Digital Commons Network^™

Middle Aged Male With Pulmonary Tuberculosis And Refractory Hypercalcemia At A Tertiary Care Centre In South East Asia: A Case Report., Azra Rizwan, Najmul Islam

Department of Medicine

55-year male of Asian descent presented with weight loss, lethargy, drowsiness and low grade fever without cough. Examination revealed crackles in the chest but no focal neurological deficit. Chest X ray revealed an infiltrate consistent with tuberculosis. Biopsy of infiltrate was negative for malignancy. Corrected calcium level revealed parathyroid independent hypercalcemia. Further diagnostic work up for drowsiness and hypercalcemia was normal. Despite receiving hydration and pharmacotherapy for his hypercalcemia, his condition failed to improve. When steroids were started, the Patient's calcium levels and symptomatology resolved. Tuberculosis causing hypercalcemia is uncommon. Steroids are useful agents, particularly in refractory cases.

Use Of Phage Display To Isolate Specifi C Human Monoclonal Antibody Fragments Against A Potential Target For Multiple Myeloma, Pei Xiong Liew, Feng Ge, Charles A. Gullo, Gerrard Kh Teoh, William Yk Hwang

Biochemistry and Microbiology

Introduction: Multiple myeloma (MM), a malignancy of plasma cells, accounts for 10% of all haematological malignancies and is currently incurable. Although it can be treated, the disease tends to relapse after several years and becomes increasingly resistant to conventional therapy. Investigations into using humoral therapy for MM are now underway with a view that novel therapeutic agents may provide a more targeted therapy for MM.

Materials and Methods: Here, phage display, a faster and more efficient method compared to classical hybridoma fusion technology, was used as a proof-of-concept to isolate several single-chain Fragment variables (scFv) against Ku86.

Results …

Community Acquired Pneumonia: Risk Factors Associated With Mortality In A Tertiary Care Hospitalized Patients, Muhammad Irfan, Syed Fayyaz Hussain, Khubaib Mapara, Shafia Memon, Mohammed Mogri, Muniza Bana, Amna Malik, Sara Khan, Nadia A Khan

Section of Pulmonary & Critical Care

OBJECTIVE: To evaluate risk factors associated with mortality in patients hospitalized with CommunityAcquired Pneumonia (CAP) from a developing country.

METHODS: An observational study was conducted on adult patients admitted with a diagnosis of CAP from January 2002 to August 2003 at Aga Khan University hospital, Karachi, Pakistan. Clinical records were reviewed for demographic characteristics, clinical and laboratory features, hospital course, and risk factors associated with mortality.

RESULTS: A total of 329 patients (187 males) were admitted with CAP. Two-third of patients had underlying co-morbid medical illnesses. Complications developed in 15.7% cases and the overall mortality rate was 11%. Risk factors …

Modulation Of Lps-Induced Activation Of Hepatic Map Kinases, Oliver Surriga

Seton Hall University Dissertations and Theses (ETDs)

Lipopolysaccharide (LPS) is a potent inflammagen that has been found to be primarily responsible for many symptoms caused by gram-negative bacterial infections. The LPS-initiated signal transduction pathways involve several terminal kinases, mainly p42/44 mitogen-activated protein kinase (MAPK), p38 MAPK and c-Jun N-terminal kinase (JNK), ultimately leading to increased expression of genes encoding such inflammatory cytokines as interleukin (IL )-1 �. IL-6 and tumor necrosis factors (TNF)-u. In this study, the effects of age on LPS-induced activation of MAPKs in the liver of rats were examined. Results show that the basal level of phosphorylated p42/44 MAPK was increased in postnatal day …

Gestational Diabetes Mellitus--A Forerunner Of Chronic Disorders In Mother And Child, Romaina Iqbal, Sobia Jawaid, Abdul Jabbar, Rahat Qureshi

Community Health Sciences

Gestational Diabetes Mellitus (GDM) can have serious immediate as well as long term consequences, both for the mother as well as the off-spring. It seems that women of south Asian origin are not only more likely to have GDM but also suffer more from the adverse consequences of the disorder. These consequences include the development of type 2 DM in women with a history of GDM and a higher risk of obesity and metabolic syndrome in the off-spring. Pakistani physicians should consider GDM seriously because the WHO states that rise in the prevalence of type 2 DM will mainly occur …

Prevalence Of Hepatitis D In Hbsag Positive Patients Visiting Liver Clinics, Naresh Kumar Seetlani, Zaigham Abbas, Sajjad Raza, Javed Yakoob, Wasim Jafri

Section of Gastroenterology

Objective: To estimate the prevalence of hepatitis D in HBsAg (hepatitis B surface antigen) positive patients visiting liver clinics.

