Medicine and Health Sciences Commons^™

Hair Dye Poisoning And Rhabdomyolysis., Munira Bokutz, Nosheen Nasir, Syed Faisal Mahmood, Sara Sajid

Department of Medicine

Hair dye ingestion is a rare cause of toxicity in Pakistan. We are presenting the case report of a 55 year old male who presented with accidental hair dye ingestion and developed laryngeal oedema requiring emergent tracheostomy. He had also developed aspiration pneumonitis and chemical oesophagitis. However, the most alarming manifestation was rhabdomyolysis. Hair dye toxicity can be fatal if not recognized early. There is no antidote available. Rhabdomyolysis is a complication and needs to be managed aggressively in order to prevent long term morbidity.

Dengue Hemorrhagic Fever Complicated By Intercostal Artery Hemorrhage., Syed Ahsan Ali, Sara Ahmed, Mehmood Riaz

Department of Medicine

Hemorrhagic manifestations are fairly common in Dengue hemorrhagic fever and are associated with increased mortality. During last few decades there have been increasing reports of Dengue infection with unusual manifestations. Here we present a case of dengue hemorrhagic fever complicated by spontaneous rupture of an intercostal artery leading to a large hematoma which was treated successfully with angio-embolization. To the authors' knowledge this is a first case of dengue hemorrhagic fever complicated by spontaneous intercostal artery hemorrhage.

Guidelines For The Initial Management Of Adults With Sepsis/Severe Sepsis/Septic Shock: 2015, Erfan Hussain, Bushra Jamil, Naseem Salahuddin

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 …

Myocarditis Complicating Plasmodium Vivax Malaria., Noreen Nasir, Saima Lalani, Zahra Aziz Samani, Aysha Almas

Department of Medicine

Myocarditis complicating Plasmodium vivax malaria is an extremely rare complication. We report this development in a young girl who was diagnosed to have P. vivax malaria on the basis of peripheral smear. While undergoing antimalarial treatment, she developed respiratory distress requiring invasive mechanical ventilation and inotropic support due to cardiogenic shock secondary to myocarditis. Cardiovascular complications are well recognized with Plasmodium falciparum malaria. Nevertheless, a high index of suspicion should be maintained for the same in Plasmodium vivax infection especially if symptoms of heart failure develop in a young patient.

Babesiosis: An Under-Recognized Tick Bourne Illness, Michael N. Daniels Do, Katie Mastoris Do, Mark Knouse Md, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Photo Quiz: Young Girl With Cough, Headache, And Visual Loss., Aisha Ilyas, Naima Fasih, Kauser Jabeen, Ehsan Bari, Syed Faisal Mahmood

Department of Medicine

No abstract provided.

Crash Course In United States Pharmacopeia Standard 797 (Usp 797): Investigation Of Positive Sterility Cultures From A Hospital Pharmacy Preparation, Terry Burger Mba, Bsn, Rn, Ne-Bc, Cic, Deborah Fry Mt (Ascp), Mba, Cic, Gary Tallarita Mt (Ascp), Cindy L. Mitman Pharm D

Department of Medicine

No abstract provided.

Closing The Gap: Revising Sterility Testing Policies And Procedures Based On The United States Pharmacopeia (Usp) 797 Guidelines And A Near Miss, Cindy L. Mitman Pharm D, Terry Burger Mba, Bsn, Rn, Ne-Bc, Cic, Deborah Fry Mt (Ascp), Mba, Cic, Gary Tallarita Mt (Ascp)

Department of Medicine

No abstract provided.

Vitamin D Accelerates Clinical Recovery From Tuberculosis: Results Of The Succinct Study [Supplementary Cholecalciferol In Recovery From Tuberculosis]. A Randomized, Placebo-Controlled, Clinical Trial Of Vitamin D Supplementation In Patients With Pulmonary Tuberculosis'., Nawal Salahuddin, Farheen Ali, Zahra Hasan, Nisar Rao, Masooma Aqeel, Syed Faisal Mahmood

Department of Medicine

BACKGROUND:

Vitamin D enhances host protective immune responses to Mycobacterium tuberculosis by suppressing Interferon-gamma (IFN-g) and reducing disease associated inflammation in the host. The objectives of this study were to determine whether vitamin Dsupplementation to patients with tuberculosis (TB) could influence recovery.

METHODS:

Two hundred and fifty nine patients with pulmonary TB were randomized to receive either 600,000 IU of Intramuscular vitamin D3 or placebo for 2 doses. Assessments were performed at 4, 8 and 12 weeks. Early secreted and T cell activated 6 kDa (ESAT6) and Mycobacterium tuberculosis sonicate (MTBs) antigen induced whole blood stimulated IFN-g responses were measured …

Austrian Syndrome: Triad Of The Past Or Harbinger Of The Future?, Mira Mitry Md, Suzanne J. Templer Do, Stacey Smith Md, Facp, Eugene P. York Md, Facp

Department of Medicine

No abstract provided.

