muhammad Islam, Khusro Shamim

Department of Medicine

Background: Assessment of knowledge among resident trainees and nurses is very important since majority of patients admitted in hospital have underlying diabetes which could lead to adverse clinical outcomes if not managed efficiently. Therefore, the purpose of this study was to evaluate and compare the knowledge related to the management of diabetes among registered nurses (RN) and trainee residents of internal medicine (IMR), family medicine (FMR) and surgery (SR) at tertiary care hospitals of Karachi, Pakistan.

Methods: A validated questionnaire consisting of 21 open ended questions related to diabetes awareness was acquired through a study done at Thomas Jefferson University …

Post Gastric Bypass Hypoglycemia: Four Cases Treated Successfully With Alphaglucosidase Inhibitor Therapy, Shavon S. Frankhouser Do, Aakif N. Ahmad Do, Gretchen A. Perilli Md, Benjamin J. Quintana Md, Marc A. Vengrove Do, Facp

Department of Medicine

No abstract provided.

Type 1 Diabetes Associated With Pegylated Interferon/Ribavirin Therapy In Chronic Hepatitis C, Ankush Sharma Md, Joseph L. Yozviak Do

Department of Medicine

No abstract provided.

Improving Quality Care Goals Through Diabetes Collaborative Rounds On An Exemplary Care And Learning Site, Stacey Smith Md, Facp, Marc Shalaby Md, Facp, Joyce Najarian Msn, Rn, Cde, Gretchen A. Perilli Md, Krista Casey Mba

Department of Medicine

No abstract provided.