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Perceptions Of Pediatric Overweight And Weight Management: A Comparison Of Parents And Physicians, Lisa K. Thomason

Masters Theses & Specialist Projects

Pediatric overweight is of paramount importance in Kentucky, as studies show prevalence rates are higher in the state than the national average. Research suggests that comprehensive treatments involving diet training, exercise training, and psychological counseling are most effective at reducing overweight in children. Little research has been done, however, to compare parents' and physicians' perceptions of obesity, its treatment, or barriers to weight management.

The purpose of this study is to examine differences in attitudes toward pediatric obesity and weight management among parents and physicians, specifically related to the importance of diet training, exercise training, and psychological counseling. Surveys were …

The Obligation Of Physicians To Medical Outliers: A Kantian And Hegelian Synthesis, Thomas J. Papadimos, Alan P. Marco

Anesthesiology Faculty Publications

Background

Patients who present to medical practices without health insurance or with serious co-morbidities can become fiscal disasters to those who care for them. Their consumption of scarce resources has caused consternation among providers and institutions, especially as it concerns the amount and type of care they should receive. In fact, some providers may try to avoid caring for them altogether, or at least try to limit their institutional or practice exposure to them.

Discussion

We present a philosophical discourse, with emphasis on the writings of Immanuel Kant and G.F.W. Hegel, as to why physicians have the moral imperative to …

Informed Consent For Medical Research: Case Studies, Catherine A. Marco

Emergency Medicine Faculty Publications

Informed consent for medical research is an essential, but challenging, process to assure the protection of the rights of potential research subjects. Numerous barriers to the informed consent process exist among patients, including impaired decisional capacity, impaired cognition, language barriers, illiteracy, insufficient time and communication, and numerous others. Because of the inherent vulnerability of patients, particular attention should be paid to addressing barriers to adequate informed consent, and steps should be taken to ensure adequate delivery of information, understanding of the study and its risks and benefits, and voluntariness of the informed consent.

Maximum Tolerable Dose Of Cyclophosphamide And Azathioprine In Pakistani Patients With Primary Renal Disease, S S. Ali, M A. Rabbani, S S M Moinuddin, Salim S. Virani, F Farooque, A Salam, A Ahmad

Section of Nephrology

Objective: The immunosuppressive regimens, at present, mainly rely on western guidelines that were derived from studies conducted in western populations. No such study exists for South Asian population, which is home to almost two billion people different in both genetics and environment from west. Locally derived thresholds for side effects markedly different from western figures may warrant re-adjustment of current local immunosuppressive regimens that are at present based largely on western guidelines. In order to define optimum dose for Cyclophosphamide (CYC) and Azathioprine (AZA) based immunosuppressive therapy, we conducted this study to find out maximum tolerable doses of azathioprine (AZA) …

Therapeutic Efficacy Of Sulfadoxine-Pyrimethamine And Prevalence Of Resistance Markers In Tanzania Prior To Revision Of Malaria Treatment Policy: Plasmodium Falciparum Dihydrofolate Reductase And Dihydropteroate Synthase Mutations In Monitoring In Vivo Resistance, K. Mugittu, M. Ndejembi, A. Malisa, M. Lemnge, Zul Premji, A. Mwita, W. Nkya, J. Kataraihya, S. Abdulla, H.-P. Beck, H. Mshinda

Pathology, East Africa

Prior to the 2001 malarial treatment policy change in Tanzania, we conducted trials to assess the efficacy of sulfadoxine-pyrimethamine (SP) and the usefulness of molecular markers in monitoring resistance. A total of 383 uncomplicated Plasmodium falciparum malaria patients (between 6 and 59 months old) were treated with SP and their responses were assessed. Mutations in the P. falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes in admission day blood samples were analyzed. Results indicated that 85.6% of the patients showed an adequate clinical response, 9.7% an early treatment failure, and 4.7% a late treatment failure. The quintuple mutant genotype …

Oral Contrast-Enhanced Ct Cholangiography--An Initial Experience, I Naseem, J Rees

