Medicine and Health Sciences Commons^™

Factors Affecting Maternal-Care During Labour At Maternity Centres Of Karachi, Pakistan: Exploratory Study, Nirmal Shahzaib, Tazeen Saeed Ali, Nousheen Pradhan, Farina Abrejo, Shahnaz Shahid Ali, Amir Ali Samnani

School of Nursing & Midwifery

Globally 529,000 women die every year due to harmful consequences of childbirth. This study aimed to explore the barriers and facilitators that influence the provision of quality care during labour at maternity centres in Karachi, Pakistan. The qualitative exploratory study design was used to study such factors from public and private maternity health facilities of Karachi, Pakistan. A total of 12 in-depth interviews were conducted through purposive sampling by using validated semi-structured interview guide. Data was analysed using content analysis manually. Among major barriers, unhygienic environment, lack of basic equipment, supplies and medicine, unprofessional attitude of staff, physical infrastructre and …

Mediating Effect Of Cognitive Function On Health-Related Quality Of Life Among Older Adults With Cardiovascular Disease In The United States, Julie K. Peterson-Newman

Nursing Dissertations - Archive

Cardiovascular diseases (CVDs) are related to disorders of the heart and blood vessels. They may become serious problems, especially in older adults. They could also negatively affect the health-related quality of life (HRQoL) of patients. Moreover, patients with CVDs may also experience cognitive issues, such as memory loss, that could be considered as a mediator in the association of CVD with HRQoL. The purpose of the study was to analyze the relationship among cognitive function, HRQoL, and CVD among older adults using a cross-sectional sample from a secondary database, including the 2019 Behavioral Risk Factor Surveillance System (BRFSS) representing the …

Prevalence And Social Determinants Of Alcohol Use Disorders In Patients Attending Primary Care Clinics In Nairobi Kenya, Verah Kabwayi

Master of Medicine in Family Medicine

Introduction: In Kenya, studies have been conducted at community levels aiming at understanding the determinants of Alcohol-Use and heavy episodic drinking which may include healthy people. However, limited studies have been done to find out social determinants of alcohol use disorders in patients at private primary care clinics in Nairobi County. The study aimed to find out the prevalence and social determinants of alcohol use disorders in patients attending primary care clinics in Nairobi. Methods: A cross-sectional survey design was used and 389 respondents purposefully recruited into the study. Data was collected using a self-administered questionnaire adapted from the alcohol …

Hybrid Cyclic-Linear Cell-Penetrating Peptides Containing Alternative Positive And Hydrophobic Residues As Molecular Transporters, Sorour Khayyatnejad Shoushtari

Pharmaceutical Sciences (MS) Theses

The cell membrane properties create a significant obstacle in intracellular delivery of cell-impermeable and negatively charged molecules. Amphiphilic cyclic peptides containing alternative arginine and tryptophan such as [WR]₅ have been shown to enhance the transport of cargo molecules across the cell membrane. Herein, we report the synthesis and biological evaluation of a novel series of hybrid cyclic-linear peptides containing alternative positive and hydrophobic amino acids on the ring and side-chain [(RW)₅]K(RW)_X (X=1-5) to compare their molecular transporter efficiency. The peptides were synthesized through Fmoc solid-phase peptide synthesis. Final compounds were purified by a reversed-phase HPLC (High …

Establishing The Role Of Dc-Sign And Glycoprotein H For Kshv Entry In B Lymphocytes, Nancy Palmerin

Pharmaceutical Sciences (MS) Theses

Kaposi sarcoma-associated herpesvirus, also known as KSHV or HHV-8, is an emerging pathogen and the causative agent of multiple cancers in immunocompromised patients. KSHV is known to cause four types of malignancies: endothelial-based Kaposi Sarcoma (KS), two rare B cell- based lymphomas; Primary effusion lymphoma, Multicentric Castleman’s disease and a recently characterized inflammatory disorder called KSHV-associated inflammatory cytokine syndrome(KICS). Unfortunately, all of the diseases associated with KSHV infection are fatal, and to this day there is no known cure. The purpose of this study is to understand the viral entry process of KSHV in tonsil-derived B lymphocytes. This study will …

Characterization Of The Growth Factor Receptor Network Oncogenes In Lung Cancer, Ashley Duche

