Digital Commons Network^™

The Prevalence Of Malaria And Assessment Of The Uptake Of Malaria Prevention Measures In Blood Donors In Two Regional Blood Transfusion Centres In Kenya, Valerie Magutu

Master of Medicine in Clinical Pathology

Transfusion transmitted malaria is one of the most common transfusion transmissible infections and is a threat to blood safety and malaria control in Sub-Saharan African countries where malaria is endemic. The majority of healthy adults living in malaria endemic areas have some degree of immunity to the disease and an asymptomatic low-level parasitaemia is known to exist in a subset of this population. Blood donors recruited from the population are screened using a donor-selection criteria that includes age, weight, self-declared well-being and measurement of vital signs but not history of recent malaria infection or treatment. The Kenya National Blood Transfusion …

Beta-Alanine Suppresses Malignant Breast Epithelial Cell Aggressiveness Through Alterations In Metabolism And Cellular Acidity In Vitro, Roger A. Vaughan, Nicholas P. Gannon, Randi Garcia-Smith, Yamhilette Licon-Munoz, Miguel A. Barberena, Marco Bisoffi, Kristina A. Trujillo

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Background: Deregulated energetics is a property of most cancer cells. This phenomenon, known as the Warburg Effect or aerobic glycolysis, is characterized by increased glucose uptake, lactate export and extracellular acidification, even in the presence of oxygen. beta-alanine is a non-essential amino acid that has previously been shown to be metabolized into carnosine, which functions as an intracellular buffer. Because of this buffering capacity, we investigated the effects of beta-alanine on the metabolic cancerous phenotype.

Methods: Non-malignant MCF-10a and malignant MCF-7 breast epithelial cells were treated with beta-alanine at 100 mM for 24 hours. Aerobic glycolysis was quantified …

Psychosocial Factors Associated With Exclusive Breastfeeding Among Pregnant Women On Follow Up In A Tertiary Maternity Hospital, Cornelia Akinyi Ochola

Master of Medicine in Paediatrics and Child Health

Introduction: Exclusive breastfeeding during the first six months of life is the ideal form of infant feeding. Health benefits of exclusive breastfeeding to infant and mother are well documented in literature. Despite this, the rate of exclusive breastfeeding in the first six months of infants‘ life in Kenya remains low. National nutrition strategy for maternal, infant and young child has set its 2017 target for exclusive breastfeeding at 80% from 32%. To achieve this target, new strategies are needed to complement current exclusive breastfeeding initiatives. Application of theory of planned behaviour model was used to determine the psychosocial factors associated …

Pain Scores Among Ed Patients: Correlation With Desire For Pain Medication, Catherine A. Marco, Megan Mcgervey, Joan Gekonde, Caitlin Martin

Emergency Medicine Faculty Publications

Introduction: Pain has been identified as the most common reason for Emergency Department (ED) visits. The verbal numeric rating pain scale (VNRS) is commonly used to assess pain in the ED. This study was undertaken to determine whether VNRS pain scores correlate with desire for pain medication among ED patients.

Methods: In this prospective survey study, eligible patients included Emergency Department patients over 18 with painful conditions. The primary outcome measures included self-reported VNRS, ED diagnosis, number of ED visits and number of ED admissions within the past year, and the self-reported desire for pain medication.

Results: Among 482 participants …

One Year Symptom Severity And Health-Related Quality Of Life Changes Among Patients Undergoing Uterine Fibroid Embolisation, Charles Muriuki Mariara

Master of Medicine in Obstetrics and Gynecology

Background: The main aim of treatment of symptomatic fibroids by various modalities including uterine fibroid embolisation is to alleviate symptoms and ultimately improve the quality of life. The efficacy of this modality of treatment in women with significant fibroid burden and large uterine volumes is not clear. Objective: To determine the change in symptom severity and health-related quality of life among patients who have undergone uterine fibroid embolisation for treatment of symptomatic uterine fibroids. Setting: Aga Khan University Hospital, Nairobi Methods: A prospective before and after study (observational) of patients undergoing uterine fibroid embolisation. Prior to embolisation, study participants underwent …

