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Postprandial Glucose Response To Mango, Banana And Sapota, Z Contractor, F Hussain, A Jabbar

Section of Pulmonary & Critical Care

Objective: Mango and Sapota are two fruits indigenous to Indian subcontinent. The objective of this study was to evaluate postprandial blood glucose response to mango and sapota in comparison to banana in patients with diabetes mellitus Type 2.METHOD: The plasma glucose response to mango, sapota and banana were determined in ten diabetic patients. Blood was tested at 0, 30, 60, 120 and 180 minutes following the ingestion of test meal.Results: The results showed that the blood glucose response to these three fruits was not different in terms of area under the curve and postprandial change in blood glucose from baseline.CONCLUSION: …

Dietary Practices And Beliefs Of Patients With Chronic Liver Disease, S H. Badruddin, S M. Jafri, A Ahmed, S Abid

Section of Diabetes, Endocrinology and Metabolism

Objective: To study of the dietary practices and beliefs of patients suffering from chronic liver disease.

Setting: Two private tertcary care hospitals.

Method: Fifty patients presenting to the Gastroenterology Clinics at the Aga Khan University Hospital and Baqai Hospital, with compensated liver disease and no other co-morbid condition which required dietary modifications, were enrolled in the study. Patients were interviewed regarding their current dietary practices using an open-ended questionnaire.

Results: The mean age of the patients was 48 years and the majority were in relatively poor nutritional status. Four had BMI's < 18; 58% had Hb < 12 g/dl and 36% had albumin levels < 3 gm/dl. The percentage of patients avoiding various foods is as follows: meats 72%, fats and oils 64%, salt 42%, spices 34%, milk and milk products 28%, rice 20%.

Conclusion: The most commonly cited reason for avoiding a …

Spectrum Of Hodgkin's Disease In Children And Adults: Impact Of Combined Morphologic And Phenotypic Approach For Exclusion Of Look-Alikes, Tanya Siddiqui, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective:

To determine the prevalence of Hodgkin’s disease (HD) and its various subtypes in children and adults and assess the use of immunohistochemical (IHC) studies in confirming HD cases and excluding its close mimicries/look-alikes.

Material and Methods:

All 265 Hodgkin’s disease cases diagnosed at The Aga Khan University Hospital, Karachi over the last 6 years (July 1991 - July 1997) were included. Of these 219 were diagnosed on routine H&E examination while in the remaining 46 cases, diagnosis was made after a thorough IHC workup. (This group initially included 161 cases labelled as lymphoproliferative disorder with HD as one of …

Insulin-Like Growth Factor Ii Signaling In Neoplastic Proliferation Is Blocked By Transgenic Expression Of The Metalloproteinase Inhibitor Timp-1, David C. Martin, John L. Fowlkes, Bojana Babic, Rama Khokha

Pediatrics Faculty Publications

Insulin-like growth factor (IGF) II is overexpressed in many human cancers and is reactivated by, and crucial for viral oncogene (SV40 T antigen, [TAg])-induced tumorigenesis in several tumor models. Using a double transgenic murine hepatic tumor model, we demonstrate that tissue inhibitor of metalloproteinase 1 (TIMP-1) blocks liver hyperplasia during tumor development, despite TAg-mediated reactivation of IGF-II. Because the activity of IGFs is controlled by IGF-binding proteins (IGFBPs), we investigated whether TIMP-1 overexpression altered the IGFBP status in the transgenic liver. Ligand blotting showed that IGFBP-3 protein levels were increased in TIMP-1-overexpressing double transgenic littermates, whereas IGFBP-3 mRNA levels were …

Facial Nerve Palsy Unusual Complication Of Percutaneous Angiography And Emoblization For Juvenile Angiofibroma, Mubasher Ikram, Kamaluddin Khan, Moazzam Murad, Tanveer Ui Haq

Section of Otolaryngology, Head & Neck Surgery

Juvenile angiofibrorna is a locally invasive, vascular and non-encapsulated neoplasm occurring almost exclusively in adolescent males. Although histologically benign, these tumors are highly aggressive and are associated with significant morbidity and occasional mortality. It has marked tendency to recur if not completely removed1 . As the tumor is highly vascular, surgely is frequently accompanied by significant intraoperative hemorrhage, which may contribute to incomplete removal and additional morbidity and mortality2 . Roberson (1972) was first to advocate pre-operative angiography and embolization of major feeding vessels as an adjunct therapeutic method in addition to surgery, to facilitate complete excision of the tumOr …

