Medicine and Health Sciences Commons^™

An Evaluation Of An Educational Program On Stigma In Mental Illness Presented By A Mental Health Consumer And Advocate, Edward R. Norris Md, Fapa, Fapm, Karen Burke Rn, Bsn, Brooke Katz Rn, Bsn, Bruce Curry Lcsw, Michael Kaufmann Md

Department of Psychiatry

No abstract provided.

Supernumerary, Ectopic Tooth In The Maxillary Antrum Presenting With Recurrent Haemoptysis., Taimur Saleem, Umair Khalid, Anam Hameed, Shehzad Ghaffar

Section of Otolaryngology, Head & Neck Surgery

Ectopic eruption of teeth in non-dental sites is a rare phenomenon and can present in a variety of ways such as chronic or recurrent sinusitis, sepsis, nasolacrimal duct obstruction, headaches, ostiomeatal complex disease and facial numbness. However, presentation of such Patients with recurrent haemoptysis has not been described in the literature so far. We have described a case of an ectopic, supernumerary molar tooth in the maxillary antrum in a Patient who initially presented with haemoptysis. A 45-year-old male presented with a 2-month history of episodic haemoptysis. A pedunculated growth from the inferior nasal turbinate was seen with fibre-optic visualization. …

Western News: Rewriting The Record On Legs, Lesley Craig, Paul Mayne

Data and Test Instruments

No abstract provided.

The Endogenous Soluble Vegf Receptor-2 Isoform Suppresses Lymph Node Metastasis In A Mouse Immunocompetent Mammary Cancer Model, Masa-Aki Shibata, Jayakrishna Ambati, Eiko Shibata, Romulo J. C. Albuquerque, Junji Morimoto, Yuko Ito, Yoshinori Otsuki

Ophthalmology and Visual Science Faculty Publications

BACKGROUND: Cancer metastasis contributes significantly to cancer mortality and is facilitated by lymphangiogenesis and angiogenesis. A new splicing variant, endogenous soluble vascular endothelial growth factor receptor-2 (esVEGFR-2) that we recently identified is an endogenous selective inhibitor of lymphangiogenesis. To evaluate the antimetastatic potential of esVEGFR-2, gene therapy with vector expressing esVEGFR-2 (pesVEGFR-2) or endostatin (pEndo) as a positive control was conducted on murine metastatic mammary cancer.

METHODS: Syngeneic inoculated metastatic mammary cancers received direct intratumoral injection of pesVEGFR-2, pEndo or pVec as control, once a week for six weeks. In vivo gene electrotransfer was performed on the tumors after each …

The Decompensating Pediatric Inpatient Simulation Scenarios, Aisha Davis, Pavan P. Zaveri

E-Learning Modules

Introduction: In July of 2009, Children’s National Medical Center (CNMC) Hospitalist and Emergency Department (ED) educators collaborated to create and implement unique simulation scenarios for trainees rotating on the pediatric hospitalist teams. The goal of this educational intervention is to teach and allow rehearsal of an approach to the unstable patient across three scenarios. Trainees use this high-fidelity, low-risksimulation to apply targeted clinical reasoning and their initial assessment and management strategies to core clinical problems. The three scenarios included in this resource cover altered mental status and seizure, respiratory distress and anaphylaxis, and refractory status asthmaticus, respectively.

Methods:This resource …

Medical Education Digest, Vol. 12 No. 6 (November/December 2010), Nova Southeastern University

Medical Education Digest

No abstract provided.

Phase Iii, Randomized, Double-Blind, Placebo-Controlled Evaluation Of Pregabalin For Alleviating Hot Flashes, N07c1, Charles L. Loprinzi, Rui Qin, Ernie P. Baclueva, Donald J. Jurgens

Articles

PURPOSE:

Hot flashes are a common problem for which effective and safe treatments are needed. The current trial was conducted on the basis of preliminary promising data that pregabalin decreased hot flashes.

