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Improving Outcome In Pediatric Intensive Care Unit In Academic Hospital In Pakistan, Anwarul Haque, Surraiya Bano

Department of Emergency Medicine

Objective:

To assess the impact on the clinical outcome of critically ill children before and after introduction of pediatric intensivist in an academic pediatric intensive care unit (PICU) inPakistan.

Methodology: :

This is aretrospective audit of children (age from one month to 14 years) admitted in the PICU during two 12-month periods in PICU of Aga Khan University Hospital (AKUH).Patients in Cohort one were managed by pediatric intensivist while in Cohort two were managed by general pediatricians.Patients were compared during the two 12-month cohort period.

Results:

During the study, in cohort one, 314 patients were admitted, mean age was 24 …

Vitamin B12 Deficiency--A Major Cause Of Megaloblastic Anaemia In Patients Attending A Tertiary Care Hospital, Saira Perwaiz Iqbal, Ghulam Nabi Kakepoto, Saleem Perwaiz Iqbal

Department of Pathology and Laboratory Medicine

BACKGROUND: Folate and vitamin B12 deficiencies have been known to cause megaloblastic anaemia. Since the deficiencies of these two vitamins are very common in Pakistani population, it would be imperative to investigate their role in causing megaloblastic anaemia. The objective of this study was to find out the contribution of folate and vitamin B12 deficiencies in causing megaloblastic anaemia in our patient population.

METHODS: In this retrospective cohort study, clinical records of 220 patients (101 females and 119 males with an age range of 1-80 years) who presented themselves with macrocytic anaemia at the Aga Khan University Hospital were collected. …

Vegf-A As An Inhibitor Of Angiogenesis And Methods Of Using Same, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Patents

The invention relates to methods and compositions for the treatment or prevention of ocular angiogenesis and neovascularization associated with neovascular disease. Administration of vascular endothelial growth factor (VEGF)-A into the eye when macrophage infiltration is reduced inhibits ocular angiogenesis.

Department Of Radiology-Annual Executive Summary Report-July 1, 2008 To June 30, 2009, Vijay M. Rao, Md

Department of Radiology Administrative Documents and Reports

87 page Annual Executive Summary Report from Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.

Table of Contents:

Department of Radiology

Chairman, Vice Chairmen 1

Divisions and Directors 1

Committees and Chairmen 1

Radiology Department Faculty Rank 2

Faculty with Secondary Appointments 3

Clinical Divisions 4

Radiology Residents and Fellows 5

Department Organizational Chart 6

Department Administration Chart 7

State of the Department 8

Appendix I: Publications Journal Articles 21

Books and Book Chapters 29

Abstracts 30

Appendix II: Formal Scientific Presentations 40

Appendix III: Honors, Editorial Activities, Service to Regional or National Organizations 61

Appendix IV: Active …

Switching And Selecting Atypical Antipsychotic Drugs: Quetiapine, Amresh Srivastava

Psychiatry Presentations

No abstract provided.

A Real-Time Prostate Cancer Detection Technique Using Needle Insertion Force And Patient-Specific Criteria During Percutaneous Intervention, Kaiguo Yan, T. Podder, L. Li, J. Joseph, D. R. Rubens, E. M. Messing, L. Liao, Y. Yu

Department of Radiation Oncology Faculty Papers

In this article, the authors present a novel real-time cancer detection technique by using needle insertion forces in conjunction with patient-specific criteria during percutaneous interventions. Needle insertion experiments and pathological analysis were performed for developing a computer-aided detection (CAD) model. Backward stepwise regression method was performed to identify the statistically significant patient-specific factors. A baseline force model was then developed using these significant factors. The threshold force model that estimated the lower bound of the cancerous tissue forces was formulated by adding an adjustable classifier to the baseline force model. Trade-off between sensitivity and specificity was obtained by varying the …

Hibernation-Like State Induced By An Opioid Peptide Protects Against Experimental Stroke, Cesar V. Borlongan, Teruo Hayashi, Peter R. Oeltgen, Tsung-Ping Su, Yun Wang

Pathology and Laboratory Medicine Faculty Publications

BACKGROUND: Delta opioid peptide [D-ala2,D-leU5]enkephalin (DADLE) induces hibernation in summer ground squirrels, and enhances preservation and survival of isolated or transplanted lungs and hearts. In the present study, we investigated the protective effect of DADLE in the central nervous system.

