Digital Commons Network^™

Benzodiazepine Self-Poisoning In Pakistan: Implications For Prevention And Harm Reduction, M M. Khan, Hashim Reza

Department of Psychiatry

The pattern of all index admissions for benzodiazepine self-poisoning to a university hospital in Karachi, Pakistan are described. Of the 329 medication self-poisoning cases, 84% were benzodiazepine overdoses. Diazepam was the preferred drug in 69% of these cases, with majority ingesting between 20-30 tablets of 5 mg each, 44% bought the benzodiazepine over the counter (OTC) for the purpose of overdose. The preference for benzodiazepines over analgesics (as freely available) may be related to the motives underlying parasuicide acts and their popularity as 'sleeping pills' in Pakistan. Educating the 'chemist' and limiting the number of tablets dispensed at a time …

Digest Of The Philadelphia College Of Osteopathic Medicine (Fall 1998), Philadelphia College Of Osteopathic Medicine

Digest

The Fall 1998 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• Approaching 100: Our Centennial
• Commencement ‘98
• Remembering David Heilig, Do, '44, OMM Professor Emeritus
• Alumni Make their Mark in the Military
• Profiles
• AHEC Exposes Students to Rural Medicine
• Class Notes
• Just Published
• In Memoriam
• Send Us Your News for Digest!
• Coming Events

Bacterial Isolates From Neutropenic Febrile Pediatric Patients And Their Sensitivity Patterns To Antibiotics, F N. Bhatti, I A. Burney, M I. Moid, T Siddiqui

Section of Internal Medicine

Patients on cytotoxic therapy often develop neutropenia and fever. Our interest was to identify the common pathogens isolated from such patients and to study the sensitivity patterns of these organisms to the antibiotics used in their treatment. Thus, guidelines can be established by hospitals to identify which antibiotics can be used in the treatment of these patients when the results of cultures and sensitivities are not available. We conducted a retrospective study of neutropenic pediatrics presenting to AKUH from July, 1990 to June, 1996. A total of 153 isolates in 35 different patients were studied. Samples for culture were taken …

Spinal Cord Compression: Histologic Spectrum Of Lesions, I. N. Soomro, N.Kayani N.Kayani, Shahid Pervez, A. S. Hussainy, R. Ahmed, S. Muzaffar, S. A. Aziz, S. H. Hasan

Department of Pathology and Laboratory Medicine

Histologic diagnosis ultimately determines the prognosis and treatment of lesions causing spinal cord compression. Modem imaging techniques have revolutionized the procedure of localizing lesions pre¬senting with signs and symptoms of spinal cord compression. As a result, these lesions are more accessible for fine needle aspiration and biopsy. A quick diagnosis is possible if cytologic preparation is made. Similarly, intraoperative frozen section facility not only provides rapid diagnosis, but also offers oppor tunity of appropriate management decision there and then. Histology in many cases needs help of special stains and immunocytochemistry. This study looks at the histologic spectrum of these lesions, …

Soft Tissue Sarcomas: Pattern Diagnosis Or Entity, Naasha Talati, Shahid Pervez

Department of Pathology and Laboratory Medicine

Soft tissue sarcomas (STS) are a diverse and heterogeneous group of tumours The sub-classification of these tumours is of importance for both prognosis and treatment. Classically, sub- categorization is based purely on histomorphological grounds, but as new techniques evolve, a more, conclusive and accurate diagnosis can be made. This study describes the prevalence of soft tissue sarcomas in adults diagnosed at The Aga Khan University Hospital (AKUH) and the impact of immunohistochemistry(IHC) on the precise sub-categorization of these tumours. The study included 364 adults (age 16+) who were diagnosed as soft tissue sarcoma in the past six years (May 1991 …

Cardiac Rehabilitation: Gender Differences In Factors Influencing Participation, Lani Lieberman, Marta Meana, Donna E. Stewart

Psychology Faculty Research

This study investigates gender differences in the barriers and incentives that are most influential in the coronary patient's decision to participate in cardiac rehabilitation (CRPs) and suggests strategies to counter these barriers. Patient surveys were administered to consecutive English-speaking attenders and referred nonattenders to a cardiac rehabilitation center at a university healthcare system in Toronto, Canada. A survey questionnaire, constructed from a literature review and advice from key informants, examined potential factors affecting decisions to engage in CRPs. One129 attenders at a CRP and 61 referred nonattenders completed the questionnaire. Physician recommendation was reported to be the most important factor …

