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Treatment Practices For Degedege, A Locally Recognized Febrile Illness, And Implications For Strategies To Decrease Mortality From Severe Malaria In Bagamoyo District, Tanzania, A.M. Makemba, P.J. Winch, V.M. Makame, G.L. Mehl, Zul Premji, J.N. Minjas, C.J. Shiff

Pathology, East Africa

Malaria remains one of the chief causes of mortality among young children in sub-Saharan Africa. Verbal autopsies for cases of childhood mortality in Bagamoyo District, Tanzania demonstrated that degedege, a locally defined illness of children characterized by fever and convulsions, is frequently treated by traditional healers. To investigate this further, an ethnographic study was carried out in one village that included in-depth interviews with 14 traditional healers and 3 focus groups with parents. Parents and traditional healers were unanimous in their conviction that degedege requires traditional treatments, at least initially, and that these treatments are effective. While traditional healers do …

Vital Signs, Winter 1996, Boonshoft School Of Medicine

Vital Signs

A twenty four 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, alumni profiles, class notes, and more.

Our Hearts Were Once Young And Gay: Health Care Rationing And The Elderly, George P. Smith Ii

Scholarly Articles

Although there exists no rigid guideline delineating society's obligation to provide health care, at a minimum Americans are entitled to an adequate level of care without excessive burdens being placed upon them. Fulfilling this ostensibly simple mandate, however, presents an enormous challenge. The need to allocate limited financial and human resources increasingly clashes with the moral desire to provide health care resources to elder Americans beyond their years of economic productivity. As a result, health care professionals face the difficult task of weighing against society's other priorities the efficiency of distributing limited health care resources to the elderly. This demand …

Moyamoya Disease Of Childhood As A Cause Of Recurrent Cerebral Ischemic Attacks--A Case Report, S Ibrahim, S S. Hyder

Department of Paediatrics and Child Health

No abstract provided.

Allergic Bronchopulmonary Aspergillosis: An Unusual Complication Of Bronchial Asthma, S F. Hussain, J A. Khan, M A. Khan

Section of Pulmonary & Critical Care

Asthma is a common medical problem in Pakistan. Allergic Bronchopulmonary Aspergillosis (ABPA), an immune mediated disease, is an unusual complication of bronchial asthma which can result in bronchiectasis, pulmonary fibrosis, respiratory failure and death. Early diagnosis is important so that with proper therapy permanent lung damage can be prevented. First described in 19521 , ABPA was thought to be a rare disorder, but with increased awareness amongst the physicians and better diagnostic techniques, äases are being recognized more frequently. The clinical features of ABPA (cough, fever, hemoptysis and lung infiltrates) are usually mistaken for pulmonary tuberculosis (TB). We present three …

An Audit On Hospital Management Of Bronchial Asthma, J A. Khan, S Saghir, G Tabassum, S F. Husain

Section of Pulmonary & Critical Care

Medical audit is a new concept in developing countries like Pakistan. We carried out this retrospective study on bronchial asthma. The purpose was to see if care given to patient with asthma meets the accepted international standard or not. During this audit several deficiencies were found. Documentation in notes about signs indicating severity of asthma was very poor. Peak flow recording in the notes was also very deficient. There was no documentation in notes whether inhalers technique of the patients has been checked or not. This audit shows that care given to asthma patients is far from satisfactory and we …

Coexistent Tuberculosis And Carcinoma Of The Colon, M Y. Sheikh, A H. Yousuf, T R. Khalid, M U. Islam, M N. Ahmed

Department of Radiology

No abstract provided.

Vital Signs, Fall 1995, Boonshoft School Of Medicine

Vital Signs

A twenty four 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, alumni profiles, class notes, and more.

A Young Boy With Abdominal Pain, A Jabbar, A Afaq, W Jafri, M Siddiqi, M Ahmed, S Hasan

Section of Gastroenterology

At times, acute diffuse abdominal pain can be a diagnostic dilemma, especially when the symptoms appear to be out of proportion to the findings on physical examination. The case of a young boy with abdominal pain is presented.

Primary Amyloidosis Of Gut Presenting With Dysphagia, Zaigham Abbas, Shahab Abid, Naim -Ur- Rehman, Shahid Pervez

Department of Pathology and Laboratory Medicine

No abstract provided.