RESULTS: Adult Sprague-Dawley rats were pretreated with DADLE (4 mg/kg every 2 h x 4 injections, i.p.) or saline prior to unilateral occlusion of the middle cerebral artery (MCA). Daily behavioral tests revealed that ischemic animals treated with DADLE did not show any significant behavioral dysfunctions compared with saline-treated ischemic animals. Opioid antagonists only transiently inhibited the protective effect of …

Epidemiology And Outcomes Of Candidemia In 2019 Patients: Data From The Prospective Antifungal Therapy Alliance Registry., David L Horn, Dionissios Neofytos, Elias J Anaissie, Jay A Fishman, William J Steinbach, Ali J Olyaei, Kieren A Marr, Michael A Pfaller, Chi-Hsing Chang, Karen M Webster

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Candidemia remains a major cause of morbidity and mortality in the health care setting, and the epidemiology of Candida infection is changing.

METHODS: Clinical data from patients with candidemia were extracted from the Prospective Antifungal Therapy (PATH) Alliance database, a comprehensive registry that collects information regarding invasive fungal infections. A total of 2019 patients, enrolled from 1 July 2004 through 5 March 2008, were identified. Data regarding the candidemia episode were analyzed, including the specific fungal species and patient survival at 12 weeks after diagnosis.

RESULTS: The incidence of candidemia caused by non-Candida albicans Candida species (54.4%) was higher …

Psychotherapy As A Treatment Modality For Psychiatric Disorders: Perceptions Of General Public Of Karachi, Pakistan, Abdul Mueed Zafar, Ali Jawaid, Hiba Ashraf, Ambreena Fatima, Rubina Anjum, Salah U. Qureshi

Department of Psychiatry

Background: Psychiatric disorders affect about 450 million individuals worldwide. A number of treatment modalities such as psychotropic medications, psychotherapy and electroconvulsive therapy can be used to treat these disorders. Attitudes of general public play a pivotal role in effective utilization of mental health services. We explored the perceptions of general public of Karachi, Pakistan regarding psychotherapy. Methods: A cross-sectional study was conducted in Karachi, Pakistan during July-August, 2008. A three-step sampling strategy and a structured questionnaire were employed to survey knowledge and perceptions of adult general public about psychotherapy. Descriptive statistics were used for baseline characteristics. Logistic regression models were …

Kinetics And Phenotype Of Vaccine-Induced Cd8+ T-Cell Responses To Toxoplasma Gondii, Kimberly A. Jordan, Emma H. Wilson, Elia D. Tait, Barbara A. Fox, David S. Roos, David J. Bzik

Dartmouth Scholarship

Multiple studies have established that the ability of CD8⁺ T cells to act as cytolytic effectors and produce gamma interferon is important in mediating resistance to the intracellular parasite Toxoplasma gondii. To better understand the generation of the antigen-specific CD8⁺ T-cell responses induced by T. gondii, mice were immunized with replication-deficient parasites that express the model antigen ovalbumin (OVA). Class I tetramers specific for SIINFEKL were used to track the OVA-specific endogenous CD8⁺ T cells. The peak CD8⁺ T-cell response was found at day 10 postimmunization, after which the frequency and numbers of antigen-specific cells …

Modulation Of Edna Release And Degradation Affects Staphylococcus Aureus Biofilm Maturation., Ethan E. Mann, Kelly C. Rice, Blaise R. Boles, Jennifer L. Endres, Dev Ranjit, Lakshmi Chandramohan, Laura H. Tsang, Mark S. Smeltzer, Alexander R. Horswill, Kenneth W. Bayles

Journal Articles: Pathology and Microbiology

Recent studies have demonstrated a role for Staphylococcus aureus cidA-mediated cell lysis and genomic DNA release in biofilm adherence. The current study extends these findings by examining both temporal and additional genetic factors involved in the control of genomic DNA release and degradation during biofilm maturation. Cell lysis and DNA release were found to be critical for biofilm attachment during the initial stages of development and the released DNA (eDNA) remained an important matrix component during biofilm maturation. This study also revealed that an lrgAB mutant exhibits increased biofilm adherence and matrix-associated eDNA consistent with its proposed role as an …