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

Prototype Internet Consultation System For Radiologists, Boris Kovalerchuk, James F. Ruiz, Evgenii Vityaev, Steven Fisher

All Faculty Scholarship for the College of the Sciences

The overall purpose of this study is to develop a prototype radiological consultation system. We concentrate our work on prototype software environment for the system. The system provides a second diagnostic opinion based on similar cases, incorporating the experience of radiologists, their diagnostic rules and a database of previous cases. The system allows a radiologist to enter the description of a particular case using the lexicon such as BI-RADS of American College of Radiology and retrieve the second diagnostic opinion (probable diagnosis) for a given case. The system also allows a radiologist to get other important information too. These advances …

Evaluation Of Chest Pain In General Practice, S Dodani

Department of Family Medicine

No abstract provided.

Posttransplant Recoarctation Of The Aorta: A Twelve Year Experience., Girish S. Shirali, C E. Cephus, M A. Kuhn, K K. Ogata, L K. Vander Dussen, R E. Chinnock, N F. Mulla, J K. Johnston, L L. Bailey, S R. Gundry, A J. Razzouk, R L. Larsen

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation.

BACKGROUND: Patients with aortic arch hypoplasia require extended arch reconstruction at transplant, with an inherent possibility of subsequent recoarctation of the aorta.

METHODS: This was a retrospective review of all children (ageyears) who underwent cardiac transplantation over a 10-year period. Collected data included pretransplant diagnosis, details of the transplant procedure and posttransplant data including development of recoarctation of the aorta, interventions for recoarctation and the …

Mouse Embryo Development In The Presence Of Capsaicin, Carlos Santiago Villar-Gosalvez

Theses and Dissertations in Biomedical Sciences

Capsaicin is the pungent agent found in hot peppers of the Capsicum genus. It is a potent neurotoxin that stimulates the degranulation and degeneration of C-afferent neurons. Capsaicin is widely used as a food condiment and medicine. Human exposure of capsaicin can exceed levels shown to be neurotoxic in laboratory animals. Additionally, capsaicin can cross the blood/placenta barrier and affect an embryo in utero. In order to assay the potential for toxicity to human embryos, mouse embryos were exposed to capsaicin and the effect of the capsaicin on embryo development was measured. Embryos were co-cultured in Krebs medium with 1% …

Leukemia Inhibitory Factor (Lif): Murine Preimplantation Embryo Development, Implantation Rates, And Skeletal Development, Michael Hayes Mitchell

Theses and Dissertations in Biomedical Sciences

Leukemia inhibitory factor (LIF) is a pleiotropic cytokine which demonstrates perplexing physiological effects. It has been demonstrated that LIF is essential for implantation in mice. Little is known relating to the manner by which LIF effects pre-implantation and post-implantation development. The objectives of this project were to determine the effects LIF on pre-implantation development, to determine the effects that it may have on implantation rates, successful pregnancy rates, and resorption rates, and to determine the effects that LIF has on the skeletal development of mice. For the embryo transfer experiments, embryos were exposed to test compounds in the transfer medium …

Well Differentiated Hepatocellular Carcinoma Metastasizing To Jaw And Oral Cavity Within Six Months Of Primary Diagnosis., Nazma Afroze, Irshad N. Soomro, Shahid Pervez, Naila Kayani, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Appendicitis: A Continuing Challenge, K M. Pal, A Khan

Department of Surgery Docs

Acute appendicitis is a common surgical emergency in urban setting, of a developing country. The computerised hospital patient database at Aga Khan University Hospital, Karachi, was utilised to obtain records of all adults with a histologically proven diagnosis of acute appendicitis. A review of patients treated over a 18 month period was undertaken. One hundred and three appendicectomies were performed for acute appendicitis during this period. The diagnosis was clinical in all cases. Investigations like leucocyte count and lower abdominal ultrasound scan were used to improve diagnostic accuracy without a clear advantage. A number of routine investigations like, haemoglobin estimation …

Hydatidosis: Experience With Hepatic And Pulmonary Hydatid Disease, T Pishori, R Azami, S M. Ali

