Medicine and Health Sciences Commons^™

Factorial Validity Of The Team Skills Scale As Used For Geriatric Interdisciplinary Team Training (Gitt), Myra G. Owens

Theses and Dissertations

Objective: To examine the factorial validity of the Team Skills Scale (TSS). The TSS is a 17-item scale developed by Hepburn, Tsukuda, and Fasser (1996). The Scale is purported to assess self-perceived team skills.Data Source: Data for this study were provided by The New York University Geriatric Interdisciplinary Team Training (GITT) Resource Center and were collected as part of the evaluation of the GITT program. The data were collected between January 1997 and June 2000.Study Design: This quasi-experiential study was focused on the trainee (N=1,715) as the unit of analysis. The Model of Individual-Level Team Competencies (Model of I-LTC) served …

Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson

Theses and Dissertations

Problem: There is a shortage of military certified registered nurse anesthetists (CRNAs). The exodus from military service to civilian careers could be a result of relative deprivation (the discrepancy that one perceives between what one has and what one could or should have). Relative deprivation is a perception of unfairness dependent on feelings (subjective data) as well as facts (objective data). Purpose: The purpose of this study was to measure relative deprivation in active duty military nurse anesthetists, to explore variables which correlate with relative deprivation, and to validate or refute the theory of relative deprivation in active duty military …

Relationship Between Functional Level And Cost Of Care Of Nursing Home Residents As Measured By The Functional Component Of The Minimum Data Set And The Breines Functional Assessment Scale, Jeanne Turnamian

Seton Hall University Dissertations and Theses (ETDs)

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Waldenstrom's Macroglobulinemia Terminating In Acute Myeloid Leukemia, Safoorah Khalid, Salman Adil, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Waldenstrom's macroglobulinemia (WM) is a rare condition, accounting for approximately 2% of haematologic malignancies. The most common causes of death in these patients are progression of the malignant lymphoproliferative process, infection and cardiac failure. Acute leukemia is a rare event in the clinical course of WM. A number of case reports have documented the development of terminal acute leukemia in patients with WM following prolonged chemotherapy.

Role Of Ict Malaria Immunochromatographic Test For Rapid Diagnosis Of Malaria, Mahadev S. Harani, M.Asim Beg, Lubna Khaleeq,, Salman Adil, Ghulam Nabi Kakepoto, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To evaluate the sensitivity and specificity of immunochromatographic test (ICT) malaria p.f/p.v using microscopy as the gold standard diagnosis. Methods: Five hundred and sixty patients of both sexes and all age groups with clinical suspicion of malaria were studied. Venous blood was collected for microscopy and ICT. Thick and thin films prepared and stained with Leishman's stain were examined. ICT malaria test was performed and interpreted according to manufacturer's instructions. Data was analyzed using Epi-6.
Results: A total of 560 cases were studied, 339 males and 221 females with age ranges between 2 to 73 years. …

Screening For Cystic Fibrosis: The Importance Of Using The Correct Tools, Uzma Shah, Tariq Moatter

Department of Pathology and Laboratory Medicine

Background: Cystic Fibrosis (CF) is a potentially lethal genetic disorder. The most frequent mutation worldwide in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene is designated as the Delta F508 mutation. This mutation was found in only 33% of Pakistani patients studied. Since the common Pakistani mutations remain to be identified, appropriate screening tools are required to identify disease. Sweat chloride determinations remain the gold standard for diagnosing CF. This study was done to emphasize the importance of using the correct tests.
Methods: The study was conducted at the Aga Khan University Hospital. The CFTR delta F508 mutation was tested …

M. Leprae Inhibits Apoptosis In Thp-1 Cells By Downregulation Of Bad And Bak And Upregulation Of Mcl-1 Gene Expression, Zahra Hasan, Mussarat Ashraf, Ali Tayyebi, Rabia Hussain