Triple Valve Endocarditis By Mycobacterium Tuberculosis: A Case Report., Quratulain Shaikh, Syed Faisal Mahmood

Department of Medicine

BACKGROUND:

Granulomas caused by Mycobacterium Tuberculosis have been observed at autopsy in the heart, pre-dominantly in the myocardium and endocardium, but rarely involving the coronary vessels and valvular structures. Mycobacterium tuberculosis valvular endocarditis is extremely rare, with most reports coming from autopsy series.

CASE PRESENTATION:

We report the case of a 17 year old immunocompetent girl who presented with history of fever, malaise, foot gangrene and a left sided hemiparesis. On investigation she was found to have infective endocarditis involving the aortic, mitral and tricuspid valves. She had developed a right middle cerebral artery stroke. She underwent dual valve replacement …

Fulminant Invasive Aspergillosis Of The Mediastinum In An Immunocompetent Host: A Case Report., Muhammad Tariq Shakoor, Samia Ayub, Zunaira Ayub, Syed Faisal Mahmood

Department of Medicine

Introduction: Invasive aspergillosis is a serious complication in immunocompromised patients. It is an opportunistic disease, which predominantly occurs in the lungs, although dissemination to virtually any organ is possible. Invasive aspergillosis in an immunocompetent patient with extension to the mediastinum has rarely been reported. Here, we present the case of a patient with no apparent immunodeficiency state, who presented with Aspergillus endocarditis and fulminant invasive aspergillosis with extensive involvement of the mediastinal structures, which ultimately was responsible for her death. To the best of our knowledge, this is the first reported case in the literature on fulminant invasive mediastinal aspergillosis …

Hcv Behavioral Health Preparation Of The Racial/Ethnic Minority: Measurement Development Of A Hcv Treatment Readiness Tool In Spanish And English, Michele Vella, Joseph L. Yozviak Do, Facp, Judith Lash Rn

Department of Medicine

No abstract provided.

Factors Associated With Loss To Follow-Up Among Hiv-Infected Patients At An Urban, Hospital-Based Outpatient Hiv Clinic, Timothy J. Friel Md, Anthony Nerino, Lynn Nagel, J D'Aversa, Anthony Strobel, Dorothy Faulkner Phd

Department of Medicine

No abstract provided.

A Quality Improvement Initiative Using A Novel Travel Survey To Define High-Risk International Travel And Promote Patient-Centered Counseling, Craig A. Mackaness Do, Mark Knouse Md, Suzanne J. Templer Do, Deepti Verma Md, Allison Osborne Ba, Michael J. Weiss Mph

Department of Medicine

No abstract provided.

A Novel Approach For A New Era: Successful Integration Of Multidisciplinary, Hepatitis C Care Within An Established Hiv Primary Care Practice, Joseph L. Yozviak Do, Facp, Orlando J. Penaloza Md, Facp, Timothy J. Friel Md

Department of Medicine

No abstract provided.

Improving Outcomes For Hispanic Patients Undergoing Peginterferon/Ribavirin Therapy For Chronic Hepatitis C In An Internist-Led, Multidisciplinary, Multi-Cultural Practice: A Unique Application Of The Medical, Joseph L. Yozviak Do, Facp, Orlando J. Penaloza Md, Facp, Judith A. Knoop

Department of Medicine

No abstract provided.

Primary Amebic Meningoencephalitis Caused By Naegleria Fowleri, Karachi, Pakistan., Sadia Shakoor, Mohammad Asim Beg,, Syed Faisal Mahmood, Rebecca Bandea, Rama Sriram, Fatima Noman, Farheen Ali,, Govinda S. Visvesvara, Afia Zafar

Department of Medicine

We report 13 cases of Naegleria fowleri primary amebic meningoencephalitis in persons in Karachi, Pakistan, who had no history of aquatic activities. Infection likely occurred through ablution with tap water. An increase in primary amebic meningoencephalitis cases may be attributed to rising temperatures, reduced levels of chlorine in potable water, or deteriorating water distribution systems.

Pseudo-Cushing’S Syndrome In A Hiv Patient With Complete Resolution Following Discontinuation Of Darunavir/Ritonavir, Rashmi Sharma Md, Margaret Hoffman-Terry Md, Facp

Department of Medicine

No abstract provided.

The Face Of Felt Stigma: Experiences Of Puerto Ricans Living With Hiv In Allentown, Pa, M Reyes Ba, Julio Jiménez Md, Joseph L. Yozviak Do, Facp, Timothy J. Friel Md, D Adams Psyd, Cynthia Beitler, Eric J. Gertner Md, Mph, E Rivera Ba, L Santiago Phd

Department of Medicine

No abstract provided.

