Medicine and Health Sciences Commons^™

Comparative Studies On Biochemical And Pharmacological Profiles Of Bovine, Ovine And Porcine Heparins, Ahmed Kouta

Master's Theses

Heparin, a highly sulfated glycosaminoglycan (GAG), is used extensively as an anticoagulant. It consists of repeating disaccharide units, containing iduronic acid (or glucuronic acid) and glucosamine, exhibiting variable degrees of sulfation. Heparin, and its analogues, are used during surgery and dialysis, and are often used to coat indwelling catheters and other devices where the vascular system is exposed. Administered parenterally, often continuously due to its short half-life, over 0.5 billion doses are required per year. Heparin is currently obtained from mucosal tissue of meat animals, mainly porcine intestine, and to a lesser extent bovine and ovine sources. The early stages …

Feasibility Of Antiretroviral Treatment Monitoring In The Era Of Decentralized Hiv Care: A Systematic Review, Minh D. Pham, Lorena Romero, Bruce Parnell, David A. Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: Regular monitoring of HIV patients who are receiving antiretroviral therapy (ART) is required to ensure patient benefits and the long-term effectiveness and sustainability of ART programs. Prompted by WHO recommendations for expansion and decentralization of HIV treatment and care in low and middle income countries, we conducted a systematic review to assess the feasibility of treatment monitoring in these settings.

Methods: A comprehensive search strategy was developed using a combination of MeSH and free text terms relevant to HIV treatment and care, health service delivery, health service accessibility, decentralization and other relevant terms. Five electronic databases and two conference …

High Resolution Melting: A Useful Field-Deployable Method To Measure Dhfr And Dhps Drug Resistance In Both Highly And Lowly Endemic Plasmodium Populations, Yaye Dié Ndiaye, Cyrille K. Diédhiou, Amy K. Bei, Baba Dieye, Aminata Mbaye, Nasserdine Papa Mze, Rachel F. Daniels, Ibrahima M. Ndiaye, Awa B. Déme, Amy Gaye, Mouhamad Sy, Tolla Ndiaye, Aida S. Badiane, Mouhamadou Ndiaye, Zul Premji, Dyann F. Wirth, Souleymane Mboup, Donald Krogstad, Sarah K. Volkman, Ambroise D. Ahouidi, Daouda Ndiaye

Pathology, East Africa

Background: Emergence and spread of drug resistance to every anti-malarial used to date, creates an urgent need for development of sensitive, specifc and feld-deployable molecular tools for detection and surveillance of validated drug resistance markers. Such tools would allow early detection of mutations in resistance loci. The aim of this study was to compare common population signatures and drug resistance marker frequencies between two populations with diferent levels of malaria endemicity and history of anti-malarial drug use: Tanzania and Sénégal. This was accomplished by implementing a high resolution melting assay to study molecular markers of drug resistance as compared to …

Reference Intervals For Thyroid Stimulating Hormone And Free Thyroxine Derived From Neonates Undergoing Routine Screening For Congenital Hypothyroidism At A University Teaching Hospital In Nairobi, Kenya: A Cross Sectional Study, Geoffrey Omuse, Ali Kassim, Francis Kiigu, Ra'ana Hussain, Mary Limbe

Pathology, East Africa

Background: In order to accurately interpret neonatal thyroid function tests (TFTs), it is necessary to have population specific reference intervals (RIs) as there is significant variation across different populations possibly due to genetic, environmental or analytical issues. Despite the importance of RIs, globally there are very few publications on RIs for neonatal TFTs primarily due to ethical and technical issues surrounding recruitment of neonates for a prospective study. To the best of our knowledge, this is the first report from Africa on neonatal RIs for TFTs.

Methods: We used hospital based data largely derived from neonates attending the wellness clinic …

Urolithiasis Analysis In A Multiethnic Population At A Tertiary Hospital In Nairobi, Kenya, Francis Kiigu, Alfred Hayombe, Daniel Maina

Pathology, East Africa

Background: Urolithiasis is a global problem whose incidence is reported to be on the rise across the world. Previously, urolithiasis was reported as being rare among the indigenous African population but recent data suggest otherwise. This study reviewed the demographic and clinical characteristics of patients with urolithiasis seen at the Aga Khan University hospital Nairobi (AKUHN) as well as the chemical composition of the stones and the modalities of therapy used.

