Medicine and Health Sciences Commons^™

Needs Assessment For Curricular Reform Of A Post Graduate Paediatric Training Programme At A Private University Hospital In Karachi, Pakistan, Sana Saeed, Khadija N. Humayun, Farah Qamar, Arshalooz Rahman, Kashif Karim

Department of Paediatrics and Child Health

In order to make and sustain changes in the curriculum, needs assessment is the key. We conducted a need assessment survey using a questionnaire based on a 7 point Likert Scale by residents and alumni. Over all response rate in the study was 77.5%. Fifty eight percent participants were females. Highest level of agreement (mean score 5.7) was found between the alumni and residents regarding the need to revise the content, teaching and assessment strategies in the programme. Twenty seven alumni (n= 38, 71%) had cleared their FCPS exams. The alumni thought that the existing teaching and assessment strategies do …

Pathophysiology Of Environmental Enteric Dysfunction And Its Impact On Oral Vaccine Efficacy, Chelsea Marie, Syed Asad Ali, Kanta Chandwe, William Petri Jr A, Paul Kelly

Department of Paediatrics and Child Health

Environmental enteric dysfunction (EED) refers to a subclinical disorder of intestinal function common in tropical countries and in settings of poverty and economic disadvantage. The enteropathy that underlies this syndrome is characterized by mucosal inflammation and villus blunting mediated by T cell activation. Epithelial cell disruption and microbial translocation drive systemic inflammation. EED in young children is associated geographically with growth failure, malnutrition, and greatly impaired responses to oral vaccines, notably rotavirus and poliovirus vaccines. In this review, we describe the pathophysiology of EED and examine the evidence linking EED and oral vaccine failure. This evidence is far from conclusive. …

Promoting Clinical Breast Evaluations In A Lower Middle–Income Country Setting: An Approach Toward Achieving A Sustainable Breast Health Program, Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, Guldarbogh Sadonshoeva, Saleem Sayani, Aliya Aminmuhammad, Farin Amersi, Sheemain Asaria, Mansoor Saleh, Zohray Talib

Medical College Documents

PURPOSE:
To promote a systems-based approach for the early detection and downstaging of breast cancer at presentation in the remote mountainous region of Gorno Badakhshan Autonomous Oblast (GBAO), Tajikistan, by introducing breast cancer awareness into the community and training health care professionals in clinical breast evaluation (CBE).
METHODS:
Through a public-private partnership between the Ministry of Health, the Aga Khan Health Services, Tajikistan, and the Aga Khan Health Board, we organized breast cancer screening in the community and trained family medicine doctors (FMDs) and family medicine nurses (FMNs) in CBE. We identified and trained CBE master trainers, who, in turn, …

Measurement Matters: Higher Waist-To-Hip Ratio But Not Body Mass Index Is Associated With Deficits In Executive Functions And Episodic Memory, Andree Hartanto, Jose C. Yong

Research Collection School of Social Sciences

Background: The current study aimed to reconcile the inconsistent findings between obesity, executive functions, and episodic memory by addressing major limitations of previous studies, including overreliance on body mass index (BMI), small sample sizes, and failure to control for confounds. Methods: Participants consisted of 3,712 midlife adults from the Cognitive Project of the National Survey of Midlife Development. Executive functions and episodic memory were measured by a battery of cognitive function tests. Results: We found that higher waist-to-hip ratio was associated with deficits in both executive functions and episodic memory, above and beyond the influence of demographics, comorbid health issues, …

Microbiological And Clinical Profile Of Infective Endocarditis Patients: An Observational Study Experience From Tertiary Care Center Karachi Pakistan, Uzma Shahid, Hasanat Sharif, Joveria Farooqi, Bushra Jamil, E. Khan

Department of Pathology and Laboratory Medicine

Background:
The study analyzed microbiological and antimicrobial susceptibility profile of organisms isolated from patients with infective endocarditis (2015–17) and compared disease outcomes in cohorts of endocarditis patient with history of prior invasive vascular intervention (high risk group) vs those without (native valve group). We hypothesized that high risk group would be more likely to have severe disease outcomes.
Methods:
This was a prospective cohort study (2015–17). All blood and cardiac tissue samples of enrolled patients suspected of endocarditis according to modified Duke’s criteria were followed for microbiological and antimicrobial susceptibility profile. The high risk group was compared with the native …

