Medicine and Health Sciences Commons^™

Respiratory Hypocapnia At Different Stages Of Lactation During Long-Term Exogenous Bovine Somatotropin In Crossbred Holstein Cattle In The Tropic, Sumpun Thammacharoen, Siripen Komolvanich, Somchai Chanpongsang, Narongsak Chaiyabutr

The Thai Journal of Veterinary Medicine

The aim of this study was to investigate the influence of long-term administration of recombinant bovinesomatotropin (rbST) on the acid-base homeostasis of lactating crossbred cows under hot and humid condition ofThailand. Two groups of five animals each of primiparous crossbred dairy cattle were supplemented either with rbSTor with control vehicle every 14 days throughout the period of lactation. The blood gas parameters, milk yield andfeed intake from both groups were recorded at each stage of lactation. Cows supplemented with rbST showed milddegree of acid-base imbalance during early to mid lactation. The lower partial pressure of carbon dioxide (paCO2) andplasma bicarbonate …

Ophthalmology Snapshot, Nalinee Tuntivanich

The Thai Journal of Veterinary Medicine

No abstract provided.

What Is Your Diagnosis, Pranee Tuntivanich, Suwicha Chuthatep

The Thai Journal of Veterinary Medicine

No abstract provided.

Factors Predicting The Recurrence Of Spontaneous Bacterial Peritonitis In Patients With Cirrhosis, Sajjad Jamil, Shahid Ahmed, Adil Memon, Sara Masood, Syed H Shah, Saeed Sadiq Hamid, Wasim Jafri

Department of Medicine

Objective: To evaluate the frequency of recurrence of spontaneous bacterial peritonitis (SBP) in patients with end stage liver disease and the factors responsible for it.

Study Design: Descriptive study.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from November 2008 till November 2009.

Methodology: Patients with cirrhosis who were admitted at AKUH with diagnosis of SBP during the study period were included. Any episode of SBP after resolution of the first index case of SBP within one year was considered as recurrence.

Results: Out of 238 cirrhotic patients, 157 (66%) had single, while 81 (34%) had recurrent …

My Patient Just Had A Transient Ischaemic Attack. Can I Predict His Risk For Stroke? Is Stroke Inevitable Or Preventable?, Maria Khan, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Factors Associated With Serum Brain Natriuretic Peptide Levels After The Fontan Procedure., Andrew M. Atz, Victor Zak, Roger E. Breitbart, Steven D. Colan, Sara K. Pasquali, Daphne T. Hsu, Minmin Lu, Lynn Mahony, Stephen M. Paridon, Michael D. Puchalski, Tal Geva, Brian W. Mccrindle, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Although a useful marker of heart failure in adults, the utility of brain natriuretic peptide concentration (BNP) for children after the Fontan procedure is not well studied.

DESIGN: BNP was measured in 510 patients who were 6-18 years old in the Pediatric Heart Network Fontan cross-sectional study at a median of 8.2 years after Fontan. Patients underwent echocardiography, exercise testing, magnetic resonance imaging (MRI) and functional health status questionnaires. Associations of BNP with baseline patient characteristics, medical history and cross-sectional assessment were examined with multivariable linear regression analyses.

RESULTS: The distribution of BNP was highly skewed, median 13.0 pg/mL …

Galvanic Corrosion Between Various Combinations Of Orthodontic Brackets And Archwires, Arash Bakhtari, T. Gerard Bradley, William K. Lobb, David W. Berzins

School of Dentistry Faculty Research and Publications

Introduction: The purpose of this study was to compare galvanic currents generated by different combinations of commonly used brackets and archwires.

Methods: As-received stainless steel, nickel-titanium, and betatitanium wires were coupled to stainless steel and titanium brackets in an artificial saliva medium. The galvanic current and amount of charge transferred for each pair were monitored with a zero resistance ammeter for 10 hours.