Department of Radiology

Objective: To describe our experience of CT (Computed tomographic) Cholangiography examination for detection of choledocholithiasis at the Aga Khan University Hospital (AKUH) Karachi Pakistan.Methods: Seven patients underwent helical CT cholangiography for suspected choledocholithiasis. Iopanoic acid (6 grams) was administered orally 8-12 hours before acquisition of a helical CT cholangiogram. Three-dimensional reconstructions and curved multiplanar reformations were generated from a set of axial source images.Results: Our patients had no adverse reactions to iopanoic acid. The degree of biliary opacification was sufficient to perform three-dimensional and curved planar reformations in 5 patients. In two patients, the biliary tree was not opacified. Both …

Ionizing Radiation Induces A Stress Response In Primary Cultures Of Rainbow Trout Skin, Fiona Lyng, M. Lyons-Alcantara, P. Owell, Sharon Ni Shuilleabhain, Colin Seymour, D. Cottell, Carmel Mothersill

Articles

Fish skin is very vulnerable to damage from physical and chemical pollutants because it is in direct contact with the aquatic environment. In this study, the effect of g radiation on primary cultures of rainbow trout skin was investigated. Primary cultures containing two cell types, epidermal cells and goblet mucous cells, were exposed to doses ranging from 0.5–15 Gy 60Co g radiation. Expression of PCNA, c-myc and BCL2 was investigated as well as growth and levels of apoptosis and necrosis. Morphological and functional changes were also studied. The irradiated cultures showed evidence of a dose-dependent increase in necrosis and enhanced …

Mammographic Criteria For Determining The Diagnostic Value Of Microcalcifications In The Detection Of Early Breast Cancer, M Yunus, N Ahmed, I Masroor, J Yaqoob

Department of Radiology

Objective: To evaluate the importance of microcalcifications in the detection of breast carcinoma in conventional mammography.Methods: This prospective study was carried out at Aga Khan University Hospital (AKUH). Mammograms of 68 patients with microcalcifications were evaluated. Craniocaudal and oblique views of both breasts were acquired on routine basis with cone compression and magnified views when required.Results: Among 68 patients with microcalcifications, 61 (89%) had clustered microcalcifications while 7 patients (10.29%) had scattered microcalcifications. Microcalcifications can occur in benign and malignant diseases. While evaluating clustered microcalcifications, few criteria have been established to determine malignant clustered microcalcifications, these include specific and nonspecific …

Oncolog, Volume 49, Number 01, January 2004, David Galloway, Katie Prout Matias, Karin M.E.H. Gwyn Md, Richard L. Theriault Do

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

• Pregnancy and Cancer Treatment Often Are Not Mutually Exclusive
• Studies of the Viral Origins of Some Cancers Lead to New Prevention, Treatment Strategies
• House Call: Cancer and Your Weight
• DiaLog: Treating Breast Cancer during Pregnancy, by Karin M.E.H. Gwyn, MD, Assistant Professor, and Richard L. Theriault, DO, Professor, Department of Breast Medical Oncology

Healing Wounds, Instilling Hope: The Tanzanian Partnership Against Obstetric Fistula, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Guérir Les Blessures, Faire Naître L’Espoir: Le Partenariat Tanzanien Contre La Fistule Obstétricale, Thoraya Ahmed Obaid, Erica Chong

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité describes a partnership formed to combat obstetric fistula in Tanzania. The Bugando Medical Center, the Women’s Dignity Project, the Tanzania Midwives Association, and the government cooperated on an extensive program for surgical repair, prevention, and policy research and activities. Lessons learned: 1) Fistula programs need to address social as well as medical issues. 2) Most repairs are successful, making an enormous difference in women’s lives. 3) Relatively little funding is necessary to start up a fistula program. 4) Fistula programs are vehicles for broader conversations about gender and poverty.