Neurological Complications In Patients With Plasmodium Vivax Malaria From Karachi, Pakistan, Mohammad Asim Beg, A Akhlaq, Najia Karim Ghanchi, B Usmani, R Shahzad, A Rahim, Mohammad Wasay

Department of Pathology and Laboratory Medicine

Background: Malaria remains an endemic disease in Pakistan with an estimated healthcare burden of 1.6 million cases annually, with Plasmodium vivax accounting for 67% of reported cases. P. vivax is the most common species causing malaria outside of Africa, with approximately 13.8 million reported cases worldwide.
Method: We report a series of P. vivax cases with cerebral involvement that presented at Aga Khan University Hospital, Karachi, Pakistan.
Results: The majority of the patients presented with high-grade fever accompanied by projectile vomiting and abnormal behaviour, seizures, shock and unconsciousness. Seven of 801 patients with P. vivax monoinfection presented or developed cerebral …

Twenty-Four Month Results From A Randomized Trial Of Cyanoacrylate Closure Versus Radiofrequency Ablation For The Treatment Of Incompetent Great Saphenous Veins., Kathleen Gibson, Nick Morrison, Raghu Kolluri, Michael Vasquez, Robert Weiss, Daniel Cher, Monte Madsen, Andrew Jones

Surgery Articles

OBJECTIVE: We previously reported 3-month and 12-month occlusion rates after treatment of clinically symptomatic saphenous vein reflux with either cyanoacrylate closure (CAC) using the VenaSeal Closure System (Medtronic, Dublin, Ireland) or radiofrequency ablation (RFA) in a randomized, multicenter, clinical trial, VenaSeal Sapheon Closure System vs Radiofrequency Ablation for Incompetent Great Saphenous Veins (VeClose). Herein we report the 24-month follow-up results of the VeClose trial.

METHODS: There were 222 patients with symptomatic great saphenous vein (GSV) incompetence who were randomly assigned to receive either CAC (n = 108) or RFA (n = 114). Patients were not allowed to receive adjunctive treatment …

Atherosclerosis In Subjects Newly Diagnosed With Human Immunodeficiency Virus Infection., Tatiana V Kirichenko, Veronika A Myasoedova, Tatiana E Shimonova, Alexandra A Melnichenko, Dmitri Sviridov, Igor A Sobenin, Alexey I Mazus, Alexander N Orekhov, Michael I Bukrinsky

Microbiology, Immunology, and Tropical Medicine Faculty Publications

HIV infection is associated with the increased risk of cardiovascular disease (CVD), even in patients successfully treated with the combination antiretroviral therapy (cART). However, the relationship between HIV, cART, and pathogenesis of CVD remains controversial. In the present study, we evaluated the carotid intima-media thickness (CIMT), a surrogate marker of atherosclerosis, in HIV-infected subjects receiving or not receiving cART. One hundred nine newly diagnosed HIV-infected subjects and one hundred nine uninfected age-matched controls (all males) without the history of CVD, hypertension, or diabetes were recruited into the present study. Cross-sectional analysis at baseline (BL) showed significantly increased levels of triglycerides …

Fear In The Veterinary Clinic: History And Development Of The Fear Free℠ Initiative, Breanna Demaline

Conspectus Borealis

No abstract provided.

Immunohistochemical Analysis Of Basigin And Axl Expression In Gliomas, Brittney N. Moore

Conspectus Borealis

No abstract provided.

