Digital Commons Network^™

Risk Of Contrast Induced Nephropathy In Hiv Patients Receiving Radiographic Contrast At Three Aga Khan Hospitals, Sitna A. Mwanzi

Master of Medicine in Internal Medicine

Aim: To study the influence of HIV infection on the development of contrast induced nephropathy in patients receiving radio contrast material Design: Prospective cohort study Patients and setting:One hundred and twenty five (125) HIV positive patients and one hundred and fifty five (155) HIV negative patients selected from in and out patient departments of the Aga Khan University Hospital, Nairobi and Aga Khan Hospitals in Mombasa and Kisumu, were evaluated for the study between August 2008 and August 2009. Methodology: Eligible patients undergoing radiological evaluation requiring the use of radio contrast material were consecutively recruited for the study after which …

Functional State Following The Fontan Procedure., Ismee A. Williams, Lynn A. Sleeper, Steven D. Colan, Minmin Lu, Elizabeth A. Stephenson, Jane W. Newburger, Welton M. Gersony, Meryl S. Cohen, James F. Cnota, Andrew M. Atz, Richard V. Williams, Renee Margossian, Andrew J. Powell, Mario P. Stylianou, Daphne T. Hsu, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in outcomes after completion of the Fontan circulation, long-term functional state varies. We sought to identify pre- and postoperative characteristics associated with overall function.

METHODS AND RESULTS: We analyzed data from 476 survivors with the Fontan circulation enrolled in the Pediatric Heart Network Fontan Cross-sectional Study. Mean age at creation of the Fontan circulation was 3.4 plus or minus 2.1 years, with a range from 0.7 to 17.5 years, and time since completion was 8.7 plus or minus 3.4 years, the range being from 1.1 to 17.3 years. We calculated a functional score for the survivors by …

Effect Of California Mission Fig Consumption On Levels Of C-Reactive Protein And Antioxidant Levels, Rasha Abdrabou

Loma Linda University Electronic Theses, Dissertations & Projects

Polyphenols exert anti-inflammatory and antioxidant effects. We investigated the effect of consumption of polyphenol-rich figs on high sensitivity C-reactive protein (CRP) and antioxidant levels in hyperlipidemic subjects. The purpose of this study was to examine the effect of fig consumption on C-reactive protein and antioxidant levels. Analyses were carried out on collected data from September to December of 2008. Using a crossover design, one hundred and two participants were recruited and randomized into an intervention phase (eating figs) and a control phase (not eating figs) for 5 weeks. Blood samples were drawn from each group at the 4th and 5th …

Physiological Changes And Participation To Exercise In Older Adults Living In Age Restricted Communities, Mary F. Shaughnessy

All-Inclusive List of Electronic Theses and Dissertations

It is known that the aging population is more susceptible to musculoskeletal and metabolic disease and would benefit from a regular exercise program. The primary objective of this study was to evaluate whether older adults (55 years of age and older) participation in a more regular exercise program would increase if there was supervision from a health professional. The second objective was to evaluate whether supervision in a regular exercise program would show physiological benefits. Subjects were recruited from three age-restricted communities; however one community was disregarded due to lack of subjects. A physical activity plan based on the American …

The Influence Of Antiretroviral Therapy On Qtc Interval Amongst Hiv Patients At Aga Khan University Hospital, Nairobi, Jay Shavadia

Master of Medicine in Clinical Pathology

Aim: To determine the influence of antiretroviral (ARV) therapy on the QTC interval amongst HIV-infected patients. Design: Prospective Comparative survey of two population samples Patients and Setting: One hundred and thirty ARV naïve and one hundred and thirty treated HIV-positive patients selected from in and out patient departments of Aga Khan University Hospital underwent clinical evaluation and 12 lead resting ECG between August 2008 and March 2009. Methodology: Eligible HIV-positive patients were conveniently sampled and had a 12-lead electrocardiogram (ECG) performed to determine the QTinterval, corrected for the heart rate by the Bazzet formula. Analysis was then performed to determine …

The Prevalence Of Postoperative Pain Following Day Surgery In The First 48 Hours At Aga Khan University Hospital, Nairobi, Gilbert Mwaka

Master of Medicine in Anaesthesiology

Introduction: Day case surgery services are increasing all over the world. The prevalence of postoperative pain after day surgery is found to be high ranging from 17% to 60%. Little is known about the prevalence of postoperative pain, in Kenya and East Africa, after day case surgeries. Objective: The objectives of this study were to investigate the prevalence of postoperative pain after day surgery at Aga Khan University (AKUH), Nairobi, to determine the severity/intensity of postoperative pain following day case surgery, and to determine the influence of anxiety and worry on the patients report on postoperative pain. Study site: The …

