Medicine and Health Sciences Commons^™

Optimization Of Functional Mri Methods For Olfactory Interventional Studies At 3t, Vishwadeep Ahluwalia

Theses and Dissertations

Functional MRI technique is vital in investigating the effect of an intervention on cortical activation in normal and patient population. In many such investigations, block stimulation paradigms are still the preferred method of inducing brain activation during functional imaging sessions because of the high BOLD response, ease in implementation and subject compliance especially in patient population. However, effect of an intervention can be validly interpreted only after reproducibility of a detectable BOLD response evoked by the stimulation paradigm is first verified in the absence of the intervention. Detecting a large BOLD response that is also reproducible is a difficult task …

Impact Of Ambient Air Pollution On Survival Of Renal Transplant Recipients, Rhonda Kristine Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

There is increasing evidence that ambient air pollution is associated with coronary heart disease morbidity and mortality. This research has focused on the general public and less so on possible sensitive subgroups even though these may have even greater susceptibility to adverse effects of ambient air pollution. With highly prevalent traditional as well as nontraditional risk factors, renal transplant recipients may potentially be a sensitive subgroup. The purpose of this study was to evaluate the possible effect of between long-term exposure to air pollution on the risk of CHD mortality among renal transplant recipients. This cohort study includes 32,239 adult, …

Effects Of Functional Appliances On Pharyngeal Airway Dimensions: A Cone Beam Computed Tomography Study, Melissa K. Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Functional appliances are intended to correct by incremental advancement of the mandible for correction of skeletal Class 11 relationships. Similar in design to functional appliances, mandibular advancing devices (MAD) are used for obstructive sleep apnea (OSA) patients as they increase the size of the airway by drawing the tongue and soft palate forwards, and thus maintain its patency during sleep. It has been shown that significant increases in airway dimensions and decreases in airway resistance were gained in OSA patients while evaluated with a MAD in place. This retrospective study evaluated volumetric, cross-sectional area and linear changes in the …

Observer Reliability Of Cephalometric Landmark Identification On 3-D Mr Images, Michael S. Pollack

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Cephalometric analysis is a cornerstone of orthodontic diagnosis, yet much information is lost when 3-dimensional structures are assessed with 2-dimensional methods. CBCT offers 3-dimensional imaging but at the cost of higher levels of ionizing radiation. Magnetic resonance imaging provides 3-dimensional imaging without ionizing radiation and additionally imparts visualization of soft tissue structures. Prior to employing MR images for cephalometric analysis, reliability of landmark identification must be assessed. The purpose of this study was to evaluate intra- and interobserver reliability in 3-dimensional landmark identification using MR images.

Materials and Methods: Fifteen cranial MR images (3.0 T, MP-RAGE) from subjects between …

Using Cone Beam Computed Tomography To Identify A Prediction Model For Obstructive Sleep Apnea, Jodi Parker

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Obstructive Sleep Apnea (OSA) patients have increased risk of morbidity and mortality. Early diagnosis may reduce morbidity and mortality. Prediction of OSA from imaging may help to identify OSA patients earlier in life. CBCT can be used for OSA diagnostic imaging due to its three-dimensional (3D) visualization of the upper airway and craniofacial complex. Magnification associated with conventional 2D radiography is eliminated with CBCT, and radiation to the patient is significantly less than previous modalities used to measure craniofacial & airway measurements associated with OSA. During a CBCT scan, the patient's image is taken supine, rather than the upright …

Effects Of Functional Appliances On The Tmj And Mandibular Length Of Skeletal Class Ii Patients: A Cone Beam Computed Tomography Study, David C. Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Functional appliances have been efficiently used in the treatment of Class II malocclusions caused by retrognathic mandibles. Cone beam computed tomography has enabled us to make more accurate linear measurements by eliminating superimposition of other structures and to analyze skeletal anatomic detail in all three planes of space. This retrospective study evaluated the osseous changes in the temporomandibular joint (TMJ) and length of the mandible in skeletal Class II malocclusion patients treated with the fixed functional appliances and compared measurements with Class I malocclusion patients treated with orthodontic mechanics that did not alter skeletal relationships.