The Incidence Of Early Upper Extremity Disability After Axillary Surgery In Patients With Early Breast Cancer, Karen Mbaabu

Master of Medicine in General Surgery

Background: The treatment of early breast cancer includes surgical removal of the tumor as well as evaluation of the axillary lymph node status. Axillary lymph node surgery, both sentinel lymph node biopsy and axillary lymph node dissection, is associated with upper arm morbidity that has been relatively understudied. The impact of this upper arm limitation has a direct effect on the patients’ quality of life. Determining the degree to which our patients experience this disability will enable the breast cancer unit to develop a prospective surveillance rehabilitative program. Objectives: The objectives of the study were to determine the occurrence of …

Frequency Of Dentofacial Asymmetries: A Cross-Sectional Study On Orthodontic Patients, Nita Kumari Bhateja, Mubassar Fida, Attiya Shaikh

Section of Dental-Oral Maxillofacial Surgery

Background: Correction of orthodontic asymmetries is crucial to achieve functional occlusion, aesthetics and stability of post orthodontic treatment results. To date valid frequency data of dentofacial asymmetries in Pakistani orthodontic patients do not exist to document orthodontic treatment need. The objectives of this study were to determine frequency of dento-facial asymmetries, severity of dental asymmetries and to determine difference in frequency of dentofacial asymmetries in mixed and permanent dentition.
Methods: The sample of this cross-sectional study comprised of 280 patients (177 females and 103 males) with no history of previous orthodontic treatment having no craniofacial anomalies. Dento-facial asymmetries were assessed …

Reducing Unsafe Menstrual Regulation Through Medication In Bangladesh, Ubaidur Rob, Ismat Ara Hena, Nargis Sultana, Md. Irfan Hossain, Reena Yasmin, Tapash Ranjan Das, Farid Uddin Ahmed

Reproductive Health

The Population Council and Marie Stopes Bangladesh, in collaboration with the Directorate General of Family Planning and with funding from the World Health Organization, tested the feasibility of introducing menstrual regulation with medication (MRM) in Bangladesh and assessed the acceptability of providing MRM using the combination drug regimen mifepristone and misoprostol in urban and rural public health facilities. As reported in this policy brief, the study demonstrates that it is feasible and safe to introduce MRM in rural and urban public health facilities. Given the choice, almost two-thirds of women preferred MRM to manual vacuum aspiration and women receiving MRM …

Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

Dans le cadre du programme de recherche « Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) », le Population Council a élaboré un Rapport du Profil Pays pour comprendre les grossesses non désirées au Sénégal. Ils ont mené une revue de la littérature, analysé des données d'enquêtes disponibles, et a mené des entretiens pour discuter plus en détail de certains aspects avec quelques parties prenantes clés. Le Profil Pays a été discuté lors d’un atelier de deux jours à Dakar regroupant les principaux acteurs du gouvernement aux niveaux central et régional, des organisations non-gouvernementales, et des acteurs de la …

Understanding Unintended Pregnancy In Senegal: Country Profile Report, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

As part of the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) research program, the Population Council has developed a Country Profile Report to understand unwanted pregnancies in Senegal. The Population Council conducted a literature review, analyzed available survey data, and conducted interviews to discuss some aspects in more detail with a number of key stakeholders. The Country Profile was discussed at a two-day workshop in Dakar bringing together key government actors at the central and regional levels, nongovernmental organizations, and civil society actors. The report is composed of six chapters, summarized in this evidence brief.

