Medicine and Health Sciences Commons^™

Ultrasound-Guided Introital Drainage Of Pyometrocolpos, I Kim, Ranjith Vellody, Hans G. Pohl, Karun Sharma, Kabir Yadav

Radiology Faculty Publications

Pyometrocolpos can be caused by congenital malformations such as distal vaginal atresia and imperforate hymen. Patients usually present with obstructive urinary tract infections, acute kidney injury, or sepsis. Percutaneous drainage of the infected fluid can help treat the patient; however, recurrence is of concern. In this case report, we present a case of a child with recurrent pyometrocolpos due to distal vaginal atresia despite initial percutaneous drainage. To our knowledge, this is the first report of ultrasound-guided introital drainage of pyometrocolpos with relief of symptoms obviating the need for repeat drainage or immediate surgery. © 2017

The Hospital Antimicrobial Use Process: From Beginning To End., William R Truong, Jason Yamaki

Articles, Abstracts, and Reports

Hospital antimicrobial stewardship (AMS) programs are responsible for ensuring that all antimicrobials are utilized in the most appropriate and safe manner to improve patient outcomes, prevent adverse drug reactions, and prevent the development of antimicrobial resistance. This Perspectives article outlines the hospital antimicrobial use process (AUP), the foundational system that ensures that all antimicrobials are utilized in the most appropriate and safe manner. The AUP consists of the following steps: antimicrobial ordering, order verification, preparation and delivery, administration, monitoring, and discharge prescribing. AMS programs should determine how each step contributes to how an antimicrobial is used appropriately or inappropriately at …

First-Pass Cyp3a-Mediated Metabolism Of Midazolam In The Gut Wall And Liver In Preterm Neonates., Janneke M Brussee, Huixin Yu, Elke H J Krekels, Berend De Roos, Margreke J E Brill, Johannes N Van Den Anker, Amin Rostami-Hodjegan, Saskia N De Wildt, Catherijne A J Knibbe

Pediatrics Faculty Publications

To predict first-pass and systemic cytochrome P450 (CYP) 3A-mediated metabolism of midazolam in preterm neonates, a physiological population pharmacokinetic model was developed describing intestinal and hepatic midazolam clearance in preterm infants. On the basis of midazolam and 1-OH-midazolam concentrations from 37 preterm neonates (gestational age 26-34 weeks) receiving midazolam orally and/or via a 30-minute intravenous infusion, intrinsic clearance in the gut wall and liver were found to be very low, with lower values in the gut wall (0.0196 and 6.7 L/h, respectively). This results in a highly variable and high total oral bioavailability of 92.1% (range, 67-95%) in preterm neonates, …

Recurrent Cns Haemangioblastomas With New Onset Of Retinal Angiomas In A Female Patient Diagnosed As Von Hippel Lindau Syndrome, Javerya Sattar, Ateeq Ahmed Khan

Pakistan Journal of Neurological Sciences (PJNS)

Von hippellindau(VHL) disease being a rare genetic disorder, presents with broad spectrum of clinical manifestation and multiorgan neoplasms. The diagnostic criteria for VHL disease include (i) one central nervous system haemangioblastoma and visceral manifestation , (ii) more than one central nervous system haemangioblastomas and (iii) known family history of VHL disease and any of the visceral manifestation. We report a case of 35 years-female patient who presented with recurrent cerebellar and spinal haemangioblastomas with new onset of retinal angioma,hepatichaemangioma and pancreatic cyst, with previous history of surgical resection of cerebellar and spinal cord lesions. This report highlights the importance of …

Unicameral Bone Cysts: Current Concepts, Shahryar Noordin, Salim Allana, Masood Umer, Mujahid Jamil, Kiran Hilal, Nasir Ud Din

Section of Orthopaedic Surgery

Unicameral bone cysts (UBC) or simple/solitary bone cysts are benign fluid filled cavities that enlarge over time, resulting in thinning of the bone. Usually these cysts are reported in the metaphyseal areas of long bones with open physes. 85% of UBCs occur almost exclusively in children and adolescents. UBCs are more aggressive in the first decade of life and correspondingly the recurrence rate for these patients is four times that for adolescents. The proximal humerus and femur account for almost 90% of these cases. UBCs are classified as active when they are within 1 cm of the physis and latent …