Materials and Methods: Twelve …

Patient/Physician Communication In Type 2 Diabetes-Related Health Behavior Change, Barbara Marie Thomas

Loma Linda University Electronic Theses, Dissertations & Projects

Adult type 2 diabetes is an increasing problem in the United States and affected over 16 million Americans in 2004. Most patients are treated in primary care settings and managed medically, but controlling insulin resistance through activity and diet is considered the greatest challenge for the next 30 years (Katen, et al., 2007). Understanding how physicians and patients communicate about health behaviors is necessary for developing the most effective strategies for facilitating health behavior change in this population. In the current study, adults with type 2 diabetes (n= 87) from the Loma Linda University Diabetes Treatment Center (LLUDTC), …

Influence Of Stainless Steel Orthodontic Brackets On Magnetic Resonance Imaging, Christian James Hoybjerg

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Magnetic resonance imaging (MRI) machines provide 2D as well as 3D images that are excellent in contrasting soft-tissue in the maxillofacial region and are void of ionizing radiation. The drawbacks include the lack of depiction of cortical bony detail and image degradation caused by substances in the scanned area. Specifically, in the orthodontic field stainless steel brackets cause more distortion of MR images then any other bracket material. It is unknown what type of stainless steel alloy causes the most MRI distortion. The purpose of this study is to evaluate the degree of craniofacial MR distortion caused by various …

A Comparative Study Of The Genotype Mtbdrplus® Assay Against A Standard Culture Method For Diagnosis And Drug Susceptibility Testing Of Tuberculosis, Peris W. Thamaini

Theses & Dissertations

Background: Nearly one-third of the global population, i.e. two billion people, is infected with Mycobacterium tuberculosis and is at risk of developing the disease. More than eight million people develop active tuberculosis (TB) every year, with about two million dying from the disease annually. Diagnosis of tuberculosis inKenya remains dependent on smear microscopy. New methods of TB diagnosis are needed which have better accuracy and are still cost effective. Molecular methods of TB diagnosis have come under investigation in a lot of studies recently. However, they have their own limitations including the inability to differentiate between active organisms and …

Risk Of Contrast Induced Nephropathy In Hiv Patients Receiving Radiographic Contrast At Three Aga Khan Hospitals, Sitna A. Mwanzi

Theses & Dissertations

Aim: To study the influence of HIV infection on the development of contrast induced nephropathy in patients receiving radio contrast material

Design: Prospective cohort study

Patients and setting:One hundred and twenty five (125) HIV positive patients and one hundred and fifty five (155) HIV negative patients selected from in and out patient departments of the Aga Khan University Hospital, Nairobi and Aga Khan Hospitals in Mombasa and Kisumu, were evaluated for the study between August 2008 and August 2009.

Methodology: Eligible patients undergoing radiological evaluation requiring the use of radio contrast material were consecutively recruited for the study after …

Median Values For Second-Trimester Maternal Serum Αlpha Fetoprotein And Human Chorionic Gonadotrophin (Double Test) At Aga Khan University Hospital-Nairobi, Nancy A. Okinda

Theses & Dissertations

Aim

To establish median values for second trimester maternal serum human chorionic gonadotrophin (HCG) and alpha fetoprotein (AFP) at Aga Khan University Hospital- Nairobi (AKUH-N) using the Abbott Micro particle Enzyme immunoassay.

Specific objectives

•To perform measurements of second trimester maternal serum human chorionic gonadotrophin (HCG) and alpha fetoprotein (AFP) and to establish observed and regressed median values.

•To establish regression coefficients for regressed medians of AFP and HCG.

•To compare these data with data obtained from other geographical regions.

Methodology

330 serum samples from women of gestational ages 15 to 20 weeks were analyzed for AFP and HCG. Observed …

Use Of Magnetic Resonance Spectroscopy (Mrs) To Improve Magnetic Resonance Imaging (Mri) In The Diagnosis Of Intracranial Pathology, Done At Aga Khan University, Joyce Sande

Theses & Dissertations

Introduction: Magnetic Resonance Spectroscopy (MRS)is a potentially useful adjunct to Magnetic Resonance Imaging (MRI) in thecharacterization of focal brain lesions. This study was aimed at showing that by the additional use of MRS (MRI, MRS), the characterization of a focal brain lesion into neoplastic, or non- neoplastic (infective, or degenerative) can be improved, as compared to the use of MRI alone.

