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2016

Department of Medicine

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Full-Text Articles in Medicine and Health Sciences

Bilateral Moyamoya Disease In A 2-Year-Old Pakistani Male Treated With Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome., Shahvaiz Magsi, Adeel Khoja, Mansoor Ali Merchant Rameez, Ariba Khan, Noman Ishaque Dec 2016

Bilateral Moyamoya Disease In A 2-Year-Old Pakistani Male Treated With Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome., Shahvaiz Magsi, Adeel Khoja, Mansoor Ali Merchant Rameez, Ariba Khan, Noman Ishaque

Department of Medicine

Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS), in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness) at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA). …


Quality Of Life After Stroke In Pakistan, Wardah Khalid, Shafquat Rozi, Tazeen S. Ali, Iqbal Azam Syed, Michael Mullen, Saleem Illyas, Qamarunnisa, Nabila Soomro, Ayeesha Kamran Kamal Dec 2016

Quality Of Life After Stroke In Pakistan, Wardah Khalid, Shafquat Rozi, Tazeen S. Ali, Iqbal Azam Syed, Michael Mullen, Saleem Illyas, Qamarunnisa, Nabila Soomro, Ayeesha Kamran Kamal

Department of Medicine

Background: There is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden.

Methodology: We used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36. In addition; we assessed complications, psychosocial and functional disability of stroke survivors. Following this quantitative survey, …


Clinical Manifestations And Outcomes Of Pulmonary Aspergillosis: Experience From Pakistan., Nousheen Iqbal, Muhammad Irfan, Ali Bin Sarwar Zubairi, Kauser Jabeen, Safia Awan, Javaid Khan Dec 2016

Clinical Manifestations And Outcomes Of Pulmonary Aspergillosis: Experience From Pakistan., Nousheen Iqbal, Muhammad Irfan, Ali Bin Sarwar Zubairi, Kauser Jabeen, Safia Awan, Javaid Khan

Department of Medicine

Introduction: Pulmonary aspergillosis has variable course of illness, severity and outcomes depending on underlying conditions. There is limited data available on the clinical manifestations and outcome of pulmonary aspergillosis from Pakistan.

Methods: To determine the clinical manifestations and outcome of pulmonary aspergillosis in a tertiary care hospital a retrospective study was conducted from 2004 to 2014 in patients admitted with pulmonary aspergillosis at the Aga Khan University Hospital Karachi, Pakistan.

Results: Of the 280 cases with provisional diagnosis of aspergillosis 69 met the inclusion criteria. The mean age was 45±15.7 years, 48 (69.6%) were men and 21 (30.4%) had diabetes …


Tct-353 Underweight Status, Platelet Reactivity, And 2-Year Clinical Outcomes In Patients Undergoing Pci With Des: An Adapt-Des Study Analysis., Puja B. Parikh Md, Ajay J. Kirtane Md, Giora Weisz Md, Thomas D. Stuckey Md, M Ozgu Ozan Ms, Bernhard Witzenbichler Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Bruce R. Brodie Md, Ernest Mazzaferri Md, Roxana Mehran Md, Gregg W. Stone Md Nov 2016

Tct-353 Underweight Status, Platelet Reactivity, And 2-Year Clinical Outcomes In Patients Undergoing Pci With Des: An Adapt-Des Study Analysis., Puja B. Parikh Md, Ajay J. Kirtane Md, Giora Weisz Md, Thomas D. Stuckey Md, M Ozgu Ozan Ms, Bernhard Witzenbichler Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Bruce R. Brodie Md, Ernest Mazzaferri Md, Roxana Mehran Md, Gregg W. Stone Md

Department of Medicine

Background

The relationships between underweight status, platelet reactivity, and clinical outcomes after PCI with DES are not well understood.

Methods

ADAPT-DES was a prospective, multicenter study of 8582 pts treated with aspirin and clopidogrel in whom routine measurement of P2Y12 reaction units (PRU) by VerifyNow testing was performed following successful DES implantation. Pts were classified according to the following body mass index (BMI) groups: Underweight (BMI/m2), normal weight (20 kg/m2 ≤ BMI/m2), overweight (25 kg/m2 ≤ BMI/m2), and obese (BMI ≥30 kg/m2).