La Planification Familiale Postpartum Au Burkina Faso - Résumé En Français, Step Up Research Programme Consortium

Reproductive Health

Ce résumé décrit une étude sur la planification familiale post-partum (PFPP) au Burkina Faso. L’étude avait pour but: de donner un aperçu de la disponibilité et la qualité des services prénatals, du post-partum, et de planification familiale au niveau des soins primaires, et d’évaluer la mesure dans laquelle ils fournissent des services efficaces de PFPP; d’évaluer l'accessibilité des services PFPP; d’explorer l’effet de facteurs sociaux, économiques, et culturels sur la demande et l'adoption de la PFPP; d’estimer l’impact, la pertinence, et la mise en œuvre de la politique nationale et des protocoles cliniques par rapport à la PFPP; et d’identifier …

International Seminar On Promoting Postpartum And Post-Abortion Family Planning: Challenges And Opportunities, Iussp Scientific Panel On Reproductive Health

Reproductive Health

The IUSSP Scientific Panel on Reproductive Health, in collaboration with the Population Council, India, and the Department of Reproductive Health and Research, World Health Organization held a seminar on “Promoting postpartum and post-abortion family planning: Challenges and opportunities” in Cochin, India, November 2014. The seminar brought together 24 scientists, policymakers, and program managers to present and discuss a range of issues relating to postpartum and post-abortion family planning. This report summarizes the papers presented at the seminar which sought to answer several key questions pertaining to postpartum and post-abortion contraception. Several conclusions drawn from the evidence are presented and research …

Unintended Pregnancy And Abortion In India: Country Profile Report, Mary Philip Sebastian, M.E. Khan, Daliya Sebastian

Reproductive Health

A review of literature and analysis of large surveys were carried out with funding from the STEP UP consortium led by Population Council to build a coherent body of robust research-based evidence on the situation in India in the context of unmet need for family planning (FP) and safe abortion services. The study found that there is insufficient training of different cadres of health staff in the public health system on abortion provision, post-abortion care, FP counseling of young couples, emergency contraception, and IUD insertion/removal. Despite service delivery guidelines in India expecting providers to provide FP counseling during antenatal visits, …

Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew

Reproductive Health

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; …

Postpartum Family Planning In Burkina Faso, Marina Daniele

Reproductive Health

This is a formative study aiming to identify the main barriers to the provision and uptake of quality postpartum family planning (PPFP) services at the supply, access, demand, and policy levels in Burkina Faso. This study reveals that there are substantial shortfalls in the availability of quality PPFP at all these levels. Most of the difficulties observed in the provision of PPFP services are due to the failure to translate largely sound policies and guidelines into practice. This study contributes to identifying priority areas and makes recommendations for improvement in order to respond to unmet need for family planning in …

Breast Cancer Survivorship In African American Women, Michelle Arda Mollica

MUSC Theses and Dissertations

With advances in screening, diagnostic capabilities, and treatments, the amount of breast cancer survivors continues to grow. African American (AA) breast cancer survivors (BCS) are a particularly vulnerable group, who experience persistent disparities in outcomes, information, and support post primary cancer treatment. Peer navigation (PN) in AA BCS could be one strategy to increase quality of life and follow-up care after treatment, though research on quality of life and PN in this population is limited. This dissertation first examines factors contributing to quality of life in AA BCS, utilizing the Quality of Life Model Applied to Cancer Survivors. Next, the …

Enhancing The Efficacy Of Enzalutamide By Inhibition Of Sphingosine Kinase 2 To Target Inflammation And Tumor Proliferation, Heather Venant

MUSC Theses and Dissertations

Prostate cancer is the second leading cause of cancer death in American men. The interaction of androgen with its receptor (AR) is one of the major pathways that contributes to the progression of prostate cancer. As a result, hormone deprivation is a major strategy for prostate cancer treatment, but the emergence of castration resistant prostate cancer (CRPC) is a major clinical problem. Recently, the novel AR inhibitor, enzalutamide, demonstrated improved survival in men with metastatic CRPC by 4.8 months (13.8 vs 18.4 months in placebo vs treated groups) (18). While these results are encouraging, they also indicate that there is …