Department of Pathology and Laboratory Medicine

Background: Virulent Mycobacterium leprae interfere with host defense mechanisms such as cytokine activation and apoptosis. The mitochondrial pathway of apoptosis is regulated by the Bcl-2 family of proteins. Expression of Fas ligand and apoptotic proteins is found in leprosy lesions and M. leprae has been shown to activate pro-apoptotic Bcl-2 genes, Bak and Bax. However, the mechanism by which M. leprae modulates apoptosis is as yet unclear. We investigated expression of apoptotic genes in THP-1 monocytes in response to infection by M. leprae and non-pathogenic M. bovis BCG.
Results: M. leprae did not induce apoptosis in THP-1 cells, while BCG …

Blood And Body Fluid Exposure And Risk To Health Care Workers, Afia Zafar

Department of Pathology and Laboratory Medicine

No abstract provided.

Extra Pulmonary Uptake Of Tc-99m-Maa Perfusion Lung Scan As A Result Of Right To Left Intra Cardiac Shunt, Riffat Hussain, Maseeh-Uz-Zaman, Sohail Abrar Khan, M Nadeem Ahmad

Department of Pathology and Laboratory Medicine

Extra pulmonary accumulation of Tc-99m-macroaggregate of albumin (MAA) is rarely seen on perfusion lung scan, and has been reported in less than 4% of a study population of nearly 380 patients1. It occurs when the agent bypasses the lungs due to a right to left (R-L) cardiac or pulmonary shunt, when it is shunted to the portal vein before reaching the right atrium and ventricle of the heart, and when the agent is degraded to a submicron particle size.2 When a pharmaceutical problem is excluded, extra-pulmonary uptake implies unusual hemodynamics with a shunt.

Limb-Shaking Transient Ischemic Attacks: Case Report And Review Of Literature, Saad Ali, Muhib Alam Khan, Bhojo Khealani

Section of Neurology

Background: Limb shaking Transient Ischemic Attack is a rare manifestation of carotid-occlusive disease. The symptoms usually point towards a seizure like activity and misdiagnosed as focal seizures. On careful history the rhythmic seizure like activity reveals no Jacksonian march mainly precipitated by maneuvers which lead to carotid compression. We here present a case of an elderly gentleman who was initially worked up as suffering from epileptic discharge and then later on found to have carotid occlusion.CASE PRESENTATION: Elderly gentleman presented with symptoms of rhythmic jerky movements of the left arm and both the lower limbs. Clinical suspicion of focal epilepsy …

Gift Authorship Practices - History, Trends And Remedies, Saba Sohail

Department of Radiology

No abstract provided.

Cisplatin Nephrotoxicity And Hydration Protocols, Ahmed Usman, Heeranand Keswani, Suresh Nagdev,, Ghulam H, Tehseen Khursheed,, Anis Malik,, Kasif Jafferi

Department of Medicine

Objective : Ahmed Usman, Heeranand Keswani, Suresh Nagdev, Ghulam Haider, Tehseen Khursheed, Anis Malik, Kasif Jafferi To evaluate the nephrotoxicity of cisplatiri in cancer patients, using different protocols of hydration.

Study Design : Randomized controlled trial.

Patients & Methods : This study was conducted between 1st June to 30th November 2004. Ninetynine patients with normal renal function were enrolled in the study and randomly assigned into the 3 study groups, each group having 33patients. In group 1 hydration was done with saline (2 liter) alone, in group 2 with saline (2 liter) and furosemide (40mg) and in group 3 with …

Neuroleptic Malignant Syndrome: Need For Early Diagnosis And Therapy, Humaira M. Khan, Nadir A. Syed, Mughis Sheerani, Bhojo Khealani, Ayeesha Kamal, Mohammad Wasay

Department of Medicine

Background: Neuroleptic Malignant Syndrome (NMS) is a medical entity that has received little attention in the clinical settings in Pakistan. The aim of our study was to review the predisposing factors, outcomes and characteristics of in-patients diagnosed with NMS.

Methods: We performed a retrospective chart review of all cases (age > 15 years) at a tertiary care center in Karachi between January 01, 1990 and November 30, 2001, diagnosed using ICD 10 coding. Data was collected using a standardized data entry form and statistical analysis was performed using Epi Info 6, Version 6.02.