PATIENTS AND METHODS:

A double-blind, placebo-controlled, randomized trial design was used to compare pregabalin at target doses of 75 mg twice daily and 150 mg twice daily with a placebo. Hot flash frequencies and scores (frequency times mean severity) were recorded daily during a baseline week and for six treatment weeks. The primary end point for this study was the change-from-baseline hot flash score during treatment week 6 …

Civilian Versus Military Trauma Management, Vivian Mcalister

Data and Test Instruments

In the 21st century, military and civilian trauma surgeons bring similar solutions to similar problems, learning one from another

J. Graham Smith Jr, Md (November 22, 1926-May 18, 2010)., Lawrence Charles Parish

Department of Dermatology and Cutaneous Biology Faculty Papers

With the passing of J. Graham Smith, Jr. on May 18, 2010, following a short illness, dermatology lost one of its most distinguished envoys. (Figure 1) Skee*, as he was known by his many friends, held the important offices in American dermatology for which he made many significant contributions.

Intracranial Cavernous Angiomas, Syed Faraz Kazim, Atta-Ul-Aleem Bhatti, Ather Enam

Section of Neurosurgery

Objective: To describe the clinical presentation, diagnosis, and management of patients presenting with intracranial cavernous angiomas (CAs) at a tertiary care hospital in Pakistan.
Study Design: Case series. Place and Duration of Study: Section of Neurosurgery, The Aga Khan University Hospital (AKUH), Karachi, from January 1990 to September 2008.
Methodology: A retrospective case note review of all patients diagnosed with intracranial CAs at AKUH during the study period. The studied variables included patient demographics, clinical presentation, family history of intracranial CAs or other space occupying lesions, modality of diagnosis, management, and outcome. Results were described as frequency percentages.
Results: During …

Cardiac Surgery In Octogenarians, Asmatullah Khan, Hassan Khan, Saulat H. Fatimi, Asadullah Khan

Section of Cardiothoracic Surgery

In Europe and North America, cardiac surgery can be done successfully on octogenarians, but differences in patient selection, surgical and bypass techniques prevent us from concluding similarly in Pakistan. This study investigated the short and long-term outcomes of cardiac surgery in octogenarians operated over a 5 years period at The Aga Khan University Hospital, from January 2001 to December 2006. Seventeen octogenarians, (mean age 81.7 ± 2.3) underwent coronary artery bypass graft (CABG). Thirty-days hospital mortality was reported in only 1 patient. Surgical complication of any kind was reported in 13 (76.5%) patients with pleural effusion being the commonest in …

Diffusion Weighted Mr Imaging (Dwi) And Adc Values In Endometrial Carcinoma, Imrana Masroor, Muhammad Zeeshan, Shaista Afzal, Nadeem Ahmad, Gulnaz Shafqat

Department of Radiology

Objective: To determine the sensitivity of MR imaging utilizing diffusion weighted imaging (DWI) in detection of endometrial cancer and to compare the Apparent Diffusion Coefficient (ADC) values of malignant and normal endometrium.

Study Design: Cross-sectional analytical study.

Place and Duration of Study: Radiology Department, Aga Khan University Hospital Karachi, from January 2007 to December 2009. Methodology: Patients were defined as undergoing MRI for suspected endometrial malignancy, and the controls were female subjects who underwent MRI examination for indications other than endometrial malignancy. Studied variables included the signal characteristics of the endometrium and ADC values. The sensitivity of DWI for the …

Dysregulation Of The Mitogen Granulin In Human Cancer Through The Mir-15/107 Microrna Gene Group, Wang-Xia Wang, Natasha Kyprianou, Xiaowei Wang, Peter T. Nelson

Pathology and Laboratory Medicine Faculty Publications

Granulin (GRN) is a potent mitogen and growth factor implicated in many human cancers, but its regulation is poorly understood. Recent findings indicate that GRN is regulated strongly by the microRNA miR-107, which functionally overlaps with miR-15, miR-16, and miR-195 due to a common 5′ sequence critical for target specificity. In this study, we queried whether miR-107 and paralogs regulated GRN in human cancers. In cultured cells, anti-argonaute RNA coimmunoprecipitation with downstream microarray analyses indicates that GRN mRNA is directly targeted by numerous miR-15/107 miRNAs. We further tested this association in human tumors. MiR-15 and miR-16 are known to be …