Bone And Renal Stone Disease In Patients Operated For Primary Hyperparathyroidism In Pakistan: Is The Pattern Of Disease Different From The West?, Syed Raziuddin Biyabani, Jamsheer J Talati

Section of Urology

Objective: To document the clinical presentation of primary hyperparathyroidism (PHPT) in a developing country and note differences from the West.
Setting: A tertiary care teaching hospital.
Method: The records of 37 patients operated for PHPT between January 1986 and December 1997 were reviewed. Symptoms, laboratory parameters and histopathology results were analyzed.
Results: Surgery for PHPT accounted for 0.055% of 67,566 operative procedures performed in the Department of Surgery during the 12 year period. The mean age of our patients was 38.4±13.2 years (range 17 to 73 years). Ninety percent of patients were less than 60 years old and 51% less …

Telomere, Telomerase And Digestive Cancer, Javed Yakoob, Hu Guo-Ling, Fan Xue-Gong, Zhang Zheng

Section of Gastroenterology

No abstract provided.

Transfer Of Lacz Marker Gene To The Meniscus, Hideyuki Goto Md, Franklin D. Shuler Md, Phd, Chanin Lamsam Md, Hans D. Moller Md, Christopher Niyibizi Phd, Freddie H. Fu Md, Paul D. Robbins Phd, Christopher H. Evans Phd

Orthopaedics

Background: Lesions in the avascular two-thirds of the meniscus do not heal well and are of concern clinically. Various growth factors promote the synthesis of matrix by meniscal cells and thus have the potential to augment healing. However, their clinical application is severely hindered by problems with delivery. An attractive approach to overcoming such problems is to transfer genes that encode the growth factors in question to the site of the injury. As a prelude to this, we evaluated methods for delivering genes to the meniscus.

Methods: Gene transfer was evaluated in vitro and in vivo with a lacZ marker …

Oncolog, Volume 44, Number 07/08, July/August 1999, Dawn Chalaire, Kimberly Jt Herrick, Robert C. Bast, Jr. Md

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

• New MRI Techniques Pinpoint Brain Tumors, Reveal Brain Functions in Real Time
• Upcoming Conferences Explore Many Topics
• Protocols: Liver Cancer Clinical Trials
• DiaLog: CA 125: The Past and the Future, by Robert C. Bast Jr., MD, Head, Division of Medicine
• House Call: Hormone Replacement Therapy: End to Hot Flashes or Fuse for New Cancers?
• Aggressive Regional Therapies Offer Some Promising Results for Patients with Liver Tumors

Identification And Characterization Of Determinants Of Head And Neck Tumor Cell Invasion, Yangguan Wu

Theses and Dissertations in Biomedical Sciences

Head and neck squamous cell carcinoma (HNSCC) is a common malignant disease with poor prognosis. The majority of patients die from local invasion or lymphatic metastasis. The mechanism(s) underlining the invasiveness of HNSCC are poorly understood. Utilizing a panel of HNSCC cell lines previously established in our laboratory, we tested the application and relevance of the three-step hypothesis of tumor invasion to HNSCC and investigated the mechanism(s) pertaining to the regulation of each step in the invasive process. Data presented in this thesis demonstrated that tumor cell invasion in HNSCC is a complex process involving three repeated sequential steps: adhesion, …

Fine Needle Aspiration Cytology (Fnac) In The Management Of Thyroid Pathology - The Aga Khan University Hospital Experience, Mubasher Ikram, Jamil Hyder, Sohail Muzaffar, Sheema H. Hasan

Section of Otolaryngology, Head & Neck Surgery

Objective: To report the efficacy of FNAC in patients with thyroid disease.
Methods: Between January 1990 and December 1994 the records of all patients treated surgically for thyroid disease at ENT Head and Neck Surgery of Aga Khan University were reviewed. All the patients had pre­operative FNAC as the first line of evaluation and the histopathologist examined post-operative thyroid specimen.
Results: Forty-five patients (36 female and 9 male) had thyroid surgery. In 26 patients out of 45, FNAC was conclusive in diagnosing the nature of disease, while in 19 patients the FNAC was inconclusive because of the presence of follicular …