Results: There were a total of 20 patients …

Minimally Symptomatic Severe Hypercalcaemia In A Patient With Parathyroid Carcinoma., Aisha Sheikh, Najmul Islam

Department of Medicine

The case of a 38 years old man with generalized pains fatigue, anorexia, constipation, polyuria serum calcium level of 20.6mg/dl in paired renal function parathyroid hormone is presented. Sestamibi scan showed a functioning left inferior parathyroid tumor, which was successfully removed. Before surgery he was managed with rehydration, diuretics and pamidronate infusion. Five months post surgery the serum calcium levels are normal and renal function has improved.

Potential Of Vibrational Spectroscopy In The Diagnosis Of Human Tumours., Eoghan O'Faolain

Doctoral

Just fewer than 20,000 people are annually diagnosed with some form of cancer in Ireland and one in three people are likely to contract some form of cancer by age 74. With the number of cases increasing at an annual rate of 2%, the early detection and treatment of cancer is becoming increasingly important. Both IR and Raman spectroscopy offer the potential for real time, quantitative detection of cancer and even precancer. This study investigates the potential of Raman and Fourier transform infrared, both benchtop and synchrotron spectroscopies for the detection of cervical cancer. The tissue was classified and its …

The Use Of Proteomic Technologies To Identify Serum Glycoproteins For The Early Detection Of Liver And Prostate Cancers, Elizabeth Ellen Schwegler

Theses and Dissertations in Biomedical Sciences

The application of proteomic technologies to identify serum glycoproteins is an emerging technique to identify new biomarkers indicative of disease severity. Many of these newly evolving protein-profiling methodologies have evolved from previous global protein expression profiling studies such as those involving SELDI-TOF-MS technologies. Though the SELDI approach could distinguish disease from normal by utilizing protein patterns as shown herein with the HCC study of chapter II, it was unable to offer sequence information on the selected peaks, and did not have the ability to analyze the entire dynamic range of the serum/plasma proteome. To address these deficiencies, new strategies that …

Understanding The Nature Of Surgical Excellence Using A Competency Modeling Approach, Hope S. Hanner-Bailey

Psychology Theses & Dissertations

Currently, a thorough description of the knowledge, skills, abilities, and other personal characteristics (KSAOs) that distinguish an exceptional surgeon does not exist. This knowledge is pertinent to the development of selection, training, and performance assessment methods that can be used to develop high performing surgeons. Expert surgeons from around the country were recruited to participate in an interview to discuss the KSAOs (i.e., the competencies) needed to be exceptional in the field. A smaller number of novice surgeons were also interviewed. The expert interview data were distilled into a competency model that consists of ten competencies and patterns within the …

Analysis Of Indentation Loading Of Cortical Bone Using Acoustic Emission Techniques, Ashkan Safari, Ger Reilly, Brendan Mccormack

Conference Papers

In this study, we recorded the number of Acoustic emission (AE) hits and related AE energy during indentation fracture of cortical bone using a PAC PCI-2 card and pico sensor. A threshold value of 43dB was used to filter premature trigger due to background noise. Registered AE hits had more than one count (threshold crossing). Amplifier gain was set at 40dB with a (0.1-1) MHz band pass filter. 8mm cubes of cortical bones were indented in the longitudinal direction at constant crosshead speed of 1 mm min-1 using a large 2D, 50˚ wedge indenter. We hypothesised that signals occurring as …

Orally Delivered, Plant-Produced Tat Protein Primes Mice For A Challenge Dna Vaccine Expressing Tat, A V. Karasev, S Foulke, C Wellens, I Zwierzynski, R Baldwin, H Koprowski, M S. Reitz Jr

Department of Microbiology and Immunology Faculty Papers

Oral Presentation.