Web-Based Application To Support Physical Fitness Information Of Elderly People, Yudhy Dharmawan, Suroto Suroto, Priguna Septia Putra

Kesmas

Penduduk lanjut usia (lansia) semakin banyak seiring meningkatnya usia harapan hidup. Banyak upaya yang harus dilakukan untuk mencegah kesakitan di lansia, salah satunya dari aspek preventif dengan menjaga kebugaran para lansia. Untuk memonitor status kebugaran lansia, maka diperlukan aplikasi pemantauan kebugaran jasmani berbasis teknologi web karena tidak ada sistem yang merekam data kebugaran para lansia. Aplikasi ini ditujukan untuk merekam data kebugaran jasmani para lansia untuk merekomendasikan gym yang sesuai berdasarkan kondisi kesehatan yang dapat diakses di mana saja. Aplikasi ini dibuat dengan bahasa pemrograman PHP dan MYSQL sebagai pengolahan basis data yang dilengkapi dengan grafik untuk memantau kebugaran jasmaninya. …

The Implementation Of Documentation By Midwives In Pekanbaru, Wan Anita

Kesmas

Dokumentasi kebidanan adalah suatu bukti pencatatan dan pelaporan yang dimiliki oleh bidan dalam melakukan catatan perawatan yang berguna untuk kepentingan pasien, bidan, dan tim kesehatan. Pendokumentasian dapat diterapkan dengan metode Subjektif, Objektif, Analisa dan Perencanaan (SOAP). Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan pelaksanaan dokumentasi SOAP oleh bidan di Kota Pekanbaru tahun 2016. Penelitian bersifat kuantitatif analitik observasional dengan desain penelitian potong lintang analitik. Sampel penelitian adalah seluruh populasi bidan yang praktik mandiri atau di rumah bersalin di Kota Pekanbaru dengan jumlah sampel sebanyak 191 bidan yang diambil dengan prosedur systematic random sampling. Data dikumpulkan melalui wawancara langsung dengan …

Adolescent’S Knowledge And Skill To Refuse Drugs, Lucky Herawati, Johan Arief Budiman, Haryono Haryono

Kesmas

Berbagai upaya telah dilakukan untuk mencegah remaja dari penggunaan narkoba, kendatipun evaluasi pengetahuan dan keterampilan remaja menolak narkoba belum pernah dilakukan. Penelitian ini dilakukan pada 300 remaja, siswa kelas 7 atau setara usia 12-15 tahun di dua kota di Provinsi Daerah Istimewa Yogyakarta. Penelitian analitik bertujuan mengetahui gambaran pengetahuan, keterampilan remaja menolak narkoba, dan hubungan keduanya dengan karakteristik remaja. Variabel yang diteliti adalah pengetahuan remaja tentang narkoba, keterampilan menolak narkoba, dan karakteristik remaja, yang dikumpulkan dengan menggunakan kuesioner (self-reported questionnaire). Data dianalisis dengan uji korelasi Pearson dan Spearman rho, dengan tingkat signifikansi 95 persen. Hasil penelitian menunjukkan bahwa rata-rata nilai …

Unleashing Endogenous Tnf-Alpha As A Cancer Immunotherapeutic., Steven F Josephs, Thomas E Ichim, Stephen M Prince, Santosh Kesari, Francesco M Marincola, Anton Rolando Escobedo, Amir Jafri

Articles, Abstracts, and Reports

Tumor necrosis factor (TNF)-alpha was originally identified in the 1970s as the serum mediator of innate immunity capable of inducing hemorrhagic necrosis in tumors. Today, a wide spectrum of biological activities have been attributed to this molecule, and clinical translation has mainly occurred not in using it to treat cancer, but rather to inhibit its effects to treat autoimmunity. Clinical trials utilizing systemic TNF-alpha administration have resulted in an unacceptable level of toxicities, which blocked its development. In contrast, localized administration of TNF-alpha in the form of isolated limb perfusion have yielded excellent results in soft tissue sarcomas. Here we …

How Can Developmental Transformations Address Culture Shock To Those Moving From Collectivist Societies Into Individualistic Ones, Such As, Chinese Immigrants Into The United States?, Fabiola Valdivia

Expressive Therapies Capstone Theses

Immigration has always existed, and lately with the heyday of social networks and media, we have witnessed high rates of immigration due to different social and political contexts that have forced people to leave their homes looking for a better situation. Many of these individuals have emigrated and continue to emigrate to the United States of America, in search of, what in some cases they believe will be, the American dream.

