Medicine and Health Sciences Commons^™

Dose Dispensing Tool For Pediatric Drug-Resistant Tuberculosis, Miza Mwanza, Ebony N. Smith, Jamie H. Au, Wei Wei Buchsteiner

ENGS 89/90 Reports

There are no current second-line antibiotics for children with Multidrug Resistant Tuberculosis (MDR TB). Current methods to treat pediatric MDR TB consist of splitting up adult formulated pills in accordance to the WHO’s recommended dosages, which depend on the weight and age of the child. This process is very inconsistent, tedious, and time consuming when using the state-of-the-art tools (kitchen knives, standard pill cutters). Under the sponsorship of Health Advocacy Innovations (HAI), we developed a mechanical tool that makes ingesting pills for child patients more convenient, consistent, and swift. Our dose-dispensing tool cuts pills into quarters, stores 30 pills, dispenses …

Serum Anti Mullerian Hormone And Renalase Levels In Predicting The Risk Of Preeclampsia, Zehra Jamil, Sana Shahid, Erum Baig, Rida Ahmad, Faryal Subhani, Syeda Sadia Fatima

Department of Biological & Biomedical Sciences

Objective: The aim of the study was to explore the association of serum AMH and Renalase with the risk of preeclampsia thereby assessing them as screening tools, reducing the risk of gravid consequences of preeclampsia.
Materials and Methods: This cross-sectional study recruited n = 95 pregnant women between 14 and 32 gestational weeks. They were categorized as a) women with gestational hypertension (n = 45); b) women with pre-eclampsia (n = 20) and c) normotensive pregnant women (n = 30) according to the ACOG criteria. Anthropometrics data and blood and urine samples were collected. AMH and Renalase levels were measured …

Longer Trinucleotide Repeats Of Androgen Receptor Gene: Infertility In Males, Mussarat Ashraf, Hemaila Tariq, Rehana Rehman

Department of Biological & Biomedical Sciences

No abstract provided.

Comparison Of Serum Levels Of Vitamin D And Vitamin D-Binding Protein In Normal, Osteopenic And Osteoporotic Postmenopausal Women, Rafat Murad, Tabassum Mahboob, Rehana Rehman, Rozeena Baig

Department of Biological & Biomedical Sciences

Objective: To compare the serum levels of vitamin D, vitamin D binding protein (VDBP) calcium and phosphate in normal, osteopenic and osteoporotic postmenopausal women categorized on the basis of bone mineral density (BMD) scores.
Methods: A cross sectional study carried out from May 2017 to August 2018. BMD measured by Dual energy X-ray Absorptiometry categorized women (aged 20- 70 years) into normal (n=37) (T score ≥ -1.0) osteopenic (n=25) (-2.5< T score, < -1) and osteoporotic (n= 26) (T score < -2.5) according to WHO classification. Serum concentrations of vitamin D, VDBP, calcium, phosphate analyzed by enzyme linked immunosorbent assay were compared by Analysis of Variance.
Results: In normal females higher levels of vitamin D and VDBP were observed [15.82 (8 - 69.18), 469.9 (269.57 - 875.55)] vs. osteopenic [(7.45 (4.66 - 15.1), 296.05 (232.58 - …

Management Of Non-Epileptic Seizures Through Hypnosis: A Case Study, Muhammad Rafiq, Sana Zaheer

Pakistan Journal of Neurological Sciences (PJNS)

Conversion disorder is associated with diverse somatic complaints including visual deficiency, psychogenic nonepileptic seizures, lethargy, paralyses etc. Studies have revealed that in addition to pharmacological treatment, psychological intervention including hypnosis has a significant impact in the management of conversion disorder. The current case study was focused to see any effect of unique hypnotic technique, Circle Therapy for the management of conversion disorder. The patient A.J. was referred for the evaluation and psychological management ofnon-epileptic seizures. After a complete physical and psychological observation and interview, stressors were identified a n d the patient underwent brief hypnotic session and it was suggested …

Multiple Sclerosis In Pakistan And Need For Multiple Sclerosis Registry, Haris Majid Rajput, Mohammad Wasay, Mazhar Badshah, Muhammad Hassan

Pakistan Journal of Neurological Sciences (PJNS)

Multiple sclerosis(MS) is an acquired chronic demyelinating disease of central nervous system is a leading cause of non-traumatic disability in young with significant socioeconomic impact. The aim of this study was to provide a comprehensive review of all available data of MS in Pakistan.