Results

Underweight pts were more often female, smokers, had higher rates of peripheral arterial disease and renal insufficiency, …


Cardiac Consequences Of The Heroin Epidemic: Loperamide Causing Torsades De Pointes, Justin L. Guthier Do, Apurva Vyas Md Nov 2016

Cardiac Consequences Of The Heroin Epidemic: Loperamide Causing Torsades De Pointes, Justin L. Guthier Do, Apurva Vyas Md

Department of Medicine

No abstract provided.


Tct-352 Proportion Of Ischemic Risk After Pci Mediated By High Platelet Reactivity On Clopidogrel: Analysis From The Adapt-Des Study., Björn Redfors, Ori Ben-Yehuda Md, Sheng-Hsuan Lin, Ariel Furer, Ajay J. Kirtane Md, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Akiko Maehara Md, Philippe Généreux Md, Gennaro Giustino Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Girma M. Ayele, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md Nov 2016

Tct-352 Proportion Of Ischemic Risk After Pci Mediated By High Platelet Reactivity On Clopidogrel: Analysis From The Adapt-Des Study., Björn Redfors, Ori Ben-Yehuda Md, Sheng-Hsuan Lin, Ariel Furer, Ajay J. Kirtane Md, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Akiko Maehara Md, Philippe Généreux Md, Gennaro Giustino Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Girma M. Ayele, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.


Tct-237 Outcomes After Successful Pci Of Severely Calcified Lesions Using Rotational Atherectomy, Cutting Balloon, Or Balloon Angioplasty Only Before Second-Generation Drug-Eluting Stent Implantation., Björn Redfors, Philippe Généreux Md, Akiko Maehara Md, Ajay J. Kirtane Md, Rushad Dordi, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Claire Litherland Ms, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md Nov 2016

Tct-237 Outcomes After Successful Pci Of Severely Calcified Lesions Using Rotational Atherectomy, Cutting Balloon, Or Balloon Angioplasty Only Before Second-Generation Drug-Eluting Stent Implantation., Björn Redfors, Philippe Généreux Md, Akiko Maehara Md, Ajay J. Kirtane Md, Rushad Dordi, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Claire Litherland Ms, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.


Tct-8 Impact Of Aspirin Resistance On Outcomes After Coronary Events., Christine Chung, Ajay J. Kirtane Md, Claire Litherland Ms, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Bruce R. Brodie Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest Mazzaferri Md, Roxana Mehran Md, Gregg W. Stone Md Nov 2016

Tct-8 Impact Of Aspirin Resistance On Outcomes After Coronary Events., Christine Chung, Ajay J. Kirtane Md, Claire Litherland Ms, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Bruce R. Brodie Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest Mazzaferri Md, Roxana Mehran Md, Gregg W. Stone Md

Department of Medicine

No abstract provided.


Clinical Outcomes Of Pneumocystis Pneumonia From A Tertiary Care Centre In Pakistan., Ali Bin Sarwar Zubairi, Hira Shahzad, Afia Zafar Nov 2016

Clinical Outcomes Of Pneumocystis Pneumonia From A Tertiary Care Centre In Pakistan., Ali Bin Sarwar Zubairi, Hira Shahzad, Afia Zafar

Department of Medicine

Objective: To assess the predisposing immunocompromised states, administration of pneumocystis jirovecii pneumonia prophylaxis, the disease course and outcomes of patients with pneumocystis jirovecii pneumonia.

Methods: The retrospective study was conducted at the Aga Khan University Hospital in Karachi. The medical records of patients diagnosed with pneumocystis jirovecii pneumonia from January 1995 to October 2015 were retrieved. Baseline characteristics, clinical course, treatment, and mortality rates were noted. SPSS 19 was used for data analysis.

Results: Of the 37 patients, 24(64.9%) were men and 13(35.1%) were women. The overall mean presenting age was 47.08±16.21 years(range: 19-83 years). Ten (27%) patients were positive …


Comments On The Editorial On Ild Published In The September 2016 Issue Of Jpma, Ali Bin Sarwar Zubairi Nov 2016

Comments On The Editorial On Ild Published In The September 2016 Issue Of Jpma, Ali Bin Sarwar Zubairi

Department of Medicine

No abstract provided.


Increasing Patient Awareness, Education And Access To Improve Completion Rates Of Colorectal, Bonnie Patek Do, Angela Magdaleno Oct 2016

Increasing Patient Awareness, Education And Access To Improve Completion Rates Of Colorectal, Bonnie Patek Do, Angela Magdaleno

Department of Medicine

No abstract provided.