Evaluation Of Oral Midazolam As Pre-Medication In Day Care Surgery In Adult Pakistani Patients, N Ahmed, F A. Khan

Department of Anaesthesia

A placebo controlled randomized double blind study was designed to assess the suitability of oral Midazolam as a premedication in day care surgery in adult Pakistani patients. Fifty ASA I and II patients aged between 20-60 years received either Midazolam 7.5 mg or a placebo approximately one hour prior to surgery. Midazolam 7.5 mg produced significant anxiolysis and sedation (p < 0.001) in comparison to placebo after one hour of premedication. There was a significant difference (p < 0.001) in the mean heart rate and blood pressure in both groups after 1 hour of premedication with a lesser rise in blood pressure and heart rate in the Midazolam group. Psychomotor performance assessed by 'n' deletion test was impaired by Midazolam (p < 0.001) and recall of pictures revealed differences (p < 0.05) in the groups at one hour after premedication. However, at four hours after surgery there were no differences in both groups. These findings indicate that rapidly acting oral Midazolam in doses of 7.5 mg provided safe and effective premedication in terms of anxiolysis, sedation, amnesia and psychomotor performance and is suitable for day surgery.

Audit Changes Clinical Practice! Impact On Rate Of Justification Of Hysterectomy Indication, Khalid S. Khan, J H. Rizvi

Department of Obstetrics & Gynaecology

After performing a baseline audit in 1986-89, an ongoing quality assurance process was initiated in January, 1990 and all hysterectomies performed over the next 2 year period were analyzed. Hysterectomy indications were divided into two groups: one in which the uterine specimen was expected to show pathology and another in which no pathology was expected. The hysterectomy was considered justified in the former if the pathology report verified the indication or showed a significant alternate pathology. In the latter, validation criteria showing documentation of certain prerequisite diagnostic procedures performed before reverting to hysterectomy, were used to ascertain justification. The overall …

Identification Of An Idiotypic Peptide Recognized By Autoantibodies In Human Immunodeficiency Virus-1-Infected Individuals, Q. L. Wang, H.-T. Wang, Edwin Blalock, Sybille Müller, Heinz Köhler

Markey Cancer Center Faculty Publications

Antibodies against HIV-1 proteins in HIV-1-infected individuals share a cross-reactive idiotype defined by the monoclonal antiidiotypic antibody 1F7 (5). Using a computer algorithm based on the molecular recognition theory, regions of inverse hydropathy between the variable sequence of 1F7 and human monoclonal anti-HIV-1 antibodies were identified, which are assumed to be involved in idiotype-antiidiotype contacts. A peptide was designed from the proposed contact in the variable heavy chain framework 3-complementarity determining region 3 (FR3-CDR3) of human antibodies and was synthesized. This peptide is recognized by the antiidiotype 1F7 and inhibits the binding of 1F7 to human anti-HIV-1 antibodies which express …

A 55 Year Old Diabetic Presenting With A Rash And Polyneuropathy, S Hyder, H Rasool, H Naqvi, Naila Kayani

Department of Pathology and Laboratory Medicine

No abstract provided.

Method For Inhibiting Angiogenesis With Aurintricarboxylic Acid, Its Analogues Or Salts, Delwood C. Collins, Antonio Gagliardi, Anjan Bhattacharyya

Obstetrics and Genecology Faculty Patents

Aurintricarboxylic acid has potent anti-angiogenic activity and may be used for new therapeutic approaches for diseases of neovascularization including the treatment of solid tumors, diabetic retinopathy and arthritis, among others.

A Call To Action: The Institute Of Medicine Report On Emergency Medical Services For Children., J F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Are Non-Diabetic Women With Abnormal Glucose Screening Test At Increased Risk Of Pre-Eclampsia, Macrosomia And Caesarian Birth?, Khalid S. Khan, Firasat A. Hashmi, J H. Rizvi

Department of Obstetrics & Gynaecology

To determine, in non-diabetic women, the relationship of abnormal glucose screening test, with the incidence of pre-eclampsia, macrosomia and caesarian delivery, from 1988-92, 5646 consecutive women attending antenatal clinic were screened with a glucose challenge test (GCT) on their first visit (usually at 16-20 weeks); those with risk factors i.e., history of unexplained perinatal loss, macrosomia or family member with diabetes and an initial abnormal screening test were rescreened at 28-32 weeks, In 482 cases the GCT was abnormal (plasma glucose value was >140 mg% 2 hours after 75g glucose challenge). Of these, 292 had one or more abnormal critical …