Aspergillosis Of The Sphenoid Sinus With The Involvement Of The Clivus, Mubasher Ikram, S.S.M. Hussain, R Ahmad

Section of Otolaryngology, Head & Neck Surgery

Introduction: Fungal infections of the nose and paranasal sinuses are frequent in this part of the world. One aspect of the increased frequency is the improved clinical, radiological and pathological diagnostic methods that are now available. Aspergillus is the commonest infecting fungus of the nose and the paranasal sinus1 . It is mainly a saprophytic spore producing fungus and can cause invasive and non-invasive infections. The initial report of fungal paranasal infection largely dealt with immunocompromised individuals as distinct from the allergic fungal infection. Aspergillosis confined to the sphenoid sinus is uncommon with only 34 cases having been reported in …

Morphological Pattern And Frequency Of Thyroid Tumors, S H. Shah, S Muzaffar, I N. Soomro, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:
The present study was done to evaluate the frequency of thyroid cancer and to find out the prevalence of histological types of thyroid tumor with respect to age and sex group.
Setting:
This study included consecutive cases of malignant tumors of thyroid gland, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).
Methods:
These cases were evaluated on H & E stained sections from paraffin embedded 10% buffered formalin fixed tissue blocks. Special stains and immunohistochemical analysis were performed whenever required.Results: A total of 8541 malignant …

Views About Women's Mental Health: Study In A Squatter Settlement Of Karachi., Fauziah Rabbani

Community Health Sciences

OBJECTIVE:

Mental health of women is globally receiving particular attention. This study assessed community's view on certain aspects of women's mental health prior to introducing an intervention.

SETTING:

The study was conducted in an urban squatter settlement located in District West of Karachi in 1997 where the Aga Khan University has set up a Primary Health Care program in partnership with the communities.

METHODS:

Using convenient sampling, door to door household survey was conducted by medical students.

RESULTS:

Two hundred and eighty one residents were interviewed. Respondents were asked to list contributory factors which lead to mental distress in women. …

Beta- And Gamma-Catenin Mutations, But Not E-Cadherin Inactivation, Underlie T-Cell Factor/Lymphoid Enhancer Factor Transcriptional Deregulation In Gastric And Pancreatic Cancer., K Caca, F T Kolligs, X Ji, M Hayes, J Qian, Alan M. Yahanda Md, Facs, D L Rimm, J Costa, E R Fearon

PCI Publications and Projects

Adenomatous polyposis coli (APC) mutations are present in >70% of colon cancers. The APC protein binds to beta-catenin (beta-cat), a protein first identified because of its role in E-cadherin (E-cad) cell adhesion. In some colon cancers lacking APC defects, mutations in presumptive glycogen synthase kinase 3beta phosphorylation sites near the beta-cat NH2 terminus appear to render beta-cat resistant to regulation by APC and glycogen synthase kinase 3beta. In cells with APC or beta-cat defects, beta-cat is stabilized and, in turn, binds to and activates T-cell factor (Tcf)/lymphoid enhancer factor (Lef) transcription factors. To further explore the role of APC, beta-cat, …

The Validation Of An Existing Sleep Apnea Questionnaire And Its Application To Clinical Orthodontics, Jeffery C. Biggs

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to validate a sleep apnea questionnaire from the Loma Linda University Sleep Disorders Center, and then to utilize the questionnaire in order to identify potential sleep apnea patients from a pre-orthodontic patient sample. Study patients were selected from the Loma Linda University Sleep Disorders Center and the Loma Linda University Orthodontics Clinic, both in Loma Linda, California, USA.

Methods: The study sample represented all of the patients initially examined from 1996 through 1998 who were age 8-15 years old at the time of the initial exam. Validation of the questionnaire was based on responses …

The Immunology Of Parturition, Ari Mayer Mackler

Loma Linda University Electronic Theses, Dissertations & Projects

Macrophage-derived factors have been implicated in the etiology of preterm labor but little is known about trafficking of this immune cell into the uterus or its regulation of uterine contractility in mice. Enhanced number and activation of macrophages was hypothesized to precede parturition. Studies characterized contractile activity and the distribution of macrophages in the uterus of C3/HeN mice before and after term (=day 19). Contractile activity by uterine strips on days 15 and 18 of pregnancy, the day of delivery, and 1 day postpartum indicate that an endogenous oscillator sustains high frequency contractions. Modest acceleration of the pacemaker occurred before …

Physical Violence During Pregnancy: Maternal Complications And Birth Outcomes, Vilma E. Cokkinides, Ann L. Coker, Maureen Sanderson, Cheryl Addy, Lesa Bethea

CRVAW Faculty Journal Articles

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence …

Acute Urinary Retention: A Primary Manifestation Of Chronic Lymphocytic Leukemia And Organ Confined Prostate Cancer, Muhammad Hammad Ather, Amanullah Memon

Section of Urology

No abstract provided.

