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Clear Cell Papillary Cystadenoma Of Epididymis, A Mimic Of Metastatic Renal Cell Carcinoma, Nausheen Yaqoob, Aamir Ahsan, Zubair Ahmad, Ambreen Nasir Khan

Department of Pathology and Laboratory Medicine

We discuss a case of 25 year old male who was evaluated for primary infertility following marriage. He had no previous history of urogenital complaints or abnormalities. In fact, his past medical history was unremarkable. On examination epididymal masses were found. Semen analysis showed azoospermia. Right epididymal mass was surgically excised. Histopathology showed an epididymal neoplasm composed of simple and complex papillary processes lining and filling the ducts. The tumor cells were clear and positive for cytoplasmic glycogen. Immunohistochemistry was also supportive. Diagnosis of clear cell papillary cystedenoma was made based on histopathological and immunohistochemical features.

Chylopericardium--A Rare Complication After Ventricular Septal Defect Repair, Saqib A Gowani, Ameer A Khowaja, Asmatullah Khan, Saulat H Fatimi

Section of Cardiothoracic Surgery

Chylopericardium is a rare complication of cardiac surgery. It may be caused by a lesion in the thoracic duct or its tributaries or by thrombosis in the confluence of the jugular and left subclavian veins, obstructing the drainage of the thoracic duct. The treatment may be conservative or surgical, depending on the duration and on the volume of the effusion. We report the case of a 1 1/2 year-old male, who, in the late postoperative period of VSD repair, was hospitalized with low-grade fever and breathlessness for one week due to the presence of chylopericardium. The clinical findings and treatment …

The Effect Of Acute Resistance Training On Resting Metabolic Rate In Men, Steven William Ball

Masters Theses

The purpose of this study was to investigate the effect of different frequencies of resistance training on an individual's resting metabolic rate (RMR). Six healthy males between the ages of 18 and 35 participated in two separate trials. The first trial involved two full-body resistance training bouts, 48 hours apart with RMR measurements pre- and post-bout and a RMR measurement 24 hours following each. The second trial consisted of four split-body resistance training bouts on four consecutive mornings with RMR measurements pre- and post-bout each morning with a fifth morning for one final RMR measurement, 24 hours after the final …

Intracytoplasmic Sperm Injection Outcome Using Ejaculated Sperm And Retrieved Sperm In Azoospermic Men., Tahira Naru, M. Nasir Sulaiman, Atiya Kidwai, M. Hammad Ather, Sana Waqar, Saadia Virk, Javed H Rizvi

Department of Obstetrics & Gynaecology

Introduction:We aimed to determine pregnancy and miscarriage rates following intracytoplasmic sperm injection (ICSI) cycles using retrieved epididymal and testicular sperm in azoospermic men and ejaculated sperm in oligospermic and normospermic men. Materials And
Methods: This retrospective study was carried out on 517 couples who underwent ICSI. They included 96 couples with azoospermia and 421 with oligospermia or normal sperm count in the male partner. Of the men with azoospermia, 69 underwent percutaneous epididymal aspiration (PESA) and 47 underwent testicular sperm extraction (TESE). In the 421 men with oligospermia or normal sperm count, ejaculated sperm was used for ICSI. The …

Frequency Of Various Types Of Headaches Inpostgraduate Medical Students Of A Tertiary Care Hospital, Sidra Aurangzeb, Muhammad Tariq, Ayesha Gul, Mehwish Hameed

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Seasonal Variation And Sex Distribution Inpatients With Guillain-Barre Syndrome, Mohsin Zaheer, Muhammad Naeem, Muhammad Nasrullah

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Hyperacute Extradural Hematoma Mimickingacute Subdural Hematoma, Amit Agrawal

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurosurgery, Manzar Hussain

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

An Audit Of The Quality Of Care Indicators For The Management Of Diabetes In Family Practice Clinics In Karachi, Pakistan, Raheem H Dhanani, Mohammad Mustafa Qureshi, Ali Khan Khuwaja, Badar Sabir Ali, Riaz Qureshi

Department of Family Medicine

BACKGROUND: Management of diabetes is a painstaking and careful approach. This study was aimed to evaluate the quality of care for the management of diabetes provided by family practitioners to their patients having diabetes. This is a retrospective audit of medical records conducted in a tertiary care teaching hospital of private sector in Karachi for one month.