Esophageal Squamous Cell Carcinoma Risk Factors In A Kenyan Population: A Case Control Study, Stanley M. Machoki

Master of Medicine in General Surgery

Background: Esophageal squamous cell carcinoma (ESCC) is a common malignancy inKenya with a dismal outcome with a majority of patients presenting late. The factors that are operative in the etiology of this disease and its geographic distribution withinKenya have not been characterized thus far. Objectives: The objective of this study was to determine the association of ESCC with Khat chewing, which is prevalent in parts ofKenya, and other commonly implicated risk factors (i.e. smoking, alcohol, diet, socioeconomic status, caustic ingestion and first degree family history of ESCC). We also determined the geographic (provincial) origin, age/sex and ethnicity of cases visiting …

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 …

Complexity, Cofactors, And The Failure Of Aids Policy In Africa, Eileen Stillwaggon

Economics Faculty Publications

Global AIDS policy still treats HIV as an exceptional case, abstracting from the context in which infection occurs. Policy is based on a simplistic theory of HIV causation, and evaluated using outdated tools of health economics. Recent calls for a health systems strategy – preventing and treating HIV within a programme of comprehensive health care – have not yet influenced the silo approach of AIDS policy.

Evidence continues to accumulate, showing that multiple factors, such as malnutrition, malaria and helminthes, increase the risk of sexual and vertical transmission of HIV. Moreover, complementary interventions that reduce viral load, improve immune response, …

Oncolog Volume 54, Number 07/08, July/August 2009, John Lebas, Sunni Hosemann, Bryan Tutt

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Frontiers in Radiosurgery
• Advanced Ovarian Cancer
• House Call: Colorectal Cancer: Life-Saving Options for Early Detection
• Reduced Wait Times Mean Faster Access for New Patients

A Study On The Effect Of Baby Walker On Mean Age Acquisition Of Motor Skills In Infants, Ahmad Talebian, Ali Honarpishe, Abbas Taghavi, Esmail Fakharian, Mahdi Parsa, Gholam Abbas Mousavi

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Metabolic Syndrome And Risk Of Cancer Mortality In Men, Jason R. Jaggers, Xuemei Sui, Steven P. Hooker, Michael J. Lamonte, Charles E. Matthews, Gregory A. Hand, Steven N. Blair

Faculty and Staff Scholarship

Background—Metabolic syndrome (MetS) has been linked with an increased risk of developing cancer; however the association between MetS and cancer mortality remains less clear. Little research has focused on pre-cancer risk factors that may affect the outcome of treatment. The purpose of this study was to examine the association between MetS and all-cancer mortality in men. Methods—The participants included 33,230 men aged 20-88 years who were enrolled in the Aerobics Center Longitudinal Study and free of known cancer at baseline. Results—At baseline 28% of all the participants had MetS. During an average of 14 years followup there were a total …

Consanguinity Among The Risk Factors For Underweight In Children Under Five: A Study From Rural Sindh, S. F. Hasnain, S. K. Hashmi

Community Health Sciences

BACKGROUND: Malnutrition is a common problem, especially in developing countries. Of the 11 million children under 5 who die each year in the developing countries mainly from preventable causes, the death of about 54% are either directly or indirectly attributable to malnutrition. The objectives of this study were to assess the prevalence and associated factors for underweight in rural Sindh.METHODS: A cross-sectional survey was conducted in Jhangara Town, located in District Dadu, Sindh. Eight hundred children under 5 years of age were enrolled. A questionnaire was used to elicit required information and anthropometric measurements were made.RESULTS: The overall prevalence for …

Comparison Of Oral Versus Injectable Vitamin-D For The Treatment Of Nutritional Vitamin-D Deficiency Rickets, Abdul Gaffar Billoo, Ghulam Murtaza, M. Ashraf Memon, Sultan Ahmed Khaskheli, Khalid Iqbal, Masood Hussain Rao

Department of Paediatrics and Child Health

OBJECTIVE: To assess the safety and acceptability of a single dose of vitamin-D versus the efficacy of injectable Vitamin-D versus oral vitamin-D.

STUDY DESIGN: Case control.

PLACE AND DURATION OF STUDY: It was carried out at the Department of Paediatrics, Kharadar General Hospital, Karachi, from August 2003 to April 2004.

METHODOLOGY: Children of the age of 6 months to 3 years with clinical, biochemical and radiological evidence of vitamin- D deficiency rickets were included. The history, clinical examination, complete blood picture, serum calcium. Phosphorus, alkaline phosphatase and X-ray of wrist joint were done. The children were divided into two groups …

Vitamin B12 Deficiency--A Major Cause Of Megaloblastic Anaemia In Patients Attending A Tertiary Care Hospital, Saira Perwaiz Iqbal, Ghulam Nabi Kakepoto, Saleem Perwaiz Iqbal

Department of Pathology and Laboratory Medicine

BACKGROUND: Folate and vitamin B12 deficiencies have been known to cause megaloblastic anaemia. Since the deficiencies of these two vitamins are very common in Pakistani population, it would be imperative to investigate their role in causing megaloblastic anaemia. The objective of this study was to find out the contribution of folate and vitamin B12 deficiencies in causing megaloblastic anaemia in our patient population.