Pharmaceutical Sciences (MS) Theses

Lung cancer remains the leading cause of cancer related deaths worldwide, reportedly contributing to 1.8 million of the 10.0 million mortalities documented in the year 2020. Although advancements have been made in therapeutics and diagnostic methods, formulation of effective treatments and development of drug resistance continues to be a challenge. These challenges arise from our lack of understanding of intricate signaling pathways, such as the Growth Factor Receptor Network (GFRN), which contributes to complex lung tumor heterogeneity allowing for drug resistance development. In this study, gene expression signatures of six GFRN oncogenes overexpressed in human mammary epithelial cells (HMECs) were …

Modulation Of Antibacterial Activity And Cytotoxicity In Amphipathic Cyclic Peptide [R4w4] Using Histidine Substitution, Ryan Stueber

Pharmaceutical Sciences (MS) Theses

Antibiotics have been the gold standard frontline defense against bacterial infections for decades. At the same time, these infecting bacteria have continued to evolve to resist developed antibiotics in an almost endless cycle. As such, we aim to take an alternative approach utilizing antimicrobial peptides (AMPs) as a means to end this cycle. [R4W4] is among known AMPs that demonstrated antimicrobial activity against methicillin-resistant staphylococcus aureus (MRSA) with a minimum inhibitory concentration (MIC) of 2.67 μg/mL. This peptide had notably effective antimicrobial activity, especially relative to linear (R4W4). However, it displayed a concerning level of cytotoxicity; eliciting a human embryonic …

An Insider’S Guide To Study Space (Center City), 2021-2022

Electronic Handouts

The University provides a variety of study areas to accommodate the studying styles and needs of its students. These include areas for quiet/individual study, formal study by a group, and areas for informal study. The University is pleased to provide you with information on the most popular areas. Please cooperate in maintaining the distinctions between these areas by observing any restrictions, and please remove any trash when you leave an area.

Lobbies and open common areas in all buildings are available for study according to the building’s operational hours unless otherwise in use for events. For security purposes, students using …

Full Opioid Agonists And Tramadol: Pharmacological And Clinical Considerations, Amber N. Edinoff, Leah A. Kaplan, Sami Khan, Murray Petersen, Emily Sauce, Christopher D. Causey, Elyse M. Cornett, Farnad Imani, Omid Moradi Moghadam, Adam M. Kaye, Alan David Kaye

School of Pharmacy Faculty Articles

Opioids are mu receptor agonists and have been an important part of pain treatment for thousands of years. In order to use these drugs appropriately and successfully in patients, whether to control pain, to treat opiate-induced side effects, or opiate withdrawal syndromes, a solid understanding of the pharmacology of such drugs is crucial. The most recognized full agonist opioids are heroin, morphine, codeine, oxycodone, meperidine, and fentanyl. Phenanthrenes refer to a naturally occurring plant-based compound that includes three or more fused rings. The opioids derived from the opium plant are phenanthrene derivatives, whereas most synthetic opioids are simpler molecules that …

Modulation Of Glucose Homeostasis By Nucleotide P2y2 Receptor And Biological Sex, Hailee Anne Marino

Graduate Theses/Dissertations

Recent insights into the pathological role of Nucleotide P2Y₂ receptor suggest P2Y₂R involvement in high fat diet-induced obesity and potentiates insulin resistance. However, these recent insights do not demonstrate how P2Y₂R modulates glucose homeostasis under physiological conditions. Further, it remains unknown how sex biological factors influence P2Y₂R receptor signaling in the regulation of glucose homeostasis. The research objective for the present study is to elucidate the novel roles of P2Y₂ in fasting blood glucose and glucose tolerance (basal insulin sensitivity) under resting conditions in males and females. We expected that under physiological …

Examining Health Inequity In Ancient Egypt, Samantha Rose Gonzalez

Graduate Theses/Dissertations

This thesis explores the history of medicine in ancient Egypt between the Middle and New Kingdoms, and offers a case study highlighting the use of religion and magic in healing and analyzing health inequity. I am interested in medical practices, treatments, diagnosis methods, and access to healthcare in the ancient world. I seek to bridge the gaps and help unify the knowledge surrounding ancient Egyptian medical practices and contribute to the studies in the history of medicine. I explore types of diseases that commonly affected the ancient Egyptians and how they integrated religion and magic into their understanding and treatment …

Predicting Severity Of Traumatic Brain Injury: A Residual Learning Model From Magnetic Resonance Images, Dacosta Yeboah