Rhnull: A Rare Blood Group Phenotype, Adnan Qureshi, Muhammad Salman, Bushra Moiz

Section of Internal Medicine

Rhnull phenotype is a rare blood group characterized by the lack of expression of all Rh antigens (D, C, c, E and e) on the red cells. The phenotype is further classified into the regulator and amorph type based on underlying genetic defect. The clinical significance of its recognition is that such patients suffer from Rhnull syndrome associated with osmotically fragile red cells called stomatocytes with subsequent chronic haemolytic anaemia of varying degree. Another importance is that such subjects readily form alloantibodies on exposure to Rh antigens. We report herein rare Rhaull phenotype in a young pregnant female which was …

Oncolog Volume 55, Number 11-12, November-December 2010, Bryan Tutt, Joe Munch

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

• Desmoid Tumors: Multidiciplinary treatment for an enigmatic disease
• Endoscopic Surgery for Skull Base Tumors: Patient selection is the key to success for the minimally invasive procedure
• INBRIEF: Earlier Breast Cancer Screening Recommended for Hispanic Women/SUMO Is Important for DNA Damage Repair/Regional Care Centers Make Cancer Treatment Easily Accessible/SIK2 Plays Critical Role in Chemotherapy Resistance
• HOUSE CALL: Books Provide Comfort, Guidence, Relaxation

Chart Rounds In The Digital Age: A Survey Of North American Institutions, M. A. Whiton, A. P. Dicker, E. J. Wuthrick, L. Doyle, A. S. Harrison, Y. R. Lawrence

Department of Radiation Oncology Faculty Papers

Purpose:

Recent reports of medical errors in radiaKon treatment delivery have emphasized the importance of quality assurance (QA) pracKces. Strict guidelines exist for medical physics QA, but not for QA procedures as applied to clinicians. We sought to document how clinical quality assurance (QA) meeKngs or “chart rounds” are performed across academic North American RadiaKon Oncology departments.

Barcoding In The Ed: Who Said It Couldn’T Be Done?, Neil Kocher Rn, Cen, Charlotte Buckenmyer Rn, Ms, Susan Teti Bsn, Rn, Tara Lynne Sell Bsn, Rn., Diane Haines Msn, Rn, Cen, Neil Kocher, Peggy Borton

Department of Emergency Medicine

No abstract provided.

A Severe Case Of Necrotizing Fasciitis Of The Abdomen: A Survivor Story, Karin Mcconville Md, Dale A. Dangleben Md, Rovinder S. Sandhu Md

Department of Surgery

No abstract provided.

Grown Up Congenital Heart Disease Patient Presenting For Non Cardiac Surgery: Anaesthetic Implications, Mohammad Hamid, Mansoor Ahmed Khan, Mohammad Irfan Akhtar, Hameedullah, Saleemullah, Khalid Samad, Fazal Hameed Khan

Department of Anaesthesia

Congenital heart disease patients surviving to adulthood have increased over the years due to various reasons. These patients are admitted in the hospital for non cardiac surgeries and other procedures more often than normal adult population. Management of grown up congenital heart disease patient presents a challenge during perioperative period for cardiologists, surgeons, intensivists and particularly for the anaesthetist. Management issues include psychological and physiological impact on the patient, complexity of defects, presence of previous palliative procedure, impact of anaesthetic agents on shunting and myocardium, endocarditis prophylaxis and associated extra cardiac anamolies.

Is Manual Reticulocyte Count A Reliable Option For Under Resourced Countries, Afsheen Farzand Ali, Bushra Moiz, Sadia Omer

Department of Pathology and Laboratory Medicine

OBJECTIVES: To establish the credibility of manual reticulocyte counts without compromising the quality of care, and to evaluate the degree of acceptability of manual reticulocyte counts in terms of accuracy and cost effectiveness in comparison with two automated haematology analyzers.