Determinants Of Inadequate Provision And Utilization Of Post Abortion Care Services In Pakistan, Marina Baig, Kiran Mubeen

Journal of Asian Midwives (JAM)

Access to safe abortion services remain a challenge in many low and middle income countries like Pakistan. Evidence suggests that Pakistan shares a huge burden of abortion related morbidities and mortalities. Timely provision of Post Abortion Care (PAC) services could assist in preventing maternal deaths associated with unsafe abortions. However, there are certain socio-cultural, financial and political factors that restricts the provision and utilization of effective PAC services. This paper explores these determinants and suggest recommendations for policy and practice to promote PAC services in Pakistan.

Prevalence And Factors Associated With Female Sexual Dysfunction Amongst Women Using Hormonal And Non-Hormonal Contraception At The Aga Khan University Hospital Nairobi Clinics, Momin Butt

Master of Medicine in Family Medicine

Background: Female sexual function is a complex phenomenon. It integrates all the body systems and is influenced by a variety of factors. Contraceptives have been shown to have variable effects on female sexual function, but there have not been adequately powered studies on this in our setting. Justification: The prevalence of female sexual dysfunction (FSD) has been shown to vary among different population subsets globally. The associations of different factors with FSD have also shown variable conclusions that are not generalizable to our setting. In Kenya there is a high discontinuation rate of contraception and this is mainly attributed to …

Faculty Development Initiatives: A Prerequisite For Capacity Building And Enhanced Productivity In A Medical Institution, Rehana Rehman, Hassan Mehmood, Syeda Fatima, Irfanullah Baig, Zohaib Rana, Mohammad Iqbal

Department of Biological & Biomedical Sciences

Objective: To determine the contribution of teaching, learning and assessment forum's initiatives on professional development of faculty and staff.
Methods: This retrospective study was conducted at the Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, from July to December 2016, and comprised teaching, learning and assessment activities carried out from 2012 to 2015. The responses acquired from feedback evaluation were recorded at the end of activity on a Likert-type scale ranging from 1-5. Positive responses were presented for each variable with respective activity type across the study years. The association of the effectiveness of teaching, learning …

Nursing News & Views - June 2018, Christine Klucznik Rn

Nursing Newsletters

No abstract provided.

Use Of A Unique Farmers’ Market Program Targeting Lower-Income Community Members, Brittany Lawrence, Anna E. Greer, Anne Marie Zimeri, Daphne C. Hernandez, Sangnam Ahn, Shaakira Jones, Matthew Lee Smith

Public Health Faculty Publications

We examined use of a farmers’ market that leverages community partnerships to provide free produce to lower-income persons. Participants (n = 422) were asked to complete a questionnaire and given an ID number, which was used to track market use from 2014 to 2015. Chi square tests were used to examine associations between 2014/2015 market use and reasons for market use, financial support received, and how attendees had learned about the market. Ordinal regression was used to identify household characteristics associated with increased market attendance. Although the proportion of lower-income attendees declined over the study period, a substantial proportion of …

A Word From The Writing Team (June 2018), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

This issue includes:

• Sign Up for Our Fall Writing Retreat
• Grammarly Pro
• New eBook on Communicating Data Clearly
• Writing Café

Estrogen Protects Neurotransmission Transcriptome During Status Epilepticus, Dumitru Iacobas, Sanda Iacobas, Nino Nebieridze, Libor Velisek, Jana Veliskova

NYMC Faculty Publications

Women with epilepsy commonly have premature onset of menopause. The decrease in estrogen levels is associated with increased occurrence of neurodegenerative processes and cognitive decline. Previously, we found that estradiol (E2) replacement in ovariectomized (OVX) female rats significantly reduced the seizure-related damage in the sensitive hilar region of hippocampal dentate gyrus (DG). However, the complex mechanisms by which E2 empowers the genomic fabrics of neurotransmission to resist damaging effects of status epilepticus (SE) are still unclear. We determined the protective effects of the estradiol replacement against kainic acid-induced SE-associated transcriptomic alterations in the DG of OVX rats. Without E2 replacement, …

Caring For Newborns With Transitional Hypoglycemia: Best Practices For Education Healthcare Providers And Families, Emelia C. Garcia, Joann D. Long, Monica T. Foster

Books, Presentations, Posters, Etc.