Results: Two-way analysis of variance (ANOVA) showed a significant difference in charge and galvanic currents when factored for type of bracket (P\0.001), but no significant difference between them when factored by type of wire (P .0.05). Specifically, …

Treating Trauma Survivors With Neurofeedback: A Grounded Theory Study Based On The Practices Of Experienced Mental Health Professionals, Christine L. Currie

Counseling & Human Services Theses & Dissertations

Neuroscience, the mental health field, and the concept of trauma as an underlying factor in mental and physical disorders have been inextricably linked since the inception of the mental health professions. Numerous quantitative studies have indicated that neurofeedback may be effective in ameliorating trauma symptoms; however, there is a paucity of research exploring the factors that produce those positive outcomes. The purpose of this qualitative grounded theory study was to explore the factors and processes that influence treatment outcomes when neurofeedback is used with trauma survivors. Thirty interviews were completed with ten experienced mental health and neurofeedback professionals identified through …

Preventing Workplace Injuries Commonly Sustained By Hotel Guestroom Attendants, Jennifer Daros

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction:

Hotels are generally organized into various departments. These provide specialized services to guests. Almost every hotel in the world has (in one form or another) a housekeeping department. Guestroom attendants (GRAs) are a primary component of any housekeeping department. GRAs (also known as maids, housekeepers, or room/suite service attendants) are employed by hotels to clean guestrooms, change bed linens, restock supplies, and provide turn down services when requested (see Appendix A). Those employed as GRAs frequently suffer injuries at work that can be costly to employers. This paper reviews some of the more common causes of GRA workplace injuries …

Chikungunya Virus In Thailand; An Update, Sonthaya Tiawsirisup

The Thai Journal of Veterinary Medicine

No abstract provided.

Application Of Flow Cytometry For Early Diagnosis And Monitoring In Cats With Immune-Mediated Hemolytic Anemia, Parkorn Limlenglert, Anudep Rungsipipat, Rosama Pusoonthornthum

The Thai Journal of Veterinary Medicine

The study aimed to apply flow cytometry (FC) for early detection and monitor of treated response cats withIMHA by measuring immunoglobulin-G (IgG) and immunoglobulin-M (IgM) on red blood cells. Coombs' test and FCmethod were performed in twenty-nine cats including: ten clinically normal client-owned cats and nineteen anemiccats with packed cell volume of less than 27%. Five anemic cats were positive for Coombs' test and had significantlyhigh levels of IgG and IgM on the red blood cells with high level of mean fluorescene intensity (MFI) measured by theFC method. In seven out of the fourteen anemic cats with negative Coombs’ results, …

Seminal Plasma Mda Concentrations Correlating Negatively With Semen Quality In Asian Elephants, Sitthawee Thongtipsiridech, Podjana Imrat, Thanida Srihawong, Sittidet Mahasawangkul, Chanin Tirawattanawanich, Kulnasan Saikhun

The Thai Journal of Veterinary Medicine

The aim of this study was to determine whether lipid peroxidation is correlated with semen quality in Asianelephant bulls. Malondialdehyde (MDA) in seminal plasma from ejaculates with varying percentages of progressivemotility was measured using Thiobarbituric Acid method. Correlation between the MDA levels and percentages ofprogressive motility and normal morphology were performed. Results revealed that the MDA levels weresignificantly negative, which correlated (p<0.05) with the percentages of progressive motility and normal morphology(R=0.2131 and 0.1685, respectively). The results also showed that the MDA levels were significantly differencebetween each bull (p<0.01). Furthermore, when the ejaculates were grouped according to motility scores into twogroups; low- (<40%) and high-percentage of progressive motility (>40%), a significant difference was detectedbetween the MDA means (±SD) of the low- (20.7±11.4 nmol/ml) and high-percentages of progressive motility(14.4±7.8 nmol/ml) groups. The results obtained from this study suggested that MDA could be a potential parameterapplicable for the …

Evaluation Of Cardboard Coated With Natural Substances In Combination With Ink On Rat Repellency, Sarinee Kalandakanond-Thongsong, Suwaporn Daendee, Boonrit Thongsong, Vivat Chavananikul

The Thai Journal of Veterinary Medicine

An effective repellent for rodent-proof cardboard-container is considered interesting especially in packagingand transport business as rat usually gnaws through the container, resulting in food deterioration or goods loss.Rodenticide usage is a common approach for rodent control; however, most rodenticides are poisonous to man aswell as to the rats. Therefore, preferably the usage of non-toxic rat repellent is an interesting alternative. In this study,various natural extracts, i.e. wintergreen oil, chilli, peppermint oil, bergamot oil and geranium oil, which had beenshown to repel rats when apply singly or in combination, were mixed with ink, coated on cardboard before beingplaced in circular open …

Effects Of Erythropoietin On Blood Pressure, Renal Function And Red Blood Cell Production In Dogs With Chronic Kidney Disease With And Without Angiotensin Converting Enzyme Inhibitor, Sujittra Ritthikulprasert, Metinee Rodphol, Adthaphonl Nimrotham, Saikaew Sattayatham, Siripen Komolvanich, Monkon Trisiriroj, Chollada Buranakarl

