Medicine and Health Sciences Commons^™

Effect Of Additional Lumbosacral Corset On The Outcome Of Patients With Non-Specific Acute Low Back Pain At The Aga Khan University Hospital, Nairobi, Stanley Aruyaru Mwenda

Master of Medicine in General Surgery

Introduction: Low back pain (LBP) is a common problem world over affecting 60-90% of the population in their lifetime. It is a leading reason for hospital admission, healthcare spending, workplace absenteeism and years lived with disability. Up to 90% of patients suffering from low back pain do not have a serious pathology warranting imaging or further intervention besides symptom relief. These are categorized as having non- specific low back pain. This has a good prognosis running a short course of 3 to 6 weeks. The management of non-specific acute LBP entails analgesia and non-pharmacologic interventions (back school and physical therapy). …

Prevalence Of Hepatic Steatosis As Diagnosed On Unenhanced Abdominal Ct, Naushad H. Karim Sokwalla

Master of Medicine in Imaging and Diagnostic Radiology

Background: Hepatic steatosis is the accumulation of triglycerides within hepatocytes. It may be broadly classified into alcoholic and non-alcoholic fatty liver disease, whereby non-alcoholic fatty liver disease is steatosis secondary to causes such as steatogenic medication. Liver biopsy remains the gold standard for diagnosis of hepatic steatosis. However, it is invasive and may potentially suffer from sampling errors. Hepatic steatosis may be diagnosed on unenhanced CT if the hepatic attenuation is less than 40 HU, or if the attenuation of the liver is at least 10 HU less than the spleen. Over the past three decades, non-alcoholic fatty liver disease …

Mitochondria Mediates Caspase-Dependent And Independent Retinal Cell Death In Staphylococcus Aureus Endophthalmitis, Pawan K. Singh, Ashok Kumar

Ophthalmology Faculty Research Publications

Bacterial endophthalmitis, a vision-threatening complication of ocular surgery or trauma, is characterized by increased intraocular inflammation and retinal tissue damage. Although significant vision loss in endophthalmitis has been linked to retinal cell death, the underlying mechanisms of cell death remain elusive. In this study, using a mouse model of Staphylococcus aureus endophthalmitis and cultured human retinal Müller glia (MIO-M1 cell line), we demonstrate that S. aureus caused significant apoptotic cell death in the mouse retina and Müller glia, as evidenced by increased number of terminal dUTP nick end labeling and Annexin V and propidium iodide-positive cells. Immunohistochemistry and western blot …

A Survey And Analysis Of The American Public's Perceptions And Knowledge About Antibiotic Resistance, Rebecca R. Carter, Jiayang Sun, Robin L.P. Jump

Faculty Scholarship

Background. Little is known about the American public's perceptions or knowledge about antibiotic-resistant bacteria or antibiotic misuse. We hypothesized that although many people recognize antibiotic resistance as a problem, they may not understand the relationship between antibiotic consumption and selection of resistant bacteria. Methods. We developed and tested a survey asking respondents about their perceptions and knowledge regarding appropriate antibiotic use. Respondents were recruited with the Amazon Mechanical Turk crowdsourcing platform. The survey, carefully designed to assess a crowd-sourced population, asked respondents to explain "antibiotic resistance" in their own words. Subsequent questions were multiple choice. Results. Of 215 respondents, the …

Medical School Watercooler Newsletter - May 29, 2016, Lindsey Lyle

Watercooler Newsletter

This is the May 29, 2016 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Dr. Trimm Named President of APPD
• Hippocrates Park Dedication Set for June 11
• USA Surgery Clinic Recognized for Customer Service
• USA Gastroenterology Welcomes Tanya Rowell
• Former USA Researcher Joins Harrison School of Pharmacy

Bupropion Induced Hyponatremia In An Elderly Patient: A Case Report And Review Of The Literature, Sahil Munjal, Yvette Smolin

NYMC Faculty Publications

We present the case of a 72-year-old female with a major depressive episode who developed hyponatremia associated with bupropion. In reviewing the literature, there are only a few case reports which pertain to this topic. The clinical symptoms of hyponatremia can be misinterpreted as a worsening of the primary psychiatric illness and can lead to potentially serious consequences if not fully evaluated. We recommend that clinicians should be well aware of this side effect and that sodium levels should be checked within the first 2 weeks after initiating treatment in patients, especially those with additional risk factors for hyponatremia, such …

Severity And Clustering Of Menopausal Symptoms Among Obese And Nonobese Postmenopausal Women In India, E. S. Sharanya Shre, Kate Trout, Sonia Pant Singh, Awnish Kumar Singh, Surapaneni Krishna Mohan, Ashish Joshi

Publications and Research

Background: The symptoms of menopause have a negative impact on quality of life, especially in women transitioning to menopause and earlier transitions. This study was conducted with the objective of assessing the effect of obesity on the severity of menopausal symptoms and the clustering of symptoms in postmenopausal women in India.