A number of fetal-maternal conditions predispose infants to hypoglycemia. Consensus on postnatal glucose screening and management is mixed contributing to ineffective communication during level of care transition. This project presents evidence informing best practices in how to educate healthcare providers and families of newborns with hypoglycemia.

A Content Analysis Of Sports Illustrated’S Portrayal Of Female Athletes And Its Impact On Society, Britney Murray

Masters Theses

This study utilizes a content analysis of Sports Illustrated covers from 1954-2016 to evaluate the amount and type of coverage permitted to female athletes through this source of print media. The covers were critiqued for both quantity and quality as it relates to the coverage afforded to female athletes and how it differs from the coverage of male athletes. The results from this study provide a foundation for those who wish to further explore and raise awareness on the issue of underrepresentation and misrepresentation of female athletes in sports media.

Evaluation Of A Digital Diabetes Prevention Program Adapted For The Medicaid Population: Study Design And Methods For A Non-Randomized, Controlled Trial., Sue E Kim, Cynthia M Castro Sweet, Eliza Gibson, Erica N Madero, Barbara Rubino, Janina Morrison, Debra Rosen, Wendy Imberg, Michael R Cousineau

Articles, Abstracts, and Reports

Previous studies have shown that lifestyle modification can successfully prevent or delay development of type 2 diabetes. This trial aimed to test if an underserved, low-income population would engage in a digital diabetes prevention program and successfully achieve lifestyle changes to reduce their risk of type 2 diabetes. Participants were recruited from three health care facilities serving low-income populations. The inclusion criteria were: a recent blood test indicating prediabetes, body mass index (BMI) > 24 kg/m

Using A Randomized Controlled Trial To Test Whether Modifications To Contingency Management Improve Outcomes For Heavy Drinkers With Serious Mental Illness., Oladunni Oluwoye, Jordan Skalisky, Ekaterina Burduli, Naomi S Chaytor, Sterling Mcpherson, Sean M Murphy, Jalene Herron, Katherine Hirchak, Mason Burley, Richard K Ries, John M Roll, Michael G Mcdonell

Articles, Abstracts, and Reports

BACKGROUND: In contingency management (CM), individuals receive rewards for alcohol abstinence. CM is associated with reduced alcohol use in adults with co-occurring serious mental illnesses (SMI). Pre-treatment urine ethyl glucuronide (uEtG) levels equivalent to daily heavy drinking (uEtG >349ng/mL) are associated with poor response to CM. Modifications to CM are needed to improve outcomes for non-responders.

AIMS: To determine if pre-treatment heavy drinkers, defined by uEtG, with SMI achieve higher levels of alcohol abstinence when they receive an increased magnitude of reinforcement for abstinence (High-Magnitude CM) or reinforcers for reduced drinking, prior to receiving reinforcers for abstinence (Shaping CM), relative …

Congenitally Corrected Transposition Of The Great Arteries In A Septuagenarian From The Developing Country Of Pakistan, Hunaina Shahab, Salima Ashiqali, Mehnaz Atiq

Section of Pulmonary & Critical Care

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital cardiac defect with atrioventricular and ventriculoarterial discordance which leads to heart failure and limits patients' lifespan. We report the case of a 70-year-old lady, from a poor province in Pakistan, who presented for the first time with palpitations and was diagnosed to have CCTGA. She had moderate pulmonic valve stenosis which was protective against heart failure. She had six children all born via spontaneous vertex delivery in her local village. This case exemplifies the fact that pulmonic stenosis is favourable for patients with CCTGA. In a country where …

The Effect Of The Slope Of The Psychometric Function On The Measurement Of Speech Recognition Threshold Using A Male Talker, Nujod Ali Bakhsh

Theses and Dissertations

Speech audiometry is the aspect of audiology that provides critical information on how individuals hear one of the most important sounds of daily life: speech. The speech recognition threshold (SRT) is a measure of speech audiometry that is widely used to provide information on an individual's capacity to hear speech. Over time, researchers and clinicians have worked to improve the SRT by developing and modifying a variety of word lists to be used during testing. Eventually, spondaic words were selected as the best stimuli for the SRT. The spondaic words had to meet four criteria: familiarity, phonetic dissimilarity, normal sampling …