Assessment Of Pneumonia Severity Indices As Mortality Predictors, Connor L. English, Thomas Chandler, Brian E. Guinn, Stephen P. Furmanek, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

BACKGROUND

The leading cause of infectious disease death in the United States is community-acquired pneumonia (CAP). Several pneumonia severity indices exist and are widely used as tools to assist physicians regarding site of care based on risk of death. However, limited data exists that discerns which of the most commonly used severity scores is the best predictor of mortality across multiple time points. The objective of this study is to determine the best mortality predictor at different time points between four of the most commonly used pneumonia severity scores.

METHODS

This was a secondary analysis of a prospective, multicenter, population-based, …

A Man With Acute Severe Pneumonia: Case Discussion From The University Of Louisville Hospital, Viswanathan Nagarajan, Srinivas R. Dontineni, Veronica Corcino, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Current And Future Antiviral Medications To Treat Influenza: Mechanisms Of Action, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Pretreatment With A Heat-Killed Probiotic Modulates The Nlrp3 Inflammasome And Attenuates Colitis-Associated Colorectal Cancer In Mice, I. Che Chung, Chun Nan Ouyang, Sheng Ning Yuan, Hsin Chung Lin, Kuo Yang Huang, Pao Shu Wu, Chia Yuan Liu, Kuen Jou Tsai, Lai Keng Loi, Yu Jen Chen, An Ko Chung, David M. Ojcius, Yu Sun Chang, Lih Chyang Chen

All Dugoni School of Dentistry Faculty Articles

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Colorectal cancer (CRC) is one of the most common malignancies worldwide. Inflammation contributes to cancer development and inflammatory bowel disease is an important risk factor for CRC. The aim of this study is to assess whether a widely used probiotic Enterococcus faecalis can modulate the NLRP3 inflammasome and protect against colitis and colitis-associated CRC. We studied the effect of heat-killed cells of E. faecalis on NLRP3 inflammasome activation in THP-1-derived macrophages. Pretreatment of E. faecalis or NLRP3 siRNA can inhibit NLRP3 inflammasome activation in macrophages in response to fecal content or …

A Race Inside The Body: Decision Of The Fate Of Newborn, Shyrose Sultan, Samreen Siraj, Zainish Zafarullah Hajani, Afsheen Hirani, Nasreen Rafiq

School of Nursing & Midwifery

Sex-selective abortion is the killing of a girl fetus merely due to its gender. It has become an emerging problem in developing countries mainly due to lack of resources and cultural stereotypes. Illegal abortions have increased and are jeopardizing not only the gender ratio but also the health of the mother by exposing them to complications and violating their rights. The aim of this paper is to evaluate a case scenario based on many ethical dilemmas and questions that arise form it. The paper presents the problem in light of major ethical principles and theories by counteracting each argument with …

Exploring Lived Experiences Of Married Pakistani Women Post-Mastectomy, Laila Hussain, Zeenatkhanu Kanji, Sharifa Bashir Lalani, Shabnam Moledina, Abida K. Sattar

School of Nursing & Midwifery

Objective: This qualitative descriptive exploratory study aimed to explore the lived experiences of married Pakistani women, 2 years post-mastectomy.
Methods: Twelve participants were recruited through purposive sampling from outpatient oncology clinic from a tertiary care hospital in Pakistan. Interviews were audio-taped and transcribed, and then themes and sub-themes were identified.
Results: Women verbalized a range of their experiences throughout the span from diagnosis to mastectomy. One over arching theme, quality of life and four main themes and their subthemes emerged from the data. Following are the themes; from history to diagnosis, worries, coping strategies, and recommendations.
Conclusions: The study findings …

Heart Failure Symptom Biology In Response To Ventricular Assist Device Implantation., Christopher S Lee, James O Mudd, Karen S Lyons, Quin E Denfeld, Corrine Y Jurgens, Bradley E Aouizerat, Jill M Gelow, Christopher V Chien, Emily Aarons, Kathleen L Grady

Articles, Abstracts, and Reports

BACKGROUND: We have a limited understanding of the biological underpinnings of symptoms in heart failure (HF), particularly in response to left ventricular assist device (LVAD) implantation.

OBJECTIVE: The aim of this study was to quantify the degree to which symptoms and biomarkers change in parallel from before implantation through the first 6 months after LVAD implantation in advanced HF.