METHODS: For this study, 150 medical records of patients with type 2 diabetes that visited family practice clinics for their diabetes care were examined. A total of 88 patient's medical records were selected and analyzed who attended the studied clinics for at least …

Chediak-Higashi Syndrome, Emaduddin Siddiqui, Shaheena Hanif

Department of Emergency Medicine

Chediak Higashi Syndrome is a rare inherited autosomal recessive disorder of immune system. Susceptibility to infection due to phagocyte dysfunction ranges from recurrent skin infection to over whelming fatal systemic infection. A five years old male child was admitted on 31st March 2006 with the complaints of pallor, fever & ear discharge for 6 month. He was treated by several medications but had temporary relief. The ear discharge was bilateral, foul smelling and of yellowish color. Past history was significant with episodes of abscess involving the different parts of body. Myeloid precursors shows giant, purple stained granules mainly in metamyelocytes, …

Knowledge About Osteoporosis Among Healthy Women Attending A Tertiary Care Hospital, Mehmood Riaz, Naushad Abid, Muhammad Junaid Patel, M. Tariq, Muhammad Shoaib Khan, Lubna Zuberi

Section of Internal Medicine

INTRODUCTION: To determinate the knowledge on osteoporosis-risk factors and disease in three age groups of Pakistani women.METHODS: In this exploratory cross-sectional study, an osteoporosis knowledge assessment questionnaire (OKAT) was used to collect data and it was delivered through a face-to-face interview. Questions were asked about symptoms of osteoporosis, knowledge of risk factors, preventive factors and treatment. A convenience sample (n =320) comprising of three groups of healthy women aged 25-35 years, 36-45 years, and over 45 years was taken. The scoring range was 0 to 20. Among-group comparisions of means were analyzed by two-way ANOVA. To determine the overall influence …

Disruption Of C-Jun Reduces Cellular Migration And Invasion Through Inhibition Of C-Src And Hyperactivation Of Rock Ii Kinase., Xuanmao Jiao, Sanjay Katiyar, Manran Liu, Susette C Mueller, Michael P. Lisanti, Anping Li, Timothy G Pestell, Kongming Wu, Xiaoming Ju, Zhiping Li, Erwin F Wagner, Tatsuo Takeya, Chenguang Wang, Richard G Pestell

Kimmel Cancer Center Faculty Papers

The spread of metastatic tumors to different organs is associated with poor prognosis. The metastatic process requires migration and cellular invasion. The protooncogene c-jun encodes the founding member of the activator protein-1 family and is required for cellular proliferation and DNA synthesis in response to oncogenic signals and plays an essential role in chemical carcinogenesis. The role of c-Jun in cellular invasion remains to be defined. Genetic deletion of c-Jun in transgenic mice is embryonic lethal; therefore, transgenic mice encoding a c-Jun gene flanked by LoxP sites (c-jun(f/f)) were used. c-jun gene deletion reduced c-Src expression, hyperactivated ROCK II signaling, …

Factors Influencing In-Hospital Length Of Stay And Mortality In Cancer Patients Suffering From Febrile Neutropenia, Amar Lal, Yasmin Bhurgri, Nida Rizvi, Mohni Virwani, Rasheed Uddin Memon, Wajeeha Saeed, Muhammad Rizwan Sardar, Pawan Kumar, Asim Jamal Shaikh, Salman Adil, Nehal Masood, Mohammad Khurshid

Section of Haematology/Oncology

Introduction: Febrile neutropenia (FN) is a major complication of chemotherapy, costly in terms of morbidity, mortality and associated financial expenditure. The present study was conducted with the goal of highlighting FN as a serious problem in Pakistan, with the longer term objective of improved cancer survival, reduction in length of stay (LOS) in hospital, morbidity, mortality and costs in our existing developing country scenario. Methods: A cross-sectional descriptive study was conducted on Patients, > or =18 years, admitted with FN as a consequence of chemotherapy at a referral hospital in Karachi from 1st September 2006 to 30th April 2007. Results: A …