Department of Surgery Docs

From 1989-1992, 35 cases comprising of 20 hepatic and 15 pulmonary hydatid cysts were seen. Four patients with pulmonary hydatid disease had previous or concomitant hepatic hydatidosis compared to no concomitant pulmonary hydatid disease in the hepatic group. Hepatic hydatid disease had a greater tendency to be right sides, infected and calcified. Anaphylactic reactions occurred in 3 of 20 patients with hepatic hydatid disease against none in 15 patients with pulmonary disease. Management consisted of evacuation, drainage and obliteration of the residual cavity by capittonage in the lung and omentoplasty in the liver. Two patients, one hepatic and one with …

Department Of Radiology-Annual Report-July 1, 1997 To June 30, 1998, David C. Levin

Department of Radiology Administrative Documents and Reports

Department of Radiology Annual Executive Summary Report, July 1, 1997 to June 30, 1998. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. 103 pages.

Clinical Problem-Solving. Through Thick And Thin., David R. Yu, Redonda Miller, Paul F. Bray

Cardeza Foundation for Hematologic Research

No abstract provided.

Tuberculosis Presenting As Polyarthritis, J A. Khan, M Y. Ahmadani

Section of Pulmonary & Critical Care

No abstract provided.

The Relation Of Weight Loss And Improved Fitness To Survival In Healthy Males, Joanna Lynn Bokovoy

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a critical public health problem because of its prevalence, medical and psychosocial effects, and resistance to intervention. Weight loss in overweight individuals has been encouraged by the United States Public Health Service and by the medical community as a means for improving health. However, recent studies have suggested either positive or negative effects of weight loss on survival. It is possible that physical fitness may have a confounding effect, or be an effect modifier on survival in weight loss studies.

This study used Cox Regression analysis to address the separate and combined association of weight loss and improved …

Detection Of Mycobacterium Tuberculosis In Paraffin Embedded Intestinal Tissue Specimens By Polymerase Chain Reaction: Characterization Of Is6110 Element Negative Strains, Tariq Moatter, Shaper Mirza, Mohammad Shahid Siddiqui, Irshad Nabi Soomro

Department of Pathology and Laboratory Medicine

Tuberculosis is still one of the most widespread infection known to mankind. Although lung is the predominant site of disease, a sizeable population in Pakistan gets intestinal disease. Clinical presentation, radiologic and endoscopic examination provide clues to the diagnosis. However, a definitive diagnosis requires biopsy material with granulomas and/or caseation complemented by acid fast staining and culture. There are many occasions when biopsy material is scanty and even in some intestinal resection cases histologic evaluation fails to confirm or rule out tuberculosis. Therefore, an investigation was conducted to assess the efficacy of PCR in the detection of mycobacterial DNA in …

Nursing Home Ownership And Public Policy: An Historical Analysis, K. R. Kaffenberger

Graduate Doctoral Dissertations

In the early days of the United States, care of the disabled elderly outside the home meant the public almshouse. By the 1920s, private, nonprofit homes for the aged were prevalent. More recently, private, for-profit facilities have grown to dominate the field.

For-profit ownership has been controversial. Underlying the controversy is the concern that quality might be lowered in order to enhance profit.

This study asks why most nursing homes are privately owned and why most privately owned nursing homes are operated for profit. It does so with reference to The Nonprofit Economy, in which Burton Weisbrod describes a …

Cholera In Children In Karachi From 1990 Through 1995: A Study Of Cases Admitted To A Tertiary Care Hospital, S Q. Nizami, B J. Farooqui

Department of Paediatrics and Child Health

Although cholera is an endemic disease in Bangladesh, India and other countries, it was never a significant cause of gastroenteritis in Pakistan before 1988. Since then, cases of cholera are identified each year, both in adults and children in Pakistan. In order to see the contribution of Vibrio cholerae as a cause of gastroenteritis in children, we reviewed the cases of cholera admitted in the pediatric ward of the Aga Khan University Hospital, Karachi, Pakistan. Of 4346 children hospitalized with gastroenteritis during 1990 through 1995, 348 children (8%) were confirmed to have cholera. The youngest child with cholera was seven …

Principles Of Family Medicine, Riaz Qureshi

Department of Family Medicine

No abstract provided.

