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Enterocutaneous Fistulae In Children - A Management Challenge, Ali Imran Amjad, Saqib Hamid Qazi, Zafar Nazir 2017 Aga Khan University

Enterocutaneous Fistulae In Children - A Management Challenge, Ali Imran Amjad, Saqib Hamid Qazi, Zafar Nazir

Zafar Nazir

No abstract provided.


Understanding The Context Of Balanced Scorecard Implementation: A Hospital-Based Case Study In Pakistan., F Rabbani, Sabrina NH Lalji, Farhat Abbas, SM Wasim Jafri, Junaid A. Razzak, Naheed Nabi, Firdous Jahan, Agha Ajmal, Max Petzold, Mats Brommels, Goran Tomson 2017 Aga Khan University

Understanding The Context Of Balanced Scorecard Implementation: A Hospital-Based Case Study In Pakistan., F Rabbani, Sabrina Nh Lalji, Farhat Abbas, Sm Wasim Jafri, Junaid A. Razzak, Naheed Nabi, Firdous Jahan, Agha Ajmal, Max Petzold, Mats Brommels, Goran Tomson

Fauziah Rabbani

Background: As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods: Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs ...


Intravesical Foreign Body: Tertiary Care Center Experience From Pakistan., Hussam Uddin Soomro,, Imran K. Jalbani, Nuzhat Faruqui 2017 SIU Academy

Intravesical Foreign Body: Tertiary Care Center Experience From Pakistan., Hussam Uddin Soomro,, Imran K. Jalbani, Nuzhat Faruqui

Nuzhat Faruqui

Foreign body in bladder is relatively uncommon condition with variable presentations. Literature is limited to case reports and small series from region. Therefore, we planned this study to review our experience regarding intravesical foreign body. This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised 14 patients having intravesical foreign bodies from March 1989 to March 2013. Demographics, presentation, mode of insertion, type of foreign body and management were noted. Of the 11(78.6%) patients included in the study, 10(90.9%) patients were male and 1(9.1%) was female. The mean age was ...


Is An Excretory Urogram Mandatory In Patients With Small To Medium-Sized Renal And Ureteric Stones Treated By Extra Corporeal Shock Wave Lithotripsy?, Hammad Ather, Nuzhat Faruqui, Sobia Akhtar, M Nasir Sulaiman 2017 Aga Khan University

Is An Excretory Urogram Mandatory In Patients With Small To Medium-Sized Renal And Ureteric Stones Treated By Extra Corporeal Shock Wave Lithotripsy?, Hammad Ather, Nuzhat Faruqui, Sobia Akhtar, M Nasir Sulaiman

Nuzhat Faruqui

Background: An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL). This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique.
Methods: This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU; ii) non-contrast enhanced helical computed tomography (UHCT); and iii) ultrasound (US) + X-ray kidney, ureter ...


Does The Afferent Tubular Segment In An Orthotopic Bladder Substitution Compromise Ureteric Antireflux Properties? An Experimental Study In Dogs, Hassan Abol- Enein, Nuzhat Faruqui, Nashwa Barakat, Ahmed A. Shokeir 2017 Aga Khan University

Does The Afferent Tubular Segment In An Orthotopic Bladder Substitution Compromise Ureteric Antireflux Properties? An Experimental Study In Dogs, Hassan Abol- Enein, Nuzhat Faruqui, Nashwa Barakat, Ahmed A. Shokeir

Nuzhat Faruqui

Objective: To study the effects of a short ureter on renal function and histology in an orthotopic bladder substitution model using a long afferent limb, in a canine model.
Materials and methods: The study included nine adult mongrel dogs. A 40-cm segment of ileum was isolated, the distal half detubularized, configured into a U-shape and sutured to form a flat plate; this was then used to augment the bladder. The proximal half of the isolated ileum remained in continuity with the enterocystoplasty to form an isoperistaltic ileal ‘chimney’. The left ureter was divided at its lumbar part and anastomosed to ...


Expression Of Ps2 In Prostate Cancer Correlates With Grade And Chromogranin A Expression But Not With Stage, Hammad Ather, Farhat Abbas, Nuzhat Faruqui, M Israr, Shahid Pervez 2017 Aga Khan University

Expression Of Ps2 In Prostate Cancer Correlates With Grade And Chromogranin A Expression But Not With Stage, Hammad Ather, Farhat Abbas, Nuzhat Faruqui, M Israr, Shahid Pervez

Nuzhat Faruqui

Background: The biological potential of prostate cancer is extremely variable. Particular interest is focused on markers not expressed in normal prostatic tissues. pS2 protein expression has been demonstrated in a range of malignant tissues in an oestrogen-independent pathway. Recently, it has been demonstrated that pS2, in prostate cancer, is closely associated with neuro-endocrine differentiation. In the present study, we have analyzed, the potential of Neuro-endocrine and pS2 (TFF1) expression in human prostate cancer determined by immunohistochemistry, in primary adenocarcinoma of the prostate and attempted to correlate this with the clinico-pathologic features of the patient and neuroendocrine expression. Methods: Ninety-five malignant ...


