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Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir 2017 Marshall University Joan C. Edwards School of Medicine

Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir

Ayman Elkadry

Sheehan’s syndrome typically occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and can present with varying degrees of pituitary insufficiency. It is more common in underdeveloped countries, and is frequently diagnosed years after delivery due to its nonspecific signs and symptoms. Failure to lactate is a common initial symptom, while many women also report amenorrhea or oligomenorrhea. This article presents a 26-year-old female with a history of hypertension, who presented to the hospital for diarrhea, vomiting, and dizziness. Her blood pressure was 80/40 mmHg, requiring aggressive fluid resuscitation, after which it remained borderline ...


Improving Chronic Pain Management Processes In Primary Care Using Practice Facilitation And Quality Improvement: The Central Appalachia Inter-Professional Pain Education Collaborative, Roberto Cardarelli, Sarah Weatherford, Jennifer Schilling, Dana King, Sue Workman, Wade Rankin, Juanita Hughes, Jonathan Piercy, Amy Conley-Sallaz, Melissa Zook, Kendra Unger, Emma White, Barbara Astuto, Bobbi Stover 2017 University of Kentucky College of Medicine

Improving Chronic Pain Management Processes In Primary Care Using Practice Facilitation And Quality Improvement: The Central Appalachia Inter-Professional Pain Education Collaborative, Roberto Cardarelli, Sarah Weatherford, Jennifer Schilling, Dana King, Sue Workman, Wade Rankin, Juanita Hughes, Jonathan Piercy, Amy Conley-Sallaz, Melissa Zook, Kendra Unger, Emma White, Barbara Astuto, Bobbi Stover

Journal of Patient-Centered Research and Reviews

Purpose: With the increasing burden of chronic pain and opioid use, provider shortages in Eastern Kentucky and West Virginia have experienced many challenges related to chronic pain management. This study tested a practice facilitator model in both academic and community clinics that selected and implemented best practice processes to better assist patients with chronic pain and increase the use of interdisciplinary health care services.

Methods: Using a quasi-experimental design, a practice facilitator was assigned to each state’s clinics and trained clinic teams in quality improvement methods to implement chronic pain tool(s) and workflow processes. Charts for 695 patients ...


Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell 2017 Graduate Medical Education Programs, Aurora Health Care

Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell

Journal of Patient-Centered Research and Reviews

The author and issue editor describes the changing faces of health care as well as movements undertaken by U.S. health systems over the last two decades to improve the treatment and documented outcomes of minority or impoverished patients and to understand the impact of cultural differences on patient care. While much progress has been made, achieving health equity will require the continued efforts of many working toward this goal.


Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner 2017 Department of Family Medicine, Aurora University of Wisconsin Medical Group

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide ...


Identifying And Targeting Age-Related Colorectal Cancer Screening Rate Disparities In Family Medicine Residency Clinics, Jonathan J. Blaza, Jasmine R. Wiley, Matthew Gill, Alonzo Jalan, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns 2017 Department of Family Medicine, Aurora University of Wisconsin Medical Group

Identifying And Targeting Age-Related Colorectal Cancer Screening Rate Disparities In Family Medicine Residency Clinics, Jonathan J. Blaza, Jasmine R. Wiley, Matthew Gill, Alonzo Jalan, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns

Journal of Patient-Centered Research and Reviews

Background: Health care systems continuously seek to improve patient care through population-level analysis of clinical quality metrics and patient characteristics to identify disparities in care. Nationally, disparities in colorectal cancer (CRC) screening rates have been identified with lower screening rates reported for patients who are uninsured and/or lower socioeconomic status, African American/black, Asian, and non-English-speaking Hispanic patients. No age-related CRC screening rate disparities with associated interventions have been reported.

Purpose: Determine and address CRC screening disparities in care provided to eligible patients > 50 years old in two primary care residency clinics.

Methods: Retrospective analysis using REAL-G (race, ethnicity ...


Conference Proceedings: Aurora Scientific Day 2017, 2017 Aurora Health Care

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.


The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study To Improve The Health Of Aurora Health Care Caregivers And Family Members, Tiffany A. Mullen, Jessica J.F. Kram, Dennis J. Baumgardner 2017 Department of Integrative Medicine, Aurora Sinai Medical Center

The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study To Improve The Health Of Aurora Health Care Caregivers And Family Members, Tiffany A. Mullen, Jessica J.F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Self-management support has been shown to improve clinical outcomes. Health coaching, one form of self-management support, empowers patients within the health care system by providing information and through collaboratively developed care plans.

Purpose: Assess the impact of The Lifestyle Initiative, a coaching-based health program utilized by Aurora Health Care caregivers or family members.

