Medicine and Health Sciences Commons^™

Epidural Anaesthesia During Labour For A Patient With Congenital Complete Heart Block: A Case Report, Abdul Monem, Ursula Chohan, Mohammed Ali

Department of Anaesthesia

We report labour pain management in a full-term pregnant patient with Congenital Complete Heart Block. She delivered uneventfully under routine monitoring with facilities for pacing at hand. She previously had an uneventful normal delivery and a D&E, both outside our hospital. Only findings were a low heart rate of 45-50 beats per minute. She never had syncopal attacks. She had a good effort tolerance on ETT. Her ejection fraction was 60% on Echocardiogram. She was given a single shot low dose spinal with fentanyl followed by epidural insertion. She successfully delivered through mid-cavity forceps in about 2.5 hours. The only …

Eltrombopag For The Treatment Of Chronic Idiopathic Thrombocytopenic Purpura, James Bussel, Bhabita Mayer, Nicole Stone, Michael Arning, Drew Provan, Mansoor Saleh

Haematology and Oncology, East Africa

Background: The pathogenesis of chronic idiopathic thrombocytopenic purpura (ITP) involves antibody-mediated platelet destruction and reduced platelet production. Stimulation of platelet production may be an effective treatment for this disorder.

Methods: We conducted a trial in which 118 adults with chronic ITP and platelet counts of less than 30,000 per cubic millimeter who had had relapses or whose platelet count was refractory to at least one standard treatment for ITP were randomly assigned to receive the oral thrombopoietin-receptor agonist eltrombopag (30, 50, or 75 mg daily) or placebo. The primary end point was a platelet count of 50,000 or more per …

Factors Associated With Teenage Pregnancy In The European Union Countries: A Systematic Review, Mari Imamura, Janet Tucker, Phil Hannaford, Miguel Oliveira Da Silva, Margaret Astin, Laura Wyness, Kitty Wm Bloemenkamp, Albrecht Jahn, Helle Karro, Jørn Olsen, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: As part of the REPROSTAT2 project, this systematic review aimed to identify factors associated with teenage pregnancy in 25 European Union countries.

Methods: The search strategy included electronic bibliographic databases (1995 to May 2005), bibliographies of selected articles and requests to all country representatives of the research team for relevant reports and publications. Primary outcome measure was conception. Inclusion criteria were quantitative studies of individual-level factors associated with teenage (13–19 years) pregnancy in EU countries.

Results: Of 4444 studies identified and screened, 20 met the inclusion criteria. Most of the included studies took place in UK and Nordic countries. …

Pregnancy Outcome In Primiparae Of Advanced Maternal Age, Ilse Delbaere, Hans Verstraelen, Sylvie Goetgeluk, Guy Martens, Guy De Backer, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: To investigate the impact of maternal age on singleton pregnancy outcome, taking into account intermediate and confounding factors.

Study design: In this population-based retrospective cohort study, perinatal data of primiparous women aged 35 years or more ( n = 2970), giving birth to a singleton child of at least 500 g, were compared to data of primiparous women aged 25–29 years old ( n = 23,921). Univariate analysis was used to assess the effect of maternal age on pregnancy outcomes. The effects of intermediate (hypertension, diabetes and assisted conception) and confounding factors (level of education) were assessed through multivariable …

Chondroblastoma Of The Cuboid With An Associated Aneurysmal Bone Cyst: A Case Report, Yasir J Sepah, Masood Umer, Khurram Minhas, Kamran Hafeez

Department of Surgery Docs

Abstract

We report the case of a young adult who presented with a painful foot due to chondroblastoma associated with an aneurismal bonecyst.Chondroblastoma is a rare benign cartilaginous neoplasm that accounts for approximately 1% of all bone tumors and characteristically arises in the epiphysis of a long bone, particularly the humerus, tibia, and femur. Chondroblastoma can affect people of all ages. It is, however, most common in children and young adults between the ages of 10 and 20 years. Association of chondroblastoma with aneurysmal bone cyst is well documented however this association has only once been reported in the cuboid.Imaging …

Lung-Derived Macrophage Migration Inhibitory Factor In Adult Patients With Septic Shock, And Its Role In Cardiocirculatory Depression, Hans Lee, Kaie Ojamaa, Greg Ruskin, Erfan Hussain, Maowen Hu, Xinchun Lin, Christine Metz, Yousef Al-Abed, Edmund Mille

Department of Medicine

Migration inhibitory factor (MIF), a critical proinflammatory mediator in sepsis, has a profound affect on cardiovascular function. Our animal studies show that the lungs release MIF into the systemic circulation during late sepsis. MIF released in this way has direct and immediate access to cardiac cells. The purpose of our study was to assess the lung as a source of MIF in human septic shock patients and to further study the MIF-associated pathways involved in cardiovascular depression.

