Medicine and Health Sciences Commons^™

Pain Management Practices Surrounding Lumbar Punctures In Children: A Survey Of Canadian Emergency Physicians., Naveen Poonai, Victoria Brzozowski, Antonia S Stang, Amy L Drendel, Philippe Boisclair, Michael Miller, Stuart Harman, Samina Ali

Paediatrics Publications

OBJECTIVES:
Lumbar punctures (LPs) are painful for children, and analgesia is recommended by academic societies. However, less than one-third of pediatric emergency physicians (EPs) adhere to recommendations. We assessed the willingness to provide analgesia among pediatric and general EPs and explored patient and provider-specific barriers.

METHODS:
We surveyed physicians in the Pediatric Emergency Research Canada (PERC) or Canadian Association of Emergency Physicians (CAEP) databases from May 1 to August 1, 2016, regarding hypothetical scenarios for a 3-week-old infant, a 3-year-old child, and a 16-year-old child requiring an LP. The primary outcome was the willingness to provide analgesia. Secondary outcomes included …

Crf Mediates Stress-Induced Pathophysiological High-Frequency Oscillations In Traumatic Brain Injury, Chakravarthi Narla, Paul S. Jung, Francisco Bautista Cruz, Michelle Everest, Julio Martinez-Trujillo, Michael O. Poulter

Physiology and Pharmacology Publications

Copyright © 2019 Narla et al. It is not known why there is increased risk to have seizures with increased anxiety and stress after traumatic brain injury (TBI). Stressors cause the release of corticotropin-releasing factor (CRF) both from the hypothalamic pituitary adrenal (HPA) axis and from CNS neurons located in the central amygdala and GABAergic interneurons. We have previously shown that CRF signaling is plastic, becoming excitatory instead of inhibitory after the kindling model of epilepsy. Here, using Sprague Dawley rats we have found that CRF signaling increased excitability after TBI. Following TBI, CRF type 1 receptor (CRFR1)-mediated activity caused …

‘That's For Old So And So's!’: Does Identity Influence Older Adults’ Technology Adoption Decisions?, Colleen E. Mcgrath

Occupational Therapy Publications

The role of identity in older adults’ decision-making about assistive technology adoption has been suggested but not fully explored. This scoping review was conducted to understand better how older adults’ self-image and their desire to maintain this influence their decision-making processes regarding assistive technology adoption. Using the five-stage scoping review framework by Arksey and O'Malley, a total of 416 search combinations were run across nine databases, resulting in a final yield of 49 articles. From these 49 articles, five themes emerged: (a) resisting the negative reality of an ageing and/or disabled identity; (b) independence and control are key; (c) the …

Initiating Participatory Action Research With Older Adults: Lessons Learned Through Reflexivity*, Colleen E. Mcgrath

Occupational Therapy Publications

Participatory action research (PAR) is well suited to research that aims to address social exclusion and inclusion in older age. Illustrations of and reflections on PAR with older adults are scarce, particularly the initiation stage, which sets the stage for the cyclical participatory action that follows. In this article, we describe the initiation of a PAR project with older adults and reflect on the alignment of this process with key participatory principles and fit within typical research structures. Findings point to the tensions between developing relationships over time and time-sensitive calls for funding, how traditional conceptions of research can influence …

Anatomic Posterolateral Corner Reconstruction Using Single Graft Plus Adjustable-Loop Suspensory Fixation Device, Ryan Wood, James Robinson, Alan Getgood

Bone and Joint Institute

© 2018 Arthroscopy Association of North America The original description of the LaPrade technique for anatomic posterolateral corner reconstruction addresses the 3 main stabilizing structures: the fibular collateral ligament, the popliteus, and the popliteofibular ligament. The use of two separate grafts (originally described with a tendo-Achilles allograft) may restrict the utility of the technique when sources of allograft may be limited and autografts must be used, particularly in the context of multiligament reconstruction. We present a modification of the technique, in which an adjustable cortical button is used for tibial fixation, which allows for the use of a single graft …

Closed Limb Fractures With Compromised Vascularization: A Narrative Review, Christopher Vannabouathong, Emil Schemitsch, Bradley Petrisor, Mohit Bhandari

Bone and Joint Institute

© The Author(s) 2019. Vascular compromised fractures typically result in a high rate of healing complications, such as avascular necrosis, nonunion, delayed union, and arthritis, which severely affect a patient’s function and quality of life. The purpose of this review was to identify and describe the epidemiology and available treatment options for the most well-known vascular compromised closed fractures. The injuries discussed in detail in this review were scaphoid, lunate, femoral neck, and talar fractures. Current evidence suggests that optimal treatment for vascular compromised fractures is dependent on the degree of fracture displacement and comminution, and the patient’s post-injury functional …