Crimean-Congo Hemorrhagic Fever In A Dengue-Endemic Region: Lessons For The Future., Farheen Ali, Taimur Saleem, Umair Khalid, Syed Faisal Mahmood, Bushra Jamil

Department of Medicine

Crimean-Congo hemorrhagic fever and dengue hemorrhagic fever are endemic in Pakistan. However, the overlap of geographic distribution and early clinical features between the two conditions make a reliable diagnosis difficult in the initial stage of illness. A 16-year-old boy presented with a history of hematemesis and high-grade fever. A preliminary diagnosis of dengue hemorrhagic fever was made and supportive treatment was instituted; however, the patient continued to deteriorate clinically. Dengue IgM antibody testing was negative on the third day of admission. Qualitative polymerase chain reaction test for Crimean-Congo hemorrhagic fever viral RNA was sent but the patient expired shortly after …

Paracoccidiomycosis And Hiv/Aids: A Common Problem In An Uncommon Location, Astrid Radermacher Do, Joseph L. Yozviak Do, Facp, Marcelo Gareca Md

Department of Medicine

No abstract provided.

Training Tomorrow’S Providers And Expanding Access To Peginterferon/Ribavirin Combination Therapyfor Chronic Hepatatis C In Underinsured/Uninsured Patients: Final Outcomes Of A Pilot, Resident-Initiated, Multidisciplinary, Hepatitis C Clinic, Nicole M. Agostino Do, Suzanne J. Templer Do, Edward Norris Md, Fapm, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Joseph L. Yozviak Do, Facp

Department of Medicine

No abstract provided.

Defining An Emerging Epidemic: Hcv Seroprevalence In A Large, Tertiary-Care Health Network In Pennsylvania, Margaret Hoffman-Terry Md, Facp, Joseph L. Yozviak Do, Facp, K Nadeem Ahmed Md, Sherrine Eid Mph, Timothy J. Friel Md, Kimberly A. Pacella, Luther Rhodes Iii Md

Department of Medicine

No abstract provided.

Range For Normal Body Temperature In The General Population Of Pakistan., Mehreen Adhi, Rabia Hasan, Fatima Noman, Syed Faisal Mahmood, Anwar Naqvi, Adib-Ul-Hasan Rizv

Department of Medicine

OBJECTIVES:

To determine the range for normal body temperature in the general population of Pakistan and to determine if any age, sex and ambient temperature related variations exist in body temperature. Moreover, to compare how much axillary temperature differs from oral temperature measurements.

METHODS:

Oral as well as left and right axillary temperature recordings were made using an ordinary mercury-in-glass thermometer in 200 healthy individuals accompanying patients at various clinics at the Sindh Institute of Urology and Transplantation (SIUT) between mid-May to mid-June 2006. Data analysis was done using Epi Info version 3.3.

RESULTS:

The range for Normal Oral Temperatures …

Answering The Cdc's Call For Universal Hiv Testing: Assesing The Impact On A Tertiary Care Referral Center Via A Blinded Seroprevalence Study, Margaret Hoffman-Terry Md, Facp, K Nadeem Ahmed Md, Joseph L. Yozviak Do, Facp, Sherrine Eid Mph, Timothy J. Friel Md, Kimberly A. Pacella, Luther Rhodes Iii Md

Department of Medicine

No abstract provided.

Changing Patterns And Outcome Of Dengue Infection; Report From A Tertiary Care Hospital In Pakistan, Mohammad Wasay, Roomasa Channa, Maliha Jumani, Afia Zafar

Department of Medicine

Objective: To identify predictors of outcome in patients with Dengue Infections at a tertiary care hospital and to analyze that if pattern of Dengue infection is changing in the past two years.

Methods: We reviewed 225 cases of confirmed dengue virus infection. The diagnosis was confirmed by presence of IgM antibodies against Dengue by ELISA in addition to fever according to WHO criteria.

Results: From years 2000-2004, 30(73%) had Dengue Fever (DF), 10(24%) had Dengue Haemorrhagic Fever (DHF) and 1(2.4%) had Dengue shock syndrome (DSS) while after 2005, 107(58%) had DF, 71(39%) had DHF and 6(3%) had DSS. Six …

Psychiatric Outcomes In A Resident-Run Multidisciplinary Hepatitis C Clinic, Nicole M. Agostino Do, Edward Norris Md, Fapm, Joseph L. Yozviak Do, Facp, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Michael Kaufmann Md

Department of Medicine

No abstract provided.

Dengue Virus Serotype 3, Karachi, Pakistan, Bushra Jamil, Rumina Hasan, Afia Zafar, Kevin Bewley, John Chamberlain, Valerie Mioulet, Moira Rowlands, Roger Hewson

Department of Medicine

No abstract provided.