Serotonergic Stimulation Of Mitochondrial Biogenesis And Their Cheminformatic Models, Richard Edwin Trager Iii

MUSC Theses and Dissertations

Kidney disease and toxicity is increasingly being tied to mitochondrial dysfunction. Cheminformatic modeling and high-throughput phenotypic screens can discover discrete subsets of selective ligands that correlate with mitochondrial biogenesis (MB) and accelerate recovery from acute kidney injury (AKI). Serotonergic (5-HT) stimulation has been shown to cause MB. Subtype specific ligands for 5-HT1F and 5-HTA/C receptors show increased uncoupled oxygen consumption rate (OCR). Our overall goal, in a screening assay, is to discover small molecules that increase MB to be used as drugs in the treatment of diseases that exhibit mitochondrial dysfunction. To achieve this goal we created pharmacophore models of …

Dual-Specificity Phosphatase-1 Regulates The Inflammatory Milieu In Head And Neck Squamous Cell Carcinoma, Xiaoyi Zhang

MUSC Theses and Dissertations

Head and neck cancer accounts for approximately 6% of diagnosed malignancies in the United States, with an estimated 35,000 incidences and over 7,000 deaths every year. Head and neck squamous cell carcinoma (HNSCC) comprises the majority of head and neck cancers, with a worldwide incidence of more than 500,000 cases. Head and neck cancer patients often present in advanced stages of disease, and despite ongoing research, survival rates remain lower than other more common malignancies. Cytokines and pro-inflammatory factors have been shown to have a critical role in the various steps of malignant transformation, including tumor growth, survival, invasion, angiogenesis, …

The Role Of Gamma-Secretase Impairment And Amyloid Beta Degradation In Alzheimer's Disease Pathogenesis, Robert J. Baranello Jr.

MUSC Theses and Dissertations

Accumulation of the amyloid β (Aβ) protein in the brain as senile plaques is a signature lesion of Alzheimer's disease (AD). The mechanisms of Aβγ accumulation that foster its deposition is a subject of intense study and represent the primary targets for most drug development efforts in the field. As one of the most important neurodegenerative diseases in the world, it is imperative that we continue to move toward efficacious treatment strategies. A number of y-secretase inhibitors (GSIs), such as N-[N-(3,5-Difluorophenacetyl-L-alanyl)]-S-phenylglycine t-butyl ester (DAPT), have been developed with the goal of reducing Aβ to treat AD. Although most studies show …

Comparison Of The Effect Of Two Human Milk Fortifiers On Clinical Outcomes In Premature Infants, Melissa Thoene, Corrine K. Hanson, Elizabeth Lyden, Laura Dugick, Leslie Ruybal, Ann Anderson-Berry

Journal Articles: Nebraska Medicine

The use of human milk fortifiers (HMF) helps to meet the high nutritional requirements of the human milk-fed premature infant. Previously available powdered products have not met the protein requirements of the preterm infant population and many neonatologists add powder protein modulars to help meet protein needs. The use of powdered products is discouraged in neonatal intensive care units (NICU) due to concern for invasive infection. The use of a commercially available acidified liquid product with higher protein content was implemented to address these two concerns. During the course of this implementation, poor growth and clinically significant acidosis of infants …

Weighing The Risks And Benefits Of Radiation Exposure And Diagnostic X-Rays In Children, Leah Costello

Physician Assistant Scholarly Project Posters

The number of X-rays, specifically CT scans, performed on patients in the United States is increasing exponentially every year. Children are at most risk for long term damage from this increase in radiation exposure. This study explores how much risk children are being exposed to and how we can, as practitioners, make informed decisions about when or when not to order CT scans. The purpose of this paper is to provide practitioners the information needed to help patients decide if the long-term risks of cancer from medical radiation outweigh the potential benefit of diagnostic or therapeutic radiation. The review of …