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2004), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 2004 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• 5 Point Plan
• In Memoriam Albert F. D’Alonzo, DO ’56
• Stem Cell Research
• The O. J. Snyder Memorial Medal Recipient
• Mason W. Pressly Memorial Medal Recipient
• The Closing of Parkview Hospital
• Cover Story: It’s our Move: Creating Training Opportunities in a Shrinking Health Care Delivery System
• Class Notes
• In Memoriam
• My Turn
• PCOM Alumni Weekend 2004
• PCOM Events

Physician Assistant Class Of 2004, Philadelphia College Of Osteopathic Medicine

All Yearbooks

Includes Accomplishments, National Physician Assistant Day, Physician Assistant Olympics, Challenge Bowl, Classroom candids, Retreat at Camp Ockanickon,

Role Of Estrogens In The Secondary Hormonal Manipulation Of Hormone Refractory Prostate Cancer, Khurram M. Siddiqui, Farhat Abbas, Syed Raziuddin Biyabani, Muhammad Hammad Ather, Jamsheer J. Talati

Section of Urology

Objective: To evaluate the role of Estrogens (Honvan) in the secondary hormonal manipulation of patients with hormone refractory prostate cancer (HRCP). Methods: Twelve patients diagnosed as hormone refractory prostate cancer received intravenous estrogens for six days (Fosfestrol, a synthetic phosphorylated estrogen derivative), followed by a maintenance oral dose of 120 mg thrice daily as second line hormonal treatment. During the treatment they were given deep venous thrombosis prophylaxis. Their stage at initial presentation, primary treatment, mode of androgen ablation, prostate specific antigen (PSA) level, duration of remission prior of HRPC status, PSA doubling time before and after estrogen treatment were …

Back To The Future: The Future Of Long-Term Care In Massachusetts, Deborah H. Thomson, John J. Ford

Gerontology Institute Publications

The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our …

Polycythemia Vera And Idiopathic Erythrocytosis: Comparison Of Clinical And Laboratory Parameters, M. Usman, F. Bilwani, G. N. Kakepoto, Salman Adil, R. Sajid, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To evaluate the various clinical and laboratory parameters of Polycythemia vera and idiopathic erythrocytosis in order to differentiate between two entities at the Aga Khan University Hospital.
Methods: Twenty six patients of polycythemia vera and 34 patients of idiopathic erythrocytosis were analyzed with respect to clinical features and laboratory findings.
Results: Patients with idiopathic erythrocytosis were males with a mean age of 41 years and no splenomegaly. Patients with polycythemia were older males and females with splenomegaly, red cell count of mor than 6.5 million/cmm, haematocrit 55%, leucocytosis, thrombocytosis and low erythropoietin level.
Conclusion: Based …

Prevalence Of Hepatitis C Virus In Lymphoproliferative Disorders, F. Bilwani, Y. Zaidi, G. N. Kakepoto, Salman Adil, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To study the prevalence of hepatitis C virus in lymphoproliferative disorders.
Methods: A case control prospective study was performed on 143 patients with lymphoproliferative disorders and 29 patients with non-hematological malignancies were taken as controls. All the patients in both groups were analyzed for various risk factors for infection with hepatitis C virus and were tested for the presence of hepatitis C virus antibody (anti HCV), cryoglobulins and rheumatoid factor antibody. Hepatitis C viremia was documented by detection of HCV RNA by polymerase chain reaction.
Results: There was no significant difference for risk factors for hepatitis …

Human Chorionic Gonadotropin Administration Is Associated With High Pregnancy Rates During Ovarian Stimulation And Timed Intercourse Or Intrauterine Insemination, Mohamed F. Mitwally, Sonya Abdel-Razeq, Robert F. Casper

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

There are different factors that influence treatment outcome after ovarian stimulation and timed-intercourse or intrauterine insemination (IUI). After patient age, it has been suggested that timing of insemination in relation to ovulation is probably the most important variable affecting the success of treatment. The objective of this study is to study the value of human chorionic gonadotropin (hCG) administration and occurrence of luteinizing hormone (LH) surge in timing insemination on the treatment outcome after follicular monitoring with timed-intercourse or intrauterine insemination, with or without ovarian stimulation.