Study question: Does the additional use of MRS improve MRI differentiation of neoplastic from non- neoplastic (infective or degenerative) focal brain lesions?

Methods: The design was prospective, analytical and comparative. 80 consecutive patients were enrolled. Conventional MRI of the …

Evaluating The Diagnostic Performance Of An Initial Transvaginal Sonogram (Tvs) In Patients With Suspected Ectopic Pregnancy, Zablon Bett

Theses & Dissertations

Purpose of the study: To evaluate the diagnostic performance of an initial transvaginal sonogram (TVS) in patients with suspected ectopic pregnancy (EP).

Objectives: 1) To determine the accuracy, sensitivity, specificity, positive and negative predictive values of an initial TVS scan in patients with suspected EP. 2) To determine the diagnostic utility of TVS findings as predictors of EP.

Methodology: This was a descriptive, prospective study of 131 consecutive mothers who had TVS for clinical suspicion of EP at the Aga Khan University hospital over a 12 month period between November 2007 and October 2008. The scans were performed in our …

Posttraumatic Spiritual Growth: A Phenomenological Study Of Cancer Survivors, Ryan Myles Denney

Dissertations

A small but growing body of research has sought to investigate the specific role of religion and spirituality in posttraumatic growth. Recently investigations have begun to focus on spiritual growth following trauma, specifically that of cancer patients and survivors. The purpose of this qualitative study was to investigate how having cancer effects the spiritual growth of cancer survivors across a multidimensional conceptualization of spirituality (Hill 2005; Tsang & McCullough, 2003). The researcher investigated the lived experience of thirteen cancer survivors with posttraumatic spiritual growth using a phenomenological method of data analysis. Participants reported experiencing spiritual growth across the following domains …

Effect Of California Mission Fig Consumption On Levels Of C-Reactive Protein And Antioxidant Levels, Rasha Abdrabou

Loma Linda University Electronic Theses, Dissertations & Projects

Polyphenols exert anti-inflammatory and antioxidant effects. We investigated the effect of consumption of polyphenol-rich figs on high sensitivity C-reactive protein (CRP) and antioxidant levels in hyperlipidemic subjects. The purpose of this study was to examine the effect of fig consumption on C-reactive protein and antioxidant levels. Analyses were carried out on collected data from September to December of 2008. Using a crossover design, one hundred and two participants were recruited and randomized into an intervention phase (eating figs) and a control phase (not eating figs) for 5 weeks. Blood samples were drawn from each group at the 4th and 5th …

The Effect Of An Educational Intervention On The Sexual Perceptions And Practices Of Adolescents In Trinidad And Tobago, Vanessa Jones

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) is one of the fastest spreading infectious diseases in the Caribbean, and is second only to Sub-Sahara Africa in the prevalence of HIV/AIDS cases. Trinidad and Tobago is the southernmost twin island republic in the Caribbean. In 1999, the 5^th leading cause of death among individuals ages 15-34 in Trinidad and Tobago was HIV/AIDS. According to UNAIDS (2006), the prevalence rate of HIV in Trinidad and Tobago is 2.6%.

Purpose. Currently, there is no standardized HIV/AIDS education program in secondary schools in Trinidad and Tobago. Since HIV/AIDS is …

Outcome Of Chronic Anal Fissures Treated With Glyceryl Trinitrate At Aga Khan University Hospital Nairobi, Ilkul H. Johnbosco

Theses & Dissertations

Background: The medical treatment for chronic anal fissure is modeled to eliminate sphincter spasm and hypertonia so that blood flow to the anal sphincter improves and the fissure heals. Efficacious pharmacological therapy avoids complications related to surgical treatment including incontinence and the risks of surgery and anesthesia. Conservative treatment of chronic anal fissure has been reported with wide variation in the healing rates. However there are few reports of conservatively treated chronic anal fissures fromAfrica, with only one paper identified in this study. Furthermore, the influence of clinical characteristics of fissures on the healing rates and recurrences have not been …

The Influence Of Antiretroviral Therapy On Qtc Interval Amongst Hiv Patients At Aga Khan University Hospital, Nairobi, Jay Shavadia

Theses & Dissertations

Aim: To determine the influence of antiretroviral (ARV) therapy on the QT_C interval amongst HIV-infected patients.