Lyme Disease Outcomes With Immediate, Short Duration Antibiotic Use Versus Delayed, Longer Duration Use, Lori A. Steinley

Physician Assistant Scholarly Project Posters

Lyme disease is the fastest growing vector-borne disease in the United States, according to the Infectious Disease Society of America (IDSA). The guidelines for diagnosis provided by the IDSA include evidence of erythema migrans rash with validation of a positive two-tier serology testing. With no established treatment standards, decreased sensitivity of testing and inconsistency of observing the rash, practitioners following the guidelines may delay treatment of antibiotics. This delay could cause progression of severity of symptoms.

The purpose of this study is to compare implementation and duration time of antibiotics and establish the treatment protocol for best clinical outcomes for …

Prevalence Of Significant Liver Fibrosis In Patients With Hiv Monoinfection Compared To Those With Hiv-Hepatitis B Coinfection As Assessed By Shear Wave Elastography, Samuel Nguku

Master of Medicine in Imaging and Diagnostic Radiology

Background: Liver disease is an emerging management problem in human immunodeficiency virus (HIV) infected patients. The incidence of chronic Hepatitis B infection, which accelerates the progression of chronic liver disease and development of liver fibrosis, is ten times higher in patients with HIV than the general population. Staging of liver fibrosis provides essential information in management of these patients. Objective: To determine the prevalence of significant liver fibrosis in patients with HIV mono-infection versus those with HIV-HBV co-infection as assessed with shear wave elastography (SWE). Methods: This was a cross-sectional study whereby HIV infected patients attending the HIV clinic at …

Incidence And Impact Of Urinary Incontinence, Pain, And Other Comorbidities On Health Related Quality Of Life (Hrqol) For Postpartum Bangladeshi Women, Lori Maria Walton, S. J. M. Ummul Ambia, Bassima Hussein Schbley

Faculty Publications

To investigate the incidence and impact of urinary incontinence (UI) and pain on health related quality of life (HRQOL) for postpartum Bangladeshi women. Methods: Prospective, cross sectional, correlational design (n=94) of postpartum Bangladeshi women, ages 18-44, with history of one or more obstetrical deliveries within the last three years. Subjects completed the Bengali version of the SF-36 and IIQ-7. Results: UI incidence was reported at 45% (n=39/86) total, 44% CS (n=18/41), and 47% (n=21/45) for NVD. IIQ-7 scores and UI presence showed strong correlations in both CS (rho=.729, 84, p<.001) and NVD (rho=.874, 84, p<.001). The highest impact of UI was reported in the CS group. One sample t-test reported significant differences for the sample when compared with the age equivalent norms for the SF-36 domain and component scores (p =.05-.001). Significant differences in HRQOL were reported for women with "pelvic/abdominal pain" and "UI" compared to those without "pain" or without "UI" and strong inverse correlations (rho=.597-.853) were reported for subjects with "pain" on the SF-36 domains (p=.001). The Mixed Birth Mode (MBM) group (n=8) reported UI incidence at 74% (n= 6/8), and pelvic/abdominal pain at 63% (n=5/8). Conclusion: No significant difference was found in UI and HRQOL measures by birth mode. However, pelvic, abdominal pain, and UI impact were found to be significant and inversely correlated to HRQOL. A significant decrease in HRQOL was reported compared to age related norm scores. Future research should address pelvic and abdominal pain and "mixed birth mode" impact on QOL and UI.