Methodology: The Menopausal Rating Scale (MRS) was used to assess the severity of menopausal symptoms of postmenopausal women of Chennai, visiting Saveetha Medical College, Chennai, India. This cross‑sectional study was conducted from August to November 2013 in Chennai, India. Sociodemographic characteristics, anthropometric measurements, blood pressure level, menopausal history, personal …

Inadequate Sedation During Therapeutic Paralysis: Use Of Bispectral Index In Critically Ill Patients, Chelsea L. Tasaka, Jeremiah J. Duby, Komal Pandya, Machelle D. Wilson, Kimberly A. Hardin

Pharmacy Practice and Science Faculty Publications

Background Patients receiving therapeutic paralysis may experience inadequate sedation due to intrinsic limitations of behavioral sedation assessment. Bispectral index (BIS™) provides an objective measure of sedation; however, the role of BIS™ is not well defined in intensive care unit (ICU) patients on neuromuscular blocking agents (NMBA).

Objective The aim of this study was to delineate the relationship between BIS™ and level of sedation for critically ill patients during therapeutic paralysis.

Methods This was a retrospective observational study conducted in ICU patients receiving continuous infusion NMBA and BIS™ monitoring. The primary endpoint was the correlation of BIS™ < 60 during therapeutic paralysis with a Richmond Agitation Sedation Score (RASS) of −4 to −5 (i.e., deep or unarousable sedation) at the time of emergence from therapeutic paralysis.

Results Thirty-one patients were …

How Should We Teach Lumbar Manipulation? A Consensus Study, Michael O'Donnell, Jo Armour Smith, Alex Abzug, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Background Spinal manipulation is an effective intervention for low back pain, yet there is little consistency in how this skill is taught.

Objectives The purpose of this study was to identify what educators and clinicians believe are important characteristics of the patient and operator position prior to side-lying lumbar manipulation and the patient position and operator motion during the manipulative thrust.

Design A multi-disciplinary correspondence-based Delphi method

Methods Three rounds of questionnaires were sent to physical therapists, osteopaths and chiropractors. Consensus was established in Round 3 if at least 75 % of respondents identified a characteristic as very important/extremely important …

The Frequency Of Influenza And Bacterial Co-Infection: A Systematic Review And Meta-Analysis., Eili Y. Klein, Bradley Monteforte, Alisha Gupta, Wendi Jiang, Larissa May, Yu-Hsiang Hsieh, Andrea Freyer Dugas

Emergency Medicine Faculty Publications

AIM: Co-infecting bacterial pathogens are a major cause of morbidity and mortality in influenza. However, there remains a paucity of literature on the magnitude of co-infection in influenza patients.

METHOD: A systematic search of MeSH, Cochrane Library, Web of Science, SCOPUS, EMBASE, and PubMed was performed. Studies of humans in which all individuals had laboratory confirmed influenza, and all individuals were tested for an array of common bacterial species, met inclusion criteria.

RESULTS: Twenty-seven studies including 3,215 participants met all inclusion criteria. Common etiologies were defined from a subset of eight articles. There was high heterogeneity in the results (I(2) …

The Hiv-1 Tat Protein Is Monomethylated At Lysine 71 By The Lysine Methyltransferase Kmt7, Ibraheem Ali, Holly Ramage, Daniela Boehm, Lynnette M. A. Dirk, Naoki Sakane, Kazuki Hanada, Sara Pagans, Katrin Kaehlcke, Katherine Aull, Leor Weinberger, Raymond Trievel, Martina Schnoelzer, Masafumi Kamada, Robert L. Houtz, Melanie Ott

Horticulture Faculty Publications

The HIV-1 transactivator protein Tat is a critical regulator of HIV transcription primarily enabling efficient elongation of viral transcripts. Its interactions with RNA and various host factors are regulated by ordered, transient post-translational modifications. Here, we report a novel Tat modification, monomethylation at lysine 71 (K71). We found that Lys-71 monomethylation (K71me) is catalyzed by KMT7, a methyltransferase that also targets lysine 51 (K51) in Tat. Using mass spectrometry, in vitro enzymology, and modification-specific antibodies, we found that KMT7 monomethylates both Lys-71 and Lys-51 in Tat. K71me is important for full Tat transactivation, as KMT7 knockdown impaired the transcriptional activity …