Methods: This was a retrospective study which utilized patients’ clinical and laboratory records from 2013 to 2014. Sixty-seven symptomatic patients with confrmed urolithiasis formed the study. This study aimed …

Knowledge Of Polymath Walks, Talks, Makes Waves, Turns Into Deeds, Hamlet Isaxanli, Waqas Ahmed

Khazar Journal of Humanities and Social Sciences

In this interview, Hamlet Isaxanli shares his opinion on polymathy. What makes a polymath? Isaxanli stresses the importance of two factors: a person’s nature may lead him/her to an insatiable thirst for knowledge and the desire to explore different fields simultaneously. On the other hand, the education system encourages polymathy from the perspective of the richness and diversity of the high school curriculum. Isaxanli also goes into the relationship between math and poetry as well as the art-science-humanities connections. He then calls attention to Omar Khayyam, Nasr al-Din Tusi and some polymaths of the 20th century. Finally yet importantly, Isaxanli …

A Rare Case Of Erythema Elevatum Diutinum Presenting As Diffuse Neuropathy, G H. Nguyen, E L. Guo, D Norris

Faculty, Staff and Students Publications

No abstract provided.

Effects Of Bidi Smoking On All-Cause Mortality And Cardiorespiratory Outcomes In Men From South Asia: An Observational Community-Based Substudy Of The Prospective Urban Rural Epidemiology Study (Pure), Mylinh Duong, Sumathy Rangarajan, Xiaohe Zhang, Kieran Killian, Prem Mony, Sumathi Swaminathan, Ankalmadagu Venkatsubbareddy Bharathi, Sanjeev Nair, Krishnapillai Vijayakumar, Indu Mohan, Romaina Iqbal, Khawar Kazmi

Community Health Sciences

Background: Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region.
Methods: This substudy of the international, community-based Prospective Urban Rural Epidemiology (PURE) study was done in seven centres in India, Pakistan, and Bangladesh. Men aged 35–70 years completed spirometry testing and standardised questionnaires at baseline and were followed up yearly. We used multilevel regression to compare cross-sectional baseline cardiorespiratory symptoms, spirometry measurements, and follow-up events (all-cause mortality, cardiovascular events, respiratory events) …

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

The Effect Of Breastfeeding On The Cognitive And Language Development Of Children Under 3 Years Of Age: Results Of Balochistan-Early Childhood Development Project, Meesha Iqbal Iqbal, Ghazala Rafique, Sumera Aziz Ali

Community Health Sciences

Background: Breastfeeding is known to be an important factor in the overall growth and development of children. Breastfeeding is thought to lead to enhance cognitive and language development of a child. However, this association has not yet been scientifically and statistically established. This study aimed to explore this association in children under 3 years of age.
Methods: This was a secondary data-analysis of the baseline data of “Balochistan – Early Childhood Development Project”. The final sample comprised of 604 children less than 3 years of age. The children were selected by three-stage stratified random sampling from three districts of Balochistan …

Can Right To Health Help Policy Makers To Address Maternal Mortality?: A Short Communication, Sumera Aziz Ali, Nadir Suhail, Savera Aziz Ali

Community Health Sciences

No abstract provided.

Long Term Survival Rate Of Tavr With And Without Dialysis., Taryn Samet Md, Sydney Pickering, Timothy S. Misselbeck, Raymond L. Singer Md, Mmm, James K. Wu Md

Department of Surgery

No abstract provided.

The Meaning Of Giving Birth: Voices Of Hmong Women Living In Vietnam, Cheryl A. Corbett, Lynn Clark Callister, Jamie Peterson Gettys, Jacob R. Hickman

Faculty Publications

Increasing knowledge about the sociocultural context of birth is essential to promote culturally sensitive nursing care. This qualitative study provides an ethnographic view of the perspectives of birthing of Hmong mothers living in the highlands of Vietnam. Unique cultural beliefs exist in Hmong culture about the spiritual and physical wold as well as ritual practices associated with childbearing. This includes variations of ancestor worship, reincarnation, and healing practices by shamans. Traditionally, Hmong families take an active role in childbirth with birth frequently occurring in the home. Situated within a large collaborative anthropology project, a convenience sample of 8 Hmong women, …

Reproducing Childbirth: Negotiated Maternal Health Practices In Rural Yucatan, Veronica Miranda

