Digital Commons Network^™

Retrospective Review Of The Use Of Swan Ganz Catheters In Our Intensive Care Unit (Icu): A Short Report, Shahla Siddiqui

Department of Anaesthesia

The widespread and often 'misuse' of the Swan Ganz (SG) or Pulmonary artery catheter has often been seen in intensive care patients. The objective of this preliminary review was to observe the trends and possibly formulate an association with outcome of the use of SG catheters as well as to determine the frequency of use and possible complications. The chart review of ten patients was carried out for the months of January and February 2004 in a retrospective manner. The incidence of SG catheter insertion was 12% per month on average. Nine out of 10 patients received the SG catheters …

Effect Of Cytokine Gene Polymorphism On Histological Activity Index, Viral Load And Response To Treatment In Patients With Chronic Hepatitis C Genotype 3, Zaigham Abbas, Tariq Moatter, Akber Hussainy, Wasim Jafri

Section of Gastroenterology

AIM: To investigate the association between cytokine gene polymorphism and disease status in chronic hepatitis C genotype 3 by liver biopsy, ALT, HCV RNA levels and response to treatment.Methods: Patients with chronic hepatitis C genotype 3 were analyzed for single nucleotide polymorphisms of interleukin (IL)-10, IL-1 beta, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta) by polymerase chain reaction using sequence-specific oligonucleotide primers. Liver biopsies were assessed by modified histological activity index (HAI) scoring system using a scale of 0-18 for grading the necro-inflammatory activity and 0-6 for staging the fibrosis. HCV RNA levels were determined by …

Continuous Asl Perfusion Fmri Investigation Of Higher Cognition: Quantification Of Tonic Cbf Changes During Sustained Attention And Working Memory Tasks, Junghoon Kim, John Whyte, Jiongjiong Wang, Hengyi Rao, Kathy Z. Tang, John A. Detre

Department of Rehabilitation Medicine Faculty Papers

Arterial spin labeling (ASL) perfusion fMRI is an emerging method in clinical neuroimaging. Its non-invasiveness, absence of low frequency noise, and ability to quantify the absolute level of cerebral blood flow (CBF) make the method ideal for longitudinal designs or low frequency paradigms. Despite the usefulness in the study of cognitive dysfunctions in clinical populations, perfusion activation studies to date have been conducted for simple sensorimotor paradigms or with single-slice acquisition, mainly due to technical challenges. Using our recently developed amplitude-modulated continuous ASL (CASL) perfusion fMRI protocol, we assessed the feasibility of a higher level cognitive activation study in twelve …

Posterior Longitudinal Ligament Status In Cervical Spine Bilateral Facet Dislocations, John A. Carrino, Geoffrey L. Manton, William B. Morrison, Alex R. Vaccaro, Mark E. Schweitzer, Adam E. Flanders

Department of Orthopaedic Surgery Faculty Papers

Objective: It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status.

Design: Retrospective case series.

Patients: A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between …

Medical Education Digest, Vol. 7 No. 6 (November/December 2005), Nova Southeastern University

Medical Education Digest

No abstract provided.

Antiviral Agents For Pregnant Women With Genital Herpes, Christopher Wenner Md

Articles

Clinical Question

Do antiviral medications prevent perinatal transmission of genital herpes to neonates?

Evidence-Based Answer

There is no evidence that the use of antiviral agents in women who are pregnant and have a history of genital herpes prevents perinatal transmission of herpes simplex virus (HSV) to neonates. [Strength of recommendation: A, based on multiple systematic reviews] However, treatment with antivirals during the last month of pregnancy does reduce the rate of HSV outbreaks in pregnant women and the resultant need for cesarean delivery. [Strength of recommendation: A, based on multiple systematic reviews]

Oncolog, Volume 50, Number 11, November 2005, Vickie J. Williams, Karen Stuyck, James D. Cox Md

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

• Cancer in Young Adults
• Do Mind/Body Techniques Work?
• House Call: Tapping into Local and Online Resources
• Phytoestrogen Consumption May Reduce Lung Cancer Risk
• DiaLog: Radiation Therapy and Lung Cancer, by James D. Cox, MD, Professor and Head of the Division of Radiation Oncology

Hepatitis B And C: Prevalence And Social Factors Associated With, Wasim Jafri, Nida Jafri, Javed Yakoob, Muhammad Islam, Sfa Tirmizi, T. Jafar, S Akhtar, Saeed Hamid, Shahab Abid, Syed H Shah, Shaikh Qamaruddin Nizami

Section of Gastroenterology

No abstract provided.