Psychological Abuse, Mental Health, And Acceptance Of Dating Violence Among Adolescents, Jeff R. Temple, Hye Jeong Choi, Joanna Elmquist, Michael L. Hecht, Michelle Miller-Day, Gregory L. Stuart, Meagan Brem, Caitlin Wolford-Clevenger

Communication Faculty Articles and Research

Purpose

Existing literature indicates that acceptance of dating violence is a significant and robust risk factor for psychological dating abuse perpetration. Past work also indicates a significant relationship between psychological dating abuse perpetration and poor mental health. However, no known research has examined the relationship between acceptance of dating violence, perpetration of dating abuse, and mental health. In addition to exploring this complex relationship, the present study examines whether psychological abuse perpetration mediates the relationship between acceptance of dating violence and mental health (i.e., internalizing symptoms of depression, anxiety, and hostility).

Methods

Three waves of longitudinal data were obtained from …

Surgical Apgar Score (Sas) Predicts Perioperative Morbidity And Length Of Stay In Patients Undergoing Esophagectomy At A High-Volume Center, Danica Giugliano, Md, Andrew Morgan, Francesco Palazzo, Md, Nathaniel R. Evans Iii, M.D., Ernest L Rosato, Md, Adam C. Berger, Md, Benjamin E Leiby, Phd

Department of Surgery Posters

Background:

Esophagectomy is a procedure that carries considerable morbidity. Many studies have evaluated factors to predict patients at risk and improve clinical outcomes. The aim of this study was to determine whether the SAS predicts complications, length of stay, and anastomotic leak for patients undergoing esophagectomy at a high-volume institution.

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern Participates in Pilot Curriculum
• Georgia Southern Examines Legal Space for Syringe Exchange Programs
• Georgia Southern Examines Emerging trends and pathogens in HealthCare

Induction Process Of Trainees In Pathology Residency, Imran Siddiqui, Natasha Bahadur Ali

Department of Pathology and Laboratory Medicine

This article describes the evolution of the induction process of pathology residency at The Aga Khan University hospital. The Department of Postgraduate Medical Education was established in 1985. The induction process is an exhaustive exercise that includes an admission test held simultaneously in Karachi, Hyderabad, Lahore, and Rawalpindi, followed by an interview of the shortlisted candidates. The pathology residency program was started 25 years ago and since then the induction process has undergone major changes with the course of time.

Use Of Antenatal Corticosteroids At Health Facilities And Communities In Low-And-Middle Income Countries., Mabel Berrueta, Jennifer Hemingway-Foday, Vanessa R. Thorsten, Robert L. Goldenberg, Waldemar A. Carlo, Ana Garces, Archana Patel, Sarah Saleem, Omrana Pasha, Elwyn Chomba, Patricia L. Hibberd, Nancy F. Krebs, Shivaprasad Goudar, Richard J. Derman, Fabian Esamai, Edward A. Liechty, Janet L. Moore, Elizabeth M. Mcclure, Marion Koso-Thomas, Pierre M. Buekens, José M. Belizán, Fernando Althabe

Community Health Sciences

BACKGROUND:

Antenatal corticosteroids (ACS) for women at high risk of preterm birth is an effective intervention to reduce neonatal mortality among preterm babies delivered in hospital settings, but has not been widely used in low-middle resource settings. We sought to assess the rates of ACS use at all levels of health care in low and middle income countries (LMIC).

METHODS:

We assessed rates of ACS in 7 sites in 6 LMIC participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Global Network for Women and Children's Health Research Antenatal Corticosteroids Trial (ACT), a cluster-randomized trial …

Research Brief: "Spousal Military Deployment During Pregnancy And Adverse Birth Outcomes", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study assesses the association between a spouse’s military deployment and adverse birth outcomes, and concluded that the effect of a spouse’s deployment on adverse birth outcomes can vary by maternal age. Given that a deployment during pregnancy or delivery can negatively affect the mother and baby, policymakers might allocate funds for additional research on the needs of expectant mothers with a deployed spouse. Future work in this field should further evaluate maternal age and number of children as modifiers of the association between these variables.