Graduate Theses/Dissertations

One of the most significant frontiers for computational scientists is the engineering of human healthcare delivery based on intelligent analysis of health data. In a variety of neurological disorders such as Traumatic Brain Injury (TBI), neuro-imaging information plays a crucial role in the decision-making regarding patient care and as a potential prognostic marker for outcome. TBI is a heterogeneous neurological disorder. Due to the economic burdens of the disorder, sorting out this heterogeneity could provide more insights and better understanding of TBI recovery trajectories, thus improving overall diagnosis and treatment options. Magnetic Resonance Imaging (MRI) is a non-invasive technique that …

Working Memory As A Predictor Of Social Distancing And Face Mask Compliance During Covid-19 Pandemic, Cassandra Jean Kemmel

Graduate Theses/Dissertations

The COVID-19 pandemic has brought about many changes in daily lives around the world. In the United States, face masks and social distancing rules have been suggested and even enforced in areas throughout the country. Compliance with these regulations will in turn, hopefully, reduce transmission and therefore the threat of the COVID-19 virus. Working memory (WM) has been found to be an integral part of the decision-making process, by assessing costs and benefits, both individually and for others. In May 2019, Xie, Campbell, and Zhang (2020) found that WM capabilities were predictive of social distancing compliance. The purpose of this …

Nucleotide P2y₂ Receptor-Dependent Leukocyte-Endothelial Interaction, Spencer E. Thomas

Graduate Theses/Dissertations

Extracellular nucleotides (ATP, UTP) released from cells act on nucleotide receptors to promote vascular inflammation. Increased leukocyte-endothelial interaction is a hallmark of vascular inflammation. The nucleotide P2Y₂ receptor (P2Y₂R), activated by extracellular ATP≈UTP, plays a role in cardiovascular homeostasis and immune regulation. Moreover, accumulating evidence from studies in vitro and in vivo models have implicated the P2Y₂R in the inflammatory response significantly contributing to the progression and pathogenesis of asthma, atherosclerosis, sepsis, and ischemia. I hypothesized that P2Y₂R activation by UTP, an agonist of the receptor, increased leukocyte rolling and adhesion in the microvasculature from baseline. To test the hypothesis, …

Digital Literacy At An Urban Cancer Center: Implications For Technology Use And Vulnerable Patients, Amy Leader, Lisa M. Capparella, L. Waldman, Ba, Rebecca Cammy, Alison Petok, Rebecca Dean, Ayako Shimada, Liana Yocavitch, Kristin L. Rising, Gregory Garber, Brooke Worster, Adam Dicker

Kimmel Cancer Center Faculty Papers

PURPOSE: eHealth literacy, or the ability to seek, find, understand, and appraise health information from electronic sources, has become increasingly relevant in the era of COVID-19, when so many aspects of patient care became dependent on technology. We aimed to understand eHealth literacy among a diverse sample of patients with cancer and discuss ways for health systems and cancer centers to ensure that all patients have access to high-quality care.

METHODS: A cross-sectional survey of patients with cancer and caregivers was conducted at an NCI-designated cancer center to assess access to the Internet, smartphone ownership, use of mobile apps, willingness …

Pre-Admission Patient Education For A Prostatectomy Enhanced Recovery After Surgery Pathway, Vanessa C. Cotton

Doctor of Nursing Practice

Background. In the United States, prostate cancer is the most common cancer diagnosed in men and a common treatment choice is a radical prostatectomy. The Enhanced Recovery After Surgery® Society developed evidence-based guidelines to optimize treatment and improve outcomes in prostatectomy patients, yet not all hospitals are utilizing these guidelines or employing all of the elements, including pre-admission education. Purpose and Objectives. The purpose of this quality improvement project was to develop, implement, and evaluate a pre-admission patient education component for a prostate surgery pathway based on the Enhanced Recovery After Surgery guidelines. Objectives included assessing the nurse’s intention to …

Functional And Radiological Outcomes Of Atypical Femur Fractures Among Elderly In Karachi, Pakistan, Rizwan Haroon Rashid, Marij Zahid, Usama Khan, Yasir Mohib, Pervaiz Hashmi