Correlation Of Three Immunohistochemically Detected Markers Of Neuroendocrine Differentiation With Clinical Predictors Of Disease Progression In Prostate Cancer., Hammad Ather, Farhat Abbas, Nuzhat Faruqui, Mohammad Israr, Shahid Pervez 2017 Aga Khan University

Correlation Of Three Immunohistochemically Detected Markers Of Neuroendocrine Differentiation With Clinical Predictors Of Disease Progression In Prostate Cancer., Hammad Ather, Farhat Abbas, Nuzhat Faruqui, Mohammad Israr, Shahid Pervez

Nuzhat Faruqui

Background: The importance of immuno-histological detection of neuroendocrine differentiation in prostatic adenocarcinoma with respect to disease at presentation and Gleason grade is gaining acceptance. There is limited literature on the relative significance of three commonly used markers of NE differentiation i.e. Chromogranin A (CgA), Neuron specific enolase (NSE) and Synaptophysin (Syn). In the current work we have assessed the correlation of immuno-histological detection of neuroendocrine differentiation in prostatic adenocarcinoma with respect to disease at presentation and Gleason grade and to determine the relative value of various markers. Materials and methods: Consecutive samples of malignant prostatic specimens (Transurethral resection of ...


An Enduring Legacy Of Discovery: Margaret Stirewalt., Lucie Henein, James J Cody, Michael H Hsieh 2017 George Washington University

An Enduring Legacy Of Discovery: Margaret Stirewalt., Lucie Henein, James J Cody, Michael H Hsieh

Urology Faculty Publications

No abstract provided.


Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka 2017 Marshall University School of Medicine

Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka

Samson Teka

Purple Urine Bag Syndrome is a rare condition characterized by purple discoloration of the urinary drainage bag. It is typically seen in elderly patients with chronic indwelling urinary catheterization, and is associated with urinary tract infections with high bacterial load, female gender, severe disability, constipation, and alkaline urine. This phenomenon occurs when tryptophan metabolites in the urine are broken down by bacteria containing indoxyl sulphatase and phosphatase enzymes. This results in the production of indigo and indirubin, which combine to give a purple appearance. This article presents a 78-year-old male with chronic urinary retention requiring intermittent Foley catheterization for the ...


Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka 2017 Marshall University School of Medicine

Purple Urine Bag Syndrome: An Educational Case Of A Colorful Condition In The Chronically Catheterized, Teshome Gebrmichael, Fikirte Feleke, Waseem Ahmed, Madhulika Urella, Samson Teka

Marshall Journal of Medicine

Purple Urine Bag Syndrome is a rare condition characterized by purple discoloration of the urinary drainage bag. It is typically seen in elderly patients with chronic indwelling urinary catheterization, and is associated with urinary tract infections with high bacterial load, female gender, severe disability, constipation, and alkaline urine. This phenomenon occurs when tryptophan metabolites in the urine are broken down by bacteria containing indoxyl sulphatase and phosphatase enzymes. This results in the production of indigo and indirubin, which combine to give a purple appearance. This article presents a 78-year-old male with chronic urinary retention requiring intermittent Foley catheterization for the ...


Interdisciplinary Learning Project, Demetrius H. Bagley, MD, Maryann Sonzogni, RN, BSN, Bridget Weissinger, CST, Kelly A. Healy, MD 2017 Thomas Jefferson University

Interdisciplinary Learning Project, Demetrius H. Bagley, Md, Maryann Sonzogni, Rn, Bsn, Bridget Weissinger, Cst, Kelly A. Healy, Md

Department of Urology Faculty Papers

Description

With a 20 year history, we have implemented a multifaceted IPE program for members of the urology team. These include urologists, both faculty and community, residents, medical students, nurses, nurse practitioners, physician assistants, medical technicians/assistants and administrative/ clerical personnel with patient contact. The program was designed with three components: a yearly symposium for all, and journal club(JC) and lectures for non-physicians. Participation is on a voluntary, noncompensatory basis. Outcome measures include routine anonymous participant feedback via questionnaire.