This document explores the implementation of developmental transformations (DvT), originally a drama therapy approach, with an immigrant population coming from a collective society such as the Asian into an …

Factors Influencing Immunisation Schedule Adherence And Completion At The Regional Level In The Philippines, Paolo Miguel Manalang Vicerra

Kesmas

Penyebab utama kematian bayi sebagian besar dapat dicegah dan terdapat alasan baik dari sisi suplai maupun permintaan layanan kesehatan hal itu dapat terus berlangsung. Penelitian ini bertujuan memastikan faktor-faktor yang memengaruhi perilaku layanan kesehatan preventif imunisasi bayi di Filipina yang tepat waktu karena tingkat kelengkapan, atau kepatuhan, telah stabil dalam beberapa dekade terakhir. Metode yang digunakan adalah pembuatan model statistik di tingkat subnasional. Sampel berisi bayi yang lahir sebelum Survei Demografi dan Kesehatan Nasional Filipina tahun 2013 untuk menentukan kepatuhan yang tepat terhadap jadwal imunisasi yang dimandatkan oleh pemerintah. Hal ini melibatkan penggabungan 17 wilayah administratif negara ke tiga wilayah …

Husband’S Support For Their Wives In Antenatal Care Visit, Awalia Hanifah, Hadi Pratomo, Giang Hoang

Kesmas

Di wilayah Puskesmas Cimanggis, Kota Depok, cakupan kunjungan antenatal pertama (K1) dan kunjungan ke-4 (K4) sebesar 99,4% (2013) dan 91% (2014). Dukungan suami ibu hamil merupakan salah satu faktor yang berperan penting dalam kunjungan antenatal pada ibu hamil. Penelitian ini bertujuan menilai faktor predisposisi, pemungkin dan penguat dari dukungan suami terhadap ANC istrinya dengan menggunakan pendekatan kualitatif dengan desain Rapid Assessment Procedure. Lima suami dan istrinya yang sedang hamil dipilih sebagai informan serta dua bidan puskesmas sebagai informan kunci. Analisis data menggunakan matriks data kualitatif dan teknik analisis tematik. Hasil penelitian menunjukkan bahwa faktor predisposisi, pemungkin dan penguat dari suami …

Influential Host Factors To The Incidence Of Hiv/Aids In Key Populations In Pati District, Dwi Murtono, Puguh Riyanto, Zahroh Shaluhiyah

Kesmas

Human Immunodeficiency Virus (HIV) dan Acquired Immune Deficiency Syndrome (AIDS) merupakan penyakit berbahaya di dunia yang salah satu metode penularannya adalah melalui hubungan seksual. Penelitian ini bertujuan menjelaskan faktor-faktor yang berpengaruh terhadap kejadian HIV/AIDS pada populasi kunci. Penelitian dilakukan dari bulan Maret sampai September 2016. Penelitian analitik observasional dengan rancangan kasus kontrol pada populasi kunci di Kabupaten Pati. Kasus sebanyak 53 pasien positif HIV/AIDS, sedangkan kontrol sebanyak 53 pasien negative HIV/AIDS.Pengambilan sampel menggunakan teknik consecutive sampling. Data diperoleh dari riwayat medis dan wawancara kuesioner. Penelitian ini menggunakan uji kai kuadrat pada analisis bivariat dan regresi logistik ganda pada analisis multivariat. …

Unsafe Behavior Of Workers In Rotary Lathe Section In One Of The Plywood Industries In East Kalimantan, Iwan Muhamad Ramdan, Dyyka Indah Wijayanti

Kesmas

Kecelakaan kerja dan penyakit akibat kerja masih menjadi masalah kesehatan dunia, dua faktor utama penyebabnya adalah perilaku dan kondisi lingkungan kerja yang tidak aman. Penelitian sebelumnya membuktikan penyebab utamanya adalah faktor perilaku yang tidak aman. Penelitian ini bertujuan menganalisis faktor-faktor yang berhubungan dengan perilaku tidak aman dalam bekerja pada tenaga kerja di PT IAW dan menganalisis faktor yang paling berpengaruh. Penelitian potong lintang dilakukan pada bulan Juli sampai Agustus 2016 terhadap 104 sampel penelitian. Variabel bebas terdiri dari persepsi, komunikasi, pengawasan, ketersediaan alat pelindung diri (APD), pelatihan dan suhu lingkungan kerja. Variabel terikat adalah perilaku tidak aman. Analisis data menggunakan …