Excess Adenosine In Murine Penile Erectile Tissues Contributes To Priapism Via A2b Adenosine Receptor Signaling, Tiejuan Mi, Shahrzad Abbasi, Hong Zhang, Karen Uray, Janci L Chunn, Ling Wei Xia, Jose G Molina, Norman W Weisbrodt, Rodney E Kellems, Michael R Blackburn, Yang Xia

Faculty, Staff and Student Publications

Priapism, abnormally prolonged penile erection in the absence of sexual excitation, is associated with ischemia-mediated erectile tissue damage and subsequent erectile dysfunction. It is common among males with sickle cell disease (SCD), and SCD transgenic mice are an accepted model of the disorder. Current strategies to manage priapism suffer from a poor fundamental understanding of the molecular mechanisms underlying the disorder. Here we report that mice lacking adenosine deaminase (ADA), an enzyme necessary for the breakdown of adenosine, displayed unexpected priapic activity. ADA enzyme therapy successfully corrected the priapic activity both in vivo and in vitro, suggesting that it was …

High Prevalence Of Helicobacter Pylori Infections By Multiple Strains In Patients With Dyspepsia From A Developing Country, Shahab Abid, Javed Yakoob, Wasim Jafri, Khalid Mumtaz, Nida Jafri, Z Abbas, Syed H Shah, Saeed Hamid, Rashida Ahmed

Section of Gastroenterology

No abstract provided.

Obstetric Fistula In Mali, Chandler O’Connell

Independent Study Project (ISP) Collection

Obstetric fistula is arguably the most devastating result of childbirth complications, aside from maternal and neonatal mortality, the latter of which almost always occurs during deliveries which result in fistula. Defined as a hole in the birth canal, obstetric fistula is generally caused by prolonged obstructed labor in the absence of prompt medical intervention.20 This injury results in chronic incontinence through the vagina as well as many other secondary health consequences.33 Additionally, it is impossible to measure the extensive social and psychological burdens suffered by women because of this affliction. Despite the fact that obstetric fistula is both preventable and …

Pediatric Safety And Quality, Susan R. Lacey, Janis B. Smith, Karen Cox

Manuscripts, Articles, Book Chapters and Other Papers

Excerpt

Pediatric care is complex due to developmental and dependency issues associated with children. How these factors impact the specific processes of care is an area of science in which little is known. We are only beginning to understand the relationship between nurse staffing and adverse events in hospitalized children; effects that may be compounded by inadequate numbers of pediatric nurses. Throughout health care providing safe and high quality patient care continues to provide significant challenges. Efforts to improve the safety and quality of care are resource intensive and take continued commitment not only by those who deliver care, but …

Metastatic Disease To The Pancreas And Spleen, Shayna L. Showalter, Eric Hager, Charles J. Yeo

Department of Surgery Faculty Papers

Isolated metastases to the pancreas and spleen are a rare occurrence. When they are diagnosed, pancreatic metastases are most often from renal cell carcinoma, lung cancer, and breast cancer. The most common source of splenic metastases is gynecological in origin; the overwhelming majority is ovarian. If extensive staging studies reveal these metastases to be isolated, then curative resection may be warranted. This review will demonstrate that long-term survival may be achieved in patients with isolated metastases and a prolonged disease-free interval.

Effectiveness Of Assigning Bi-Rads Category-3 To Breast Lesion With Respect To Follow-Up, Imrana Masroor

Department of Radiology

OBJECTIVE: To determine the effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up.STUDY DESIGN: A cohort study.

PLACE AND DURATION OF STUDY: Radiology Department, the Aga Khan University Hospital, Karachi, from January 2002 to December 2004.