Results

The programs were very positively received. Limiting obstacles were also observed. Initially too many papers were assigned in the ...


Structure Activity Relationship Studies Of Novel Diarylpentanoid Analogs Targeting The Androgen Receptor In Prostate Cancer Cells, Haili Coffin, Marco Bisoffi 2017 Chapman University

Structure Activity Relationship Studies Of Novel Diarylpentanoid Analogs Targeting The Androgen Receptor In Prostate Cancer Cells, Haili Coffin, Marco Bisoffi

Student Research Day Abstracts and Posters

The development of prostate cancer (PCa) relies strongly on the activation of the androgen receptor (AR) signaling pathway by its natural ligand dihydrotestosterone. Furthermore, PCa progression to metastatic disease represents oncogene addiction to AR activity. Androgen ablation therapy is thus a mainstay therapy against this disease, but the development of ligand-independent AR activation and persisting AR expression eventually leads to castration resistant PCa (CRPC). Therefore, down-regulation of AR expression in PCa cells may be an effective therapeutic modality. The diarylpentanoid ca27 has previously been shown to down-regulate AR expression by an unknown mechanism of action. The present work represents a ...


Antimicrobial Resistance In Urinary Tract Infections Caused By Escherichia Coli, Oyebola Fasugba 2017 Australian Catholic University

Antimicrobial Resistance In Urinary Tract Infections Caused By Escherichia Coli, Oyebola Fasugba

Theses

Urinary tract infections (UTI) are one of the most common bacterial infections in hospital and community settings requiring antimicrobial treatment. Escherichia coli (E. coli), a bacterium frequently implicated in UTI, is becoming increasingly resistant to antimicrobials. Antimicrobial resistance (AMR) reduces the effectiveness of antimicrobial agents, leading to difficulty in treatment of patients, with the potential to prolong the duration of illness and increase mortality in patients. To date in Australia, there is a paucity of data comparing resistance patterns over time for hospital- and community-acquired E. coli UTI with no published data on incidence and risk of urinary E. coli ...


Urologists’ Views On Contact With Industry Representatives: A Pilot Survey, Marc Zeffren, Joel Hillelsohn, Michael Stern 2017 New York Medical College

Urologists’ Views On Contact With Industry Representatives: A Pilot Survey, Marc Zeffren, Joel Hillelsohn, Michael Stern

NYMC Student Posters

Purpose: The current survey aims to determine the various ways in which urologists at all levels of training view the nature of their relationships with industry representatives, and the effects these relationships may have on clinical practice and behavior. Methods: We sent an anonymous SurveyMonkey® questionnaire to a cohort of approximately 1700 practicing urologists in various urologic subspecialties across the country. The questionnaire elicited information related to demographics, personal awareness of institutional guidelines regarding PR/DMR, and opinions regarding the following: •the ability of industry-supplied gifts to compromise judgment •the utility and appropriateness of industry representatives in the clinical setting ...


Effect Of Duration Of Symptoms On Orchiectomy Rates In Testicular Torsion In Patients Under 25: Important Prognostic Trends, Lior Taich, Marc Zeffren, Muhammad Choudhury 2017 New York Medical College

Effect Of Duration Of Symptoms On Orchiectomy Rates In Testicular Torsion In Patients Under 25: Important Prognostic Trends, Lior Taich, Marc Zeffren, Muhammad Choudhury

NYMC Student Posters

The purpose of this study is to explore the relationship between duration of symptoms in testicular torsion and the effect on orchiectomy rates, with the intention of establishing an updated timeline for clinical management and surgical urgency.


Metformin Inhibits The Proliferation Of Benign Prostatic Epithelial Cells, Zongwei Wang, Xingyuan Xiao, Rongbin Ge, Jijun Li, Cameron W. Johnson, Cyrus Rassoulian, Aria F. Olumi 2017 Harvard Medical School

Metformin Inhibits The Proliferation Of Benign Prostatic Epithelial Cells, Zongwei Wang, Xingyuan Xiao, Rongbin Ge, Jijun Li, Cameron W. Johnson, Cyrus Rassoulian, Aria F. Olumi

Open Access Articles

OBJECTIVE: Benign prostatic hyperplasia (BPH) is the most common proliferative abnormality of the prostate affecting elderly men throughout the world. Epidemiologic studies have shown that diabetes significantly increases the risk of developing BPH, although whether anti-diabetic medications preventing the development of BPH remains to be defined. We have previously found that stromally expressed insulin-like growth factor 1 (IGF-1) promotes benign prostatic epithelial cell proliferation through paracrine mechanisms. Here, we seek to understand if metformin, a first line medication for the treatment of type 2 diabetes, inhibits the proliferation of benign prostatic epithelial cells through reducing the expression of IGF-1 receptor ...