METHODS: This was a prospective cohort study of 101 patients receiving an LVAD for the management of advanced HF. Data on symptoms (dyspnea, early and subtle symptoms [HF Somatic Perception Scale], pain severity [Brief Pain Inventory], wake disturbance [Epworth Sleepiness Scale], …

Co-Activation Of Macrophages And T Cells Contribute To Chronic Gvhd In Human Il-6 Transgenic Humanised Mouse Model., Rintaro Ono, Takashi Watanabe, Eiryo Kawakami, Makoto Iwasaki, Mariko Tomizawa-Murasawa, Masashi Matsuda, Yuho Najima, Shinsuke Takagi, Saera Fujiki, Rumi Sato, Yoshiki Mochizuki, Hisahiro Yoshida, Kaoru Sato, Hiromasa Yabe, Shunichi Kato, Yoriko Saito, Shuichi Taniguchi, Leonard D. Shultz, Osamu Ohara, Masayuki Amagai, Haruhiko Koseki, Fumihiko Ishikawa

Faculty Research 2019

BACKGROUND: Graft-versus host disease (GVHD) is a complication of stem cell transplantation associated with significant morbidity and mortality. Non-specific immune-suppression, the mainstay of treatment, may result in immune-surveillance dysfunction and disease recurrence.

METHODS: We created humanised mice model for chronic GVHD (cGVHD) by injecting cord blood (CB)-derived human CD34

FINDINGS: In cGVHD humanised mice, we found activation of T cells in the spleen, lung, liver, and skin, activation of macrophages in lung and liver, and loss of appendages in skin, obstruction of bronchioles in lung and portal fibrosis in liver recapitulating cGVHD. Acute GVHD humanised mice showed activation of T …

Systems Genetics Of Sensation Seeking., Price E. Dickson, Tyler A Roy, Kathryn A. Mcnaughton, Troy Wilcox, Padam Kumar, Elissa J Chesler

Faculty Research 2019

Sensation seeking is a multifaceted, heritable trait which predicts the development of substance use and abuse in humans; similar phenomena have been observed in rodents. Genetic correlations among sensation seeking and substance use indicate shared biological mechanisms, but the genes and networks underlying these relationships remain elusive. Here, we used a systems genetics approach in the BXD recombinant inbred mouse panel to identify shared genetic mechanisms underlying substance use and preference for sensory stimuli, an intermediate phenotype of sensation seeking. Using the operant sensation seeking (OSS) paradigm, we quantified preference for sensory stimuli in 120 male and 127 female mice …

Mutations In Dna Repair Genes Are Associated With Increased Neoantigen Burden And A Distinct Immunophenotype In Lung Squamous Cell Carcinoma., Young Kwang Chae, Jonathan F Anker, Michael S Oh, Preeti Bais, Sandeep Namburi, Sarita Agte, Francis J Giles, Jeffrey H Chuang

Faculty Research 2019

Deficiencies in DNA repair pathways, including mismatch repair (MMR), have been linked to higher tumor mutation burden and improved response to immune checkpoint inhibitors. However, the significance of MMR mutations in lung cancer has not been well characterized, and the relevance of other processes, including homologous recombination (HR) and polymerase epsilon (POLE) activity, remains unclear. Here, we analyzed a dataset of lung squamous cell carcinoma samples from The Cancer Genome Atlas. Variants in DNA repair genes were associated with increased tumor mutation and neoantigen burden, which in turn were linked with greater tumor infiltration by activated T cells. The subset …

Evolutionary Dynamics Of Residual Disease In Human Glioblastoma., I Spiteri, G Caravagna, G D Cresswell, A Vatsiou, D Nichol, A Acar, L Ermini, K Chkhaidze, B Werner, R Mair, E Brognaro, Roel G W Verhaak, G Sanguinetti, S G M Piccirillo, C Watts, A Sottoriva

Faculty Research 2019

BACKGROUND: Glioblastoma is the most common and aggressive adult brain malignancy against which conventional surgery and chemoradiation provide limited benefit. Even when a good treatment response is obtained, recurrence inevitably occurs either locally (∼80%) or distally (∼20%), driven by cancer clones that are often genomically distinct from those in the primary tumour. Glioblastoma cells display a characteristic infiltrative phenotype, invading the surrounding tissue and often spreading across the whole brain. Cancer cells responsible for relapse can reside in two compartments of residual disease that are left behind after treatment: the infiltrated normal brain parenchyma and the sub-ventricular zone. However, these …

Prognostic Value Of A Modified Surprise Question Designed For Use In The Emergency Department Setting., Samir A Haydar, Tania D Strout, Alicia G Bond, Paul Kj Han

Articles, Abstracts, and Reports

OBJECTIVE: Few reliable and valid prognostic tools are available to help emergency physicians identify patients who might benefit from early palliative approaches. We sought to determine if responses to a modified version of the surprise question, "Would you be surprised if this patient died in the next 30 days" could predict in-hospital mortality and resource utilization for hospitalized emergency department patients.