Methods: The Lifestyle Initiative is a coaching-based approach for Aurora caregivers or family members enrolled in Aurora’s health insurance network. Individuals were recruited from the care management database, and all participants had an Aurora primary care provider. Participation was limited to those ≥ 18 years of ...


Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir 2017 Marshall University Joan C. Edwards School of Medicine

Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir

Marshall Journal of Medicine

Sheehan’s syndrome typically occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and can present with varying degrees of pituitary insufficiency. It is more common in underdeveloped countries, and is frequently diagnosed years after delivery due to its nonspecific signs and symptoms. Failure to lactate is a common initial symptom, while many women also report amenorrhea or oligomenorrhea. This article presents a 26-year-old female with a history of hypertension, who presented to the hospital for diarrhea, vomiting, and dizziness. Her blood pressure was 80/40 mmHg, requiring aggressive fluid resuscitation, after which it remained borderline ...


Use Of Services Of Spiritual Healers Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai 2017 Aga Khan University

Use Of Services Of Spiritual Healers Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai

Waris Qidwai

Objective: To study the use of the services of spiritual healers, among patients visiting the family physicians, at a teaching hospital in, Karachi. Design: Cross-sectional survey
Place and Duration of Study: Family practice center, the Aga Khan University, Karachi, from February to June, 2001
Subjects and Methods: A total of 387 patients were surveyed. A questionnaire was developed and administered to collect information on the use of the services of spiritual healers among the respondents.
Results: Most of the respondents were young, well educated and better placed socio-economically. The use of the services of spiritual healers was found in 45 ...


Patient Complaints Among Emergency Room Patients At A Teaching Hospital In Karachi, Waris Qidwai, Muhammad Baqir, Syed Sohail Ali, Semi Ayub 2017 Aga Khan University

Patient Complaints Among Emergency Room Patients At A Teaching Hospital In Karachi, Waris Qidwai, Muhammad Baqir, Syed Sohail Ali, Semi Ayub

Waris Qidwai

OBJECTIVES: To study the chief presenting complaints among patients presenting to the Emergency Medical services. SETTING: This study was conducted at the Emergency Room of Aga Khan University Hospital, Karachi during March and April, 2003. METHODS: A survey was carried out by the study investigators. This survey included patients who were not very sick and were selected at random. Demographic profiles of the respondents were noted. EPI-info and SPSS computer software programs were used for analysis of the results. RESULTS: One hundred patients were surveyed. The majority was relatively young, married men and women, well educated and better socio-economically placed ...


The Art Of Practicing Scientific Medicine, Waris Qidwai 2017 Aga Khan University

The Art Of Practicing Scientific Medicine, Waris Qidwai

Waris Qidwai

No abstract provided.


Physical Exercise As A Key Health Determinant Among Patients, Waris Qidwai, Danish Saleheen, Sadia Saleem, Marie Andrades, Iqbal Azam 2017 Aga Khan University

Physical Exercise As A Key Health Determinant Among Patients, Waris Qidwai, Danish Saleheen, Sadia Saleem, Marie Andrades, Iqbal Azam

Waris Qidwai

No abstract provided.


Sexual Knowledge And Practice In Pakistani Young Men, Waris Qidwai 2017 Aga Khan University

Sexual Knowledge And Practice In Pakistani Young Men, Waris Qidwai

Waris Qidwai

Background: There is a shortage of scientific data on the subject of sexuality from Pakistan. We decided to document misconceptions among Pakistani young men, regarding masturbation and nocturnal emissions and to make a case for sex education in the country. Objective: To study the knowledge, attitude and practice of Pakistani young men as regards masturbation and nocturnal emissions and to see any associations with demographic factors like age, marital status, occupation, level of education and socio economic status. Method: A questionnaire was developed, based on the objectives of the study. It was administered to 188 men between the ages 18-30 ...


The Utilization Of Services Of Health Care Providers Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, Iqbal Azam, S. S. Ali, S. Ayub 2017 Aga Khan University

The Utilization Of Services Of Health Care Providers Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, Iqbal Azam, S. S. Ali, S. Ayub

Waris Qidwai

Objective: To study the utilization of services of Health care providers among patients presenting to Family Physicians in a teaching hospital in Karachi.Methodology: It was a cross sectional study. A questionnaire was developed to collect patient’s utilization of services of health care providers. The investigators administered the questionnaire to 387 patients, after purpose of the study was explained, written consent was taken and confidentiality was assured. Results: The study population included more females than males, with average age of 32.6 years. The majority were married, well educated, in private and government service, were students or housewives. We ...