Methodology: All HbsAg positive patients who had visited two liver clinics; in Karachi and in Jacobabad, from October 2007 to March 2008, were included in this study. These patients were tested for HBV DNA and HDV RNA by PCR technique, HBeAg and anti-HDV. Clinical status of the patients was evaluated by examination, routine biochemical tests and ultrasound.

Results: Total numbers of patients included in the study were 362 comprising of 151 patients from the clinic in Jacobabad and 211 from Karachi. …

Inhibition Of Yeast Hexokinase By The Antimalarial Drug Artemisinin: Probing Mechanism Of Action With A Model Enzyme, Jennifer S. Spence

Biological Sciences Theses & Dissertations

A leading infectious cause of death, malaria threatens approximately half of the world's population, and drug-resistant strains of Plasmodium falciparum have created immense difficulty in chemotherapy of the disease. The artemisinin (ART) class of antimalarials may represent a powerful solution. In addition to their safety, effectiveness, and moderate cost, they are the only drugs in use for which there has been no widespread evidence of clinical resistance. The exact parasiticidal mechanism of ART is highly contested, but evidence suggests that protein alkylation may play a role in cytotoxicity. in vitro essays were performed using yeast hexokinase (HK) to demonstrate a …

Directing Diarrhoeal Disease Research Towards Disease-Burden Reduction, Margaret Kosek, Claudio F. Lanata, Robert E. Black, Damian G. Walker, John D. Snyder, Mohammed Abdus Salam, Dilip Mahalanabis, Olivier Fontaine, Zulfiqar Ahmed Bhutta, Shinjini Bhatnagar, Igor Rudan

Woman and Child Health

Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research …

The Time Is Ripe, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Development And Validation Of An Index Of Musculoskeletal Functional Limitations, Jeffrey N. Katz, Elizabeth A. Wright, John A. Baron, Elena Losina

Dartmouth Scholarship

While musculoskeletal problems are leading sources of disability, there has been little research on measuring the number of functionally limiting musculoskeletal problems for use as predictor of outcome in studies of chronic disease. This paper reports on the development and preliminary validation of a self administered musculoskeletal functional limitations index.

A Comparison Of Fluoroquinolones Versus Other Antibiotics For Treating Enteric Fever: Meta-Analysis, Durrane Thaver, Anita K. M. Zaidi, Julia Critchley, Asma Azmatullah, Syed Ali Madni, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Objectives: To review evidence supporting use of fluoroquinolones as first line agents over other antibiotics for treating typhoid and paratyphoid fever (enteric fever).
Design: Meta-analysis of randomised controlled trials. Data sources: Cochrane Infectious Diseases Group specialised register, CENTRAL (issue 4, 2007), Medline (1966-2007), Embase (1974-2007), LILACS (1982-2007), selected conferences, reference lists, and ongoing trial register (November 2007).
Review methods: Trials comparing fluoroquinolones with chloramphenicol, cephalosporins, or azithromycin in culture-proven enteric fever were included. Two reviewers extracted data and assessed methodological quality. Odds ratios with 95% confidence intervals were estimated. Trials recruiting over 60% children were analysed separately from trials on …

Prospects For Developing Odour Baits To Control Glossina Fuscipes Spp., The Major Vector Of Human African Trypanosomiasis, Maurice O. Omolo, Ahmed Hassanali, Serge Mpiana, Johan Esterhuizen, Jenny Lindh, Mike J. Lehane, Philippe Solano, Jean Baptiste Rayaisse, Glyn A. Vale, Steve J. Torr, Inaki Tirados

All Peer-Reviewed Publications

We are attempting to develop cost-effective control methods for the important vector of sleeping sickness, Glossina fuscipes spp. Responses of the tsetse flies Glossina fuscipes fuscipes (in Kenya) and G. f. quanzensis (in Democratic Republic of Congo) to natural host odours are reported. Arrangements of electric nets were used to assess the effect of cattle-, human- and pig-odour on (1) the numbers of tsetse attracted to the odour source and (2) the proportion of flies that landed on a black target (1 × 1 m). In addition responses to monitor lizard (Varanus niloticus) were assessed in Kenya. The effects of …

To Flee Or To Fight, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Sero-Negative Celiac Disease With Dermatitis Herpetiformes: A Case Report., Mehreen Adhi, Asma Farooq, Syed Ali Hamid, Rabia Hasan, Salman Mamji, Akhtar Ali Baloch

Department of Surgery Docs

Introduction:We report a case of sero-negative celiac disease in Pakistan. Case Presentation: A 20-year-old female presented with papulovesicular rash for 15 years, diarrhea for 8 years, spasms of hands and twitching of face for 4-5 months. She had mild anemia, low vitamin-D3 and serum calcium. On exclusion of other causes of malabsorption, anti-tissue transglutaminase antibodies (immunoglobulin-A & immunoglobulin-G), anti-endomysial antibodies, total immunoglobulin-A levels and skin biopsy were performed, which were normal. Intestinal biopsy revealed subtotal villous atrophy. Patient was prescribed gluten-free diet, to which she responded with alleviation of symptoms.