PATIENTS AND METHODS: Women undergoing X-ray mammography and assigned BI-RADS category-3 and recommended short-term (6-monthly) follow-up were included. Out of these, 44 patients were lost to follow-up and were excluded from the study. The lesions that remained stable after short-term follow-up were recommended routine (annual) follow-up. Needle localization and open surgical biopsy was performed, if the lesion progressed or calcifications increased …

Practice Of Use Of Antiemetic In Patients For Laparoscopic Gynaecological Surgery And Its Impact On The Early (1st Two Hrs) Postoperative Period, Samina Ismail

Department of Anaesthesia

There is no agreed technique for minimizing PONV (Postoperative Nausea and Vomiting) although some techniques are associated with low rate. Best practice involves identifying high risk patients and surgeries and use of prophylactic antiemetic where appropriate. Laparoscopic gynaecological surgery has high incidence of PONV (54-92%). An audit on the practice of antiemetic use in diagnostic laparoscopic gynaecological surgery was done in the department of anaesthesia of Aga Khan University Hospital from 1st January to 30th June 2006. We included all the patients scheduled for this procedure lasting less than 90 minutes. Anaesthetist involved in the audit identified the patient falling …

An Assessment Of An Education Intervention On Youth Sports Coaches Knowledge Of Concussions, Heidi Elizabeth Brigham

Human Movement Studies & Special Education Theses & Dissertations

Research has shown that sport related concussions are occurring at high rates across the United States. Research has also shown that there are many misconceptions among youth sports coaches regarding concussions. Therefore the purpose of this study was to determine the effects of an educational intervention on the knowledge of concussion recognition, management and prevention for youth sports coaches. A secondary purpose was to compare various relationships between demographic characteristics and the concussion knowledge assessment scores. A twenty-one question multiple choice assessment and 16 option symptom recognition checklist was utilized to assess concussion knowledge prior to and following an educational …

Investigation Of A Validation Technique For The Registration Of 3d Points Directly To Subjects With Pectus Excavatum, Taryn Tacosa Cuper

Computational Modeling & Simulation Engineering Theses & Dissertations

Pectus excavatum (PE) is a congenital deformity that results in a "caved in" appearance of the chest wall. The cause of this condition is unknown, but research suggests that an in vivo investigation of the biomechanical properties of the costal cartilages of subjects with PE may offer insight. Force and deflection measurements are proposed as a way to obtain this data; however, accurate location of cartilage from the skin level would be required for such an effort. Given the multiple potential sources of error with this process, a validation procedure to ensure the appropriateness of the findings must be developed; …

The Application Of Innovative High-Throughput Techniques To Serum Biomarker Discovery, Izabela Debkiewicz Karbassi

Theses and Dissertations in Biomedical Sciences

Time-of-flight mass spectrometry continues to evolve as a promising technique for serum protein expression profiling and biomarker discovery. As seen in our initial SELDI-TOF MS and MALDI-TOF MS profiling study of serum for the assessment of breast cancer risk, many profiling strategies typically employ single chemical affinity beads or surfaces to decrease sample complexity of dynamic fluids like serum. However, most proteins, captured on a particular surface or bead, are not resolved in the lower mass range where mass spectrometers are most effective. To this end we have designed an expression profiling workflow that utilizes immobilized trypsin paramagnetic beads in …

Cannabinoids: A Novel Treatment Strategy For Retinal Neurodegenerative Disorders, Sandeep Samudre

Theses and Dissertations in Biomedical Sciences

Synthetic and naturally occurring cannabinoids are known to decrease intraocular pressure (IOP). Glaucomatous damage to the retina and optic nerve progresses even after therapy to maintain normal intraocular pressure (IOP). Topical application of cannabinoids decreases IOP while not affecting blood pressure or heart rate. Based upon their effects on other tissues, we hypothesize that these analogs reduce IOP and may also confer direct neuroprotective effects on the retina, possibly via CB1 and/or CB2 receptors. The purpose of this study is to determine if the newly synthesized CB agonists, lipid soluble O-1812 (CB 1), and water soluble O-2545 (CB 1

The …

Health State Valuation In Mild To Moderate Cognitive Impairment: Feasibility Of Computer-Based, Direct Patient Utility Assessment, Neal V. Dawson, Mendel E. Singer, Marian B. Patterson, Susie A. Sami, Iahn Gonsenhouser, Heather A. Lindstrom, Kathleen A. Smyth, Melissa Barber Butson, Peter J. Whitehouse