Giardiasis In Patients With Dyspeptic Symptoms, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Saeed Hamid, Hasnain Ali Shah, Lubna Rizvi, Muhammad Islam, Hizbullah Shaikh

Section of Gastroenterology

AIM:

To investigate the prevalence of giardiasis in patients with dyspeptic symptoms.

METHODS:

Clinical records of consecutive patients who attended Gastroenterology Department at Aga Khan University Hospital from January 2000 to June 2003 and had esophagogastroduodenoscopy (EGD) with duodenal biopsies and international classification of diseases 9th revision with clinical modifications (ICD-9-CM) coded with giardiasis were studied.

RESULTS:

Two hundred and twenty patients fulfilled the above criteria. There were 44% (96/220) patients who were giardiasis positive, 72% (69/96) of them were males and 28% (27/96) of them were females. There were 65% (81/124) males and 35% (43/124) females who were giardiasis …

Colorectal Carcinoma, Extent And Spread In Our Population. Resection Specimens Give Valuable Information, Zubair Ahmad, Rooma Idrees, Rashid Ahmed, Naila Kayani, Shahid Pervez, Sheema Habibul Hasan

Department of Pathology and Laboratory Medicine

Objective: To acquire information about the extent and spread of colorectal carcinomas in our population by examining colon and colorectum resection specimens received.

Methods: All colon and colorectum resection specimens received in the section of Histopathology, Aga Khan University Hospital, Karachi from January 1, 2003 to July 31, 2003 were included in the study.

Results: Eighty five resection specimens were received during the study period, 69.41% patients were males, and 30.59% were females. The mean age for males was 49 years and for females 48 years. Tumor location was in left colon (58.82%), and in right colon (41.18%). The average …

Dural Metastases Presenting As An Extradural Hematoma: A Rare Presentation, Muhammad Shahzad Shamim, Muhammad Ehsan Bari, S. Ather Enam

Department of Surgery Docs

Abstract

We report a case of an elderly man who presented with hemiparesis and plain CT scan findings highly suggestive of an extradural hematoma as the underlying cause. This patient was later found to have dural metastases secondary to bronchogenic carcinoma. Dural metastases are rare, usually presenting as dural mass, but may also present as chronic subdural or extradural hematoma on non contrast CT scan, leading to an erroneous diagnosis in the unsuspecting.

When Red Lights Look Yellow, Joanne M. Wood, David A. Atchison, Alex Chaparro

Publications

Purpose. Red signals are typically used to signify danger. This study was conducted to investigate a situation identified by train drivers in which red signals appear yellow when viewed at long distances (∼900 m) through progressive-addition lenses.

Methods. A laboratory study was conducted to investigate the effects of defocus, target size, ambient illumination, and surround characteristics on the extent of the color misperception of train signals by nine visually normal participants. The data from the laboratory study were validated in a field study by measuring the amounts of defocus and the distances at which the misperception of the color of …

Surgical Emphysema In The Neck As A Result Of A Dental Procedure, Moghira Iqbal, Mubasher Ikram, Farhan Raza, Ninette Banday

Section of Otolaryngology, Head & Neck Surgery

We report the development of subcutaneous emphysema in a middle-aged woman that occurred several hours after she had undergone a dental restoration procedure. The patient presented to the emergency department, and she was admitted for observation and prophylactic antibiotic coverage. She recovered in 3 days without further intervention and was discharged.

Role Of Rapid Urease Test And Histopathology In The Diagnosis Of Helicobacter Pylori Infection In A Developing Country, Javed Yakoob, Wasim Jafri, Shahab Abid, Zaigham Abbas, Saeed Hamid, Muhammad Islam, Kashif Anis, Hasnain Ali Shah, Hizbullah Shaikh

Section of Gastroenterology

Background

The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.