The Thai Journal of Veterinary Medicine

Blood pressure, renal function, urinary protein excretion and red blood cell count were measured in 29 dogswith chronic kidney disease which received hormone recombinant human Erythropoietin (rHuEPO). The experimentwas divided into 2 parts. Parts 1 comprised 3 groups of dogs. Group 1 dogs were studied prior to erythropoietin(EPO) injection (pre-EPO). Group 2 dogs received EPO 100 U/kg 2-3 times a week. Group 3 dogs received both EPOand angiotensin converting enzyme inhibitor which was enalapril 5 mg/kg/daily. The duration of medication wasbetween 7 to 40 days. In part 2 of the experiment, all parameters were measured in the same dogs before …

Aquapuncture Using Vitamin B Complex On Intraocular Pressure In Two Dogs With Cataracts And Low Intraocular Pressure, Wei-Yau Shia, Yun-Hsia Hsiao, Ming-Wei Lee, Li-Shiue Shiu, Shiun-Long Lin, Wei-Ming Lee

The Thai Journal of Veterinary Medicine

Two mixed breed dogs, aged 13 years old and 12 years old, with low intraocular pressure are described.These dogs presented with low intraocular pressure (IOP) and cataract. Cataracts were treated for one year by VTPhak®. For the IOP, it was 6 mmHg in both eyes of dog A and 8 mmHg in both eyes of dog B. According to ourevaluation and based on owner’s consent, the dogs should be treated with aquaupuncture using vitamin B complexevery two weeks. Thereafter, the intraocular pressure of these two dogs was evaluated every two months. The localacupoints were BL-1 (Jing Ming), BL-2 (Cuan Zhu), …

Relationship Between The Quetelet’S Index, Homa-Ir Index And Prostate Size In Patients With Benign Prostatic Hyperplasia At St.Mary’S Hospital In, Timothy Onyuma

Master of Medicine in Anatomic Pathology

Introduction: Benign prostatic hyperplasia is a highly prevalent disease and is considered an inevitable correlate of ageing. Several theories have been advanced in a bid to explain its pathogenesis, the most popular ones relating to sex steroid hormones (1). Currently facets of the metabolic syndrome of which two principal components are insulin resistance and high BMI have been postulated to be related to growth of the prostate (2). Insulin resistance is assessed by the HOMA-IR index. Some studies have demonstrated an association between these indices and the size of the prostate (3). While others have not (4). We set out …

Department Of Radiology-Annual Executive Summary Report-July 1, 2010 To June 30, 2011, Vijay M. Rao, Md

Department of Radiology Administrative Documents and Reports

90 page Department of Radiology Annual Executive Summary Report, July 1, 2010 to June 30, 2011, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Tables 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 22

Books and Book Chapters 30

Abstracts 33

Appendix II: Formal Scientific Presentations 44

Appendix III: Honors, Editorial Activities, Service to Regional …

Rural Hospital System Affiliations And Their Effects On Hospital Economic Performance, 2004-2008, Mark Swofford

Theses and Dissertations

The formation of multi-hospital systems represents one of the largest structural changes in the hospital industry. As of 2008, system affiliated hospitals outnumbered stand alone hospitals 2511 to 2167 and the percentage of system affiliated rural hospitals has increased dramatically from 24.8% in 1983 to 42.2% in 2008 (based on AHA data for non-federal acute care general hospitals). The effects of system membership on hospital performance have been of great interest to health care researchers, but the majority of research on multi-hospital systems has either focused exclusively on urban facilities or pooled urban and rural facilities in the same sample, …

Malignant Lymphoma Subtypes In A Private Hospital In Nairobi: A Retrospective Cross-Sectional Study, Omar A. Sherman

Master of Medicine in Anatomic Pathology

Introduction: Lymphoma diagnosis integrates clinical, morphological, immunophenotypical and molecular genetic features as evident from the World Health Organization (WHO) classification of lymphoid malignancies.(1, 2) Although it is standard practice for histopathology laboratories in developed countries to confirm and further sub classify lymphomas using immunohistochemistry and other molecular techniques, the same is not true for developing countries like Kenya. The reasons that prevent the performance of these tests are the prohibitive costs and inadequate trained personnel. Objectives: The aims of this study were to retrospectively classify lymphomas diagnosed at The Aga Khan University Hospital (AKUHN) Laboratory based on the WHO classification …