Primary Spinal T-Cell Rich B-Cell Lymphoma: A Case Report, Suhail Muzaffar Suhail Muzaffar, Irshad Nabi Soomro, Naila Kayani, Shahid Siddiqui, Yousuf A. Husein, Rashid Jooma

Department of Pathology and Laboratory Medicine

No abstract provided.

The Baculovirus Anti-Apoptotic P35 Protein Promotes Transformation Of Mouse Embryo Fibroblasts., M Resnicoff, B. Valentinis, D. Herbert, D. Abraham, P D. Friesen, E. S. Alnemri, R Baserga

Department of Microbiology and Immunology Faculty Papers

The baculovirus p35 protein is a potent inhibitor of programmed cell death induced by a variety of stimuli in insects, nematodes, and mammalian cell lines. The broad ability of p35 in preventing apoptosis has led us to investigate its effect on mouse embryo fibroblasts in vitro and in vivo. For this purpose, we have used R- cells (3T3-like fibroblasts derived from mouse embryos with a targeted disruption of the insulin-like growth factor I receptor (IGF-IR) genes) and R508 cells (derived from R- and with 15 x 10(3) IGF-IRs per cell). Both cell lines grow normally in monolayer, but they do …

Identification Of Fetal Dna And Cells In Skin Lesions From Women With Systemic Sclerosis, Carol M. Artlett, J. Bruce Smith, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

BACKGROUND: Systemic sclerosis is a disease of unknown origin which often occurs in women after their childbearing years. It has many clinical and histopathological similarities to chronic graft-versus-host disease. Recent studies indicate that fetal stem cells can survive in the maternal circulation for many years post partum. This finding suggests that fetal cells persisting in the maternal circulation or tissues could be involved in the pathogenesis of systemic sclerosis by initiating a graft-versus-host reaction.

METHODS: We used the polymerase chain reaction (PCR) to identify Y-chromosome sequences in DNA extracted from peripheral-blood cells and skin lesions from women with systemic sclerosis …

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 1998), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 1998 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• Our Centennial
• Planting the Seeds for Better Physician Communication
• Library Steps into 21st Century
• Convention Highlights
• Uncle Manny Leaves a Legacy
• Mission Milestones
• Profiles
• Lights, Camera, Action
• Class Notes
• Just Published
• In Memoriam
• Coming Events

Mathematical Models Of Tumors And Their Remote Metastases, Carryn Bellomo

Mathematics & Statistics Theses & Dissertations

Clinical observations and indications in the literature have led us to investigate several models of tumors. For example, it has been shown that a tumor has the ability to send out anti-growth factors, or inhibitors, to keep its remote metastases from growing. Thus, we model the depleting effect of such a growth inhibitor after the removal of the primary tumor (thus removing the source) as a function of time t and distance from the original tumor r.

It has also been shown clinically that oxygen and glucose are nutrients critical to the survival and growth of tumors. Thus, we model …

Haemolytic Uraemic Syndrome In Childhood: An Experience Of 7 Years At The Aga Khan University, S H. Ibrahim, Z A. Bhutta, I A. Khan

Department of Paediatrics and Child Health

We reviewed the case records of all children admitted to the Aga Khan University Hospital (AKUH) with a diagnosis of Haemolytic Uremic Syndrome (HUS) over a 7 year period (July, 1988-June, 1995). A total of 33 patients were admitted to the Pediatric ward at (AKUH) with a median age of 16 months (range 4 months-9 years). 97% cases identified were of the classic variety and no familial case was identified. The mean duration of illness was 27 days, 39% had an illness > 28 days. Diarrhoea and prior antibiotic used was in 97% patients. Oliguria at admission was seen in 52.5% …

Mitochondrial Myopathy With Atypical Subacute Presentation, Oren Cohen, Israel Steiner, Zohar Argov, Avi Ashkenazi, Judith Diment, Ann Saada, Yaron River

Department of Neurology Faculty Papers

Mitochondrial myopathies usually have a chronic course of progressive limb weakness, exercise induced myalgia without muscle tenderness, and normal or only mildly raised serum creatine kinase. Acute or subacute presentation or exacerbation of nervous system signs is common in Leber's hereditary optic neuropathy (LHON) and in mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), but has not been reported for muscle in mitochondrial diseases. We describe a patient who presented with rapidly progressive, subacute muscle weakness due to a mitochondrial disorder.