METHODS: For this observational study, emergency physicians responded to the modified surprise question with each admission over a five-month study period. Logistic regression analyses were completed and standard test characteristics evaluated.

RESULTS: 6,122 visits were evaluated. Emergency physicians responded …

Primary Pulmonary Plasmacytoma Presenting With Rare Igg Lambda Monoclonal Gammopathy, Yasmin Rahim, Farrukh Zia Tareen, Rashida Ahmed, Javaid Khan

Section of Pulmonary & Critical Care

Extramedullaryplasmacytoma (EMP) represents a peculiar and typically progressive malignancy that can originate outside the bone marrow. Primary pulmonary plasmacytoma (PPP) is a rare subset of EMP, confined to the lung. A 55-year-old man, diabetic, non-smoker presented to our clinic with a right chest wall swelling. A routine chest radiograph showed a well-circumscribed opacity in the right upper lung zone. A CT of the chest revealed a large right upper lobe mass with extensive local infiltration. Biopsy and immunohistochemical evaluation led to a diagnosis of PPP. Screening for multiple myeloma was negative. Serum immunofixation showed an IgG lambda monoclonal gammopathy, found …

Movement-Related Cortical Potential In Patients With Acute Stroke, Ahmed Elbokl, Ahmed M. Elsayed, Nevin M. El Nahas, Ramez R. Moustafa, Tamer M. El Sayed

Journal of Medicine in Scientific Research

Aim To identify the pattern and side of brain plasticity following acute stroke in patients who recovered and assess motor upper limb function using motor-related cortical potentials. Patients and methods Eleven patients diagnosed with acute ischemic stroke were recruited from in patients and stroke clinic within Ain Shams University Hospital. They were assessed after 2 or more weeks from stroke onset and showed power in finger flexors and extensors of two or more according to Medical Research Council; their motor recovery was assessed by using Fugal–Meyer scale. A high-density 64-channel electroencephalogram connected to an event-related potential software detector is used …

Differential Impact Of Bleeding Avoidance Strategies On Risk-Adjusted Pci-Related Bleeding Rates Within A Large Multistate Health System, Tyler J Gluckman, L Wang, Kateri Spinelli, Jl Petersen, P Huang, Sv Rao

Articles, Abstracts, and Reports

No abstract provided.

Neoantigen Screening Identifies Broad Tp53 Mutant Immunogenicity In Patients With Epithelial Cancers., Parisa Malekzadeh, Anna Pasetto, Paul F Robbins, Maria R Parkhurst, Biman C Paria, Li Jia, Jared J Gartner, Victoria Hill, Zhiya Yu, Nicholas P Restifo, Abraham Sachs, Eric Tran, Winifred Lo, Robert Pt Somerville, Steven A Rosenberg, Drew C Deniger

Articles, Abstracts, and Reports

No abstract provided.

Report Of An Inferior Rectal Nerve Variant Arising From The S3 Ventral Ramus., Graham Dupont, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

In surgical approaches to the perineum in general and anal region specifically, considering the possible variations of the inferior rectal nerve is important for the surgeon. Normally, the inferior rectal nerve originates as a branch of the pudendal nerve. However, during routine dissection, a variant of the inferior rectal nerve was found where it arose directly from the third sacral nerve ventral ramus (S3). Many cases have described the inferior rectal nerve arising independently from the sacral plexus, most commonly from the fourth sacral nerve root (S4); however, few cases have reported the inferior rectal nerve arising from S3. Herein, …

Variant Anatomy Of The Buccal Nerve., Mayank Patel, Joe Iwanaga, Shogo Kikuta, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Knowledge of the anatomy and variations of the nerves of the oral cavity is important to surgeons who operate this region. Herein, we report a rare case of a buccal nerve with two distinct roots. The anatomy of this case and its clinical applications is discussed.