Section of Orthopaedic Surgery

Objective: To assess the functional and radiological outcomes in a unique class of fractures i.e. atypical femur fractures and to assess the effects of osteoblastic agents in healing.
Methods: It is a retrospective observational study conducted at Aga Khan University Hospital, Karachi, Pakistan. All patients with atypical femur fractures who were surgically managed with intramedullary nailing from January, 2013 to June, 2017 and with a follow-up till December 2019, were included in the study. Radiological outcomes were expressed as mean healing time and functional outcomes were recorded as mean Short Musculoskeletal Functional Assessment (SMFA) score.
Results: A total of twenty-four …

Bedside Index (Bisap) V/S Ranson Scores In Predicting Mortality And Severity In Patients With Acute Pancreatitis, Nazir Najeeb Kapadia, Emaduddin Siddiqui

Department of Emergency Medicine

Objective: To determine the diagnostic accuracy of the bedside index for severity in acute pancreatitis in comparison with Ranson scores in predicting mortalities and severities in patients with acute pancreatitis.
Methods: The cross-sectional study was conducted at the Department of Emergency Medicine, Aga Khan University Hospital, Karachi, from July 1, 2017, to January 1, 2018, and comprised patients who presented with acute pancreatitis. The bedside index for severity in acute pancreatitis score was applied in the emergency department and the patients were followed up in ward/intensive care unit where Ranson scores were calculated within the following 48 hours. Both the …

Host Genetic Control Of Gut Microbiome Composition., Jason A. Bubier, Elissa J Chesler, George M. Weinstock

Faculty Research 2021

The gut microbiome plays a significant role in health and disease, and there is mounting evidence indicating that the microbial composition is regulated in part by host genetics. Heritability estimates for microbial abundance in mice and humans range from (0.05-0.45), indicating that 5-45% of inter-individual variation can be explained by genetics. Through twin studies, genetic association studies, systems genetics, and genome-wide association studies (GWAS), hundreds of specific host genetic loci have been shown to associate with the abundance of discrete gut microbes. Using genetically engineered knock-out mice, at least 30 specific genes have now been validated as having specific effects …

Domestic Chicken Diversity: Origin, Distribution, And Adaptation., Raman Akinyanju Lawal, O Hanotte

Faculty Research 2021

Chicken is the most numerous among the domesticated livestock species. Across cultures, religions, and societies, chicken is widely accepted with little or no taboo compared to other domestic animals. Its adaptability to diverse environmental conditions and demonstrated potential for breeding improvement provide a unique genetic resource for addressing the challenges of food security in a world impacted by climatic change and human population growth. Recent studies, shedding new knowledge on the chicken genomes, have helped reconstruct its past evolutionary history. Here, we review the literature concerning the origin, dispersion, and adaptation of domestic chicken. We highlight the role of human …

Diagnostics And Correction Of Batch Effects In Large-Scale Proteomic Studies: A Tutorial., Jelena Čuklina, Chloe H Lee, Evan G Williams, Tatjana Sajic, Ben C Collins, María Rodríguez Martínez, Varun S Sharma, Fabian Wendt, Sandra Goetze, Gregory R Keele, Bernd Wollscheid, Ruedi Aebersold, Patrick G A Pedrioli

Faculty Research 2021

Advancements in mass spectrometry-based proteomics have enabled experiments encompassing hundreds of samples. While these large sample sets deliver much-needed statistical power, handling them introduces technical variability known as batch effects. Here, we present a step-by-step protocol for the assessment, normalization, and batch correction of proteomic data. We review established methodologies from related fields and describe solutions specific to proteomic challenges, such as ion intensity drift and missing values in quantitative feature matrices. Finally, we compile a set of techniques that enable control of batch effect adjustment quality. We provide an R package, "proBatch", containing functions required for each step of …

Chinese Herbal Medicine To Reduce Radiation-Induced Oral Mucositis In Head And Neck Cancer Patients: Evidence From Population-Based Health Claims, Hsin-Hua Li, Hanoch Livneh, Wei-Jen Chen, Ming-Chi Lu, Wen-Yen Chiou, Shih-Kai Hung, Chia-Chou Yeh, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Subjects with head and neck cancer (HNC) often experience post-treatment side effects, particularly radiation-induced oral mucositis (RIOM). This study aimed to explore the association of Chinese herbal medicine use with the sequent risk of RIOM among them.