Examination Of Psychological Risk Factors For Chronic Pain Following Cardiac Surgery: Protocol For A Prospective Observational Study, Michael H. Mcgillion, Shaunattonie Henry, Jason W. Busse, Carley Ouellette, Joel Katz, Manon Choinière, Andre Lamy, Richard Whitlock, Shirley Pettit, Jacqueline Hare, Krysten Gregus, Katheryn Brady, Nazari Dvirnik, Stephen Su Yang, Joel Parlow, Deborah Dumerton-Shore, Ian Gilron, D. Norman Buckley, Harsha Shanthanna, Sandra L. Carroll, Peter C. Coyte, Shanil Ebrahim, Wanrudee Isaranuwatchai, Denise N. Guerriere, Jeffrey Hoch, James Khan, Joy Macdermid, Geraldine Martorella, J. Charles Victor, Judy Watt-Watson, Kimberly Howard-Quijano, Aman Mahajan, Matthew T.V. Chan

Bone and Joint Institute

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. INTRODUCTION: Approximately 400 000 Americans and 36 000 Canadians undergo cardiac surgery annually, and up to 56% will develop chronic postsurgical pain (CPSP). The primary aim of this study is to explore the association of pain-related beliefs and gender-based pain expectations on the development of CPSP. Secondary goals are to: (A) explore risk factors for poor functional status and patient-level cost of illness from a societal perspective up to 12 months following cardiac surgery; and (B) determine the impact …

The Material-Weight Illusion Disappears Or Inverts In Objects Made Of Two Materials, Vivian C. Paulun, Gavin Buckingham, Melvyn A. Goodale, Roland W. Fleming

Brain and Mind Institute Researchers' Publications

© the American Physiological Society. The material-weight illusion disappears or inverts in objects made of two materials. J Neurophysiol 121: 996 –1010, 2019. First published January 23, 2019; doi:10.1152/jn.00199.2018.—The material-weight illusion (MWI) occurs when an object that looks heavy (e.g., stone) and one that looks light (e.g., Styrofoam) have the same mass. When such stimuli are lifted, the heavier-looking object feels lighter than the lighter-looking object, presumably because well-learned priors about the density of different materials are violated. We examined whether a similar illusion occurs when a certain weight distribution is expected (such as the metal end of a hammer …

The Gradient Of The Reinforcement Landscape Influences Sensorimotor Learning, Joshua G.A. Cashaback, Christopher K. Lao, Dimitrios J. Palidis, Susan K. Coltman, Heather R. Mcgregor, Paul L. Gribble

Brain and Mind Institute Researchers' Publications

© 2019 Cashaback et al. Consideration of previous successes and failures is essential to mastering a motor skill. Much of what we know about how humans and animals learn from such reinforcement feedback comes from experiments that involve sampling from a small number of discrete actions. Yet, it is less understood how we learn through reinforcement feedback when sampling from a continuous set of possible actions. Navigating a continuous set of possible actions likely requires using gradient information to maximize success. Here we addressed how humans adapt the aim of their hand when experiencing reinforcement feedback that was associated with …

The Speech-Language Pathologist's Role In Supporting The Development Of Self-Regulation: A Review And Tutorial, Amanda Binns, Janis Oram Cardy

PRECISe Preschool Speech and Language Publications

Purpose

Children’s engagement in self-regulation is a strong and positive predictor of their social and academic success, making self-regulation an important focus for caregivers and clinicians. The aims of this article are to provide a framework for understanding self-regulation and to identify strategies speech-language pathologists can use to integrate self-regulation work into their clinical practice.

Method

Empirically supported considerations describing the developmental progression from co-regulation to self-regulation are outlined, and the effects of stress on self-regulation are discussed. A clinical framework is provided to guide speech-language pathologists in considering stress and self-regulation in their clinical work. Strategies are provided to …

Effect Of Acupressure On Dysmenorrhea Among Adolescents, Maha Mohamed Mady, Safaa Gaber Aly, Sahar Mohammed Othman

Journal of Medicine in Scientific Research

Background Dysmenorrhea is a significant public health problem, which has a negative effect on female's health, social relationships, school or work activities, and psychological status. Purpose The purpose of the study was to evaluate the effect of acupressure on Sanyinjiao Acupoint (SP6) on primary dysmenorrhea among adolescents. Patients and methods Research design was an experimental case–control study. A total of 100 girls were randomly assigned to two equal groups (A and B): group A included 50 girls who received SP6 acupressure, whereas group B included 50 girls who received only light skin touching. Menstrual pain was measured by using a …