Theses and Dissertations--Anthropology

This ethnographically informed dissertation focuses on the ways rural Yucatec Maya women, midwives and state health care workers participate in the production of childbirth and maternal health care practices. It further addresses how state health programs influence the relationships and interactions between these groups. Although childbirth practices in Yucatan have always been characterized by contestation, negotiation and change, their intensity and speed have significantly increased over the last decade. Drastic changes in the maternal health of rural indigenous communities in Mexico and throughout the world are directly connected to intensified state interventions that favor biomedicine over traditional health systems. In …

Fish Oil With Higher Dha Content And Voluntary Exercise Decreases Postmenopausal Bone Loss, Jameela Banu, Gabriel Fernandes

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

There is increasing evidence suggesting that fish oil (FO) decreases bone resorption by reducing osteoclastogenesis and regular exercise (EX) increases bone mass. EX is associated with increasing bone formation. Therefore, the combined effects of FO intake and EX may have additive effects by both increasing bone formation and decreasing bone resorption. To demonstrate this, we studied the effects of FO and EX on the bone of mice after an ovariectomyinduced bone loss.

Twelve months old C57BL/6 female mice were either sham operated or ovariectomized, divided into different dietary and EX group and maintained for 3 months before sacrifice.

The distal …

Parental Input To Children With Asd And Its Influence On Later Language, Aparna Nadig, Janet Bang

Faculty Research, Scholarly, and Creative Activity

In this chapter, we review evidence on parental input to children with autism spectrum disorder (ASD), moving from quantitative measures of linguistic features to qualitative measures of interaction. First, we examine lexical and syntactic features (e.g., number of utterances, mean length of utterance [MLU]) in the input provided to children with ASD compared with TD [typically developing] children matched on language level. Second, we turn to work on parental responsiveness, or the tendency to provide verbal or gestural input in sync with the child’s focus of attention, and how this compares across dyads including a child with ASD or a …

Practicing Sacred Encounters: A Narrative Analysis Of Relational, Spiritual, And Nursing Leadership, Margaret Woodrow Mark

Antioch University Dissertations & Theses

This research examined one large health system that has, through a stated mission outcome that every encounter is a sacred encounter, sought to enhance relationships occurring within the health care environment. Seeking to understand the lived experience of sacred encounters through the lens of nurse leaders in one acute care hospital settings this study examined how nurse leaders experienced their leadership role in realizing sacred encounters. Participants were defined as nurse leaders from one hospital setting and included nurse managers, directors and one vice president. A narrative thematic analysis framed by situational analysis was the method of inquiry. Data was …

Young Adults In Transition: Factors That Support And Hinder Growth And Change, Mona Treadway

Antioch University Dissertations & Theses

Young adults between 18 and 24 years of age with mental illness are significantly less likely to receive mental health services than adults in older age groups.Nationally, higher rates of depression, substance abuse, and psychiatric issues are reported in this age group.A therapeutic model referred to as young adult transition programs has emerged to better address the unique developmental challenges found in this age group.This study examined 317 critical incidents that supported or hindered young adults in a therapeutic transition program.The research design used a combination of an instrumental case study and critical incident technique (CIT).Using interviews and the Outcome …

Lived Experience Of Military Mental Health Clinicians: Provided Care To Oif And Oef Active Duty Service Members Experiencing War Stress Injury, David W. Vandegrift

Antioch University Dissertations & Theses

Military mental health clinicians (MMHCs) have been essential to Operations Enduring Freedom and Iraqi Freedom. They served in extreme stress conditions, including on the front lines. As co-combatant/clinician, the MMHC bridged unique perspectives on the effects of war stress experienced by Active-Duty Service Members (ADSMs). To date, no study has focuses uniquely on MMHCs narratives as they provided care from this multiple perspective. This investigation was carried out from a phenomenological perspective. A single, open-ended question was asked of seven MMHCs about lived experiences while serving, resulting in in-depth interviews. These were textually coded. Though clinician positive and negative experiences …

Effects And Mechanisms Of Porcine Reproductive And Respiratory Syndrome Virus (Prrsv) Type 1 And Type 2 On The Permeability And Viability Of Porcine Endometrial Epithelial Cells, Dran Rukarcheep

Chulalongkorn University Theses and Dissertations (Chula ETD)