Dysuria: An Uncommon Presentation In Emergency Department Following Bladder Neck Disruption., Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell 2017 George Washington University

Dysuria: An Uncommon Presentation In Emergency Department Following Bladder Neck Disruption., Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell

Emergency Medicine Faculty Publications

Prostate cancer is the most common life-threatening cancer diagnosed in men. Complications of prostatectomies vary and often include urinary incontinence, erectile dysfunction and pain, while other complications go unreported. While emergency physicians are already familiar with the more common post-operative complications presenting to their departments, including urinary retention, ileus, surgical site infections, venous thromboembolisms and urinary tract infections, they must have a high index of suspicion for rarer complications. We report a case of posterior bladder neck disruption as a complication of a robotic assisted laparoscopic prostatectomy that presented to the emergency department as dysuria and abdominal pain following urination.


Metastatic Melanoma To The Bladder: Case Report And Review Of The Literature., Rohit V. Patil, Solomon L Woldu, Elena Lucas, Andrew M Quinn, Franto Francis, Vitaly Margulis 2017 George Washington University

Metastatic Melanoma To The Bladder: Case Report And Review Of The Literature., Rohit V. Patil, Solomon L Woldu, Elena Lucas, Andrew M Quinn, Franto Francis, Vitaly Margulis

Urology Faculty Publications

A 49-year-old Caucasian woman presented to the dermatology clinic for follow-up of malignant melanoma with a complaint of painless gross hematuria. Two years prior she was diagnosed with malignant melanoma from a skin lesion on her left flank treated with wide excision, negative axillary sentinel lymph node biopsy, and adjuvant radiotherapy. Subsequently, she had no evidence of disease until urologic evaluation of her hematuria revealed two lesions in her bladder and cytopathology demonstrated findings consistent with malignant melanoma. We review literature on melanoma metastatic to the bladder and discuss the potential role of metastasectomy and other treatment strategies in such ...


H-Ipse Is A Pathogen-Secreted Host Nucleus Infiltrating Protein (Infiltrin) 3 Expressed Exclusively By The Schistosoma Haematobium Egg Stage, Luke Pennington, Abdulaziz Alouffi, Evaristus Mbanefo, Debalina Ray, David Heery, Theodore Jardetzky, Michael Hsieh, Franco Falcone 2017 George Washington University

H-Ipse Is A Pathogen-Secreted Host Nucleus Infiltrating Protein (Infiltrin) 3 Expressed Exclusively By The Schistosoma Haematobium Egg Stage, Luke Pennington, Abdulaziz Alouffi, Evaristus Mbanefo, Debalina Ray, David Heery, Theodore Jardetzky, Michael Hsieh, Franco Falcone

Urology Faculty Publications

Urogenital schistosomiasis, caused by the parasitic trematode Schistosoma haematobium, affects over 112 million people worldwide. As with S. mansoniinfections, the pathology in urogenital schistosomiasis is mainly related to the egg stage, which induces granulomatous inflammation of affected tissues. Schistosoma eggs and their secretions have been studied extensively for the related S. mansoniorganism which is more amenable to laboratory studies. Indeed, we have shown that IPSE/alpha-1 (M-IPSE herein), a major protein secreted from S .mansoni eggs, can infiltrate host cells. Although M-IPSE function is unknown, its ability to translocate to their nucleus and bind DNA suggests a possible ...


Press-Pulse: A Novel Therapeutic Strategy For The Metabolic Management Of Cancer, Thomas Seyfried, George Yu, Joseph Maroon, Dominic D'Agostino 2017 George Washington University

Press-Pulse: A Novel Therapeutic Strategy For The Metabolic Management Of Cancer, Thomas Seyfried, George Yu, Joseph Maroon, Dominic D'Agostino

Urology Faculty Publications

Background

A shift from respiration to fermentation is a common metabolic hallmark of cancer cells. As a result, glucose and glutamine become the prime fuels for driving the dysregulated growth of tumors. The simultaneous occurrence of “Press-Pulse” disturbances was considered the mechanism responsible for reduction of organic populations during prior evolutionary epochs. Press disturbances produce chronic stress, while pulse disturbances produce acute stress on populations. It was only when both disturbances coincide that population reduction occurred.

Methods

This general concept can be applied to the management of cancer by creating chronic metabolic stresses on tumor cell energy metabolism (press disturbance ...


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