Transcranial Doppler Assessment Of Patients With Cerebral Small Vessel Disease, Alaa Ebrahim Ata Ata Shaaban, Mahmoud H. Ebrahim, Mohamed M. T. Elbaghdady, Salma H. M. Khalil

Journal of Medicine in Scientific Research

Background Cerebral small vessel disease (SVD) refers to any pathology in all vascular structures (small arteries, arterioles, capillaries, venules, and small veins). Transcranial Doppler is a bedside, inexpensive, noninvasive technique that can assess intracerebral circulation in real time and can be used for continuous monitoring. Aim of the work Our study tried to detect the pathogenesis of cerebral SVD, especially the implication of the cerebral large artery disease. Moreover, it assessed the ability of transcranial Doppler in evaluating the severity of cerebral SVD and people who are at risk. Patients with cardioembolic risk were excluded. Patients and methods A cross-sectional …

Mechanochemical Ablation Versus Thermal Ablation As A Management Modality For Primary Great Saphenous Varicose Veins, Abdulrahman M. A. Abdulrahman, Mahmoud Z. A. Elganzoury, Nader M. M. Hamada, Nihal M.E E. Selim

Journal of Medicine in Scientific Research

Background Chronic venous insufficiency is one of the most common conditions in the world. The WHO defines varicose veins (VV) of the lower limbs as dilated superficial veins presenting as baggy or cylindrical in shape and possessing damaged valves. In 70% of cases saphenous veins are affected. Objective This is a comparative, prospective study to compare thermal ablation versus maechanochemical ablation in the management of VV. Patients and methods This study was conducted on 40 patients who had primary great saphenous VV in the form of incompetence of saphenofemoral junction and/or great saphenous presented to the Vascular Department of Ain …

Evaluation Of Inseq To Identify Genes Essential For, Ramamoorthy Sivakumar, Jothi Ranjani, Udayakumar S Vishnu, Sathyanarayanan Jayashree, Gabriel L Lozano, Jessica Miles, Nichole A Broderick, Changhui Guan, Paramasamy Gunasekaran, Jo Handelsman, Jeyaprakash Rajendhran

Faculty Research 2019

The reciprocal interaction between rhizosphere bacteria and their plant hosts results in a complex battery of genetic and physiological responses. In this study, we used insertion sequencing (INSeq) to reveal the genetic determinants responsible for the fitness of Pseudomonas aeruginosa PGPR2 during root colonization. We generated a random transposon mutant library of Pseudomonas aeruginosa PGPR2 comprising 39,500 unique insertions and identified genes required for growth in culture and on corn roots. A total of 108 genes were identified as contributing to the fitness of strain PGPR2 on roots. The importance in root colonization of four genes identified in the INSeq …

Recommended Housing Densities For Research Mice: Filling The Gap In Data-Driven Alternatives., Karen L. Svenson, Beverly J Paigen

Faculty Research 2019

Space recommendations for mice made in the Guide for Care and Use of Laboratory Animals have not changed since 1972, despite important improvements in husbandry and caging practices. The 1996 version of the Guide put forth a challenge to investigators to produce new data evaluating the effects of space allocation on the well-being of mice. In this review, we summarize many studies published in response to this challenge. We distinguish between studies using ventilated or nonventilated caging systems and those evaluating reproductive performance or general well-being of adult mice. We discuss how these studies might affect current housing density considerations …

Bacterial Contents Of Seminal Fluid Of Iraqi Infertile Men, Aya Zuhair, Ghanim Hussein, Anwar N. Al-Bassam

Al-Nisour Journal for Medical Sciences

This study aimed to estimate the percentage of bacterial infection among infertile males in Iraq with special reference to the predominant bacterial type.One hundred and five samples were collected from infertile patients as well as fertile individual, Seventy samples were collected from male individuals suffering from infertility either primary or secondary, as well as 35 samples were collected from fertile persons serve as a control group .All samples collected in this study were subjected to inoculation on proper media to investigate bacterio-spermia. Seminal plasma of liquefied samples were collected from all samples by centrifugation at 3000 rpm for 7min, plasma …

Antibiotics Resistance Among Clinical Isolates Of Staphylococcus Aureus, Pseudomonas Aeruginosa And Escherichia Coli, Mohammed Hayder Hashim, Marwa Hameed Alkhafaji

