Digital Commons Network^™

Visual Outcome Of Cataract Surgery, Farzeen Khalid Hashmi, Qazi Assad Khan, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 – 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract …

Closing The Gap: Revising Sterility Testing Policies And Procedures Based On The United States Pharmacopeia (Usp) 797 Guidelines And A Near Miss, Cindy L. Mitman Pharm D, Terry Burger Mba, Bsn, Rn, Ne-Bc, Cic, Deborah Fry Mt (Ascp), Mba, Cic, Gary Tallarita Mt (Ascp)

Department of Medicine

No abstract provided.

Patients' Insight Of Interpreting Prescriptions And Drug Labels--A Cross Sectional Study., Muhammad Junaid Patel, Muhammad Shoaib Khan, Farheen Ali, Zehra Kazmi, Safia Awan, Ayesha Sorathia

Department of Medicine

Background: Errors in consuming drugs are associated with significant morbidity and mortality, besides an impact on the already overburdened health-care system. Misunderstanding drug labels and prescriptions plays an important role in contributing to adverse drug events.

Objective: To evaluate abilities to understand prescriptions and drug labels among patients attending tertiary care hospital in Karachi.

Methods: A cross sectional study was conducted at the Aga Khan University Hospital (AKUH), from January to March 2009. After informed consent, 181 adult patients and their healthy attendants were interviewed at AKUH using a standardized questionnaire, which ascertained patient demographics, factors that might increase exposure …

Examining Universal Primary Healthcare Through Community-Based Initiatives, Donald E. Warden

Oglethorpe Journal of Undergraduate Research

This paper examines enacting community-based primary healthcare programs and initiatives. It looks at the weaknesses of past attempts, the successes of current attempts, and gives insight into ways everyday citizens can change the way the world does healthcare. There are social, economic, and political barriers as to why these programs are not enacted. Since 1978, Member states of the United Nations strive towards healthcare for all. The original 1978 Declaration of Alma-Ata sets the bar at achieving this goal by the year 2000. Now in the 21^st century, the world still battles inadequate healthcare. Nations continue to strive towards …

A Quality Improvement Investigation Of Pediatric Asthma Services For Patients And Their Families, Tina Dimartino

Graduate Student Independent Studies

This quality improvement project sought to identify attributes of pediatric patients with asthma and their caregivers at a hospital serving pediatric patients and families in Bronx, NY. Anonymous, self-report surveys focused on rates of asthma inpatient admission and emergency department visits, general understanding of asthma, current services utilized in the hospital and interest in the potential expansion of existing services. Additionally, the project explored the prospective development of the current educational healthcare video system within the hospital.

Late Effects Of Childhood Cancer : Implications For Child Life Specialists, Meghan Brewer

Graduate Student Independent Studies

No abstract provided.

Providing Family-Centered Care For Families And Patients With Autism Spectrum Disorders : A Guide For Healthcare Professionals, Kacie Wilson

Graduate Student Independent Studies

The purpose of this thesis is to provide healthcare professionals in the pediatric healthcare setting with the necessary tools to provide high quality family-centered care to children with ASD and to their families.

Creating An Optimal Healing Environment For Pediatric Patients And Families : A Medical School Course On Child Life Theory And Practice, Erin Halman

Graduate Student Independent Studies

This project outlines an introductory child life course intended for medical students. The course covers salient topics from a graduate level child life curriculum, as well as skills identified as the most useful for physicians in a survey of certified child life specialists.

A Trip To The Epilepsy Monitoring Unit : Using Video Modeling To Prepare Children And Caregivers For Inpatient Eeg Monitoring, Peyton Katz

Graduate Student Independent Studies

The goal of this project was to outline the benefits of utilizing video modeling in the preparation of children and families within a child life department's preparation program.

Extracorporeal Membrane Oxygenation For Bridge To Decision And To Recovery., Hitoshi Hirose, Md, Phd, Shingeki Tabaka, Md, James Diehl, Md, Nicholas C. Cavarocchi, Md

Department of Surgery Faculty Papers

Extracorporeal life support has advanced from its humble beginnings over 3 decades ago, with the first description of its success in a patient with Acute Respiratory Distress Syndrome (ARDS), going as far back as 1971. The indications for extracorporeal membrane oxygenation (ECMO) therapy include refractory respiratory and/or cardiac failure, and ECMO is now being increasingly used in adult patients. In this case report, we present a patient who had traveled from India to the United States, where she developed acute decompensated biventricular failure and shock, requiring ECMO placement as a bridge to a decision. During her first few days on …

Rhinoscleroma Presenting As A Nasal-Palatal Mass With Airway Obstruction, Mark C. Domanski, Alexander Rivero, David E. Kardon

Surgery Faculty Publications

We report a case of a 45-year-old male with severe rhinoscleroma. The patient presented to the emergency room with dyspnea from a long-standing nasal-palatal mass. A tracheostomy was required for airway control. While dyspnea in the presence of an upper airway mass is typical of malignancy, consideration of non-oncological etiologies is important. We review the epidemiology, pathology, diagnosis, and treatment of rhinoscleroma.