METHODS: In this retrospective cohort study, clinical records of 220 patients (101 females and 119 males with an age range of 1-80 years) who presented themselves with macrocytic anaemia at the Aga Khan University Hospital were collected. …

Epidemiology And Outcomes Of Candidemia In 2019 Patients: Data From The Prospective Antifungal Therapy Alliance Registry., David L Horn, Dionissios Neofytos, Elias J Anaissie, Jay A Fishman, William J Steinbach, Ali J Olyaei, Kieren A Marr, Michael A Pfaller, Chi-Hsing Chang, Karen M Webster

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Candidemia remains a major cause of morbidity and mortality in the health care setting, and the epidemiology of Candida infection is changing.

METHODS: Clinical data from patients with candidemia were extracted from the Prospective Antifungal Therapy (PATH) Alliance database, a comprehensive registry that collects information regarding invasive fungal infections. A total of 2019 patients, enrolled from 1 July 2004 through 5 March 2008, were identified. Data regarding the candidemia episode were analyzed, including the specific fungal species and patient survival at 12 weeks after diagnosis.

RESULTS: The incidence of candidemia caused by non-Candida albicans Candida species (54.4%) was higher …

Weight Gain Associated With Hormonal Contraception Use In Adolescents Is Not Different From Control, Abdel Salous, Valerie Jones, Maria Melguizo Castro, Linah Al-Alem, Hatim A. Omar

Pediatrics Faculty Publications

The use of hormonal contraception is commonly associated with weight gain. The purpose of this retrospective study was to explore the association between the use of hormonal contraception and weight change in an outpatient adolescent patient population in Lexington, Kentucky. Data were gathered from the charts of 259 adolescent female patients seen in an outpatient adolescent clinic for up to 72 months. At the initial visit, all patients were evaluated for risk-taking behavior and received preventive counseling. Patients were categorized as either contraception users or non-users (control group). Contraception users were subdivided into Depot Medroxyprogesterone Acetate (DMPA) user group or …

Field Testing Adolescent Females For Cardiovascular Disease Risk, C. Jayne Brahler, Wesley R. Stephens, Betsy Donahoe Fillmore

Physical Therapy Faculty Publications

Over-fatness and poor cardiovascular (CV) fitness are well-documented risk factors for cardiovascular disease (CVD) in adults, but less is known about their association with disease risk in adolescents. This study aimed to determine the relationship between anthropometrics, fitness, and CVD risk.

Six anthropometric indicators of body fatness, seven measures of fitness, and seven metabolic and hemodynamic CVD risk factors were measured in a convenience sample of 28 female high school students (15-18 years of age). A tally was made of the number of factors for which each subject was outside the normal reference range (CVD risk).

Correlation analyses were completed …

Quality Of Life And Depression: Outcome Markers For A Weight Management Program, Cecilia Dueñas

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric obesity has become a national epidemic and current trends suggest a continued increase. Obese children have been found to have higher incidences of depression and a lower quality of life (QOL) than children from other often more severe medical populations. As a result, weight management programs are on the increase with the majority measuring outcome success through weight loss and decreased body mass index (BMI). It is evident however, that health factors are not the only factors associated with obesity, and that psychosocial components are important as well. The Loma Linda University Growing Fit Program is unique in that …

Tuberculosis In San Bernardino County, 1993-2004 : Lifestyle And Environmental Factors, Anuj Bhatia

Loma Linda University Electronic Theses, Dissertations & Projects

An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, …

Acetabular Morphometry And Prevalence Of Hip Dysplasia In The South Asian Population, Masood Umer, Yasir J. Sepah, Sharjeel Asif, Iqbal Azam Syed, Muhammad Umar Jawad

Section of Orthopaedic Surgery

We carried out a cross-sectional study to measure the association of the seven acetabular parameters with pelvic morphometry and prevalence of hip dysplasia in our population. Convenience sampling was carried out and 250 consecutive patients who came to AKUH for intravenous pyelogram and had no complaints in the region of the hip joint were enrolled in the study. Post-micturition standardized plain antero-posterior pelvic radiographs of 250 asymptomatic adults (500 hip joints) was studied. There were 136 males (54.4%) and 114 females (45.6%). Mean age of our study population was 38 years (15-78 years). The average center edge angle was 35.5±6.6° …

Impact Of Infection Control Activities On The Rate Of Needle Stick Injuries At A Tertiary Care Hospital Of Pakistan Over A Period Of Six Years: An Observational Study., Afia Zafar, Faiza Habib, Roshan Hadwani, Muslima Ejaz, Khurshid Khowaja, Rozina Khowaja, Seema Irfan

Department of Pathology and Laboratory Medicine

Background:Accidental exposure to blood and body fluids is frequent among health care workers. They are at high risk of nosocomial transmission of blood borne pathogens due to injuries caused by used sharps. We are reporting impact of surveillance and educational program on the rate of needle stick injuries among health care workers at a tertiary care hospital in Pakistan.