Primary Malignant Pleural Effusion With A Profound Type B Lactic Acidosis, Rachel Kinney Do, Christine Saraceni Do, Eliot L. Friedman Md Oct 2016

Primary Malignant Pleural Effusion With A Profound Type B Lactic Acidosis, Rachel Kinney Do, Christine Saraceni Do, Eliot L. Friedman Md

Department of Medicine

No abstract provided.


Acquired Small Bowel Mucosa-Associated Lymphoid Tissue Lymphoma In The Absence Of Helicobacter Pylori, Travis Magdaleno Md, Anastasia Shnitser Md Oct 2016

Acquired Small Bowel Mucosa-Associated Lymphoid Tissue Lymphoma In The Absence Of Helicobacter Pylori, Travis Magdaleno Md, Anastasia Shnitser Md

Department of Medicine

No abstract provided.


Pitfalls In Conventional Imaging And The Diagnostic Use Of Endoscopic Ultrasound Of Pancreatic Neuroendocrine Tumors, Travis Magdaleno Md, Shashin Shah Md, Hiral N. Shah Md, Robert Shepard Oct 2016

Pitfalls In Conventional Imaging And The Diagnostic Use Of Endoscopic Ultrasound Of Pancreatic Neuroendocrine Tumors, Travis Magdaleno Md, Shashin Shah Md, Hiral N. Shah Md, Robert Shepard

Department of Medicine

No abstract provided.


An Unusual Pathogen Causing Native Valve Endocarditis., Aneela Hussain, Nosheen Nasir, Bushra Jamil Oct 2016

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

Department of Medicine

No abstract provided.


Increased Level Of Morning Surge In Blood Pressure In Normotensives: Across-Sectional Study From Pakistan., Aysha Almas, Fateh Ali Tipoo Sultan, Khawar Kazmi Oct 2016

Increased Level Of Morning Surge In Blood Pressure In Normotensives: Across-Sectional Study From Pakistan., Aysha Almas, Fateh Ali Tipoo Sultan, Khawar Kazmi

Department of Medicine

Objective: To determine the mean morning surge (MS) in blood pressure, the frequency of increased morning surge in normotensive subjects, and to compare those with morning surge with those without MS.

Study Design: A cross-sectional, comparative study. Place and Duration of Study: The Department of Medicine, The Aga Khan University Hospital, Karachi, from April 2011 to March 2012.

Methodology: Adult normotensive healthy volunteers aged 35 to 65 years were inducted. Their ambulatory blood pressure (ABP) was measured over a 24-hour period, using digital ambulatory blood pressure monitors. Morning surge was calculated as the average of four readings after waking minus …


Not All That Wheezes Is Asthma, Areeb Zamir Md, Noor Salam Md, Andy Iriza Do, Andres Zirlinger Md Oct 2016

Not All That Wheezes Is Asthma, Areeb Zamir Md, Noor Salam Md, Andy Iriza Do, Andres Zirlinger Md

Department of Medicine

No abstract provided.


Erdheim-Chester Disease And Neuroendocrine Gastrointestinal Neoplasms, Samer Bolis Do, Patrick Hickey Do, Hiral N. Shah Md, Shashin Shah Md Oct 2016

Erdheim-Chester Disease And Neuroendocrine Gastrointestinal Neoplasms, Samer Bolis Do, Patrick Hickey Do, Hiral N. Shah Md, Shashin Shah Md

Department of Medicine

No abstract provided.


Successful Overtube Assisted Ercp: A Single-Center Case Series, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md, Tanveer Imam Md Oct 2016

Successful Overtube Assisted Ercp: A Single-Center Case Series, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md, Tanveer Imam Md

Department of Medicine

No abstract provided.


Idiopathic Hyperammonemia And Rituximab Therapy, Samer Bolis Do, Daniel Schwed-Lustgarten, James Ross Md, Facp Oct 2016

Idiopathic Hyperammonemia And Rituximab Therapy, Samer Bolis Do, Daniel Schwed-Lustgarten, James Ross Md, Facp

Department of Medicine

No abstract provided.


Closing The Gap: Deployment Of An Over-The-Scope Clip After Colonic Endoscopic Mucosal Resection, Matthew Sullivan Do, Shashin Shah Md, Hiral N. Shah Md Oct 2016

Closing The Gap: Deployment Of An Over-The-Scope Clip After Colonic Endoscopic Mucosal Resection, Matthew Sullivan Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.