Al-Nisour Journal for Medical Sciences

The pattern of antibiotic susceptibility of nine isolate of (E. coli, P. aerugensa and S. aureus) to five antibiotics ceftazidime (CAZ), azithromycin (AZM), amoxicillin-clavulanate (AMC), ciprofloxacin (CIPR), and cefoxitin (CTX) was determined using disc diffusion method. The results showed that S. aureus isolates were 100% resistant all to antibiotics AMC, CAZ, CTX (Extended-spectrum β-lactamases). While 66.6% of isolates were AZM resistant and 33.3% of S. aureus isolates resist CIP. All E. coli isolate (100%) were resistant to (CTX and CAZ) and 66.6% of E. coli isolates were resistant to CIPR and AMC. P. aerugensa were 100% resistant to AMC and …

The Effect Of Some Biochemical Parameters On Patients With Renal Failure, Inas Sattar Abd

Al-Nisour Journal for Medical Sciences

This study was carried out for ninety patients with renal failure in Al karama hospital/ Baghdad compared with (fifty) healthy as control group. To determine hemaglobulin PCV, and serum urea, glucose, albumin, potassium, glutamic pyruvic transminase (GPT) and glutamic oxaloacetic transminase (GOT) were measure for both group. The patients had known from its disease on based history and clinical examination. This study showed elevated in significant difference of mean value (p<0.01) at all level serum (Na+, K+) concentration, albumin, urea and glutamic pyruvic transminase (GPT) between patients group and healthy control. the result also appeared no significant (p<0.05) in level of glutamic oxaloacetic transminase GOT between them.

Determining Levels Of Rheumatoid Factor (Rf) And C - Reactive Protein (Crp) In A Blood Sample Of Iraqi Patients With Rheumatoid Arthritis (Ra), Muataz Mohammed Al-Taee, Duaa Ibrahim Mohmood, Mayada Mahmood Muhammed

Al-Nisour Journal for Medical Sciences

Rheumatoid arthritis (RA) is a common autoimmune disease characterized by chronic inflammation and joint destruction. The aim of this study was to investigate levels of Rheumatoid factor (RF) and C- Reactive protein in Iraqi RA patients. Blood samples were obtained from 50 RA patients (males and females) referred to Rheumatology consultation clinic in Baghdad teaching hospital, Medical city, with a mean age of 40.88±18.75 years. On the other hand, blood samples were obtained from 50 healthy controls with a mean age of 38.90±14.73 years. Results showed that Rheumatoid factor (RF) was detected in all serum samples taken from RA patients …

Species Specificity Between The Trematoda Fasciola Hepatica And The Molluscan Host, Ilham Abdulwahid Majeed

Al-Nisour Journal for Medical Sciences

Larval development of Fasciola hepatica in abnormal snail intermediate host Lymnaea palustris was studied. This incompatible host-parasite relationship was investigated under Transmission Electron Microscopy (TEM) to determine the fate of penetrated miracidia. It is believed that no larval development beyond the sporocyst was allowed to proceed by the defense system of L. palustris. This reaction was in the form of defense cell (haemocytes) aggregation around sporocyst. These haemocytes vary in appearance under TEM, some have a vary electron dense cytoplasm, others are much more electron lucid. These appeared to correspond to granulocytes and amoebocytes respectively, as described by other workers. …

Himmelfarb Library Liaison Letter - March 2019, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.

Diffusion-Weighted Mri: Role In Diagnosing Hepatic Focal Lesions, Ibrahim M. Helmy, Manal A. El-Refaei, Medhat M. Refaat, Mohammed A. M. Yousef

Journal of Medicine in Scientific Research

Objective The objective of this study was to highlight the role of quantitative and qualitative diffusion-weighted MRI (DW-MRI) in differentiating benign and malignant hepatic focal lesions, thus increasing the efficacy of conventional hepatic MRI, in addition to evaluating the effect of using different b-values. Patients and methods This study was carried out from January to November 2016. We prospectively scanned patients with suspected liver focal lesion referred from Hepatology Unit by high-field 1.5 T MRI. The data were tabulated and manipulated using SPSS, version 14, with the level of significance set at less than 0.05. Results The study revealed …

Current Situation And Future Recommendations For Neurophysiology Services In Pakistan, Imran Ahmad, Farooq Azam Rathore

Pakistan Journal of Neurological Sciences (PJNS)

Clinical neurophysiology is defined as “a medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity, whether spontaneous or stimulated”.1 There are different models of practice for clinical neurophysiology around the world. In some countries it is considered to be an independent specialty, while in other countries it is integrated with neurology.