Methods:

At Aga Khan University Hospital sharp injuries are reported to infection control office. To reduce these incidents a quality improvement project was inducted in the year 2005. Health care workers were educated, surveillance data from 2002 to 2007 was …

A Case Study On Using The Via Christi Breastfeeding Assessment Tool In A Clinical Setting, Rouba Taha

Honors Scholar Theses

Aims- The goal of this study is to obtain a subjective point of view of the use, benefits, and shortcomings of the Via Christi breastfeeding Assessment Tool in a clinical setting.

Methods- This case study is based on a single yet detailed interview with a lactation consultant who has utilized the Via Christi Breastfeeding Tool in a clinical setting.

Findings- Advantages of the Via Christi Breastfeeding Assessment Tool include that the tool is practical and concrete, encompassing both a subjective dimension and the basic elements of breastfeeding. Shortcomings of the tool include its non-specificity in focus on the feeding technique …

Vital Signs, Spring/Summer 2009, Boonshoft School Of Medicine

Vital Signs

A fifty-six page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles and smaller pieces that focus on faculty, students, milestones and more.

Oncolog Volume 54, Number 05, May 2009, John Lebas

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Targeting Inflammation in Cancer Prevention
• Treating Radiation Necrosis of the Brain
• Preclinical Studies Reveal Effectiveness of Therapies for Pediatric Cancers
• House Call: Protect and Check Your Skin

Correlates Of Soy Food Consumption In Adventist Health Study-2, Yen Ang

Loma Linda University Electronic Theses, Dissertations & Projects

Much has been discussed about the health benefits and risks of soy consumption but very little is known about who the consumers are. Most of what is known has been observed mainly in Asian populations who consume high levels of soy. Very little is known about soy food intake in the western population who typically has low consumption level. The Seventh-Day Adventist cohort in North America is the only population known in the West with soy food intake that is comparable to the Asian population living in the East.

Soy consumers in a population known for its healthier lifestyle and …

Com Outlook Spring 2009, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Digest Of The Philadelphia College Of Osteopathic Medicine (Summer 2009), Philadelphia College Of Osteopathic Medicine

Digest

The Summer 2009 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates and Kudos
• Development News
• GA-PCOM Mason W. Pressly Memorial Medal
• Crisis in the ER: Repairing the Nation’s Health Care Safety Net
• Challenges
• Finding Answers
• Physician Assistants Ease Burden
• Primary Care Physicians Are Key
• PCOM Provides Leadership
• Reunion Years Roundtable
• The Inspiration Behind the Simmy Ginsburg Humanitarian Award
• Class Notes
• In Memoriam
• My Turn Essay
• PCOM Events

Visual Impairment And Eye Care Among Older Americans: Secondary Analysis Of The Behavioral Risk Factor Surveillance System (Brfss), Amy L. Freeland

Dissertations

The aim of this three-paper format dissertation is to explore three topics relevant to public health and vision loss. The three papers are independent studies, yet build upon each other by first describing the population of people aged 40 years and older in the United States in terms of visual impairment, diagnosed eye disease/injury, and their use of eye care, and then next exploring the factors that influence eye care use for both the general population and the subpopulation of people with diagnosed diabetes. The first paper provides a state-level examination of the characteristics of people aged 40 years and …

Laparoscopic Treatment Of Pancreatic Pseudocysts In Children., Suzanne M. Yoder, Steven Rothenberg, Kuojen Tsao, Mark L. Wulkan, Todd A. Ponsky, Shawn D. St Peter, Daniel J. Ostlie, Timothy D. Kane

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pancreatic pseudocysts are problematic sequelae of pancreatitis or pancreatic trauma causing persistent abdominal pain, nausea, and gastric outlet obstruction. Due to the low volume of disease in children, there is scant information in the literature on the operative management of pseudocysts with minimally invasive techniques. We conducted a multi-institutional review to illustrate several technical variations utilized in achieving laparoscopic cystgastrostomy in the pediatric population.

METHODS: A retrospective review was conducted of all patients who underwent laparoscopic cystgastrostomy in five institutions. Patient data, operative techniques, and postoperative course were analyzed.

RESULTS: There were 13 patients with a mean age of …