Design: Prospective Comparative survey of two population samples

Patients and Setting: One hundred and thirty ARV naïve and one hundred and thirty treated HIV-positive patients selected from in and out patient departments of Aga Khan University Hospital underwent clinical evaluation and 12 lead resting ECG between August 2008 and March 2009.

Methodology: Eligible HIV-positive patients were conveniently sampled and had a 12-lead electrocardiogram (ECG) performed to determine the QTinterval, corrected for the heart rate by the Bazzet formula. Analysis was then performed to …

The Prevalence Of Postoperative Pain Following Day Surgery In The First 48 Hours At Aga Khan University Hospital, Nairobi, Gilbert Mwaka

Theses & Dissertations

Introduction: Day case surgery services are increasing all over the world. The prevalence of postoperative pain after day surgery is found to be high ranging from 17% to 60%. Little is known about the prevalence of postoperative pain, in Kenya and East Africa, after day case surgeries.

Objective: The objectives of this study were to investigate the prevalence of postoperative pain after day surgery at Aga Khan University (AKUH), Nairobi, to determine the severity/intensity of postoperative pain following day case surgery, and to determine the influence of anxiety and worry on the patients report on postoperative pain.

Study site: The …

Cumulative Incidence Of Post Dural Puncture Headache Following Caesarean Section Under Spinal Anaesthesia At The Aga Khan University Hospital Nairobi, Ednah K. Gisore

Theses & Dissertations

Introduction: Post dural puncture headache can be a debilitating complication of subarachnoid anaesthesia for a new mother. Successful management of post dural puncture headache requires adherence to clear policies and protocols with close follow up of patients by an experienced obstetric anaesthetist.

Objective: This study examined the cumulative incidence and severity of post dural puncture headache in obstetric patients who consented for spinal anaesthesia for caesarean section at the Aga Khan University Hospital, Nairobi.

Study site: The Aga Khan University Hospital, Nairobi.

Study Design: Prospective Cohort study.

Study Population: All women who underwent caesarean sections under spinal anaesthesia and …

Tuberculosis In San Bernardino County, 1993-2004 : Lifestyle And Environmental Factors, Anuj Bhatia

Loma Linda University Electronic Theses, Dissertations & Projects

An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, …

Quality Of Life And Depression: Outcome Markers For A Weight Management Program, Cecilia Dueñas

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric obesity has become a national epidemic and current trends suggest a continued increase. Obese children have been found to have higher incidences of depression and a lower quality of life (QOL) than children from other often more severe medical populations. As a result, weight management programs are on the increase with the majority measuring outcome success through weight loss and decreased body mass index (BMI). It is evident however, that health factors are not the only factors associated with obesity, and that psychosocial components are important as well. The Loma Linda University Growing Fit Program is unique in that …

Glenohumeral Internal Rotation Deficit And Ulnar Collateral Ligament Injury In Baseball Pitchers, Cristina C. Nistler

Culminating Projects in Kinesiology

No abstract provided.

Attitudes And Beliefs That Predict Taiwanese Older Adults' Intentions To Attend Strength And Balance Training Programs, Shih-Fan Lin

Loma Linda University Electronic Theses, Dissertations & Projects

The rate of participation in the strength and balance training (SBT) program, an effective fall prevention intervention, is very low among older adults. To increase older adults' participations in SBT programs, this study involved an observational and cross-sectional study design to understand factors that affect Taiwanese older adults' intention to attend SBT programs utilizing the theory of planned behavior. Questionnaires that measured constructs of the theory of planned behavior (attitude, subjective norm, perceived behavioral control, and behavioral, normative, and control beliefs) were collected from 221 community-dwelling Taiwanese elderly women between the age of 55 and 94. Simple correlations and multiple …

Mnte-2-Pyp And Radiation In A Prostate Cancer Model: Implications For Radiotherapy, Adeola Y. Makinde