The Resurgence Of The Adora2b Receptor As An Immunotherapeutic Target In Pancreatic Cancer, Inah Lee, James J Knierim

Faculty, Staff and Student Publications

Subfields of the hippocampus display differential dynamics in processing a spatial environment, especially when changes are introduced to the environment. Specifically, when familiar cues in the environment are spatially rearranged, place cells in the CA3 subfield tend to rotate with a particular set of cues (e.g., proximal cues), maintaining a coherent spatial representation. Place cells in CA1, in contrast, display discordant behaviors (e.g., rotating with different sets of cues or remapping) in the same condition. In addition, on average, CA3 place cells shift their firing locations (measured by the center of mass, or COM) backward over time when the animal …

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Jefferson Surgical Solutions

No abstract provided.

Jss Editorial Board & Credits

Jefferson Surgical Solutions

No abstract provided.

News In Brief

Jefferson Surgical Solutions

No abstract provided.

Those Who Give

Jefferson Surgical Solutions

No abstract provided.

On The Job

Jefferson Surgical Solutions

No abstract provided.

More Veggies, Less Breast Cancer: Unlocking One Secret To Prevention

Jefferson Surgical Solutions

No abstract provided.

Meet Our Surgical Interns

Jefferson Surgical Solutions

No abstract provided.

Comprehensive Breast Program Continues To Set The Trend

Jefferson Surgical Solutions

No abstract provided.

Overview From The Chairman

Jefferson Surgical Solutions

No abstract provided.

Heart Transplant Program Offers A New Lease On Life

Jefferson Surgical Solutions

No abstract provided.

Depression In The Elderly: Does Family System Play A Role? A Cross-Sectional Study, Ather M. Taqui, Ahmed Itrat, Waris Qidwai, Zeeshan Qadri

Department of Family Medicine

Background

The most common geriatric psychiatric disorder is depression. The role of family systems in depression among the elderly has not been studied extensively. It has been suggested that urbanization promotes nucleation of family systems and a decrease in care and support for the elderly. We conducted this study in Karachi, a large urban city of Pakistan, to determine the relationship between the type of family system and depression. We also determined the prevalence of depression in the elderly, as well as correlation of depression with other important socio-demographic variables.

Methods

A cross-sectional study was carried out in the premises …

An Update On The Diagnosis And Treatment Of Early Lyme Disease: "Focusing On The Bull's Eye, You May Miss The Mark", Amber Stonehouse, James S. Studdiford, C. Amber Henry

Department of Family & Community Medicine Faculty Papers

To confidently diagnose and treat Lyme disease, the clinician must first understand the natural history of this disease, especially its protean early manifestations. Emergency physicians, primary care physicians, and other providers need to be vigilant in terms of the timely recognition of erythema migrans (EM), the unique marker of early localized stage 1 disease. The classic EM, originally described as a slowly expanding bull's eye lesion, is now recognized to be present in only the minority of cases (9%); the dominant morphologic lesion of EM is now recognized to be the diffusely homogenous red plaque or patch, which occurs in …

Paraumbilical Collateral Veins On Mri As Possible Protection Against Portal Venous Thrombosis In Candidates For Liver Transplantation, Sachit Verma, Donald G. Mitchell, Yulia Lakhman, Diane Bergin, Ronald J. Dolin, Cataldo Doria, Laurence Parker

Department of Radiology Faculty Papers

Background: We retrospectively evaluate the potential protective influence of patent paraumblical vein (PUV) collaterals against portal vein (PV) thrombosis and reduced PV diameter in candidates for orthotopic liver transplant (OLT)

Methods: Dynamic 3D contrast-enhanced MRI at 1.5T was obtained in 309 patients with cirrhosis without evidence of malignancy. All MR studies were reviewed by one reader for PUV collaterals, PV thrombosis and PV diameter. Statistical analysis was performed by Fisher exact tests; 50 selected studies were reviewed independently by two additional readers to determine interobserver agreement via intraclass correlation coefficient (ICC).

Results: Patent PUV was noted in …

Com Outlook Fall 2007, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Traumatic Carotid-Cavernous Fistula: Clinical Presentation And Outcome, Atta A. Bhatti, S. Soulat Raza, Muhammad Ehsan Bari, S. Ather Enam, Tanveer Ul Haq, Zafar Sajjad

Section of Neurosurgery

Objective:To evaluate the presentation, clinical course and outcome of traumatic carotid-cavernous fistula (CCF) withendovascular treatment at our institution during the last five years.
Design: Retrospective descriptive study.
Setting: The study included patients seen at Aga Khan University Hospital from January 2000 to December 2005.
Methods: Retrospective analysis based on data retrieval from medical records using ICD coding system. Only those cases who had traumatic CCF and underwent endovascular treatment were included in the study.
Results: A total of 8 patients were diagnosed with post-traumatic CCF and 11 procedures were done. Mean age at presentation was 35.6 years; …

Chemotherapy And Survival For Patients With Multiple Myeloma: Findings From A Large Nationwide And Population-Based Cohort, Nidhi Rohatgi, Xianglin L. Du, Ann L. Coker, Lemuel L. Moye, Michael Wang, Shenying Fang

CRVAW Faculty Journal Articles

Objective: To assess the patterns of chemotherapy use for patients with multiple myeloma and to determine if chemotherapy is effective in prolonging survival outside the clinical trial settings.