Direct Experience With Cervical Cancer Patient, Husband Support, And Self-Perception As Determinant Factors Of Women’S Desire To Take Via Screening Test, Nur Anisah Rahmawati, Linda Dewanti

Kesmas

Kanker serviks menyebabkan 10.3% kematian pada perempuan di Indonesia. Inspeksi visual asam asetat (IVA) telah digunakan untuk program skrining sejak tahun 2014 tetapi hanya 2,45 % perempuan yang melakukan pemeriksaan pada tahun 2015. Di tempat penelitian, cakupan skrining metode IVA kurang dari 1%. Penelitian sebelumnya menyebutkan faktor psikososial sebagai satu faktor penting, tetapi sedikit penelitian yang menganalisis peran dukungan suami dan pengalaman langsung dengan penderita kanker serviks. Penelitian ini bertujuan mempelajari hubungan antara pengalaman langsung dengan penderita kanker serviks, dukungan suami, persepsi diri dan keinginan perempuan melakukan skrining IVA. Penelitian potong lintang dilakukan secara acak pada perempuan berusia 25-55 tahun …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• American Statistical Association (ASA) announces 2018 winner of Award for Outstanding Statistical Contributions for the Betterment of Society

Utilization Of Imaging To Identify A Benign Condition Mimicking Acute Appendicitis In A Child, Neelam Phalke Md, Zubin Mehta Md, Samrat Das Md

School of Medicine Faculty Research

One of the most concerning causes of abdominal pain affecting children is acute appendicitis. However, there are benign conditions that can closely mimic appendicitis in children. In this article, we present a case of a child admitted for possible acute appendicitis and determined to have a condition known as omental infarction. The patient was managed medically and made a full recovery without surgical intervention. The aim of this case report is to review omental infarction and present a way of differentiating this disease from appendicitis, utilizing imaging, with the goal of avoiding surgical intervention. We also discuss the presentation and …

Leveraging Pharma To Lower Premiums: Medical Loss Ratio Regulation In The Pharmaceutical Industry, Cami R. Schiel

BYU Law Review

Many recognize escalating drug prices as a significant dilemma related to America’s rising healthcare costs. Yet few can agree on what to do about them. Unaffordable drug prices are a result of many complex forces. One theory to address this problem is to reduce all government intervention and let normal market forces act as they usually do to bring the goods’ prices down to consumer-friendly ranges. However, the prescription drug market is not, and perhaps never can be, a normal market. Reasons for this include (1) a lack of price transparency, (2) information and control asymmetries between patients and physicians, …

Antiphosphatidylserine Antibody As A Cause Of Multiple Dural Venous Sinus Thromboses And St-Elevation Myocardial Infarction, Chelsea K. Varner, Caillin W. Marquardt, Peter V. Pickens

Student Papers, Posters & Projects

Objective: Rare disease Background: Antiphospholipid syndrome (APS) is an autoimmune disease characterized by antibodies directed against phos-pholipids on plasma membranes. Through unclear mechanisms, APS confers hypercoagulability. APS may cause recurrent thromboses in the arterial and venous vasculature. We report a case of primary APS resulting in cerebral venous thrombosis and ST-elevation myocardial infarction (STEMI) for which only antiphosphatidylserine (aPS) IgM antibody was positive after extensive investigation. Case Report: A 48-year-old male was admitted after a witnessed generalized seizure with subsequent confusion. Imaging demonstrated thrombosis of multiple central nervous system (CNS) sinuses, including the superior sagittal sinus and bilateral transverse sinuses. …

Anidulafungin: A Noninferior Alternative To Fluconazole For Treatment Of Esophageal Candidiasis, Blake S. Sanford

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Krause DS, Simjee AE, van Rensburg C, et al. A randomized, double-blind trial of anidulafungin versus fluconazole for the treatment of esophageal candidiasis. Clin Infect Dis. 2004;39(6):770-775. doi: 10.1086/423378.