Methods

Retrospective analysis of 2000 consecutive completed treatment cycles (637 timed-intercourse and …

Low Dose Intravenous Minocycline Is Neuroprotective After Middle Cerebral Artery Occlusion-Reperfusion In Rats, Lin Xu, Susan C. Fagan, Jennifer L. Waller, David Edwards, Cesar V. Borlongan, Jianqing Zheng, William D. Hill, Giora Feuerstein, David C. Hess

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Minocycline, a semi-synthetic tetracycline antibiotic, is an effective neuroprotective agent in animal models of cerebral ischemia when given in high doses intraperitoneally. The aim of this study was to determine if minocycline was effective at reducing infarct size in a Temporary Middle Cerebral Artery Occlusion model (TMCAO) when given at lower intravenous (IV) doses that correspond to human clinical exposure regimens.

Methods

Rats underwent 90 minutes of TMCAO. Minocycline or saline placebo was administered IV starting at 4, 5, or 6 hours post TMCAO. Infarct volume and neurofunctional tests were carried out at 24 hr after TMCAO using …

Effect Of Four-Day Psyllium Supplementation On Bowel Preparation For Colonoscopy:A Prospective Double Blind Randomized Trial [Isrctn76623768], Walter A. Salwen, Marc D. Basson

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Patients with new onset constipation or presumed hemorrhoid bleeding frequently require the use of both fiber supplements and diagnostic colonoscopy. We sought to determine whether preliminary fiber supplementation would alter the tolerability or efficacy of a standard bowel preparation for colonoscopy

Methods

A prospective, double blind, randomized trial was designed to compare a short course of a psyllium-based supplement versus placebo prior to a colon lavage. Patients were given an unlabeled canister of powder, and instructed to take 1 tablespoon with 8 oz of water bid for 4 days before colonoscopy. A 4-liter polyethylene based glycol lavage was …

Characterization Of Insulin-Like Growth Factor Binding Protein-2 Secretion In Mouse Mesangial Cells, Marianne Ellen Albert

MUSC Theses and Dissertations

Dysregulation of the insulin-like growth factor (IGF) system plays a key role in the hyperproliferative state seen in diabetic complications. Enhanced IGF-I activity plays a causal role in diabetic glomerulosclerosis (DG) by stimulating mesangial cell proliferation, secretion and hypertrophy. Other alterations of the IGF system may include increased IGF-I receptor (IGF-IR) and increased IGF binding protein (IGFBP) expression. The IGFBP family consists of six soluble binding proteins, IGFBP 1-6, which have higher affinities for the IGFs than the IGF-IR, resulting in blocking IGF access to the IGF-IR. Since the IGFBPs primarily function to inhibit IGF action, we hypothesize that overexpression …

Co-Regulation Of Expression Of Phase Ii Metabolizing Enzymes And Multidrug Resistance-Associated Protein 2, Viviana A. Catania, Enrique J. Sánchez Pozzi, Marcelo G. Luquita, María L. Ruiz, Silvina S. M. Villanueva, Brett Jones, Aldo D. Mottino

Toxicology and Cancer Biology Faculty Publications

Treatment of experimental animals with prototypical enzyme inducers represents a useful tool to characterize the role of different isozymes in drug metabolism and to improve our knowledge on factors regulating their synthesis at the transcriptional level. The effect of model enzyme inducers on phase II (conjugating) enzyme families, including UDP-glucuronosyltransferase’s and glutathione-S-transferase’s, has been well characterized in rodent liver. More recently, the effect of inducers on the expression of canalicular multidrug resistance-associated protein 2 (Mrp2) has been focused upon. The identification of a number of conjugated drugs as Mrp2 substrates suggests that both the conjugation and transport systems act coordinately …

A Need To Change Behavior And Attitudes In Medical Practice, Waris Qidwai

Department of Family Medicine

No abstract provided.