Clinico-Morphological Pattern And Frequency Of Bone Cancer, Sajid H. Shah, Suhail Muzaffar, Irshad N. Soomro, Shahid Pervez, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevelence of various histological types of osseous malignancies with respect to age, sex and site of origin.

Setting:

This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).

Methods:

These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required.

Results:

A total of 169 …

Economic Development And Health Status Among The Poor In Squatter Settlements Of Karachi., Fauziah Rabbani, Anwer T. Merchant

Community Health Sciences

OBJECTIVE:

Socioeconomic status is an important determinant of health outcome measures. This study examines and presents some of the important health outcomes amongst the higher and lower socioeconomic groups within the urban poor.

SETTING:

Data analysis is based on a Health and Demographic Survey conducted in urban squatter settlements of Karachi in 1996.

METHODS:

A structured questionnaire was administered to all households in the catchment area. The indicator used to assess economic status is ownership of assets.

RESULTS:

Comparison between the two economic levels shows that the lower socio-economic group was more likely to experience child mortality, (CI; 1.02-1.29, p …

Dysphagia In Hereditary Sensory Autonomic Neuropathy Type Iv, U Shah, M Arshad, T Mozaffar

Department of Paediatrics and Child Health

No abstract provided.

Radiculopathy And Myelopathy At Segments Adjacent To The Site Of A Previous Anterior Cervical Arthrodesis., Alan S. Hilibrand, Gregory D. Carlson, M A Palumbo, P K Jones, H H Bohlman

Rothman Institute Papers

BACKGROUND: We studied the incidence, prevalence, and radiographic progression of symptomatic adjacent-segment disease, which we defined as the development of new radiculopathy or myelopathy referable to a motion segment adjacent to the site of a previous anterior arthrodesis of the cervical spine.

METHODS: A consecutive series of 374 patients who had a total of 409 anterior cervical arthrodeses for the treatment of cervical spondylosis with radiculopathy or myelopathy, or both, were followed for a maximum of twenty-one years after the operation. The annual incidence of symptomatic adjacent-segment disease was defined as the percentage of patients who had been disease-free at …

Immunohistochemical Evaluation Of Small Round Cell Tumors Of Childhood, Sajid H. Shah, Irshad N. Soomro, M. Shahid Siddiqui, Shahid Pervez, Sheema H. Hassan

Department of Pathology and Laboratory Medicine

Objective:

This study was done to evaluate the pediatric undifferentiated small round cell tumors with immunohistochemical staining.

Setting:

The present study included consecutive cases of small round cell tumors which were diagnosed in children (<15 years) in the section of Histopathology at the Aga Khan University Hospital, Karachi during the period of two years.

Methods:

The group of undifferentiated small round cell tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks.

Results:

The category of undifferentiated small round cell tumors included rhabdomyosarcoma (23.2%), primitive neuroectodermal tumor (17.9%), non-Hodgkin’s lymphoma (16.1%), neuroblastoma (14.2%), Ewing’s sarcoma (10.7%) in order of frequency. Osteosarcoma (Small cell variant), retinoblastoma and medulloblastoma comprised …

Insulinlike Growth Factor 1- And 2-Augmented Collagen Gel Repair Of Facial Osseous Defects, James S. Toung, Roy C. Ogle, Raymond F. Morgan, William H. Lindsey

School of Medical Diagnostics & Translational Sciences Publications

BACKGROUND: Defects of the facial bone structure are common problems for the facial plastic surgeon. Native type 1 collagen gels (T1CGs) have been shown to mediate repair of facial critical-size defects in rat models.

OBJECTIVE: To evaluate the efficacy of T1CG augmented with insulinlike growth factor (IGF) 1, IGF-2, and a combination of IGF-1 and IGF-2 on the repair of facial critical-size defects in a rodent model.