Development And Validation Of An Index Of Musculoskeletal Functional Limitations, Jeffrey N. Katz, Elizabeth A. Wright, John A. Baron, Elena Losina

Dartmouth Scholarship

While musculoskeletal problems are leading sources of disability, there has been little research on measuring the number of functionally limiting musculoskeletal problems for use as predictor of outcome in studies of chronic disease. This paper reports on the development and preliminary validation of a self administered musculoskeletal functional limitations index.

Technology, Context, Synthesis, Rosalyn P. Scott

Department of Surgery Faculty Publications

No abstract provided.

Mitogen-Activated Protein Kinase (Mapk) Pathways Mediate Embryonic Responses To Culture Medium Osmolarity By Regulating Aquaporin 3 And 9 Expression And Localization, As Well As Embryonic Apoptosis., Christine E Bell, Nathalie M K Larivière, Patricia H Watson, Andrew J Watson

Obstetrics & Gynaecology Publications

BACKGROUND: In order to advance the development of culture conditions and increase the potential for supporting normal preimplantation embryo development in vitro, it is critical to define the mechanisms that early embryos utilize to survive in culture. We investigated the mechanisms that embryos employ in response to culture medium osmolarity. We hypothesized that mitogen-activated protein kinase (MAPK) pathways mediate responses to hyperosmotic stress by regulating Aquaporin (AQP) 3 and 9 expression as well as embryonic apoptosis.

METHODS: Real-time reverse transcription and polymerase chain reaction and whole-mount immunofluorescence were used to determine the relative mRNA levels and protein localization patterns of …

A Dominant Loss-Of-Function Gja1 (Cx43) Mutant Impairs Parturition In The Mouse, Dan Tong, Xuerong Lu, Hong-Xing Wang, Isabelle Plante, Ed Lui, Dale W. Laird, Donglin Bai, Gerald M. Kidder

Physiology and Pharmacology Publications

Expression of GJA1 (commonly known as connexin43 or Cx43), a major myometrial gap junction protein, is upregulated before the onset of delivery, suggesting an essential role for Cx43-mediated gap junctional intercellular communication (GJIC) in normal uterine contraction during parturition. To determine how a disease-linked Cx43 mutation affects myometrial function, we studied a mutant mouse model carrying an autosomal dominant mutation (Gja1Jrt) in the gene encoding Cx43 that displays features of the human genetic disease oculodentodigital dysplasia. We found that Cx43 level, specifically the phosphorylated species of the protein, is significantly reduced in the myometrium of the mutant mice (Gja1Jrt/+), as …

Ageing Population: Status, Challenges And Opportunities For Health Care Providers In Pakistan, Waris Qidwai Dr

Department of Family Medicine

No abstract provided.

Comparison Of Urdu Version Of Strengths And Difficulties Questionnaire (Sdq) And The Child Behaviour Check List (Cbcl) Amongst Primary School Children In Karachi, Ehsan Ullah Syed, Sajida Abdul Hussein, Syed Iqbal Azam, Abdul Ghani Khan

Department of Psychiatry

OBJECTIVE: To compare CBCL (Child Behaviour Check Llist) Urdu, with the validated Urdu version of Strengths and Difficulties Questionnaire (SDQ) used as "gold standard" among school children in Karachi, Pakistan, and to develop local cutoffs for CBCL using SDQ as a gold standard.

STUDY DESIGN: A cross-sectional study.

PLACE AND DURATION OF STUDY: Schools of Karachi metropolitan area from January to December 2006.

METHODOLOGY: The Strengths and Difficulties Questionnaire (SDQ) and Child Behaviour Check List (CBCL) was completed by parents of 5-11 years old primary school children in Karachi. Appropriate cutoff points for total problem, internalizing and externalizing scales were …

Benzodiazepine: Slow Sand Of Addiction, Haider Naqvi, Sajjad Hussan, Fatema Dossa

Department of Psychiatry

No abstract provided.