Placental Expression Of Angiopoietin-1, Angiopoietin-2 And Tie-2 During Placental Development In An Ovine Model Of Placental Insufficiency-Fetal Growth Restriction., Amy S Erickson Hagen, Ryan J Orbus, Randall B Wilkening, Timothy Regnault, Russell V Anthony

Paediatrics Publications

Fetal growth restriction (FGR) is associated with increased perinatal morbidity and mortality, and often results from functional placental insufficiency. Placentation requires extensive vasculogenesis and subsequent angiogenesis, in both maternal and fetal tissues. Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) are angiogenic growth factors expressed in the placenta, and compete for binding to a common receptor, Tunica interna endothelial cell kinase-2 (Tie-2). Our objective was to examine Ang-1, Ang-2 and Tie-2 expression in ovine placental tissue obtained from normal and FGR pregnancies throughout gestation. Fetal cotyledon and maternal caruncle tissue concentrations of Ang-1, Ang-2 and Tie-2 mRNA were assessed by real-time reverse transcriptase-polymerase …

Comparison Of Two Surveys Of Head Injured Patients Presenting During A Calendar Year To An Urban Medical Centre 32 Years Apart, Rashid Jooma, Shahid Ahmed, Abdul Malik Zarden

Section of Neurosurgery

Objective: To study the patients presenting with head injuries to a tertiary hospital in Karachi during the year 2003.
Methods: During the calendar year 2003, a cross-sectional study was conducted of all patients presenting to the casualty department of Jinnah Postgraduate Medical Centre (JPMC) with head injury. Personal information was collected from the patient's attendants at presentation or later if the patient had been brought in by the emergency services as an unknown person. The circumstances of the injury were similarly established and the clinical features documented.
Results: During the year 2003, a total of 3008 patients reported to the …

The Health Status Of Southern Children: A Neglected Regional Disparity, Jeffrey Goldhagen, Radley Remo, Thomas Bryant, Peter Wludyka, Amy B. Dailey, David Wood, Graham Watts, William Livingood

Health Sciences Faculty Publications

Purpose: Great variations exist in child health outcomes among states in the United States, with southern states consistently ranked among the lowest in the country. Investigation of the geographical distribution of children’s health status and the regional factors contributing to these outcomes has been neglected. We attempted to identify the degree to which region of residence may be linked to health outcomes for children with the specific aim of determining whether living in the southern region of the United States is adversely associated with children’s health status.

Methods: A child health index (CHI) that ranked each state in the United …

Inhibition Of Collagen Gene Expression In Systemic Sclerosis Dermal Fibroblasts By Mithramycin, Nora Sandorfi, Natalia Louneva, Elena Hitraya, Gyorgy Hajnoczky, Biagio Saitta, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

ABSTRACT

Introduction. The antitumor antibiotic mithramycin has also been shown to be a potent and effective inhibitor of fibrosis following glaucoma surgery. This DNA interacting drug displays high affinity binding to GC rich sequences in DNA, including those present in the promoter of the gene encoding the Α1 chain of type I collagen (COL1A1).

Objective. To evaluate the effects of mithramycin on the production of type I collagen in fibroblast cultures from patients with systemic sclerosis. Methods. Confluent cultures of dermal fibroblasts from patients with recent onset of the diffuse form of systemic sclerosis were treated with varius concentrations of …

Oncolog, Volume 50, Number 12, December 2005, Sunni Hosemann, Diane Witter

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

• Moving New Drugs from "Bench to Bedside and Back"
• House Call: When the End Is Near: Ways to Cope When a Loved One Is Terminally Ill
• After Katrina: Caring for Cancer Patients in the Wake of the Storm

Validity Of Frozen Section In The Diagnosis Of Breast Lumps: 5 Years Experience At The Aga Khan University Hospital., Naila Kayani, Nuzhat Sultana

Department of Pathology and Laboratory Medicine

Abstract

Objective: To determine the accuracy of frozen section in the diagnosis of breast lump. Methods: Frozen section diagnosis given in consecutive breast biopsies performed in 5 years in our laboratory was evaluated against the final pathology report of permanent sections. Results: The Aga Khan University Hospital Lab receives more than 400 cases per year for frozen section. Three hundred and nineteen consecutive frozen sections of breast lumps examined from 1999-2003 were considered for analysis. Age of patients ranged between 22 and 90 years (mean age 49 years). In 316 cases (99%) there was no difference between the frozen section …