METHODS: Visual reticulocyte enumeration was evaluated for comparability, within-batch precision and costing with respect to Coulter STKS and Gen S haematology analyzers.

RESULTS: The results of reticulocyte estimation for 80 samples as obtained by 3 modes were correlated using Pearson's correlation coefficient (r) which were computed as 0.884, 0.875, and 0.793 for manual-Gen.S, Gen.SSTKS and manual-STKS respectively thus showing positive …

Neonatal Mortality And Prevalence Of Practices For Newborn Care In A Squatter Settlement Of Karachi, Pakistan: A Cross-Sectional Study., Afsheen Ayaz, Sarah Saleem

Department of Pathology and Laboratory Medicine

Background: During the past two decades there has been a sustained decline in child and infant mortality, however neonatal mortality has remained relatively unchanged. Almost all neonatal deaths (99%) occur in developing countries, where the majority are delivered at homes. Evidence suggests that these deaths could be prevented by simple, inexpensive practices and interventions during the pregnancy, delivery and postnatal period. In Pakistan over the last decade extensive efforts have been made by the international donors and government to implement these practices. However, limited attempts have been made to explore if these efforts have made a difference at the grass …

Pp32 (Anp32a) Expression Inhibits Pancreatic Cancer Cell Growth And Induces Gemcitabine Resistance By Disrupting Hur Binding To Mrnas., Timothy K Williams, Christina L Costantino, Nikolai A Bildzukewicz, Nathan G Richards, David W Rittenhouse, Lisa Einstein, Joseph A Cozzitorto, Judith C Keen, Abhijit Dasgupta, Myriam Gorospe, Gregory E Gonye, Charles J Yeo, Agnieszka K Witkiewicz, Jonathan R Brody

Department of Surgery Faculty Papers

The expression of protein phosphatase 32 (PP32, ANP32A) is low in poorly differentiated pancreatic cancers and is linked to the levels of HuR (ELAV1), a predictive marker for gemcitabine response. In pancreatic cancer cells, exogenous overexpression of pp32 inhibited cell growth, supporting its long-recognized role as a tumor suppressor in pancreatic cancer. In chemotherapeutic sensitivity screening assays, cells overexpressing pp32 were selectively resistant to the nucleoside analogs gemcitabine and cytarabine (ARA-C), but were sensitized to 5-fluorouracil; conversely, silencing pp32 in pancreatic cancer cells enhanced gemcitabine sensitivity. The cytoplasmic levels of pp32 increased after cancer cells are treated with certain stressors, …

The Addition Of Rituximab To Fludarabine And Cyclophosphamide Improves Progression-Free Survival In Patients With Previously Treated Chronic Lymphocytic Leukemia., Amit Mahipal, Mark Weiss

Department of Medical Oncology Faculty Papers

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in the United States. There has been considerable progress in understanding the biology and treatment of CLL in last 20 years. The introduction of purine analogs (pentostatin, fludarabine, and cladribine) dramatically increased the response rates compared to alkylating agents. Combination chemoimmunotherapy has further improved the overall frequency of response to over 80% in treatment-naïve and over 60% in relapsed/ refractory disease, respectively.

Effects Of High Intraoperative Inspired Oxygen On Postoperative Nausea And Vomiting In Gynecologic Laparoscopic Surgery, Tatjana Šimurina, Md, Msc, Boris Mraović, Md, Simon Mikulandra, Md, Msc, Zdenko Sonicki, Md, Phd, Nina Sulen, Md, Branko Dukić, Md, Tong J. Gan, M.D

Department of Anesthesiology Faculty Papers

Study objective: To assess the efficacy of intraoperative different inspired oxygen fractions (FIO2) of 0.8 and 0.5 when compared with standard FIO2 0.3 in prevention of postoperative nausea and vomiting (PONV).

Design: A prospective, controlled, randomized, double-blind study.