Community Health News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Participates in Pilot Curriculum

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Examines Legal Space for Syringe Exchange Programs
• Georgia Southern Examines Emerging Trends and Pathogens in Healthcare

Graphene Quantum Dots-Based Drug Delivery For Ovarian Cancer Therapy, Yiru Qin

USF Tampa Graduate Theses and Dissertations

Ovarian cancer, one of the most dreadful malignancies of the female reproductive system, poses a lethal threat to women worldwide. In this dissertation, the objective was to introduce a novel type of graphene quantum dots (GQDs) based nano-sized drug delivery systems (DDS) for ovarian cancer treatment. As a starting point, the facile synthesis method of the GQDs was established. Subsequently, the targeting ligand,folic acid (FA), was conjugated to GQDs. Next, a FDA approved chemotherapeutic drug, Doxorubicin (DOX), was loaded to form the GQDs-FA-DOX nano-conjugation as the DDS. Moreover, the uptake profile and anti-cancer effect of the GQDs-FA-DOX were validated in …

Conditions Facilitant L’Appropriation De Démarches Préventives En Santé Psychologique Au Travail Par Les Gestionnaires, Caroline Biron, France St-Hilaire, Geneviève Baril-Gingras, Marie-Esther Paradis, Shirley Chabot, Rébecca Lefebvre, Hans Ivers, Michel Vézina, Pierre-Sébastien Fournier, Mahée Gilbert-Ouimet, Chantal Brisson

Rapports de recherche scientifique

De plus en plus d’évidences scientifiques montrent que les risques psychosociaux (RPS), tels une demande psychologique élevée, une faible latitude décisionnelle, un faible soutien social et un déséquilibre entre les efforts et la reconnaissance reçue au travail, contribuent au développement de problèmes de santé psychologique, de troubles musculosquelettiques de même que de maladies cardiovasculaires. Ces atteintes à la santé figurent parmi les principales causes d’absence du travail pour maladie. La littérature sur les interventions préventives en santé psychologique concerne principalement les interventions visant à modifier certaines caractéristiques individuelles (par exemple les habitudes de vie des travailleurs) plutôt que …

Rare Case Of Metastatic Pituitary Disease, Anitha Somasundaram, Md, Kevin D. Judy, Md, Kevin Furlong, Do

Department of Neurosurgery Posters

Background:

Metastatic involvement of the pituitary gland is extremely rare. We present a case of metastatic pituitary disease with panhypopituitarism and diabetes insipidus.

Use Of Propensity Score Matching To Identify A Strong Association Between Health Care Provider Advice Not To Smoke And Quit Attempts Among Mid-Adolescent Smokers, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background:

• Nearly 1 out of 7 U.S. adolescents is a current cigarette smoker by the time they leave high school. ¹
• Although almost one third of adolescents who saw a healthcare provider in the past month were advised to quit or avoid tobacco,² research on the influence of provider advice on quit attempts among adolescent smokers has shown mixed results. ³
• These results may be due to selection bias—adolescent smokers who get advice may be different from those who do not on a range of factors including age of initiation, smoking frequency, attitudes toward smoking, exposure to other anti-tobacco …

Prior Binge Ethanol Exposure Potentiates The Microglial Response In A Model Of Alcohol-Induced Neurodegeneration, Simon Alex Marshall, Chelsea Rhea Geil Nickell, Kimberly Nixon

Pharmaceutical Sciences Faculty Publications

Excessive alcohol consumption results in neurodegeneration which some hypothesize is caused by neuroinflammation. One characteristic of neuroinflammation is microglial activation, but it is now well accepted that microglial activation may be pro- or anti-inflammatory. Recent work indicates that the Majchrowicz model of alcohol-induced neurodegeneration results in anti-inflammatory microglia, while intermittent exposure models with lower doses and blood alcohol levels produce microglia with a pro-inflammatory phenotype. To determine the effect of a repeated binge alcohol exposure, rats received two cycles of the four-day Majchrowicz model. One hemisphere was then used to assess microglia via immunohistochemistry and while the other was used …

Elevated Mtss1 Expression Associated With Metastasis And Poor Prognosis Of Residual Hepatitis B-Related Hepatocellular Carcinoma, Xiu-Yan Huang, Zi-Li Huang, Bin Xu, Zi Chen

Dartmouth Scholarship

Background: Hepatectomy generally offers the best chance of long-term survival for patients with hepatocellular carcinoma (HCC). Many studies have shown that hepatectomy accelerates tumor metastasis, but the mechanism remains unclear.