The Impacts Of Medicaid Expansion On Rural Low-Income Adults: Lessons From The Oregon Health Insurance Experiment., Heidi Allen, Bill J. Wright, Lauren Broffman

Articles, Abstracts, and Reports

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for …

Secukinumab Improves Active Psoriatic Arthritis Symptoms And Inhibits Radiographic Progression: Primary Results From The Randomised, Double-Blind, Phase Iii Future 5 Study., Philip Mease, Désirée Van Der Heijde, Robert Landewé, Shephard Mpofu, Proton Rahman, Hasan Tahir, Atul Singhal, Elke Boettcher, Sandra Navarra, Karin Meiser, Aimee Readie, Luminita Pricop, Ken Abrams

Articles, Abstracts, and Reports

OBJECTIVES: To evaluate the effect of subcutaneous (s.c.) secukinumab, an interleukin-17A inhibitor, on clinical signs and symptoms and radiographic progression in patients with psoriatic arthritis (PsA).

METHODS: Adults (n=996) with active PsA were randomised 2:2:2:3 to s.c. secukinumab 300 mg or 150 mg with loading dose (LD), 150 mg without LD or placebo. All groups received secukinumab or placebo at baseline, weeks 1, 2 and 3 and then every 4 weeks from week 4. The primary endpoint was the proportion of patients achieving an American College of Rheumatology 20 (ACR20) response at week 16.

RESULTS: Significantly more patients achieved an …

Erratum To Inequivalence Of Non-Aggressiveness In Clinically Diagnosed Lung Cancers And Overdiagnosis In Lung Cancer Screening Trials., Jerome M Reich, Jong S Kim

Articles, Abstracts, and Reports

[This corrects the article DOI: 10.21037/jtd.2018.01.164.].

Transcriptional Correlates Of Proximal-Distal Identify And Regeneration Timing In Axolotl Limbs, S. Randal Voss, David Murrugarra, Tyler B. Jensen, James R Monaghan

Neuroscience Faculty Publications

Cells within salamander limbs retain memories that inform the correct replacement of amputated tissues at different positions along the length of the arm, with proximal and distal amputations completing regeneration at similar times. We investigated the possibility that positional memory is associated with variation in transcript abundances along the proximal-distal limb axis. Transcripts were deeply sampled from Ambystoma mexicanum limbs at the time they were administered fore arm vs upper arm amputations, and at 19 post-amputation time points. After amputation and prior to regenerative outgrowth, genes typically expressed by differentiated muscle cells declined more rapidly in upper arms while cell …

Trevo Stent-Retriever Mechanical Thrombectomy For Acute Ischemic Stroke Secondary To Large Vessel Occlusion Registry., Osama O Zaidat, Alicia C Castonguay, Raul G Nogueira, Diogo C Haussen, Joey D English, Sudhakar R Satti, Jennifer Chen, Hamed Farid, Candace Borders, Erol Veznedaroglu, Mandy J Binning, Ajit Puri, Nirav A Vora, Ron F Budzik, Guilherme Dabus, Italo Linfante, Vallabh Janardhan, Amer Alshekhlee, Michael G Abraham, Randall Edgell, Muhammad Asif Taqi, Ramy El Khoury, Maxim Mokin, Aniel Q Majjhoo, Mouhammed R Kabbani, Michael T Froehler, Ira Finch, Sameer A Ansari, Roberta Novakovic, Thanh N Nguyen

Articles, Abstracts, and Reports

BACKGROUND: Recent randomized clinical trials (RCTs) demonstrated the efficacy of mechanical thrombectomy using stent-retrievers in patients with acute ischemic stroke (AIS) with large vessel occlusions; however, it remains unclear if these results translate to a real-world setting. The TREVO Stent-Retriever Acute Stroke (TRACK) multicenter Registry aimed to evaluate the use of the Trevo device in everyday clinical practice.