Infected Non-Union Of Tibia Treated With Ilizarov External Fixator: Our Experience, Shah Fahad, Aysha Habib, Muhammad Awais, Masood Umer, Haroon Rashid

Section of Orthopaedic Surgery

Introduction: Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes.
Materials and Methods: A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one …

Does Surgeon Experience Influence The Amount Of Radiation Exposure During Orthopedic Procedures?: A Systematic Review, Azeem Tariq Malik, Hamid Hussain Rai, Riaz Hussain Lakdawala

Section of Orthopaedic Surgery

With an increasing use of intraoperative fluoroscopy in operating rooms worldwide, the topic of radiation exposure has become a major concern among hospital staff, doctors and patients alike. Since fluoroscopy has become an integral part in orthopedic intraoperative management, we sought to identify whether surgeon grade or experience plays a role in the amount of radiation used and consequently exposed. We performed a systematic review examining the association between surgeon experience and radiation exposure using primary outcome measures (radiation dose and total screening time/fluoroscopy time). To be included in the review, the study population had to compare varying surgeon experience …

Template Operative Note: A Better Documentation, Fareed Ahmed Shaikh, Abdul Rehman Alvi, Noman Shahzad, Tanzeela Gala, Ghulam Murtaza

Section of General Surgery

Operative notes are a valuable part of patient's medical record, and carry the medico-legal significance. One way of improving it is to introduce the template form operative notes. Only few studies have been done worldwide to compare both the forms of operative notes. This cross-sectional study was conducted in the department of General Surgery, AKUH. This included the patients who underwent Laparoscopic cholecystectomy (Complying with inclusion criteria) from August 2013 till March 2014. Out of 24 patients, 19 were females. The completeness of data in template group was significantly better than traditional group (79.2% vs. 8.3%). There was no significant …

Choice Of Therapeutic Anti-Seizure Medication In Patients With Brain Tumour, Altaf Ali Laghari, Syed Ijlal Ahmed, Namra Qadeer, Muhammad Shahzad Shamim

Section of Neurosurgery

Seizures are common in patients with brain tumours, even though prophylactic anti-seizure treatment for all patients with brain tumours is not recommended. Newer anti-epileptic drugs have shown benefits that outweigh the side effects of treatment and can also be given in combination with traditional anti-epileptic drugs. The authors have reviewed the literature on the various combinations of anti-epileptics in patients with seizures and brain tumours.

Commentary: Telehealth Holds Promise, But Human Touch Still Needed, Todd Czartoski

Articles, Abstracts, and Reports

No abstract provided.

Cardiovascular Disease Risk Factors In Pakistani Population With Newly Diagnosed Type 2 Diabetes Mellitus: A Cross-Sectional Study Of Selected Family Practitioner Clinics In Four Provinces Of Pakistan (Cardip Study), Syed Abbas Raza, Mariam Hassan, Farhana Badar, Farah Rasheed, Fouzia Meerza, Sumeyya Azam, Ali Jawa, Imtiaz Hassan, Faisal Masood Qureshi, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Objective: To explore cardiovascular risk factors in people with newly-diagnosed type 2 diabetes mellitus.

Methods: The cross-sectional, prospective, multicentre, study was conducted from June 2014 till July 2015 at family practice clinics in 27 cities across Pakistan, and comprised individuals aged 30-50 years diagnosed with type 2 diabetes mellitus within the preceding six months. Laboratory investigations were conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, and Aga Khan University Hospital, Karachi. The 10-year absolute risk of fatal or non-fatal coronary heart disease and stroke was calculated using the United Kingdom Prospective Diabetes Study Risk Engine version 2.0. …

Rationale And Protocol For Estimating The Economic Value Of A Multicomponent Quality Improvement Strategy For Diabetes Care In South Asia, Kavita Singh, Mohammed K. Ali, Raji Devarajan, Roopa Shivashankar, Dimple Kondal, Vamadevan S. Ajay, V. Usha Menon, Premlata K. Varthakavi, Vijay Viswanathan, Qamar Masood

Section of Diabetes, Endocrinology and Metabolism

Background: Economic dimensions of implementing quality improvement for diabetes care are understudied worldwide. We describe the economic evaluation protocol within a randomised controlled trial that tested a multi-component quality improvement (QI) strategy for individuals with poorly-controlled type 2 diabetes in South Asia.

Methods/Design: This economic evaluation of the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) randomised trial involved 1146 people with poorly-controlled type 2 diabetes receiving care at 10 diverse diabetes clinics across India and Pakistan. The economic evaluation comprises both a within-trial cost-effectiveness analysis (mean 2.5 years follow up) and a microsimulation model-based cost-utility analysis (life-time horizon). …