Methods: An orthotopic nude mice model with palliative HCC hepatectomy was performed in this study. Metastasis-related genes in tumor following resection were screened; HCC invasion, metastasis, and some molecular alterations were examined in vivo and in vitro. Clinical significance of key gene mRNA expression was also analyzed.

Association Of 24-32wk Maternal Triglyceride Levels And Neonatal Birth Weight At The Aga Khan University Hospital, Demetrius Mududa Omondi

Master of Medicine in Obstetrics and Gynecology

Introduction: The association of neonatal birth weight and mid-term maternal lipid levels has been demonstrated in several studies with elevated serum triglyceride levels shown to be a strong predictor of the large for gestational age baby/ fetal macrosomia. Maternal diabetes remains the strongest risk factor for developing a LGA/macrosomic baby explained by the Pederson hypothesis. However non-diabetic macrosomia is still an obstetric dilemma with the attendant fetal and maternal complications. This phenomenon could be explained by altered maternal lipid metabolism as lipids have been shown to be important for normal fetal growth and development. Objective: Our primary objective was to …

Membrane Insertion For The Detection Of Lipopolysaccharides: Exploring The Dynamics Of Amphiphile-In-Lipid Assays, Loreen R. Stromberg, Nicolas W. Hengartner, Kirstie L. Swingle, Rodney A. Moxley, Steven W. Graves, Gabriel A. Montaño, Harshini Mukundan

School of Veterinary and Biomedical Sciences: Faculty Publications

Shiga toxin-producing Escherichia coli is an important cause of foodborne illness, with cases attributable to beef, fresh produce and other sources. Many serotypes of the pathogen cause disease, and differentiating one serotype from another requires specific identification of the O antigen located on the lipopolysaccharide (LPS) molecule. The amphiphilic structure of LPS poses a challenge when using classical detection methods, which do not take into account its lipoglycan biochemistry. Typically, detection of LPS requires heat or chemical treatment of samples and relies on bioactivity assays for the conserved lipid A portion of the molecule. Our goal was to develop assays …

A Review Of Studies Of Ventilation And Indoor Air Quality In New Homes And Impacts Of Environmental Factors On Formaldehyde Emission Rates From Composite Wood Products, Francis (Bud) Offermann, Cheri Marcham

Publications

• While increasing outdoor air ventilation rates does reduce the indoor concentrations of air contaminants with indoor sources, the actual reductions in concentrations can differ significantly from those calculated with the assumption of a constant indoor emission rate.
• The ratio of actual to predicted concentration reductions for the low to high outdoor air ventilation modes ranged from 0.59 for formaldehyde to 1.37 for benzaldehyde.
• Increases in emission rates for compounds such as formaldehyde are consistent with mass transfer theory for emissions from materials such as composite wood where mass transfer is limited by gas-phase diffusion across the boundary layer.
• Decreases in …

Synapse Formation In Monosynaptic Sensory–Motor Connections Is Regulated By Presynaptic Rho Gtpase Cdc42, Fumiyasu Imai, David R. Ladle, Jennifer R. Leslie, Xin Duan, Tilat A. Rizvi, Georgianne M. Ciraolo, Yi Zheng, Yutaka Yoshida

Neuroscience, Cell Biology & Physiology Faculty Publications

Spinal reflex circuit development requires the precise regulation of axon trajectories, synaptic specificity, and synapse formation. Of these three crucial steps, the molecular mechanisms underlying synapse formation between group Ia proprioceptive sensory neurons and motor neurons is the least understood. Here, we show that the Rho GTPase Cdc42 controls synapse formation in monosynaptic sensory–motor connections in presynaptic, but not postsynaptic, neurons. In mice lacking Cdc42 in presynaptic sensory neurons, proprioceptive sensory axons appropriately reach the ventral spinal cord, but significantly fewer synapses are formed with motor neurons compared with wild-type mice. Concordantly, electrophysiological analyses show diminished EPSP amplitudes in monosynaptic …

Literature Review On Hospital Costs For Patients Undergoing Colectomy, Brian P.H. Chen, Scm, Hang Cheng, Martha Romney, Rn, Ms, Jd, Mph, Carine Chia-Wen Hsiao

College of Population Health Posters

Objective:

This study aims to identify the range of direct hospital costs associated with a minimally invasive or open colectomy procedure across different countries.

Poster presented at 2016 ISPOR conference in Washington DC.