Perceptions About Female Sexuality Among Young Pakistani Men Presenting To Family Physicians At A Teaching Hospital In Karachi, Waris Qidwai 2017 Aga Khan University

Perceptions About Female Sexuality Among Young Pakistani Men Presenting To Family Physicians At A Teaching Hospital In Karachi, Waris Qidwai

Waris Qidwai

Objective: To study the perceptions about female sexuality among young Pakistani men, presenting to family physicians at a teaching hospital in Karachi, Pakistan Study Design: A questionnaire based prevalence study. Setting: Questionnaire administered to 188 young Pakistani men, between the ages 18-30 veai-s, who presented to family physicians, at the outpatient department of the Aga Khan University Hospital, Karachi, Pakistan. Main Outcome Measures: Perception among Pakistani young men about enjoyment of sexual experiences in women, whether women stop to enjoy sexual experiences during stress, menstruation, pregnancy and after menopause. Whether they are aware about “orgasm” in women and their belief ...


Physician Assisted Suicide Perceptions Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, H. Qureshi, S. S. Ali, M. Alam, S. I. Azani 2017 Aga Khan University

Physician Assisted Suicide Perceptions Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, H. Qureshi, S. S. Ali, M. Alam, S. I. Azani

Waris Qidwai

Objective: To study the perceptions on physician assisted suicide, among patients presenting to family physicians, at a teaching hospital in Karachi, Pakistan. Method: The study was carried out at the Community Health Center of The Aga Khan University Hospital, Karachi, between December 1999 and May 2000. The principal and co-investigators filled a pre-coded and pre­tested questionnaire consisting of important demographic characteristics and bio-medical ethics issues. A system of convenience sampling was used and a written consent was taken from respondents over the age of 16 years, who agreed to participate. The data were managed by using the Epi Info ...


Perceptions On Bioethics Among General Practitioners In Karachi, Pakistan, Waris Qidwai, Hafeez Qureshi, Iqbal Azam, Syed Sohail Ali, Semi Ayub 2017 Aga Khan University

Perceptions On Bioethics Among General Practitioners In Karachi, Pakistan, Waris Qidwai, Hafeez Qureshi, Iqbal Azam, Syed Sohail Ali, Semi Ayub

Waris Qidwai

Objective: To study the perceptions on bioethics among general practitioners in Karachi, Pakistan.
Design: A questionnaire based cross sectional survey. Settings: 85 general practitioners in Karachi were surveyed at their clinic premises. Main outcome measures: Perceptions on the broad principles of bioethics.
Results: The majority of general practitioners were males, with mean age of 36.3 years, had minimal postgraduate qualifications and continuing medical education. They reported the top five moral duties of a physician and their reaction in the event of the death of a close relative due to a doctor's negligence. A significant number of respondents agreed ...


Perception About Family Physicians: Results Of A Survey Of Patients Visiting Specialist Clinics For Treatment, S. A. Huda, Z. A. A. Samani, Waris Qidwai 2017 Aga Khan University

Perception About Family Physicians: Results Of A Survey Of Patients Visiting Specialist Clinics For Treatment, S. A. Huda, Z. A. A. Samani, Waris Qidwai

Waris Qidwai

Objective: To study the perceptions about Family Medicine among patients visiting Specialist Physicians for treatment. Methods: A questionnaire based survey was conducted at the Specialist Clinic, Aga Khan University Hospital, Karachi, Pakistan, in June 2004. Trained volunteers administered the questionnaire among patients visiting Specialist Physicians for treatment. Confidentiality was ensured to all patients and written informed consent was taken as part of the ethical requirements for the conduct of the study. SPSS computer software and Microsoft Excel were used for data management. Results: A total of 100 patients visiting the Specialist Clinic were interviewed, of which fifty four (54%) were ...


Structured Feedback From Students In Tutorial Teaching, Waris Qidwai 2017 Aga Khan University

Structured Feedback From Students In Tutorial Teaching, Waris Qidwai

Waris Qidwai

No abstract provided.


The Hippocratic Oath: Has It Ceased To Be Relevant?, Waris Qidwai 2017 Aga Khan University

The Hippocratic Oath: Has It Ceased To Be Relevant?, Waris Qidwai

Waris Qidwai

The Greek physician Hippocrates (460-377 B.C) is traditionally regarded as the founder of medicine, scientific discipline and medical ethics.The Hippocratic Oath, taken by ancient and medieval doctors, requires high ethical standards from medical doctors. Its principles are considered important in professional and ethical education of medical doctors even today. The Hippocratic Oath has survived, with over-riding power, the test of time since it addresses the intrinsic nature of medicine. Even those who know little of it or reject parts of it acknowledge it to be a symbol of the values of medicine. It has been argued that it ...


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