Methods

One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard …

Heterotopic Glial Tissue In Tonsil: A Case Report, Nausheen Yaqoob, Zubair Ahmed, Akhtar Husain

Department of Pathology and Laboratory Medicine

We describe a six month old boy with a mass in the left tonsil. It was present since birth and was enlarging progressively. It was completely excised. Histopathology showed a choristoma of neural origin composed of glial cells--astrocytes in a fibrillary background, and a choroid plexus. Immunohistochemistry confirmed the findings.

Metanephric Adenoma: A Rare Benign Renal Tumour, Nausheen Yaqoob, Jai Pal Paryani, Naila Kayani, Mohammad Zafar Rafique, Raziuddin Biyabani

Department of Pathology and Laboratory Medicine

Metanephric adenoma is a rare benign renal tumour. We are reporting one histologically proven such case in a 23 year old male from Afghanistan. He presented with severe right flank pain since 3 weeks. Nephrectomy was done and histopathology was consistent with the diagnosis of metanephric adenoma. This novel renal mass has been reported to have benign clinical course despite its symptomatic presentation and large tumour size. There is no distinguishing radiological feature with can differentiate it from malignant tumours. So far, a uniformly benign clinical course has been associated with Metanephric adenoma, but given its relatively recent identification and …

Barnacles, Old Age Marks, Or Just Plain Seborrheic Keratoses., Lawrence Charles Parish, Joseph A. Witkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

Growing older may mean more wrinkles and creaking joints, but why does it also entail an accumulation of barnacles. These brown, somewhat friable, often warty lesions are more common on senior citizens but are not necessarily limited to the chronologically challenged. Seborrheic keratoses (SKs) can be easily recognized (fig 1), but the itching and the occasional scratch-induced dermatitis make them more than a cosmetic nuisance. (fig 2)

SKs can go by a variety of names, ranging from basal cell papillomas, senile warts, and senile keratoses to seborrheic verrucae and verrucous senilis. The various terms provide no more information on their …

Encephalopathy Caused By Bartonella Henselae Following Cat Scratch, Joseph L. Yozviak Do, Facp, John Margraf Md, Marcelo Gareca Md

Department of Medicine

No abstract provided.

Evaluation Of Stature Development During Childhood And Adolescence In Individuals With Familial Hypophosphatemic Rickets, Mauro M. S. Borghi, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

This review was conducted to study the diagnosis, treatment, and growth progression in infants and adolescents with familial hypophosphatemic rickets. The bibliographic search was carried out utilizing the electronic databases MEDLINE, OVID, and LILACS and by direct research within the last 15 years using the keywords rickets, familial hypophosphatemia, vitamin D deficiency, stature growth, childhood, and adolescence. Article selection was done by comparing the evaluation of the growth in patients with familial hypophosphatemic rickets, including the variables that might affect them, for possible future therapeutic proposals. It is concluded that the most significant fact in the treatment of familial hypophosphatemic …

Cardiac Transplant Following Failed Fontan Or Glenn Procedures., Naveen L. Pereira, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Com Outlook Fall 2005, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Role Of Computed Tomography In Acute Pancreatitis And Its Complications Among Age Groups, Ishtiaq Ahmed Chishty, Vaqar Bari, Sajida Pasha, Dawar Burhan, Zishan Haider, Zafar Rafique

Department of Radiology

Objective: To determine value of CT scan in diagnosis of acute pancreatitis, its complications and to correlate with severity among different age groups.Methods: The study was carried out from August 2001 to August 2002 at the Radiology Department, Aga Khan University Hospital. A total of 40 patients (33 male and 7 female) with age range from 16-71 years were divided in three groups. Group I was less than 40 years (12 patients), Group II was between 40-60 years (17 patients), and Group III was more than 60 years (11 patients). CT scans were assessed for pancreatic necrosis and its complications. …

Oncolog, Volume 50, Number 10, October 2005, Beth Notzon, Rachel Williams, Maurie Markman Md

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

• Cytogenetics: Major Insights from Microscopic Details
• Breaking the News
• House Call: From My Bookshelf to Yours
• DiaLog: Intraperitoneal Chemotherapy: A New Strategy for Advanced Ovarian Cancer, by Maurie Markman, MD, Vice President for Clinical Research

Evaluation Of African-American And White Racial Classification In A Surveillance, Epidemiology, And End Results Cancer Registry, Diva A. Patel, Alicia Knowles, Ann G. Schwartz, Kendra Schwartz

FMPHS Faculty Publications

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry.

Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined.

Results: Most self-identified African Americans and Whites were correctly classified (sensitivity= 98.5%, specificity=99.7%). Males were two times more likely to be misclassified than females [odds …

Near-Infrared Characterization Of Breast Tumors In Vivo Using Spectrally-Constrained Reconstruction, Subhadra Srinivasan, Brian W. Pogue, Ben Brooksby, Shudong Jiang, Hamid Dehghani, Christine Kogel, Wendy A. Wells, Steven P. Poplack, Keith D. Paulsen

Dartmouth Scholarship

Multi-wavelength Near-Infrared (NIR) Tomography was utilized in this study to non-invasively quantify physiological parameters of breast tumors using direct spectral reconstruction. Frequency domain NIR measurements were incorporated with a new spectrally constrained direct chromophore and scattering image reconstruction algorithm, which was validated in simulations and experimental phantoms. Images of total hemoglobin, oxygen saturation, water, and scatter parameters were obtained with higher accuracy than previously reported. Using this spectral approach, in vivo NIR images are presented and interpreted through a series of case studies (n=6 subjects) having differing abnormalities. The corresponding mammograms and ultrasound images are also evaluated. Three of six …

Frequency Of Irritable Bowel Syndrome In College Students., Wasim Jafri, Javed Yakoob, Nadim Jafri, Muhammad Islam, Qazi Masroor Ali

Section of Gastroenterology

Background:

This study was carried out to investigate the presence of irritable bowel syndrome (IBS) in college students and compare its distribution in the non-medical college and medical college students.

Methods:

We collected data from 508 students by inviting them to fill out a questionnaire based on Rome II criteria for the diagnosis of IBS from November 2001 to February 2004. Two major cities Karachi and Bahawalpur were selected and it was coordinated by the section of Gastroenterology, Department of Medicine, Aga Khan University Hospital and Quaid-e-Azam Medical College, Bahawalpur.

Results:

A total of 508 subjects with males 43 %(220/508) …

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

Flow Cytometric And Demographic Analysis Of T Cell Acute Lymphoblastic Leukemia In Pakistani Population., M R. Khawaja, S S. Allana, N N. Akbaral, S N. Adil, M. Khurshid, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background: This study was carried out to analyze the proportion of T cell acute lymphoblastic leukemia (TALL) among all acute lymphoblastic leukemia (ALL) in Pakistani population and its correlation with the demographic features. Accuracy of cell surface markers used in flow cytometric analysis of the leukemic cells was also determined.

Methods: Data of 209 consecutive cases of acute lymphoblastic leukemia (ALL) presenting between July 1995 and July 2003 was analyzed. Flow cytometry was performed on all ALL cases using the standard protocols. TALL markers included CD3, CD5 and CD7.

Results: Proportion of TALL among known ALL Pakistani patients was 17.22%. …

Bullous Eruption On The Posterior Thigh, James Studdiford, Amber Stonehouse

Department of Family & Community Medicine Faculty Papers

No abstract provided.

The Influence Of Concurrent Cognitive Tasks On Postural Sway In Children, Yvette Blanchard, Shannon Carey, Jocelyn Coffey, Alison Cohen, Trisha Harris, Stephanie Michlik, Geraldine Pellecchia

All PTHMS Faculty Publications

Purpose: The purpose of this study was to examine the influence of concurrent tasks on postural sway in children.

Methods: Nineteen fourth-grade students, while standing on a balance platform, were asked to stand still, count backward, and read second-grade level sentences. The AMTI Accusway System was used to calculate the length of center of pressure path (LCOP), sway range (SR), and variability (SV) in mediolateral (ML) and anteroposterior (AP) directions of sway.

Results: Analysis of variance revealed a main effect of cognitive task condition for SR-AP, SR-ML, SV-AP, and SV-ML. Post hoc comparisons revealed lower values of those four dependent …