Perception About Family Physicians: Results Of A Survey Of Patients Visiting Specialist Clinics For Treatment, S. A. Huda, Z. A. A. Samani, Waris Qidwai

Department of Family Medicine

Objective: To study the perceptions about Family Medicine among patients visiting Specialist Physicians for treatment.
Methods: A questionnaire based survey was conducted at the Specialist Clinic, Aga Khan University Hospital, Karachi, Pakistan, in June 2004. Trained volunteers administered the questionnaire among patients visiting Specialist Physicians for treatment. Confidentiality was ensured to all patients and written informed consent was taken as part of the ethical requirements for the conduct of the study. SPSS computer software and Microsoft Excel were used for data management.
Results: A total of 100 patients visiting the Specialist Clinic were interviewed, of which fifty four …

Ever Increasing Need For Family Physicians, Waris Qidwai

Department of Family Medicine

No abstract provided.

Awareness Of The Process Of Informed Consent Among Family Practice Patients In Karachi, H. Bhurgri, Waris Qidwai

Department of Family Medicine

Objective: To study the awareness of 'Informed Consent', among patients presenting to Family Physicians.
Methods: A cross-sectional study was carried out at the Community Health Centre, Aga Khan University Hospital, Karachi in July 2002. Written Consent was taken and confidentially was assured
Results: Out of the 100 patients interviewed, 80 agreed to participate in the study, forty-four men and thirty-six women. Approximately half the participants (45%) were graduates and 40% had less than five years of school education. The awareness of the process of 'informed consent' was observed in only 20% of the respondents, all in the educational …

The Hippocratic Oath: Has It Ceased To Be Relevant?, Waris Qidwai

Department of Family Medicine

The Greek physician Hippocrates (460-377 B.C) is traditionally regarded as the founder of medicine, scientific discipline and medical ethics.The Hippocratic Oath, taken by ancient and medieval doctors, requires high ethical standards from medical doctors. Its principles are considered important in professional and ethical education of medical doctors even today. The Hippocratic Oath has survived, with over-riding power, the test of time since it addresses the intrinsic nature of medicine. Even those who know little of it or reject parts of it acknowledge it to be a symbol of the values of medicine. It has been argued that it is its …

Distribution Of Lower Urinary Tract Symptoms (Luts) In Adult Women, M Andrades, R Paul, A Ambreen, S Dodani, Rh Dhanani, Waris Qidwai

Department of Family Medicine

OBJECTIVE: To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms.
DESIGN: Cross-sectional analytical study.
PLACE AND DURATION OF STUDY: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002.
SUBJECTS AND METHODS: A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center.
RESULTS: Fifty-two percent of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence …

A Young Man With Hoarseness Of Voice, Waris Qidwai, S. Rehman

Department of Family Medicine

A 45 year-old driver presented with a two months history of hoarseness, fever, productive cough, anorexia and weight loss. He chewed tobacco. He was previously seen and treated without benefit by a family Physician and two ear, nose and throat consultants. Crackles were heard in the left scapular region. An X-Ray of the chest showed a right apical cavity, perihilar infiltrates and blunting of left costophrenic angle. His sputum smear showed acid fast bacilli. A high index of suspicion for tuberculosis is recommended while dealing with such cases. Complete recovery of patient's voice with anti-tubercular therapy confirmed it was a …

Tissue Kallikrein In Cardiac Remodeling And Renal Damage In Genetic And Salt-Induced Hypertension Rat Models, Grant Anderson Bledsoe

MUSC Theses and Dissertations

Abnormalities of the tissue kallikrein-kinin system have been identified in the pathogenesis of hypertension and cardiac and renal diseases. The purpose of this study was to investigate the effect of exogenous tissue kallikrein gene delivery on heart and kidney injury in pressure overload and volume overload hypertension using spontaneously hypertensive rats (SHR) and Dahl salt-sensitive (DSS) rats. In order to examine the role of kallikrein in cardiac protection, adenovirus encoding the human tissue kallikrein gene was injected intravenously into SHR. Expression of recombinant human tissue kallikrein was identified in rat serum by ELISA and heart and kidney tissue by RT-PCR/Southern …