The Impact Of A Multimodal Approach To Pre-Emptive Analgesia On Postoperative Pain And Analgesic Requirements For Patients Undergoing Orthopaedic Lower Limb Surgery At The Aga Khan University Hospital, Nairobi: A Single Blind Randomised Controlled Trial, John M. Bugo

Master of Medicine in Anaesthesiology

Study Objective: The aim of this study was to evaluate the postoperative morphine-sparing and pain reducing effects of a preemptive, multimodal, perioperative analgesic regimen incorporating the use of preincisional intrathecal blockade plus parenteral anti-inflammatory agents, in patients undergoing lower limb orthopaedic surgery. Study design: Prospective Single blinded Randomized Controlled Trial. Study setting: The Aga Khan Hospital, Nairobi, Kenya. Methods: 44 ASA physical status 1 and 2 patients undergoing lower limb orthopaedic surgery were randomly allocated into two groups of 22 patients each. Patients in the Intervention group were given a preincisional subarachnoid injection of 15mg hyperbaric Bupivacaine and 25mcg Fentanyl, …

A Randomised Controlled Trial Investigating The Effect Of Adding Fentanyl To Low Dose Bupivacaine In Combined Spinal-Epidural Anaesthesia, Using Epidural Volume Extension Technique In Caesarean Section, Mudola V. Manyano

Master of Medicine in Anaesthesiology

Background: Epidural volume extension (EVE), is a technique whereby a small-dose intrathecal block is enhanced by an epidural injection of physiological saline. This epidural injection exerts a compression effect on the dura, which then leads to a cranial increase in sensory spread of the intrathecal local anaesthetic. The lower dose of local anaesthetic required in the EVE technique has made it possible to avoid the side effects of the conventional dose of local anaesthetic while still having the benefit of adequate anaesthesia. Several studies have been conducted in this area; these studies have either used or omitted fentanyl. The successful …

Prevalence Of Postpartum Depression Using The Edinburgh Postpartum Depression Scale At The Aga Khan University Hospital, Nairobi, Warfa Khadija

Master of Medicine in Obstetrics and Gynecology

Background: Postpartum depression is an illness that affects 10-20% of mothers following delivery; the impact it has on the family, partner and the new born baby is significant. There are insufficient data in Kenya as its rate and severity hence the impact is unknown. Screening could allow earlier treatment of these mothers and prevent the long term effects on the family. Objectives: The primary objective was to identify the prevalence of postpartum depression at the Aga Khan University Hospital and to identify associations between participant’s socio demographics and depression. Methods: Cross sectional study to screen postpartum women six weeks after …

The Use Of Mcv And Mch To Screen For Iron Deficiency In Pregnancy Among Women With Normal Haemoglobin Values, Charles M. Muteshi

Master of Medicine in Obstetrics and Gynecology

Background: Worldwide the commonest cause of anaemia is inadequate nutritional supply manifest as iron deficiency. Iron deficiency affects 25% of the world’s population and up to 50% in the developing world. Most susceptible are women of child bearing age and infants. In pregnancy most iron deficiency is detected when there is already resultant anaemia by measuring the haemoglobin content. It is important to develop a tool that could pick out women who are iron deficient before anaemia ensues. This study aims to determine the predictive ability of red cell mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) in screening …

Hepatitis B Vaccination Rate And Determining Factors Amongst Health Care Workers At Aga Khan University Hospital, Nairobi, Herman Ekea

Master of Medicine in Internal Medicine

Aim: To determine Hepatitis B vaccination rate and determining factors for health care workers (HCWs) at AKUHN. Design: Cross sectional analytical study Study subjects and setting: Aga Khan University Hospital-Nairobi, is a 254 bed tertiary hospital, with 815 HCWs with occupational risk of infection with hepatitis B virus (HBV). The hospital has a HCW vaccination policy and vaccine available to HCWs as part of medical scheme Methodology: Two hundred and sixty six (266) eligible HCWs of all cadres were stratified then randomly recruited after giving informed consent. A questionnaire was then administered to assess knowledge, attitude and practice towards HBV …

Prevalence Of Low Bone Mineral Density Amongst Resident Doctors At The Aga Khan University Hospital, Nairobi, Rose Ndumia