The Impact Of Community Use Of Novel Oral Anticoagulants On An Academic Medical Center, Luis Eraso, Md, Taki Galanis, Md, Kristina Kipp, Pharm.D., Walter K. Kraft, Md, Michael Palladino, Pharm.D., Cacp, Alejandro Perez, Md, Kimberle Ferebee-Spruill, Crnp, Geno Merli, Md, Brian G. Swift, Pharm.D., Mba, Lynda Thomson, Brittany Vining

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Warfarin has been a mainstay of therapy for treatment and prevention of venous thromboembolic disease (VTED) and prevention of stroke and systemic embolism for over 50 years. Recent FDA approval of several novel oral anticoagulants has offered more extensive treatment options for management of these disease states.

The availability of the novel anticoagulants offers an attractive alternative to warfarin therapy for patients due to their convenience of use. In comparison to warfarin, dabigatran, rivaroxaban and apixaban offer: - a fixed dosage regimen

- a relatively small potential drug interaction profile

- minimal laboratory monitoring

- little to no dietary restrictions. …

From Qualitative Work To Intervention Development In Pediatric Oncology Palliative Care Research, Terrah Foster Akard, Mary Jo Gilmer, Debra L. Friedman, Barbara Given, Verna L. Hendricks-Ferguson, Pamela S. Hinds

Pediatrics Faculty Publications

Qualitative methods can be particularly useful approaches to use with individuals who are experiencing a rare disease and thus who comprise a small sample (such as children with cancer) and are at points in care that few experience (such as end of life). This data-based methods article describes how findings from a qualitative study were used to guide and shape a pediatric oncology palliative care intervention. Qualitative data can lay a strong foundation for subsequent pilot intervention work by facilitating the development of an underlying study conceptualization, providing recruitment feasibility estimates, helping establish clinically meaningful inclusion criteria, establishing staff acceptability …

History And Hope: The International Humanitarian Reader, Kevin M. Cahill, M.D.

Institute of International Humanitarian Affairs

History and Hope: The International Humanitarian Reader provides a better understanding—both within and outside academia—of the multifaceted demands posed by humanitarian assistance programs. The Reader is a compilation of the most important chapters in the twelve-volume International Humanitarian Affairs book series published by Fordham University Press. Each selected chapter has been edited and updated. In addition, the series editor, Kevin M. Cahill, M.D., has written, among other chapters, an introductory essay explaining the academic evolution of the discipline of humanitarian assistance. It focuses on the “Fordham Experience”: its Institute of International Humanitarian Affairs (IIHA) has developed practical programs for training …

Medical Education Digest, Vol. 15 No. 3 (May/June 2013), Nova Southeastern University

Medical Education Digest

No abstract provided.

An Ehealth System Supporting Palliative Care For Patients With Non-Small Cell Lung Cancer: A Randomized Trial, David H. Gustafson, Lori L. Dubenske, Kang Namkoong, Robert Hawkins, Ming-Yuan Chih, Amy K. Atwood, Roberta Johnson, Abhik Bhattacharya, Cindy L. Carmack, Anne M. Traynor, Toby C. Campbell, Mary K. Buss, Ramaswamy Govindan, Joan H. Schiller, James F. Cleary

Community & Leadership Development Faculty Publications

BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non-small cell lung cancer (NSCLC).

METHODS: In total, 285 informal caregiver-patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks …

Polypharmacy In Elderly: A Cautious Trail To Tread, Saniya Raghib Sabzwari, Waris Qidwai, Seema Bhanji

Department of Family Medicine

Polypharmacy has now increasingly come into focus as the recipient of healthcare in old age worldwide. In elderly it is associated with frequent adverse drug reactions (ADRs) and drug-drug interactions resulting in significant morbidity. Geriatrics is still an emerging specialty in South Asia, especially in Pakistan, where multiple reasons for polypharmacy exist. An extensive literature review of articles using key words like \'polypharmacy,\' \'elderly\' was conducted. The recently updated Beers Criteria of classification of inappropriate drugs in the elderly was reviewed in detail. Articles of relevance to polypharmacy and evaluation of guidelines for appropriate interventions to minimise inappropriate drug prescribing …