METHODS: Twenty-three centers enrolled consecutive AIS patients treated from March 2013 through August 2015 with the Trevo device. The primary outcome was defined as achieving a Thrombolysis in Cerebral Infarction (TICI) score of ≥2b. Secondary outcomes included 90-day modified Rankin Scale (mRS), …

Investigating The Role Of Gold Nanoparticle Shape And Size In Their Toxicities To Fungi, Kangze Liu, Zhonglei He, Hugh Byrne, James Curtin, Furong Tian Technological University Dublin

Articles

Gold nanoparticles (GNPs) are increasingly being used in a wide range of applications, and such they are being released in greater quantities into the environment. Consequently, the environmental effects of GNPs, especially toxicities to living organisms, have drawn great attention. However, their toxicological characteristics still remain unclear. Fungi, as the decomposers of the ecosystem, interact directly with the environment and critically control the overall health of the biosphere. Thus, their sensitivity to GNP toxicity is particularly important. The aim of this study was to evaluate the role of GNP shape and size in their toxicities to fungi, which could help …

Optimised Solid State 13c Cp-Mas Nmr For Accurate Determination Of %Degree Of Acetylation Of Extracted Cancer Pagurus Crab Shell Chitin, Fionn O Fearghail

Other resources

No abstract provided.

Maternal Mortality – A Perspective For A Nation, Sampat Shivangi

Manipal Journal of Medical Sciences

No abstract provided.

Femoro-Acetabular Impingement In Athlete: A Case Report, Sarthak Patnaik, Ajay Singh Thakur

Manipal Journal of Medical Sciences

Injuries in sports persons and athletes have tremendous financial implications and can often be career-ending. The injuries to the hip in particular, have not been given due importance in the past probably because the diagnosis and treatment were either ambiguous or not well developed. But, with improvement in the radiological studies especially MR arthrogram and newer hip arthroscopic surgery techniques, both diagnosis and management of such injuries have improved leaps and bounds. Hip arthroscopy as a diagnostic and treatment modality has offered an excellent tool to treat such injuries in athletes. This case report of a 21-year-old athlete had symptoms …

Serious Mental Illness In Heavy Drinkers Is Associated With Poor Treatment Outcomes In Outpatients With Co-Occurring Disorders., Oladunni Oluwoye, Emily Leickly, Jordan Skalisky, Sterling Mcpherson, Katherine Hirchak, Debra Srebnik, John M Roll, Richard K Ries, Michael G Mcdonell

Articles, Abstracts, and Reports

The objective of this study was to determine whether the interaction between type of serious mental illness (SMI) and pre-treatment drinking severity, assessed by ethyl glucuronide (EtG), predicts EtG-positive urine samples submitted during treatment in outpatients with co-occurring alcohol dependence and SMI. Seventy-nine participants were randomized to treatment-as-usual or treatment-as-usual and contingency management (CM) targeting alcohol abstinence. Generalized estimating equations were used to assess the interaction of pre-treatment drinking (heavy drinking or light drinking) and SMI diagnosis (major depression, bipolar, or schizophrenia-spectrum disorders) across a 12-week treatment period. In the overall sample, the interaction of drinking severity and SMI diagnosis …

Creutzfeldt-Jakob Disease: A Case Report Presenting To The Emergency Department, Muhammad Akbar Baig, Sadaf Sheikh

Pakistan Journal of Neurological Sciences (PJNS)

Creutzfeldt-Jakob disease is lethal and most common spongiform encephalopathy worldwide and is rarely encountered in the Emergency department. For the benefit of patients and healthcare workers, rapid consideration of this condition needs to be sought in the setting of rapid neurological decline and myoclonic jerky movements. We present a case of a 54-year old male with behavioral changes, jerky body movements, cognitive dysfunction and left sided weakness developing over the course of few months and presented to our Emergency Department for the evaluation for stroke. Due to the non-specific nature of psychiatric and neurologic complaints, the initial diagnosis remained unclear. …

Frequency Of Vitamin D Deficiency In Multiple Sclerosis Patients: A Cross Sectional Study., Samar Iltaf Pechuho, Alam Ibrahim Siddiqui, Sajjad Husain Jalbani, Safia Sultana, Samina Shaikh, Nagina Shaikh, Fahim Soomro, Mukesh Kumar, Abdul Rehman, Tariq Qazi, Shoaib Soomro, Rizwan Shaikh, Ghulam Mustafa Tunio, Abdul Qayoom Memon

Pakistan Journal of Neurological Sciences (PJNS)

Vitamin D deficiency is linked to poor treatment response in patients with Multiple S clerosis. The aim of this study is to define the frequency of Vitamin D deficiency for early detection and timely intervention leading to improved morbidity rates.