Immune Response To The Carcinoembryonic Antigen In Patients Treated With An Anti-Idiotype Antibody Vaccine, Kenneth A. Foon, Mala Chakraborty, William J. John, Amanda Sherratt, Heinz Köhler, Malaya Bhattacharya-Chatterjee

Markey Cancer Center Faculty Publications

We have generated an IgG1 murine monoclonal anti-idiotype antibody (Ab2) designated 3H1, which mimics a specific epitope on the carcinoembryonic antigen (CEA). Patients with CEA positive tumors are immunologically "tolerant" to CEA. We used 3H1 as a surrogate for CEA for vaccine therapy of 12 patients with advanced colorectal cancer. Each of the patients received a minimum of four intracutaneous injections of aluminum hydroxide precipitated 3H1 at either 1, 2, or 4 mg dosage per injection. 9 of 12 patients demonstrated anti-anti-idiotypic (Ab3) response to 3H1. All nine patients generated specific anti-CEA antibody demonstrated by reactivity with radiolabeled purified CEA; …

Department Of Radiology-Annual Report-July 1, 1994 To June 30, 1995, David C. Levin

Department of Radiology Administrative Documents and Reports

Department of Radiology Annual Report, July 1, 1994 to June 30, 1995. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States. 120 pages.

Ciprofloxacin In Multi-Resistant Infections In Childhood: An Audit, D M. Khan, Z A. Bhutta

Department of Paediatrics and Child Health

Ciprofloxacin is a new orally administrable fluoroquinolones, with considerable efficacy against multiresistant organisms. Its use in the paediatric age group however, is controversial because of the risk of potential articular toxicity. We retrospectively reviewed ciprofloxacin usage over a 32 week periods (June, 1991-September, 1993) in paediatric inpatients at The Aga Khan University Hospital. Ciprofloxacin was used in 21 cases, singly in 11 (52%) and in combination with other antibiotics in a further 10 (48%). The response to therapy was adjudged as 'good' or 'fair' in 13 (62%) cases. Ciprofloxacin was the only sensitive antibiotic in 4 (19%) and resistance to …

Posttraumatic Stress Disorder In Parents Of Traumatic Brain Injury Patients, Carol Farr

Loma Linda University Electronic Theses, Dissertations & Projects

Traumatic Brain Injury (TBI) produces cognitive, behavioral, and affective deficits with resulting problems such as improper social behavior, increased aggression, emotional, personality and characterological changes. The impact upon the survivor, the sibling, as well as the parental subsystem has been well documented in the literature. Post-Traumatic Stress Disorder (PTSD) has been diagnosed in several different types of trauma survivors, although rarely have individual psychological symptoms been studied in parents.

This research examined the possible vulnerability factors that are associated with TBI and their potential influence upon PTSD symptomology. Questionnaires were mailed to 266 parents of TBI patients with a response …

Predicting Intentions Of Physical Therapy Students To Practice Primary Prevention, Sharon Potter Anderson

Loma Linda University Electronic Theses, Dissertations & Projects

Physical therapy (PT) has traditionally been a hands-on, tertiary-care field. Although the American Physical Therapy Association has mandated a broader perspective, little primary prevention is yet being reported in the U. S. An attitude change toward prevention must occur if physical therapists can be expected to become involved in preventive physical therapy. The purpose of this project was to determine predictors of physical therapy student intention to perform primary prevention with a questionnaire based on Ajzen's Theory of Planned Behavior. The theory uses attitude, subjective norm and perceived control to predict intention based on beliefs and strength of beliefs in …

Uhs-Communicator: May/June/July 1995, University Of Health Sciences College Of Osteopathic Medicine, Uhs-Com Alumni Association

Communicator (1991-2012)

Contents: 1995 Commencement -- UHS Foundation Contributors -- Mary Lou Butterworth, D.O. Accepts Position as Acting UHS Foundation President -- Oklahoma City Bombing -- One Graduate's Success: Mary Sue Kendrick, D.O. -- News -- Alumni Association's Corner of the World.

Diagnostic Evaluation Of Pleural Effusion And The Role Of Needle Pleural Biopsy, S F. Hussain, S Mujahid, J A. Khan

Section of Pulmonary & Critical Care

No abstract provided.