Both PRRSV types 1 and 2 revealed the sign of reproductive disorders associated with a lesion at implantation sites. Impairment of maternal glandular endometrium cell integrity and function by PRRSV infection may impact a proper nourishing fetus. This research was aimed to examine the effects of PRRSV type 1 and type 2 directly on the viability and barrier function of the endometrium using porcine glandular endometrial epithelial cell culture (PEG). The comparison of the route and the strain of PRRSV infection coinciding with their virulent in reproductive epithelia were considered. PEG cells isolated from the 4-6 months old PRRSV-free-herd gilts …

Potentials Of Ivabradine To Improve Cardiac Function In Dogs With Naturally Occurring, Asymptomatic Degenerative Mitral Valve Disease, Prapawadee Pirintr

Chulalongkorn University Theses and Dissertations (Chula ETD)

The main hypothesis of the present study is that ivabradine (1.0 mg/kg, orally, twice daily) can reduce heart rate (HR), myocardial oxygen consumption (MVO2) and improve cardiac function in dogs with degenerative mitral valve disease (DMVD) partly due to a reduction of cardiomyocyte apoptosis. In order to test the hypothesis, this study was divided into three parts. The first part aimed to determine the appropriate single oral dose of ivabradine for reduction of HR and MVO2 as assessed by rate-pressure product (RPP= HR x systolic blood pressure). Once the appropriate dose was achieved, the second part was conducted to investigate …

Potentials Of Ivabradine To Improve Cardiac Function In Dogs With Naturally Occurring, Asymptomatic Degenerative Mitral Valve Disease, Prapawadee Pirintr

Chulalongkorn University Theses and Dissertations (Chula ETD)

The main hypothesis of the present study is that ivabradine (1.0 mg/kg, orally, twice daily) can reduce heart rate (HR), myocardial oxygen consumption (MVO2) and improve cardiac function in dogs with degenerative mitral valve disease (DMVD) partly due to a reduction of cardiomyocyte apoptosis. In order to test the hypothesis, this study was divided into three parts. The first part aimed to determine the appropriate single oral dose of ivabradine for reduction of HR and MVO2 as assessed by rate-pressure product (RPP= HR x systolic blood pressure). Once the appropriate dose was achieved, the second part was conducted to investigate …

Effects Of Short-Term Growth Hormone Administration On Plasma Leptin Levels In Normal And Diet-Induced Obesity Rats, Sutharinee Likitnukul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Obesity has related to the alteration of hormonal profiles, i.e. growth hormone (GH), insulin and leptin. Because of the pleiotropic mechanisms of GH, it plays important roles both in the pathophysiological mechanisms and the therapeutic hormonal supplementation, which probably affected plasma leptin. The present research aimed firstly to demonstrate the effect of short-term GH administration on plasma leptin in 3 conditions; basal, meal-induced and fasting condition, from the rats with different adipose tissue mass. Secondly, to investigate short-term effect of GH on insulin sensitivity and body adiposity in control, diet resistant (DR) and diet-induced obesity (DIO) rats. In this regard, …

The Protective Effect Of Hydroxyxanthone On The Leakiness Of Intestinal Epithelia By The Proinflammatory Cytokine Related To Bacterial Endotoxin, Wannaporn Chayalak

Chulalongkorn University Theses and Dissertations (Chula ETD)

Leaky gut characterized as decreased transepithelial electrical resistance and increased paracellular permeability to macromolecules is associated with several fatal diseases including sepsis. Pro-inflammatory cytokine IL-1β is a critical mediator of underlying mechanism through activation of myosin light chain kinase pathway. Blocking the inducible phosphorylated myosin light chain (p-MLC) indicates the successful treatment. Xanthones predominantly found in mangosteen (Garcinia mangostana) has been indicated as a potent anti-inflammatory action. Hydroxyxanthones (HDX), the major natural xanthones, have been recently synthesized in various forms. This study aimed to examine and screen the action of various forms of synthetic HDXs, in preventing the increased paracellular …

Prevalence And Molacular Genetic Analysis Of Human Respiratory Syncytial Virus And Enterovirus 68 Among Children With Acute Lower Respiratory Tract Infection In Thailand, I-Lada Thongpan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Respiratory syncytial virus (RSV) causes acute lower respiratory tract infection in infants and young children worldwide. A clear description of local RSV molecular epidemiology, evolution, and transmission requires detailed sequence data and can inform new strategies for virus control and vaccine development. To investigate the RSV burden in Thailand over six consecutive years (January 2012 to December 2017). There were two different methods to detect RSV in the present study. First, we screened 3306 samples obtained from children ≤5 years old with acute respiratory tract infection using semi-nested reverse-transcription polymerase chain reaction (RT-PCR) during January 2012 to December 2015. Second, …