Loma Linda University Electronic Theses, Dissertations & Projects

A major limitation of successful radiation therapy in cancer treatment is the increase in normal tissue damage as higher doses are used to achieve greater tumor destruction. Radiation dose optimization in cancer therapy requires achieving maximum tumor destruction with minimal damage to normal tissue Antioxidants have been shown to protect normal tissues against radiation damage, as radiation-induced tissue damage results predominantly from reactive oxygen species that directly damage cellular components. However, for effective use as normal tissue radioprotectants in radiotherapy, these antioxidants must not protect the tumors. Mn (III) tetrakis (N-ethylpyridinium-2-yl) porphyrin (MnTE-2-PyP) is a metalloporphyrin antioxidant that has been …

Multiple Sclerosis Fatigue Management, Becca Gillis

Master of Arts in Occupational Therapy Theses and Projects

The purpose of this Master’s Project was to research Multiple Sclerosis and to gather a significant amount of knowledge to thoroughly understand this disease and the effects it may have on an individual diagnosed with MS. More specifically and as previously stated, fatigue is a very common and often debilitating symptom of MS. As a result, this project was directed toward helping us, as students and future occupational therapists, to become fatigue management experts by learning how to intervene and teach fatigue management/energy conservation courses to a population of individuals largely impacted by this disease. In addition, it was our …

Stories, Ethics And The Interpretation Of Meaning: Bearing Witness To Mothers' Stories Of Their Neonatal Intensive Care Unit Experience, Angela Chisum Blackburn

Dissertations

This study grounded in narrative perspectives was conducted to uncover mothers' experience of having a baby in the Neonatal intensive Care Unit (NICU). The purpose of this study was to describe and interpret mothers NICU experiences, and to sensitize health care professionals about the importance of mothers' personal experience stories.

The NICU experience began with mothers' birth experience or the incident that led up to her infant requiring care in the NICU and her experience extended beyond the NICU with future concerns about the health and wellbeing of her baby.

Stories of mothers' experience were gleaned from data generated from …

Correlates Of Soy Food Consumption In Adventist Health Study-2, Yen Ang

Loma Linda University Electronic Theses, Dissertations & Projects

Much has been discussed about the health benefits and risks of soy consumption but very little is known about who the consumers are. Most of what is known has been observed mainly in Asian populations who consume high levels of soy. Very little is known about soy food intake in the western population who typically has low consumption level. The Seventh-Day Adventist cohort in North America is the only population known in the West with soy food intake that is comparable to the Asian population living in the East.

Soy consumers in a population known for its healthier lifestyle and …

Photochemical Delivery Of Bleomycin In Malignant Glioma Cells, Joseph William Blickenstaff Iii

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite continued efforts, glioblastoma multiforme (GBM) remains an incurable form of primary brain cancer. Surgical resection followed by radiation treatment and chemotherapy have been the most effective modalities in prolonging median survival time to 14 months. This research aims to study the response of two different cell culture models to a novel drug delivery method termed photochemical internalization (PCI). PCI is a technique to improve the utilization of macromolecules (e.g. the chemotherapeutic drug bleomycin) in site-specific cancer therapy. This concept is based on the use of specially designed photosensitizers (e.g. aluminum phthalocyanine disulfonate; AlPcS _2a ) which preferentially localize in …

Using Thermoluminescent Dosimeters To Measure The Dose From High And Low Energy X-Ray Sources, Wesley Leon Boyd

UNLV Theses, Dissertations, Professional Papers, and Capstones

This work focused on using thermoluminescent dosimeters (TLDs) to measure the doses from two x-ray sources, a CT scanner and a linear accelerator (linac). In addition ion chambers were used to determine the isodose contours from the operation of the linac. 1mm x 1mm x 1mm TLD-100 microcubes were placed in a Lawrence Livermore National Laboratory (LLNL) torso phantom and irradiated using a Toshiba Aquilion One 320-Slice CT Scanner. Different thicknesses of shielding composed of antimony and bismuth powder suspended in an ethylene copolymer were used to shield the phantom and the dose reduction was measured. The dose reduction ranged …