Clinical And Translational Implications Of The Caveolin Gene Family: Lessons From Mouse Models And Human Genetic Disorders., Isabelle Mercier, Jean-Francois Jasmin, Stephanos Pavlides, Carlo Minetti, Neal Flomenberg, Richard G Pestell, Philippe G Frank, Federica Sotgia, Michael P Lisanti

Department of Stem Cell Biology and Regenerative Medicine Faculty Papers & Presentations

Here we review the clinical and translational implications of the caveolin gene family for understanding the pathogenesis of human diseases, including breast and prostate cancers, pulmonary hypertension, cardiomyopathy, diabetes, and muscular dystrophy. Detailed phenotypic analysis of caveolin knockout mice has served to highlight the crucial role of a caveolin deficiency in the pathogenesis of many human disease processes. Mutations in the human caveolin genes are associated with a number of established genetic disorders (such as breast cancer, lipodystrophy, muscular dystrophy, and cardiomyopathy), making the caveolins important and novel targets for drug development. The implementation of new strategies for caveolin replacement …

Chorioangioma Of The Placenta With Hydrops Foetalis, Gulnaz Shafqat, Farah Iqbal, Farhan Rizvi

Department of Radiology

Chorioangioma, the non trophoblastic tumour, constitutes the commonest benign growth of the placenta. Though benign, 30% rate of maternal or foetal complications are associated with large masses. Sonography including colour Doppler imaging provides the best modality not only for its diagnosis but also the foetal status. A case of large placental chorioangioma has been reported here resulting in dismal foetal outcome diagnosed on antenatal ultrasound.

Weight Gain Associated With Hormonal Contraception Use In Adolescents Is Not Different From Control, Abdel Salous, Valerie Jones, Maria Melguizo Castro, Linah Al-Alem, Hatim A. Omar

Pediatrics Faculty Publications

The use of hormonal contraception is commonly associated with weight gain. The purpose of this retrospective study was to explore the association between the use of hormonal contraception and weight change in an outpatient adolescent patient population in Lexington, Kentucky. Data were gathered from the charts of 259 adolescent female patients seen in an outpatient adolescent clinic for up to 72 months. At the initial visit, all patients were evaluated for risk-taking behavior and received preventive counseling. Patients were categorized as either contraception users or non-users (control group). Contraception users were subdivided into Depot Medroxyprogesterone Acetate (DMPA) user group or …

Oncolog Volume 54, Number 06, June 2009, John Lebas, Maude Veech

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

• Chronic Myelogenous Leukemia: Refining Approaches to Treatment
• Advancing the Treatment of Lymphedema
• House Call: Hospice: Comforting Care When the End Is Near

It Is More Than Just A Reproductive Healthcare Visit: Experiences From An Adolescent Medicine Clinic, Marlene B. Huff, Kimberly K. Mcclanahan, Heather A. Brown, Hatim A. Omar

Pediatrics Faculty Publications

The gynecologist may be the only physician that an adolescent depends on for primary and reproductive healthcare services. Because adolescent females often make personal healthcare decisions without the benefit of supportive parents/caregivers, it is imperative that the gynecologist understands the developmental issues encountered during this phase of life. The objective of this study is to identify cited complaints of adolescent females seeking reproductive care and, thus, provide gynecologists with needed information about the medical/mental health issues that may be encountered during routine reproductive care exams. The study group was adolescent females between the ages of 12 and 20 years old. …

Field Testing Adolescent Females For Cardiovascular Disease Risk, C. Jayne Brahler, Wesley R. Stephens, Betsy Donahoe Fillmore

Physical Therapy Faculty Publications

Over-fatness and poor cardiovascular (CV) fitness are well-documented risk factors for cardiovascular disease (CVD) in adults, but less is known about their association with disease risk in adolescents. This study aimed to determine the relationship between anthropometrics, fitness, and CVD risk.

Six anthropometric indicators of body fatness, seven measures of fitness, and seven metabolic and hemodynamic CVD risk factors were measured in a convenience sample of 28 female high school students (15-18 years of age). A tally was made of the number of factors for which each subject was outside the normal reference range (CVD risk).