Faculty Scholarship

Background. Most patients with dementia will, at some point, need a proxy health care decision maker. It is unknown whether persons with various degrees of cognitive impairment can reliably report their health-related preferences. Methods. The authors performed health state valuations (HSVs) of current and hypothetical future health states on 47 pairs of patients with mild to moderate cognitive impairment and their caregivers using computer-based standard gamble, time tradeoff, and rating scale techniques. Results. Patients' mean (SD) age was 74.6 (9.3) years. About half of the patients were women (48%), as were most caregivers (73%), who were on average younger (mean …

Gastric Juice For The Diagnosis Of H Pylori Infection In Patients On Proton Pump Inhibitors, Javed Yakoob, Shahid Rasool, Z Abbas, Wasim Jafri, Shahab Abid, Muhammad Islam, Zubair Ahmad

Section of Gastroenterology

Aim:To determine the efficacy of gastric juice polymerase chain reaction (PCR) for the detection of H pylori infection in comparison with histology and gastric antral biopsy PCR in Patients on a proton pump inhibitor (PPI).

Methods:

Eighty-five consecutive Patients with dyspeptic symptoms were enrolled. Gastric biopsies for histology, PCR and gastric juice were collected at endoscopy for PCR of the H pylori urease C gene (ure C). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive and negative likelihood ratio for PCR of gastric juice for the H pylori ure C gene was compared to histology …

Basis For Treatment Of Tuberculosis Among Hiv-Infected Patients In Tanzania: The Role Of Chest X-Ray And Sputum Culture, Muhammad Bakari, Robert D. Arbeit, Lillian Mtei, Johnson Lyimo, Richard Waddell, Mecky Matee, Bernard F. Cole, Susan Tvaroha

Dartmouth Scholarship

Active tuberculosis (TB) is common among HIV-infected persons living in tuberculosis endemic countries, and screening for tuberculosis (TB) is recommended routinely. We sought to determine the role of chest x-ray and sputum culture in the decision to treat for presumptive TB using active case finding in a large cohort of HIV-infected patients. Ambulatory HIV-positive subjects with CD4 counts ≥ 200/mm3 entering a Phase III TB vaccine study in Tanzania were screened for TB with a physical examination, standard interview, CD4 count, chest x-ray (CXR), blood culture for TB, and three sputum samples for acid fast bacillus (AFB) smear and culture.

Renin Inhibition Reduces Hypercholesterolemia-Induced Atherosclerosis In Mice, Hong Lu, Debra L. Rateri, David L. Feldman, Richard Charnigo, Akiyoshi Fukamizu, Junji Ishida, Elizabeth Grace Oesterling, Lisa A. Cassis, Alan Daugherty

Saha Cardiovascular Research Center Faculty Publications

The role of the renin angiotensin system (RAS) in atherosclerosis is complex because of the involvement of multiple peptides and receptors. Renin is the rate-limiting enzyme in the production of all angiotensin peptides. To determine the effects of renin inhibition on atherosclerosis, we administered the novel renin inhibitor aliskiren over a broad dose range to fat-fed LDL receptor-deficient (Ldlr^-/-) mice. Renin inhibition resulted in striking reductions of atherosclerotic lesion size in both the aortic arch and the root. Subsequent studies demonstrated that cultured macrophages expressed all components of the RAS. To determine the role of macrophage-derived angiotensin in …

Medical Education Digest, Vol. 10 No. 2 (March/April 2008), Nova Southeastern University

Medical Education Digest

No abstract provided.

A Technological Approach To Reaching A Hidden Population Of Problem Drinkers., Daniel Z Lieberman, Suena W Huang

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: The most common obstacle to the treatment of individuals with drinking problems is that most do not seek treatment. This study compared a group of treatment-seeking patients with users of an alcohol-evaluation Web site to determine whether an Internet application could reach a population of problem drinkers who are distinct from those served by currently available forms of care.

METHODS: An open-source application was developed that was modeled on the Drinker's Check-Up, which has been shown to increase motivation for behavior change while presenting itself as a nonthreatening evaluation. To recruit non-treatment seekers, the program was offered as a …