The Effects Of Strength Training On Isometric Force Production Symmetry In Recreationally Trained Males, Caleb D. Bazyler, Christopher A. Bailey, Chieh-Ying Chiang, Kimitake Sato, Michael H. Stone

ETSU Faculty Works

Objectives: The purpose of this investigation was to determine what effect a bilateral strength training regimen has on isometric force production symmetry and if changes in force production symmetry can be accounted for by differences in pre-intervention strength levels. Design: Sixteen recreationally trained males (1-RM squat: 146.8 ± 23.0 kg.) were assigned to two groups for the 7-week training intervention: strong (S) and weak (W) based on pre-training squat isometric peak force allometrically scaled (IPFa) at 120° knee angle. Methods: Subjects completed a 7-week training intervention following a block-periodized model and were tested on measures of dynamic (1RM squat) and …

The Relationship Of Force Production Asymmetry And Performance In Athletes Of Different Strength Levels, Christopher A. Bailey, Caleb D. Bazyler, Chieh-Ying Chiang, Kimitake Sato, Michael H. Stone

ETSU Faculty Works

The purpose of this study was to evaluate the relationship between force production asymmetry and performance of athletes with differing strength levels in males and females. Collegiate athletes (n=129) from various sports were ranked according to isometric mid-thigh pull peak force and the top (‘strong’) and bottom (‘weak’) 25% were used for analysis. Symmetry index (SI) scores were calculated and correlated with their respective force-time characteristics using bivariate correlations. For the weaker males, several negative moderate correlations were observed; however, no statistically significant correlations were observed for the females in either group. These findings indicate that force production asymmetry is …

Extending The Indications Of Flow Diversion To Small, Unruptured, Saccular Aneurysms Of The Anterior Circulation., Nohra Chalouhi, Md, Robert M Starke, Steven Yang, Cory D Bovenzi, Stavropoula Tjoumakaris, David Hasan, L. Fernando Gonzalez, Robert H. Rosenwasswer Md, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

BACKGROUND AND PURPOSE: Flow diverters are currently indicated for treatment of large and complex intracranial aneurysms. The purpose of this study was to determine whether the indications of flow diversion can be safely extended to unruptured, small, saccular aneurysms (<10 >mm) of the anterior circulation.

METHODS: Forty patients treated with the pipeline embolization device (PED) were matched in a 1:4 fashion with 160 patients treated with stent-assisted coiling based on patient age, sex, aneurysm location, and aneurysm size. Procedural complications, angiographic results, and clinical outcomes were analyzed and compared.

RESULTS: The rate of periprocedural complications was 5% in the PED …

Treatment Of Chronic Hepatitis D Patients With Pegylated Interferon: A Real-World Experience, Zaigham Abbas, Mohammad S. Memon, Hammad Mithani, Wasim Jafri, Saeed Hamid

Section of Gastroenterology

Background: Published experience of treating chronic hepatitis D patients with pegylated interferon (PEG-IFN)-alpha is limited. The aim of this study was to determine the efficacy of 48 weeks of treatment with PEG-IFN in naive patients outside the clinical trial setting, in the real world.

Methods: Patients with chronic hepatitis D were treated with PEG-IFN. The primary end points were sustained clearance of HDV RNA and normal alanine aminotransferase (ALT) at 24 weeks post-treatment.

Results: The total number of patients treated with PEG-IFN was 104; 91 males, mean age ±SD 30.1 ±10.0 years (range 15-55). Cirrhosis was present in …

Importance Of Bacillithiol In The Oxidative Stress Response Of Staphylococcus Aureus, Ana C. Posada, Stacey L. Kolar, Renata G. Dusi, Patrica Francois

Dartmouth Scholarship

In Staphylococcus aureus, the low-molecular-weight thiol called bacillithiol (BSH), together with cognate S-transferases, is believed to be the counterpart to the glutathione system of other organisms. To explore the physiological role of BSH in S. aureus, we constructed mutants with the deletion of bshA (sa1291), which encodes the glycosyltransferase that catalyzes the first step of BSH biosynthesis, and fosB (sa2124), which encodes a BSH-S-transferase that confers fosfomycin resistance, in several S. aureus strains, including clinical isolates. Mutation of fosB or bshA caused a 16- to 60-fold reduction in fosfomycin resistance in these S. aureus strains. High-pressure liquid chromatography analysis, which …