Outcome Of Endoscopic Therapeutic Interventions: Are They Different Among Various Non- Malignant Esophageal Diseases, Rustam Khan, Shahab Abid, Saeed Hamid, Z Abbas, Syed H Shah, Wasim Jafri

Section of Gastroenterology

Background: This study was carried out to evaluate and compare the outcome of various causes of non-malignant lesions of the esophagus after endoscopic therapeutic intervention.

Methods: A cohort of patients with non-malignant dysphagia presenting at Aga Khan University hospital, a tertiary care setting who underwent endoscopic intervention was studied. Response to treatment was evaluated by improvement in dysphagia score on a scale of 0-4 and weight gain.

Results:99 subjects (53 males) were included. Mean age was 48.6 +/- 17.2 years. Dysphagia for solids was present in 48%, for liquids in 3% and for both in 49% patients. Significant weight …

Comparison Between Gram Stain And Culture For The Characterization Of Vaginal Microflora: Definition Of A Distinct Grade That Resembles Grade I Microflora And Revised Categorization Of Grade I Microflora, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Leen Van Simaey, Catharine De Ganck, Ellen De Backer, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Background: The microbiological diagnosis of bacterial vaginosis is usually made using Nugent's criteria, a useful but rather laborious scoring system based on counting bacterial cell types on Gram stained slides of vaginal smears. Ison and Hay have simplified the score system to three categories and added a fourth category for microflora with a predominance of the Streptococcus cell type. Because in the Nugent system several cell types are not taken into account for a final score, we carried out a detailed assessment of the composition of the vaginal microflora in relation to standard Gram stain in order the improve the …

A Case Of Transient Diabetes Insipidus Following Cardiopulmonary Bypass, Omer Ashraf, Hasanat Sharif, Mansoor Shah

Section of Cardiothoracic Surgery

Cardiopulmonary bypass surgery has been linked with a number of postoperative complications. One of the frequently reported physiological alterations is the relative diuresis seen in the immediate post-op period. Rarely reported though is the development of full-blown diabetes insipidus in such patients. The etiology is unknown and has only been hypothesized in the past. We present the clinical course of a 54 year old male who developed transient diabetes insipidus post bypass surgery with subsequent recovery following exogenous vasopressin administration. The physiological alteration leading to the development of diabetes insipidus in a small fraction of bypass patients remains unknown. We …

Vital Pulp Therapy With Mineral Trioxide Aggregate: An Outcomes Study, Heather H. Lauer

Loma Linda University Electronic Theses, Dissertations & Projects

Mineral trioxide aggregate (MTA) is used in a variety of endodontic procedures. MTA is proven to provide good marginal adaption to dentin, to be biocompatible, and to stimulate dentin bridge formation through animal studies. These properties make MTA a potentially useful material to be used in vital pulp therapy. Clinical data on the use of MTA as a vital pulp medicament is sparse. The purpose of this study was to evaluate the clinical outcome of vital pulp therapy using MTA as the pulp medicament. Inclusion criteria for patient selection for recall was based on pulp treatment necessary from carious pulp …

Mechanisms Of Hbo-Induced Neuroprotection In A Neonatal Hypoxia-Ischemia Model, John Winter Calvert

Loma Linda University Electronic Theses, Dissertations & Projects

With an incidence approaching 1/4000 live births and as high as 60% in low birth weight infants, cerebral hypoxia-ischemia during the perinatal period is the single most important cause of acute mortality and chronic disability in newborns. Herein, we tested the hypothesis that following a hypoxic-ischemic insult hyperbaric oxygen (HBO) treatment can restore high energy metabolite levels in the affected regions of the brain and through this increase in energy levels ameliorate the spread of cell death following the insult. We also investigated if an additional mechanism by which HBO affords its neuroprotection is by altering the expression of the …