METHODS: Twenty-four retired male breeder Sprague-Dawley rats were divided into 4 groups of 6 animals. Facial critical-size defects were created by removing the nasalis bones with a bone-cutting drill. Defects were treated with …

Carotid Doppler Ultrasonography In Young Stroke Patients, A A. Razzaq, B A. Khan, C K. Jadoon, S M. Baig

Section of Neurology

Background: The present study focuses on the role of carotid doppler ultrasonography (CDUS) in the diagnosis and management of carotid stenosis in young stroke patients.

Methods: The findings of carotid doppler in 45 ischemic stroke patients between 15-45 years of age were reviewed retrospectively. The variables of interest for this study included risk factors for atherosclerotic disease, primary abnormality detected on carotid doppler ultrasonography (ulceration vs. stenosis), degree of stenosis and the type of plaque (soft vs. calcified).

Results: The prevalence of hypertension and diabetes was 50% and 35% respectively. The rate of carotid stenosis in the …

Oncolog, Volume 44, Number 03, March 1999, Dawn Chalaire, Beth W. Allen, Alison Ruffin

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

• Vaccines, Other New Options Expand Renal Cancer Therapy Program
• Thirteen-story Alkek Hospital Makes Debut
• Training Takes Prevention and Early Detection Worldwide
• Nephrectomy Before or After Systemic Therapy­--That Is the Question
• House Call: Alcohol and Cancer: Making Sense of a Cocktail of Risks and Benefits
• Protocols: Renal Cell Carcinoma Trials Offer Therapies for Treated and Untreated Patients
• Compass: New Quarterly Supplement Offers Perspectives on Clinical Guidelines

Home Observation For Asymptomatic Coin Ingestion: Acceptance And Outcomes. The New York State Poison Control Center Coin Ingestion Study Group., Gregory P. Conners, D J. Cobaugh, R Feinberg, R Lucanie, T Caraccio, C M. Stork

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To obtain preliminary estimates of the acceptance rate and the frequency of adverse outcomes, and to identify issues related to acceptance, associated with management of asymptomatic pediatric coin ingestion by home observation, in preparation for a large-scale prospective study.

METHODS: Scripted telephone follow-up of callers who had reported asymptomatic pediatric coin ingestions to one of five poison control centers six to 36 months previously, which had been managed by home observation.

RESULTS: Of the 67 callers enrolled, 41 (67%) reported contacting a physician regarding the coin ingestion, despite home observation instruction by poison control center personnel. Those who did …

Nebulized Nitroglycerin In Children With Pulmonary Hypertension Secondary To Congenital Heart Disease, Hatim Omar, Fangqi Gong, Mei Y. Sun, Stanley Einzig

Pediatrics Faculty Publications

Pulmonary hypertension continues to be a major cause of morbidity and mortality, despite new treatments. Since inhaled nitric oxide has been reported to be effective in some cases, we investigated using nebulized nitroglycerine to treat pulmonary hypertension in children with congenital heart disease. Four children (ages 6-72 months) with severe pulmonary hypertension secondary to congenital heart disease (all with membranous ventricular septal defect, undergoing cardiac catheterization) were given 3 cc of nebulized normal saline over 10 min as placebo control, followed by nebulized nitroglycerine (20 micrograms/Kg in 3 cc normal saline). Normal saline administration did not elicit any change, but …

Clinico-Morphological Pattern Of Intracranial Tumors In Children, Sajid H. Shah, Irshad N. Soomro, Akbar S. Hussainy, S H. Hassan

Department of Pathology and Laboratory Medicine

Objective:
The objective of present study was to observe the histopathological pattern of intracranial tumors in children (< 15 yrs) and to correlate the site of lesion along with the histological diagnosis.
Setting:
The study included consecutive cases of intracranial tumors diagnosed in children (< 15 yrs.) in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of three years.
Methods:
The initial histological evaluation of these lesions was performed on H and E stained section of paraffin embedded tissue. Special stains and immunohistochemical analysis was done whenever indicated.
Results:
During the study period, fifty-four cases of intracranial tumors were diagnosed in children. The age ranged from 1-1/2 years to 4 years with male to female ratio of 1.1:1. Astrocytoma comprised 39% of all intracranial tumors of childhood. Medulloblastoma …