Depressive Symptoms And Untreated Coronal Dental Caries Among Adults Ages 21-64 Years, Nhanes 2013-2014, R. Constance Wiener, Chan Shen, Patricia A. Findley, Nilanjana Dwibedi, Usha Sambamoorthi

Clinical and Translational Science Institute

Background: Depression has been linked to poor oral health among patients seeking dental care. However, systematic research on the relationship between depressive symptoms and oral health is limited. Objective: To examine the association of depressive symptoms with untreated dental caries among adults aged 21-64 years. Basic Research Design: Cross-sectional secondary analysis. Setting: The data were extracted national data collected in the United States (2013-2014 National Health Nutrition and Examination Survey). Participants: The sample consisted of 3,127 non-institutionalized civilians. Main outcome measure: Untreated coronal dental caries (yes, no) was the key outcome variable. Depressive symptom categories (none, moderate, and severe) were …

A Cause To Action: Learning To Develop A Culturally Responsive/Relevant Approach To 21st Century Water Safety Messaging Through Collaborative Partnerships, Angela K. Beale-Tawfeeq, Austin Anderson, William D. Ramos

International Journal of Aquatic Research and Education

Globally, and in the United States, drowning is considered a “neglected public health threat” (WHO, 2014b). Reports have shown that there are groups of people in certain communities who are at greater risk. African Americans, as a group, have a drowning death rate 9% higher than that of the overall population, with the greatest disparity being among African American youth (Gilchrist & Parker, 2014). While many national programs and organizations present water safety awareness and drowning prevention efforts within communities, very few offer multi-sectorial collaborative efforts (WHO, 2017a) among culturally and linguistically diverse (CLD) aquatic stakeholders designed to empower, promote, …

Effects Of Mantra Meditation Versus Music Listening On Knee Pain, Function, And Related Outcomes In Older Adults With Knee Osteoarthritis: An Exploratory Randomized Clinical Trial (Rct), Kim E. Innes, Terry Kit Selfe, Sahiti Kandati, Sijin Wen, Zenzi Huysmans

Clinical and Translational Science Institute

Objective. Disease-modifying treatments for OA remain elusive, and commonly used medications can have serious side efects. Although meditation and music listening (ML) have been shown to improve outcomes in certain chronic pain populations, research in OA is sparse. In this pilot RCT, we explore the efects of two mind-body practices, mantra meditation (MM) and ML, on knee pain, function, and related outcomes in adults with knee OA. Methods. Twenty-two older ambulatory adults diagnosed with knee OA were randomized to a MM (N=11) or ML program (N=11) and asked to practice 15-20 minutes, twice daily for 8 weeks. Core outcomes included …

Transcriptomic Insights On The Virulence-Controlling Csra, Badr, Rpon, And Rpos Regulatory Networks In The Lyme Disease Spirochete, William K. Arnold, Christina R. Savage, Kathryn G. Lethbridge, Trever C. Smith, Catherine A. Brisette, Janakiram Seshu, Brian Stevenson

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Borrelia burgdorferi, the causative agent of Lyme disease, survives in nature through a cycle that alternates between ticks and vertebrates. To facilitate this defined lifestyle, B. burgdorferi has evolved a gene regulatory network that ensures transmission between those hosts, along with specific adaptations to niches within each host. Several regulatory proteins are known to be essential for the bacterium to complete these critical tasks, but interactions between regulators had not previously been investigated in detail, due to experimental uses of different strain backgrounds and growth conditions. To address that deficit in knowledge, the transcriptomic impacts of four critical …

Evaluation Of Self-Report Adherence Measures And Their Associations With Detectable Viral Load Among People Living With Hiv (Plhiv) In China, Wendi Da, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Objectives Self-report antiretroviral therapy (ART) adherence has been consistently associated with clinical outcomes. This study aims to compare the accuracy of self-report ART adherence measures with varying recall timeframes or item contents to predict virological response.

Methods Data from a cross-sectional study among 2146 participants on ART in Guangxi, China were used. Detectable viral load was defined as viral load > 50 copies/ml. Adherence was measured using the number of days on which all doses were taken in the past month (i.e., the “one-month days taken” measure), the number of days on which any dose was missed in the past month …