Pilot Study On The Efficiency Of Water-Only Decontamination For Firefighters’ Turnout Gear, Anthony Calvillo, Erin N. Haynes, Jeff Burkle, Kenny Schroeder, Angelo Calvillo, Julie Reese, Tiina Reponen

Epidemiology and Environmental Health Faculty Publications

Firefighters are exposed to toxic environments upon entering burning structures. Many structures contain synthetic materials which release toxic chemicals when on fire. These chemicals can enter the body through multiple routes of exposure, including inhalation and skin absorption. Thus, according to the fire departments included in this study, firefighters now conduct on-site decontamination procedures to remove hazardous chemicals, including polycyclic aromatic hydrocarbons from the surface of firefighter turnout gear. Several methods are being practiced at the local level, including decontamination with soap and water, and decontamination with water alone. The water-only decontamination method requires less time and supplies yet has …

Heat Exposure And Hypohydration Exacerbate Physiological Strain During Load Carrying, Elizabeth L. Adams, Douglas J. Casa, Robert A. Huggins, Julie K. Demartini, Rebecca L. Stearns, Rachel M. Kennedy, Lindsay J. Distefano, Lawrence E. Armstrong, Carl M. Maresh

All PTHMS Faculty Publications

Heat exposure and hypohydration induce physiological and psychological strain during exercise; however, it is unknown if the separate effects of heat exposure and hypohydration are synergistic when co-occurring during loaded exercise. This study compared separate and combined effects of heat exposure and hypohydration on physiological strain, mood state, and visual vigilance during loaded exercise. Twelve males (mean±SD; age, 20±2 years; body mass, 74.0±8.2 kg; maximal oxygen uptake, 57.0±6.0 mLkg-1min-1) completed 4 trials under the following conditions: euhydrated temperate (EUT), hypohydrated temperate (HYT), euhydrated hot (EUH), and hypohydrated hot (HYH). Exercise was 90 min of treadmill walking (∼50% VO2 max, 5% …

Sphk2−/− Mice Are Protected From Obesity And Insulin Resistance, Shwetha Ravichandran, Brian S. Finlin, Philip A. Kern, Sabire Özcan

Clinical and Translational Science Faculty Publications

Sphingosine kinases phosphorylate sphingosine to sphingosine 1‑phosphate (S1P), which functions as a signaling molecule. We have previously shown that sphingosine kinase 2 (Sphk2) is important for insulin secretion. To obtain a better understanding of the role of Sphk2 in glucose and lipid metabolism, we have characterized 20- and 52-week old Sphk2^−/− mice using glucose and insulin tolerance tests and by analyzing metabolic gene expression in adipose tissue. A detailed metabolic characterization of these mice revealed that aging Sphk2^−/− mice are protected from metabolic decline and obesity compared to WT mice. Specifically, we found that 52-week old …

Value Of Periodic Transcutaneous Daytime Carbon Dioxide Monitoring In Screening For Respiratory Failure In Patients With Amyotrophic Lateral Sclerosis, Muhammad K Rafiq

Pakistan Journal of Neurological Sciences (PJNS)

There is no single test currently available, which can predict respiratory failure in patients with amyotrophic lateral sclerosis (ALS) with high sensitivity and specificity. This study explores the potential use of transcutaneous carbon dioxide (PtcCO2) monitoring in early detection of respiratory failure in ALS.

Prevalence Of Stress And Depression Among University Students Of Karachi, Nida Naseem, Lubna Naz, Nazneen Zehra

Pakistan Journal of Neurological Sciences (PJNS)

Stress is an all-time concerned issue in undergraduate students. Stress levels are high due to workload, pressure of academic and extra-curricular activities and unhealthy lifestyle. Though stress can be beneficial for academic growth but increased magnitude can be harmful for physiological, psychological and social aspects.

Evaluating Quality Of Contraceptive Counseling: An Analysis Of The Method Information Index, Karen T. Chang, Mulenga Mukanu, Ben Bellows, Waqas Hameed, Amanda M. Kalamar, Karen A. Grépin, Xaher Gul, Nirali M. Chakraborty

Community Health Sciences

The Method Information Index (MII) is calculated from contraceptive users' responses to questions regarding counseling content-whether they were informed about methods other than the one they received, told about method-specific side effects, and advised what to do if they experienced side effects. The MII is increasingly reported in national surveys and used to track program performance, but little is known about its properties. Using additional questions, we assessed the consistency between responses and the method received in a prospective, multicountry study. We employed two definitions of consistency: (1) presence of any concordant response, and (2) absence of discordant responses. Consistency …