Adenovirus Induced Rhabdomyolysis Causing Hemodialysis Dependent Acute Renal Failure, Deepika Jain Md, Andres Zirlinger Md, Matthew J. Miles Do Oct 2016

Adenovirus Induced Rhabdomyolysis Causing Hemodialysis Dependent Acute Renal Failure, Deepika Jain Md, Andres Zirlinger Md, Matthew J. Miles Do

Department of Medicine

No abstract provided.


Malignant Paraganglioma-Associated Takotsubo Cardiomyopathy, Robert Schreiner Do, Yehia Y. Mishriki Md Oct 2016

Malignant Paraganglioma-Associated Takotsubo Cardiomyopathy, Robert Schreiner Do, Yehia Y. Mishriki Md

Department of Medicine

No abstract provided.


Ampullary Carcinoid: A Case Report, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md Oct 2016

Ampullary Carcinoid: A Case Report, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.


Dome-Type Carcinoma Of The Ascending Colon: A Case Report, Patrick Hickey Do, Shanth A. Goonewardene Md, Shashin Shah Md, Hiral N. Shah Md, Anthony G. Auteri Md Oct 2016

Dome-Type Carcinoma Of The Ascending Colon: A Case Report, Patrick Hickey Do, Shanth A. Goonewardene Md, Shashin Shah Md, Hiral N. Shah Md, Anthony G. Auteri Md

Department of Medicine

No abstract provided.


The Impact Of Code Sepsis On Inpatient Mortality, Samer Bolis Do, Noor Salam Md, Matthew Mccambridge Md Oct 2016

The Impact Of Code Sepsis On Inpatient Mortality, Samer Bolis Do, Noor Salam Md, Matthew Mccambridge Md

Department of Medicine

No abstract provided.


Hemophagocytic Lymphohistiocytosis, An Overlooked Culprit Of Disseminated Intravascular Coagulation, Shivtaj Mann Do Oct 2016

Hemophagocytic Lymphohistiocytosis, An Overlooked Culprit Of Disseminated Intravascular Coagulation, Shivtaj Mann Do

Department of Medicine

No abstract provided.


Increased Level Of Morning Surge In Blood Pressure In Normotensives: A Cross-Sectional Study From Pakistan, Aysha Almas, Fatehali Tipoo Sultan, Khawar Kazmi Oct 2016

Increased Level Of Morning Surge In Blood Pressure In Normotensives: A Cross-Sectional Study From Pakistan, Aysha Almas, Fatehali Tipoo Sultan, Khawar Kazmi

Department of Medicine

Objective: To determine the mean morning surge (MS) in blood pressure, the frequency of increased morning surge in normotensive subjects, and to compare those with morning surge with those without MS. Study Design: A cross-sectional, comparative study. Place and Duration of Study: The Department of Medicine, The Aga Khan University Hospital, Karachi, from April 2011 to March 2012. Methodology: Adult normotensive healthy volunteers aged 35 to 65 years were inducted. Their ambulatory blood pressure (ABP) was measured over a 24-hour period, using digital ambulatory blood pressure monitors. Morning surge was calculated as the average of four readings after waking minus …


Appearances Can Be Deceiving - Colon Cancer Mimicking Ileocolitis, Abdul Aleem Md, Muhammad Qasim Md, Patrick Hickey Do, Hiral N. Shah Md Oct 2016

Appearances Can Be Deceiving - Colon Cancer Mimicking Ileocolitis, Abdul Aleem Md, Muhammad Qasim Md, Patrick Hickey Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.


Increased Level Of Morning Surge In Blood Pressure In Normotensives: A Cross-Sectional Study From Pakistan, Aysha Almas, Fatehali Tipoo Sultan, Khawar Kazmi Oct 2016

Increased Level Of Morning Surge In Blood Pressure In Normotensives: A Cross-Sectional Study From Pakistan, Aysha Almas, Fatehali Tipoo Sultan, Khawar Kazmi

Department of Medicine

Objective: To determine the mean morning surge (MS) in blood pressure, the frequency of increased morning surge in normotensive subjects, and to compare those with morning surge with those without MS.

Study Design: A cross-sectional, comparative study.

Place and Duration of Study: The Department of Medicine, The Aga Khan University Hospital, Karachi, from April 2011 to March 2012.

Methodology: Adult normotensive healthy volunteers aged 35 to 65 years were inducted. Their ambulatory blood pressure (ABP) was measured over a 24-hour period, using digital ambulatory blood pressure monitors. Morning surge was calculated as the average of four readings after waking …