General Practitioners' Knowledge And Approach To Chronic Kidney Disease In Karachi, Pakistan, S Yaqub, W Kashif, M Q. Raza, H Aaqil, A Shahab, M A. Chaudhary, S A. Hussain

Section of Nephrology

Due to lack of adequate number of formally trained nephrologists, many patients with chronic kidney disease (CKD) are seen by general practitioners (GPs). This study was designed to assess the knowledge of the GPs regarding identification of CKD and its risk factors, and evaluation and management of risk factors as well as complications of CKD. We conducted a cross-sectional survey of 232 randomly selected GPs from Karachi during 2011. Data were collected on a structured questionnaire based on the kidney disease outcomes and quality initiative recommendations on screening, diagnosis, and management of CKD. A total of 235 GPs were approached, …

Beliefs About Complementary And Alternative Medicine In Hiv-Infected Black Women Using The Theory Of Planned Behavior, Stephanie G. Lino

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Black women make up 12% of the female population in the U.S, yet they account for 66% of new HIV infections. In 2002, AIDS was the most cited reason for death among Black women age 25-34. While prevention remains, a major effort targeting treatment efficacy and modalities for this sub-group need to be better understood.

Purpose. The purpose of this study is to assess whether HIV-positive Black women’s attitudes, subjective norms and perceived behavioral control are related to intention of dietary supplements and spiritual practices use in their HIV treatment.

Method. In phase one, Grounded Theory methods (N= …

Patients With Disabilities As Teachers (P-Dat) Training In Medical Education, Rebecca Royce-Hickey Do, Sweety Jain Md, Susan E. Hansen Ma, Nyann Biery Ms

Department of Family Medicine

No abstract provided.

The Impact Of Family History On Medullary Thyroid Cancer In Men2a Patients, Nicole D. Mohrbacher

Dissertations and Theses (Open Access)

The American Thyroid Association recently classified all MEN2A-associated codons into increasing risk levels A-C and stated that some patients may delay prophylactic thyroidectomy if certain criteria are met. One criterion is a less aggressive family history of MTC but whether families with the same mutated codon have variable MTC aggressiveness is not well described. We developed several novel measures of MTC aggressiveness and compared families with the same mutated codon to determine if there is significant inter-familial variability. Pedigrees of families with MEN2A were reviewed for codon mutated and proportion of RET mutation carriers with MTC. Individuals with MTC were …

Increasing Health Care Costs And Its Adverse Impact On Healthcare, Waris Qidwai

Department of Emergency Medicine

No abstract provided.

Sickle Cell Disease: A Quality Improvement Initiative For Emergency Department Providers, Pretrescia Marie Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sickle Cell Disease (SCD) is an incurable, chronic condition that results in a constellation of disorders, frequent emergency department (ED) visits, and repeated hospital admissions. Those affected often suffer from pain crisis, infection, acute chest syndrome, stroke, and multi-organ impairment and frequently do not receive adequate pain management during acute pain episodes because ED providers view them as drug seeking. The majority of patients with SCD are African-American and may be low income, uninsured, or on Medicaid. As a result, these demographics make ED under-treatment of pain in patients with SCD a health equity issue. This was a pre-experimental one …

Medical Errors Related To Look-Alike And Sound-Alike Drugs, Samina Ismail,, Arshad Taqi

Department of Anaesthesia

Despite recent developments in the inventory management, introduction of electronic drug trolleys and cabinets, color coding of the filled syringes and many more interventions, medication errors could not be eliminated. The most common of these are syringe swap and human errors regarding wrong drug administration due to look-alike drug containers or sound-alike names of the drugs belonging to diverse groups. Many of the fatalities, that occur in third world countries due to these causes, go unnoticed and unregistered. This special article complements two special editorials on the same topic by Professor Joseph D. Tobias et al and Professor Robert Stoelting, …

Comparison Of The Pervasive Developmental Disorders Screening Test And Modified Checklist For Autism In Toddlers: Which Is The Better Predictor Of Autism In Toddlers?, Vanessa Marie Fessenden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early intervention for children with autism spectrum disorders (ASD) has significant impact on children and families. Early intervention optimizes long-term diagnosis for children with ASD. Unfortunately, many children with ASD are not diagnosed until after age three and often receive services from a local school district rather than through early intervention services. However, many of the symptoms of ASD can be hard to identify because symptoms during infancy may be more difficult to detect or may present differently than manifestations of the symptoms at older ages. Despite the difficulty in identifying symptoms of ASD in young children, there are certain …