Setting: General hospital, postanesthesia care unit (PACU) and gynecologic floor room. Patients: 120 ASA physical status I and II women, aged 21 to 76 y, undergoing elective gynecologic laparoscopic surgery.

Interventions: Patients were randomized to receive gas mixture of 30% oxygen in air (FI O2=0.3, group G30), 50% oxygen in air (FIO2=0.5, group G50) or 80% oxygen in air (FIO2=0.8, group G80), …

Obstructive Sleep Apnea And Ocular Disorders., Deepak P. Grover

Wills Eye Hospital Papers

PURPOSE OF REVIEW: Obstructive sleep apnea is a diagnosis that ophthalmologists can screen for when a patient presents with certain risk factors. Recent literature provides strong data for associations between sleep apnea and ocular disorders.

RECENT FINDINGS: A potentially serious disorder, sleep apnea can lead to many systemic and ocular complications. Recent findings provide data on the prevalence of sleep apnea with various disorders. Adequate treatment of sleep apnea has also shown to reverse both systemic and eye-related complications.

SUMMARY: Early diagnosis and management of sleep apnea is critical for reducing the risk of devastating systemic complications and preserving ocular …

Acute Administration Of Rt-Pa For Acute Stroke In Pakistani Patients--What Does The Available Evidence Teach Us?, Maria Khan, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Successful Management Of Invasive Aspergillosis With Voriconazole And Amphoteracin B Therapy In A Patient With Acute Mycloid Leukemia (Aml-M2), Nauman Fazal Manzoor, Sidra Azim, Zehra Fadoo

Department of Paediatrics and Child Health

An eleven-year-old boy presented with one month's history of fever and weight loss. He was diagnosed with Acute Mycloid Leukemia (AML-M2). During treatment he developed recurrent infections with neutropenia requiring prolonged antibiotics and subsequently developed invasive aspergillosis. He was treated with amphotericin B and Voriconazole. This case shows the efficacy and safety of combined antifungal therapy, including voriconazole, for invasive aspergillosis complicating AML.

Back To The Suture: The Two 5 Mm Port Laparoscopic Appendectomy, James Lee Md, Margaret Moore Md, Dale A. Dangleben Md

Department of Surgery

No abstract provided.

Frequency And Characteristic Features Of Portal Hypertensive Gastropathy In Patients With Viral Cirrhosis., Shahid Ahmed, Khalid Mumtaz, Umair Syed Ahmed, Hasnain Ali Shah, Shahab Abid, Saeed Hamid, Wasim Jafri

Section of Gastroenterology

To determine the frequency and specific characteristic features of portal hypertensive gastropathy (PHG) in cirrhosis due to viral etiology. Cross-sectional descriptive study. The Aga Khan University Hospital, Karachi, from June 2006 till June 2008. Patients with hepatitis B and C cirrhosis were included who underwent screening esophago-gastroduodenoscopy (EGD) for varices. Baveno III consensus statement was used for diagnosing PHG on endoscopy and divided them into two subgroups i.e. mild and severe. Data related to platelet/spleen ratio, MELD score and Child Turcotte Pugh (CTP) score indicating severity of cirrhosis were recorded in all patients. Findings were compared by using independent sample …

Role Of Growth Factors In The Pathogenesis Of Tissue Fibrosis In Systemic Sclerosis., Sergio A. Jimenez, Susan V. Castro, Sonsoles Piera-Velazquez

Department of Medicine Faculty Papers

The most severe clinical and pathologic manifestations of systemic sclerosis (SSc) are the result of a fibrotic process characterized by the excessive and often progressive deposition of collagen and other connective tissue macromolecules in skin and numerous internal organs. The mechanisms involved in the initiation and progression of the remarkable fibrotic process in SSc remain largely unknown. Extensive recent studies have indicated that a variety of polypeptide growth factors play a crucial role in this process. The most commonly implicated growth factors include transforming growth factor beta (TGF-β), connective tissue growth factor (CTGF), platelet derived growth factor (PDGF), and vascular …