Conclusions:

Negative serology should not rule out celiac disease, …

Hd: Hurtling Towards Death, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Nectin-1 Is Degraded In Chlamydia Trachomatis-Infected Genital Epithelial Cells And Is Required For Herpes Simplex Virus Co-Infection-Induced C. Trachomatis Persistence., Jingru Sun

Electronic Theses and Dissertations

The obligate intracellular bacterium Chlamydia trachomatis is the most common bacterial STD agent in the US. This bacterium has a unique biphasic developmental cycle in which the infectious elementary body (EB) infects a host mucosal epithelial cell and differentiates into the replicative form (the reticulate body or RB) within a modified vacuole called an inclusion. The RB later divides and develops back into an EB and is released, perpetuating the infectious cycle. When developing chlamydiae are exposed to unfavorable environmental conditions, they deviate from the normal developmental cycle into a non-infectious but viable state termed persistence. Previous data from our …

Does Unemployment Decrease Cancer Mortality?, Benjamin Torres Galick

Economics Honors Projects

Recent research indicates that healthier lifestyles during recessions decrease the most common U.S. mortalities, but not cancer. However, they combine specific cancer mortalities with different progressions into one, possibly obscuring cancer’s link to unemployment. This paper estimates a fixed-effects regression model on unemployment and the nine most prevalent cancers between 1988 and 2002 using state-level panel data. Five cancers and total cancer are procyclical, and suggest that unemployment affects both incidence and gestation for some cancers. Consistent with the medical literature, this paper contradicts previous economic research and suggests that behavioral factors significantly impact cancer mortality.

The Role Of Interferon Gamma In The Regulation Of Il-18 Binding Protein And The Development Of Autoimmune Arthritis In A Genetically Non-Susceptible Mouse Strain, Timothy Daniel Kayes

Theses and Dissertations (ETD)

The etiology of the autoimmune disease rheumatoid arthritis (RA) is unknown, but the role of cytokines, including IFN-g, as effectors of immune cell function has been established by the examination of cytokine production in RA patients and through the use of animal models. C57BL/6 (B6) mice that express MHC class II molecules of the b haplotype (I-A^b) are not typically susceptible to collagen-induced arthritis (CIA), the most widely studied animal model of RA. When the gene encoding IFN-g is removed by genetic deletion, however, susceptibility to CIA is conferred. In addition, T cell responses against the immunogen that …

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.

Molecular Epidemiology Of Methicillin-Resistant Staphylococcus Aureus (Mrsa), Ilene Bautista

UNLV Theses, Dissertations, Professional Papers, and Capstones

Staphylococcus aureus is a frequent cause of a myriad of infections in hospitals, healthcare facilities and community settings. It is often related to skin and soft tissue infection, but it can also cause other diseases varying from food poisoning to endocarditis and toxic shock syndrome. According to a study by Kuehnert et al. (2006) there has been a strong association between Staphylococcus aureus (S. aureus) carriage and risk factors for subsequent infections. Subsequent infection from S. aureus , including methicillin-resistant S. aureus (MRSA) infection, can be projected by looking at the presence of S. aureus nasal colonization. The purpose of …

Women's Health And Fitness Magazines: An Accurate Portrayal?, Jennifer M. Shymansky

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study is a content analysis examining the representation of health information, particularly the leading causes of death, in cover story headlines of one year of the top women's health and fitness magazines: Prevention , Shape , Fitness , Self , Health and Women's Health. The study is grounded in social responsibility theory, a normative media theory. The findings show that women's health and fitness magazines' cover story headlines predominately discuss diet and exercise for weight loss, rather than the leading causes of death facing women. This under representation of actual societal health concerns can limit the vast readerships' health …

The Combined Effect Of In-Situ Tumor And Irradiation On Peritumoral Brain Vasculature, Janice Ann Zawaski

Theses and Dissertations (ETD)

In the USA, 200,000 brain tumors are diagnosed each year with glioma representing 8.4% of the 200,000. The standard treatment for glioma consists of surgical resection, when possible, followed by radiation therapy (RT) and/or chemotherapy. Radiation therapy is one of the most effective treatments of brain tumors; however, the therapeutic ratio of RT is limited by damage to the normal tissue. We hypothesize that tumor growth has an adverse effect on the peritumoral tissue through the angiogenic/inflammatory environment it creates rendering it susceptible to further damage by RT which may be prevented by using anti-angiogenic/anti-inflammatory agents. We have developed a …

Does Admission Hyperglycemia Predict Intracranial And Extracranial Vasculopathy?, Ather Mohammed Taqui, Ayeesha Kamran Kamal, Saqib Ali Gowani, Bhojo A Khealani, Shafquat Rozi

Community Health Sciences

Objective: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.
Methods: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.
Results: Out of the total of 216 patients, the age of majority of the patients (83.3%) was >50 years …

Metabolic Syndrome, Inflammation, Heart Rate Variability, And Fitness In Obese African American Youth, Belinda J. Fleming

Theses and Dissertations (ETD)

Purpose. The purposes of this dissertation were to (1) explore the relationships among fitness, heart rate variability (HRV), inflammation and components of the Metabolic Syndrome in obese African American youth participating in a supervised weight management program, (2) examine the effect of change in severity of obesity on these variables, and (3) identify predictors of weight loss.