Need For Multilevel Strategies And Enhanced Acceptance Of Contraceptive Use In Order To Combat The Spread Of Hiv/Aids In A Muslim Society: A Qualitative Study Of Young Adults In Urban Karachi, Pakistan, Syed Farid-Ul-Hasnain, Eva Johansson, Saleema A. Gulzar, Gunilla Krant

Community Health Sciences

This qualitative study explored knowledge, attitudes, beliefs and perceptions of sexual and reproductive health, focusing specifically on contraceptive use and HIV prevention among young unmarried men and women, 17-21 years, in urban Karachi, Pakistan. The main theme, identified as underlying meaning in the focus group discussions was "Societal norms and perceptions create barriers to knowledge and awareness about sexual and reproductive health matters among young adults". A knowledge gap was revealed concerning HIV/AIDS and contraceptive use among young males and females, who have to rely on media and peers for information seeking. Study participants perceived that HIV/AIDS is incurable and …

The Nordinet® International Outcome Study And Novonet® Answer Program®: Rationale, Design, And Methodology Of Two International Pharmacoepidemiological Registry-Based Studies Monitoring Long-Term Clinical And Safety Outcomes Of Growth Hormone Therapy (Norditropin®)., Charlotte Höybye, Lars Sävendahl, Henrik Thybo Christesen, Peter Lee, Birgitte Tønnes Pedersen, Michael Schlumpf, John Germak, Judith Ross

Department of Pediatrics Faculty Papers

OBJECTIVE: Randomized controlled trials have shown that growth hormone (GH) therapy has effects on growth, metabolism, and body composition. GH therapy is prescribed for children with growth failure and adults with GH deficiency. Carefully conducted observational study of GH treatment affords the opportunity to assess long-term treatment outcomes and the clinical factors and variables affecting those outcomes, in patients receiving GH therapy in routine clinical practice.

DESIGN: The NordiNet® International Outcome Study (IOS) and the American Norditropin® Studies: Web Enabled Research (ANSWER Program®) are two complementary, non-interventional, observational studies that adhere to current guidelines for pharmacoepidemiological data.

PATIENTS: The studies …

Lessons Learned From Training Of Promotores De Salud For Obesity And Diabetes Prevention, Erica T. Sosa, Lesli Biediger-Friedman, Zenong Yin

Journal of Health Disparities Research and Practice

Background: Promotores de Salud are impactful in reducing health disparities for Hispanic communities. The purpose of this paper is to present the training process and fidelity of study protocol implementation using a promotora model for community-based diabetes prevention.

Methods: Five Hispanic bilingual promotores were recruited from a Community Health Worker program and received intensive 30-hour promotora training on how to recruit participants, lead group sessions, and support participants making behavior changes. Evaluation of the training included a survey and focus group to assess promotores’ feedback, a post-training knowledge test to assess knowledge acquired during the training and an observational assessment …

Coping With Pediatric Cancer: Conversational Methods Utilized By Parents And Children When Dealing With Pediatric Cancer, Chelsi Morgan Walls

Graduate Research Symposium (2010 - 2017)

This thesis sought to analyze how parents communicate with their child regarding pediatric cancer treatments. When dealing with pediatric cancer, it is vital that parents and their child communicate about the illness in order to effectively cope with the cancer. Using Uncertainty Management Theory, along with sub-concepts of the theory (i.e., appraisals, inferences, and illusions), this thesis sought to discover which coping mechanism (i.e., affect-management or buffering) would be chosen to manage the illness. Under UMT, appraisals were assessed, resulting in positive and negative appraisal, which indicated whether the individual handled the issue with either an inference based on general …

Better Drug Therapy For The Children Of Africa: Current Impediments To Success And Potential Strategies For Improvement, Stuart M. Macleod, Janet K. Finch, William Macharia, Gabriel M. Anabwani

Paediatrics and Child Health, East Africa

A commentary is presented on the urgent need for a comprehensive effort to improve the practice of pediatric therapeutics in Africa. A call for action is addressed to a variety of practitioners internationally, many of whom possess skills that could be fruitfully applied to the improvement of health outcomes for African children. Successful engagement with the many challenges requires the complementary effort of researchers in basic and clinical pharmacology and toxicology, nurses, pharmacists, physicians, clinical pharmacologists, clinical pharmacists, and political leaders and civil servants. While a comprehensive or systematic review of the relevant literature has not been attempted, the authors …