Pathomechanism Of X-Linked Osteogenesis Imperfecta, Siraprapa Tongkobpetch

Chulalongkorn University Theses and Dissertations (Chula ETD)

Osteogenesis imperfecta (OI) or brittle bone disease is a genetic disorder characterized by deformities of bones and multiple bone fractures. We identified a new causative gene, MBTPS2, in two unrelated patients with OI inherited in X-linked pattern (X-OI). MBTPS2 or site-2 protease (S2P) is a protease that cleaves the transmembrane proteins to activate them acting as transcription factors. To determine pathomechanism of X-OI caused by MBTPS2 mutations, S2P functions were investigated. RNA and protein of S2P were stable. Instead, the defective S2P decreases its cleavage activities. ATF6 and CREB3L1 are target proteins of S2P. We demonstrated decreased a transcriptional activity …

Isoquinoline Alkaloid Composition And Expression Of Biosynthetic Genes In Mechanically Wounded Sacred Lotus, Thitirat Meelaph

Chulalongkorn University Theses and Dissertations (Chula ETD)

Isoquinoline alkaloids, a plant secondary metabolites present in many plant species including lotus (Nelumbo nucifera Gaertn.). Lotus leaf contains high amount of bioactive nuciferine and N-nornuciferine. A set of enzyme including NCS, 6OMT and CNMT and WRKY transcription factors (WRKY TFs) has been reported to have corresponding function in the biosynthesis isoquinoline alkaloids. Thus, we performed quantitative analysis on expression level of these corresponing genes and on nuciferine and N-nornuciferine content in lotus leaf using mechanical wounding method. Sequence analysis clearly showed that all the targeted genes possess the conserved region belongs to their protein families. The accumulation of compound …

Effects Of Mitragynine On Morphine And Methamphetamine Addiction In Animal Models Of Addiction, Rittinarong Meepong

Chulalongkorn University Theses and Dissertations (Chula ETD)

Kratom (Mitragyna speciosa Korth) has long been used in folklore medicine in Southeast Asian countries. It has been used for its analgesic effects and treatment of opioid withdrawal. Mitragynine is a major alkaloid found in the leaves of kratom plant that exerts its effects via activation of opioid receptors and other receptors in the central nervous system. This study aimed to provide evaluation of abuse liability and potential of mitragynine in the treatment for opioids and amphetamine type stimulants addictions. Abuse liability of mitragynine and its effects on morphine and methamphetamine addiction were evaluated by drug discrimination, conditioned place preference …

Protein Profiling Analysis Of Platelets In Hypercoagulable State Of Β-Thalassemia/Hbe Patients, Puangpaka Chanpeng

Chulalongkorn University Theses and Dissertations (Chula ETD)

β-thalassemia/HbE is an inherited hemolytic anemia caused by defect in β-globin synthesis resulting in accumulation of excess α-globin chains in red blood cells. A hypercogulable state leading to high risk of thromboembolic event is one of the most common complications observed in this disease, particularly in patients with splenectomy. Previous studies suggested that increased platelet activation and coagulation factors in β-thalassemia/HbE intermediate patients promote the hypercoagulable state. However, the hypercoagulable state as well as the molecular mechanism regarding this pathogenesis in β-thalassemia/HbE is not yet well understood. This study aimed to identify proteins related to platelet activation and to hypercoagulable …

Comparison Between Digital Image Analysis And Visual Assessment Of Immunohistochemical Her2 Expression In Breast Cancer, Morten Ragn Jakobsen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Assessment of HER2 status is considered standard of care in the histopathologic workup of breast cancer and conveys prognostic and predictive information used to guide treatment decisions. The assessment is often carried out in a two-step approach where immunohistochemical expression of HER2 protein is first evaluated by conventional microscopy and equivocal cases are further analyzed by in-situ hybridization techniques to assess gene amplification status. Methods: In this study we compared conventional manual assessment of immunohistochemical HER2 expression with digital image analysis (DIA) and consensus manual assessment by a panel of three pathologists. From our archive we retrieved sections of …