Methods: We studied a nationwide and population-based retrospective cohort of 4902 patients ≥65 years of age with stage II or III multiple myeloma from 1992 to 1999, identified from the Surveillance, Epidemiology, and End-Results-Medicare data. Multivariate logistic regression was used to estimate the odds ratio of receiving chemotherapy and Cox proportional hazard model was used to estimate the hazard ratio of mortality associated with chemotherapy.

Results: Of 4902 patients with stage II …

Neurosurgical Training In Pakistan, Ather Enam

Section of Neurosurgery

No abstract provided.

Umbilical Cord Prolapse--A Review Of Diagnosis To Delivery Interval On Perinatal And Maternal Outcome, Rozilla Sadia Khan, Tahira Naru, Faryal Nizami

Department of Obstetrics & Gynaecology

Objective: To determine the significance of the Diagnosis to Delivery Interval (DDI) on perinatal outcome and maternal complications in patients with umbilical cord prolapse.
Methods: This was a case series of 44 patients identified with "Umbilical cord prolapse" during a 10-year period at the Aga Khan University Hospital. Data was retrieved for gestational age, foetal presentation, DDI, incision to delivery time, delivery method, apgar score, birth weight and outcome, and maternal complications. The influence of DDI on perinatal mortality, apgar scores at 5 minutes, neonatal intensive care unit (NICU) admission and maternal complications resulting from mode of delivery with cord …

Characterisitcs Of Patients With Acute Coronary Syndrome: Where Is The Gender Gap?, Marna R. Greenberg Do, Mph, Facep, Tecla Brabazon Do, Anne Marie Crown, Sharon R. Kimmel Phd

Department of Emergency Medicine

No abstract provided.

The Value Of A Promotora-Led Diabetes Education Program, Eric J. Gertner Md, Mph, Hannah D. Paxton Rn, Mph

Department of Family Medicine

No abstract provided.

Effects Of Atomoxetine On Growth In Children With Attention-Deficit/Hyperactivity Disorder Following Up To Five Years Of Treatment., Thomas J. Spencer, Christopher J. Kratochvil, R. Bart Sangal, Keith E. Saylor, Charles E. Bailey, David W. Dunn, Daniel A. Geller, Charles D. Casat, Robert S. Lipetz, Rakesh Jain, Jeffrey H. Newcorn, Dustin D. Ruff, Peter D. Feldman, Amanda J. Furr, Albert J. Allen

Journal Articles: Psychiatry

OBJECTIVE: To examine the effects on growth of long-term pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD), we present findings from an ongoing 5-year study of the efficacy and safety of treatment with atomoxetine.

METHODS: North American patients, 6-17 years old at study entry (N = 1,312) and with Diagnostic and Statistical Manual of Mental Disorders,4th edition (DSM-IV) ADHD, were studied under open-label atomoxetine treatment. Sixty-one were studied up to 5 years.

RESULTS: After 1 month's treatment, patients weighed less than expected from their starting percentiles relative to population norms, with a maximum shortfall at 15 months and a return to expected …

The Effectiveness Of Prophylactic Eye Drops On The Reversal Of Uv-Light Induced Cataracts, Contessa Bly Bowman

Theses and Dissertations

Cataracts are a cloudiness of the lens within the eye which obstructs vision. They are found in many species including rats, dogs, and humans. Vision is hindered where this "cloudiness", made of water build up and broken crystalline, proteins take form. Oculvet is an eye medication, used by veterinarians, containing carnosine as its active ingredient. Topical application of carnosine is reported to be an effective treatment for the prevention and removal of pre-existing cataracts. For this experiment, Sprague- Dawley rats were anesthetized and exposed to ultraviolet radiation, UVB and UVC. They were divided into four groups (n = 32), three …

Rhabdomyolysis After Laparoscopic Nephrectomy., Deborah T. Glassman, William G. Merriam, Edouard J. Trabulsi, Dolores Byrne, Leonard Gomella

Department of Urology Faculty Papers

BACKGROUND AND OBJECTIVES: Laparoscopic renal surgery has become a widely applied technique in recent years. The development of postoperative rhabdomyolysis is a known but rare complication of laparoscopic renal surgery. Herein, 4 cases of rhabdomyolysis and a review of the literature are presented with respect to pathogenesis, treatment, and prevention of this dire complication. METHODS: A retrospective review of over 600 laparoscopic renal operations over the past 8 years was performed. All cases of postoperative rhabdomyolysis were identified. A Medline search was performed to find articles related to the development of postoperative rhabdomyolysis. Cases of rhabdomyolysis developing after laparoscopic renal …