Master of Medicine in Imaging and Diagnostic Radiology

Objective: This was a cross-sectional study carried out amongst resident doctors training at the Aga Khan University Hospital, Nairobi to determine their bone mineral density and investigate for any association between the bone mineral density and the residents’ lifestyle. Methods: 65 randomly selected residents from various departments in the Aga Khan University Hospital, Nairobi, underwent a Dual Energy X-ray Absorptiometry (DXA) scan and filled out questionnaires to assess their physical activity, sunlight exposure and calcium intake. This was carried out between April and June 2011. Results: 65 residents were included in the final analysis. 50 residents (76.9% with a 95% …

The Influence Of Depression On Adherence To Antiretroviral Therapy Among Hiv Infected Patients At Aga Khan University Hospital (Nairobi), Evelyn W. Karanja-Mbugua

Master of Medicine in Internal Medicine

Aim: To determine the influence of depression on adherence to antiretroviral (ARV) therapy among HIV-infected patients. Design: Cross-sectional survey Patients: One hundred and forty HIV-positive patients on treatment with Combination Antiretroviral Therapy selected from the out-patient department of Aga Khan University Hospital took part in the survey. Methodology: Every third patient who was eligible was assessed for adherence to antiretroviral therapy using The Adult AIDS Clinical Trial Group follow up adherence questionnaire followed by screening for depression using the Patient Health Questionnaire 9. Pharmacy data was then retrieved for the same patients and used to assess adherence by the medication …

Stratification Of White Matter Hyperintensities In Young And Middle Age Adults Using Hydrogen Magnetic Resonance (H-Mr) Spectroscopy, M’Mene E. Elvis

Master of Medicine in Imaging and Diagnostic Radiology

Objective: The objective of this study was to stratify white matter hyperintensities on the basis of neuronal integrity in young and middle age adults by comparing the level of N-acetyl aspartate and creatine ratios in white matter hyperintensity lesions and normal appearing white matter using hydrogen magnetic resonance (H-MR) spectroscopy at 1.5 Tesla(T) Methods: Fifty consecutive patients who fulfilled the inclusion criteria aged 18-50yrs who were referred for magnetic resonance imaging(MRI) of the brain at the Radiology department of Aga Khan University Hospital over a six month period between January and June 2011 were included in the study. These patients …

Prevalence Of Nasal Carriage Of Methicillin-Resistant Staphylococcus Aureus In Healthcare Workers At Aga Khan University Hospital, Nairobi, Geoffrey A. Omuse

Master of Medicine in Clinical Pathology

Objective: To establish the prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare workers (HCW) at Aga Khan University Hospital, Nairobi (AKUHN). Background: Healthcare workers are a major reservoir of MRSA and may play a role in the spread of nosocomial MRSA infections. MRSA can cause significant morbidity and mortality. There is both molecular and epidemiological evidence linking HCW to MRSA outbreaks. Method: A cross sectional study conducted between July and December 2010. Nasal swabs were taken from 246 randomly selected HCW from various departments.MRSA was identified using both phenotypic and genotypic methods. Antibiotic susceptibility testing of all …

Prevalence Of Genital Chlamydia Infection In Urban Women Of Reproductive Age, Ruchika Kohli-Kochhar

Master of Medicine in Clinical Pathology

Background: Chlamydia trachomatis is one of the major causes of sexually transmitted infections throughout the world. It is the primary cause for pelvic inflammatory disease, tubal infertility and ectopic pregnancy in females. Most infections are asymptomatic and remain undetected. The burden of disease in the Kenyan population is not well characterised and few previous studies, done in Kenya, show the prevalence of genital Chlamydia infection in sexually active females. There is a need to define prevalence in our local population as a public health need and to determine whether rapid point-of-care testing should be incorporated as a component of sexually …

Comparison Of Wavelet Compressed Mri Cineloop Images Versus Originally Acquired Non-Modified Mri Images For Detection Of Brain Lesions, Patrice K. Anangwe

Master of Medicine in Imaging and Diagnostic Radiology

Brief background: Image compression has been widely accepted as the solution to the explosion of imaging data since the advent of multiaxial multisequence imaging. However, compromise on diagnostic quality secondary to this modification has been an issue. Many studies have been carried out looking at just noticeable differences but few have been undertaken to look at the difference in ability to detect pathology in original versus cineloop compressed images. This study was done to compare lesion detection ability of cineloop compressed images as compared to original images. Objectives: A comparative study to evaluate detection of brain lesions in wavelet compressed …