Increased Alpha 1(I) Procollagen Gene Expression In Tight Skin (Tsk) Mice Myocardial Fibroblasts Is Due To A Reduced Interaction Of A Negative Regulatory Sequence With Ap-1 Transcription Factor., Neena Philips, Reza I. Bashey, Sergio A. Jimenez

Department of Medicine Faculty Papers

The TSK mouse, a model of fibrosis, displays exaggerated connective tissue accumulation in skin and visceral organs including the heart. To study the mechanisms of myocardial fibrosis in TSK mice, we established several strains of TSK mice myocardial fibroblasts in culture and examined the regulation of collagen gene expression in these cells. These strains displayed increased collagen gene expression in comparison with myocardial fibroblasts established from normal mice. On an average, the TSK myocardial fibroblast cultures showed a 4-fold increase in collagen synthesis and 4.4- and 3.6-fold increases, respectively, in alpha 1(I) and alpha 1(III) collagen mRNA steady state levels. …

Vital Signs, Spring 1995, Boonshoft School Of Medicine

Vital Signs

A twenty four 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, alumni profiles, class notes, and more.

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 1995), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 1995 issue of the Digest of the includes the following articles:

• President's Perspective
• PCOM Leads the Way in GME
• Campaign Passes $3 Million Mark
• Memorial Service Honors Daniel L. Wisely, DO
• PCOM Profile
• Student Achievements
• PCOM Students Awarded Scholarships
• Robert S. Maurer, DO, '62: Caring for the Future
• PCOM: Never UnConventional in the Springl
• POMA Elects Officers
• PCOM Welcomes Five Board Members
• Campus Update
• Class Acts
• In Memoriam
• Coming Events
• Last Chance to Support Golf Classic Ad Book!

Cholera Admissions In Adults 1989-1994: A Hospital Based Study, Z Abbas, S M. Jafri, S Abid, H Khan

Section of Gastroenterology

In order to gain insight into the distribution of cholera over the years and proportion of monthly admissions under our adult medical services, we scrutinized our records of hospital discharges between 1989 and 1994. Only culture positive cases were included. Each year most of the cases of cholera are admitted between May and November with almost disease free interval from December to April. In 1992 admission rate was 4.24/1000 medical admissions which increased to 12.65 in 1993 and 13.73 in 1994. Though the Vibrio cholerae 01 Ogawa was the major isolate upto May, 1993, Vibrio cholerae non-01 serogroup 0139 dominated …

A Change Of Il-2 And Il-4 Production In Patients With Helicobactor Pylori Infection, X. G. Fan, Javed Yakoob, X. J. Fan, P. W. N. Keeling

Section of Gastroenterology

Helicobactor pylori is the most common cause of gastroduodenal inflammation. However, the exact immune pathogenesis is not fully understood. To look for evidence of the immunological mechanism in H. pylori associated disease, we measured cytokine interleukin-2 (IL-2) and IL-4 levels produced by peripheral blood lymphocytes (PBL) and gastric biopsies in 20 subjects with or without H. pylori infection. H. pylori can stimulate IL-2 and IL-4 production from PBL in H. pylori negative as well as H. pylori positive individuals. The spontaneous IL-2 production by PBL and gastric biopsies was greater (p < 0.0025, <0.001)in H. pylori negative individuals than that in H. pylori infected patients. Increased IL-4 levels from PBL in H. pylori infected patients were found in the presence of H. pylori (p < 0.0025). An increased spontaneous production of IL-4 from gastric biopsies was also observed in H. pylori infected patients (p < 0.025). In conclusion, an enhanced type 2 cytokine production was observed in H. pylori infected patients, which may be responsible for H. pylori chronic infection.

Polyclonal Mycobacterium Avium Infections In Patients With Aids: Variations In Antimicrobial Susceptibilities Of Different Strains Of M. Avium Isolated From The Same Patient., C Fordham Von Reyn, Nicholas J. Jacobs, Robert D. Arbeit, Joe N. Maslow, S Niemczyk

Dartmouth Scholarship

Broth microdilution MICs were determined for pairs of strains isolated from five AIDS patients with polyclonal Mycobacterium avium infection. Four (80%) of the five patients were infected simultaneously with strains having different antimicrobial susceptibility patterns. These findings have implications for the interpretation of susceptibility data in M. avium prophylaxis and treatment trials.