Correlation analyses were completed …

Evaluation Of Two Elisa Assay Kits Against Rt-Pcr For Diagnosis Of Dengue Virus Infection In A Hospital Setting In Karachi, Pakistan, Erum Khan, Vikram Mehraj, Amna Nasir, Nabil Ahmad Khan, Bushra Billoo, Tariq Moatter, Rumina Hasan

Department of Pathology and Laboratory Medicine

OBJECTIVE: To evaluate two commercially available ELISA-based kits against RT-PCR for the diagnosis of dengue virus infection in a Tertiary Care center in Karachi.METHODS: During the 2006 Dengue outbreak, sera were collected from patients clinically classified as dengue fever and graded according to WHO grading. Out of these, 83 samples were selected randomly and analyzed using two different commercial kits (PanBio versus Calbiotech) and were compared with RT-PCR. Clinical charts of the inpatients were also reviewed. Statistical significance was considered at P < or = 0.05.RESULTS: Clinically, a total of 29 (69%) in-patients were diagnosed with dengue haemorrhagic fever, the remaining 13 (30.9%) were diagnosed as dengue fever. Diagnostic PCR was positive in 73 (87.9%) of the total 83 patients. PanBio capture ELISA had a sensitivity of 83.5%. Calbiotech on the other hand, had a sensitivity of 50.7%. The association of PanBio assay with PCR was found to be statistically significant (p

Parents Ask: Am I Risking Autism If I Vaccinate My Children?, Rhea Paul

Communication Disorders Faculty Publications

There is no evidence that autism is caused by any vaccine or any additive or preservative ever used in one. There have been large, well-controlled studies done all over the Western world that have confirmed this finding over and over again. There is no reason for any parent to deny a child the crucial protection today’s vaccines offer out of misguided fear that doing so would increase the risk for autism.

Quality Of Life And Depression: Outcome Markers For A Weight Management Program, Cecilia Dueñas

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric obesity has become a national epidemic and current trends suggest a continued increase. Obese children have been found to have higher incidences of depression and a lower quality of life (QOL) than children from other often more severe medical populations. As a result, weight management programs are on the increase with the majority measuring outcome success through weight loss and decreased body mass index (BMI). It is evident however, that health factors are not the only factors associated with obesity, and that psychosocial components are important as well. The Loma Linda University Growing Fit Program is unique in that …

Mnte-2-Pyp And Radiation In A Prostate Cancer Model: Implications For Radiotherapy, Adeola Y. Makinde

Loma Linda University Electronic Theses, Dissertations & Projects

A major limitation of successful radiation therapy in cancer treatment is the increase in normal tissue damage as higher doses are used to achieve greater tumor destruction. Radiation dose optimization in cancer therapy requires achieving maximum tumor destruction with minimal damage to normal tissue Antioxidants have been shown to protect normal tissues against radiation damage, as radiation-induced tissue damage results predominantly from reactive oxygen species that directly damage cellular components. However, for effective use as normal tissue radioprotectants in radiotherapy, these antioxidants must not protect the tumors. Mn (III) tetrakis (N-ethylpyridinium-2-yl) porphyrin (MnTE-2-PyP) is a metalloporphyrin antioxidant that has been …

Attitudes And Beliefs That Predict Taiwanese Older Adults' Intentions To Attend Strength And Balance Training Programs, Shih-Fan Lin

Loma Linda University Electronic Theses, Dissertations & Projects

The rate of participation in the strength and balance training (SBT) program, an effective fall prevention intervention, is very low among older adults. To increase older adults' participations in SBT programs, this study involved an observational and cross-sectional study design to understand factors that affect Taiwanese older adults' intention to attend SBT programs utilizing the theory of planned behavior. Questionnaires that measured constructs of the theory of planned behavior (attitude, subjective norm, perceived behavioral control, and behavioral, normative, and control beliefs) were collected from 221 community-dwelling Taiwanese elderly women between the age of 55 and 94. Simple correlations and multiple …

Tuberculosis In San Bernardino County, 1993-2004 : Lifestyle And Environmental Factors, Anuj Bhatia

Loma Linda University Electronic Theses, Dissertations & Projects

An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, …