Method. This study consisted of a post-hoc analysis of existing pre and post-intervention data obtained from 50 African-American youth (70% female, aged 7-18 years). Anthropometric assessment of height, weight, waist circumference, systolic blood pressure, body mass index, body mass index percentile …

Feasibility Study Of Liquid-Based Cytology For Post-Treatment Surveillance Of Patients With Vulvar Intraepithelial Neoplasia, Wendy Likes

Theses and Dissertations (ETD)

Introduction: Colposcopy and tissue biopsy remain the gold standard for diagnosing vulvar intraepithelial neoplasia (VIN). Vulvar colposcopy is fairly nonspecific. As a result, many women undergo unwarranted painful biopsies. Vulvar cytology, which is relatively painless, inexpensive and allows a larger area to be sampled, may likely reduce false negative diagnoses. However, previous cytological studies that used conventional methodologies were largely unsuccessful in diagnosing VIN. In this study, liquid based cytology and HPV typing by PCR have been assessed as possible alternatives to biopsy for follow-up surveillance of women treated for VIN.

Methods: Women with a history of VIN and a …

Associations Among Health Literacy Levels And Health Outcomes In Pregnant Women With Pregestational And Gestational Diabetes In An Urban Setting, Rosemary Ann Mclaughlin

Theses and Dissertations (ETD)

Purpose/Objectives: Poor health literacy is a problem for over 45% of American adults and is associated with a variety of adverse health outcomes. Low health literacy has been associated with poor prenatal care utilization and a higher likelihood of poorer glycemic control. Poor glycemic control can lead to poor birth outcomes for both the mother and infant. Health literacy levels of pregnant women with diabetes can influence these outcomes and need to be known early in the pregnancy. Interventions can influence tighter glycemic control and lessen the impact of diabetes for the mother and infant. Therefore, the purpose of this …

Pax5 Haploinsufficiency Cooperates With Bcr-Abl1 To Induce Acute Lymphoblastic Leukemia, Christopher B. Miller

Theses and Dissertations (ETD)

Acute lymphoblastic leukemia (ALL) is the commonest pediatric malignancy and comprises several distinct subtypes each with its own unique pathogenesis, clinical behavior, and response to therapy. Chromosomal aberrations are a hallmark of ALL but alone fail to induce leukemia. Pediatric ALLs can be divided into several categories based on the expression of several genetically conserved chromosomal translocations including the t(9,22)[BCR-ABL1], t(1,19)[TCF3-PBX1], t(12,21)[ETV6-RUNX1], MLLrearranged leukemia’s, hyperdiploid and hypodiploid karyotypes, and T-lineage leukemia. Each translocation confers a characteristic transforming phenotype within the cell in which it originates but is alone insufficient to induce overt leukemia. …

The Role Of Inflammation In The Early Radiation Response, Christy Marie Wilson

Theses and Dissertations (ETD)

Radiation is one of the principal treatments for adults and children with brain tumors, and is one of the oldest established treatments for tumors of all types. Currently, the limiting factor for the use of radiation is the effect on normal tissue adjacent to the tumor. Toxicity, including early and late effects from radiation, limits the dose administered to the tumor and reduces the probability of cure. This work has three aims in its attempt to understand and limit early radiation damage: characterize the role of the inflammatory molecules tumor necrosis factor alpha (TNF) and intracellular adhesion molecule-1 (ICAM-1) in …

Effect Of Obesity On The Traditional And Emerging Cardiovascular Disease Risk Factors In African American Women, Queen Obiageli Henry-Okafor

Theses and Dissertations (ETD)

Background: Obesity is a growing health care concern with cardiovascular disease (CVD) implications. African American women (AAW) have the highest prevalence rate of obesity and highest CVD morbidity and mortality rate of all ethnic groups. The traditional CVD risk factors have not been sufficient to explain this disparity in disease prevalence and outcomes. Current knowledge is limited regarding the interaction between various levels of adiposity and both traditional and emerging CVD risk factors, particularly in AAW. This study sought to explore these interactions.

Methods: The study design was a cross-sectional, descriptive, correlational analysis of 48 AAW ages 18 to 45 …

A Huntington's Warrior Lays Down His Shield, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.