Methods: This cohort study used a nationwide health insurance database to identify subjects newly diagnosed with HNC, aged 20 to 60 years, who received treatment between 2000 and 2007. Among them, a total of 561 cases received CHM after HNC onset (CHM users); the remaining 2395 cases were non-CHM users. All patients were followed to the end of 2012 to …

Beneficial Effects Of The 30-Minute Door-To-Needle Time Standard For Alteplase Administration, Suja S Rajan, Marquita Decker-Palmer, Jessica Wise, Thanh Dao, Cindy Salem, Sean I Savitz

Faculty and Staff Publications

Objective: The American Heart Association recently raised the bar on the timely treatment of acute ischemic stroke (AIS) with intravenous alteplase. Our study looks at the effectiveness of this new standard, by examining the effect of varying door-to-needle times of alteplase initiation on the clinical, quality of care, and efficiency of care outcomes.

Methods: This retrospective case-control study examined 752 AIS patients treated with intravenous alteplase in a large academic health system during 2015-2018, and compared their outcomes after treatment within 30, 45, and 60 min of arrival. The outcomes compared were: (1) clinical - discharge and 90-day modified Rankin …

Diabetes And Physical Activity Among Saudi Women, Zainab Mohammed H Alyousef

Nursing Dissertations - Archive

Given the fact that Saudi women with DM have more obesity but lower levels of physical activity compared to men, and have additional cultural barriers to physical activity, new interventions are needed. Home-based interventions would be ideal as the women would not need to rely on transportation to a gymnasium or park for exercise. Although, home-based interventions are relatively low-cost, for both the patient and the healthcare system, no studies were found in which researchers tested an exercise intervention in Saudi women with DM delivered at home using the Internet. The purpose of this proposed study will be to evaluate …

Glucose Gel As A Treatment For Neonatal Hypoglycemia, Karen Christine Stanzo

Nursing Dissertations - Archive

This article-based dissertation consists of two complete manuscripts related to oral glucose gel, which is used to treat neonatal hypoglycemia (NH). In the first manuscript, a pre and post-intervention retrospective study was completed to examine the effects of the introduction of glucose gel on the exclusive breastfeeding rate and the admission rate to the neonatal intensive care unit (NICU) on neonates over 35 weeks gestation who were at risk for NH in a mother-baby unit of a Baby-Friendly hospital. There were 198 newborns in the pre-intervention sample and 203 in the post-intervention sample. The exclusive breastfeeding rates in the pre-intervention …

Kujdesi Infermieror Në Trajtimin E Plagëve Kirurgjikale, Adelina Krasniqi

Theses and Dissertations

Plaget operatore jane plage ne lekure ose ne inde te thella te kryera gjate nje procedure kirurgjikale nga nje mjet kirugjikal .si ne rastin konkret me instrumentin kirugjikal.bisturia. . Në kuptimin që ne përdorim sot plaga është dëmtimi apo prishja e tërësisë së lëkurës dhe elementeve anatomike të saj. Na duket i arsyeshëm se klasifikimi që i ndan plagët në dy tipa kryesorë: në plagë që kanë humbur ind dhe në plagë që nuk kanë humbur ind dhe lidhur me këtë pikë shumë të rëndësishme bëhet edhe vlerësimi i plagëve në vartësi të shkaktarit, karakteristikat anatomiko-patologjike.

Qëllimi parësor i hulumtimit: …

Përdorimi I Antibiotikëve Te Fëmijët, Habibe Gjinolli

Theses and Dissertations

Qëllimi i këtij hulumtimi është të identifikohen antibiotiket më të përdorur te fëmijët si dhe të analizohen diagnozat më të përshkruara te fëmijët gjatë 1 muaji. Antibiotikët janë lëndë kimikisht të përcaktuara me origjinë biologjike, të cilët, edhe pse nuk zotërojnë karakter enzimatik, në përqendrime të ulëta ndalojnë proceset e rritjes.

Pjesëmarrësit ishin fëmijë të moshës 0-17 vjeç nga vende të ndryshme të Komunës së Ferizajit. Instrumenti i përdorur është libri i Protokolit i reaprtit të pediatrisë i cili tregon për moshën, gjinin, diagnozën dhe terapinë më të përdorur.

Rezultatet në këtë hulumtim treguan se antibiotiku më i përdorur ishte …

Kujdesi Infermieror Tek Pacientët Me Diabet, Arianë Zogaj

Theses and Dissertations

No abstract provided.

Kujdesi Infermieror Te Pacientet Me Karcinome Te Gjirit, Fjolla Shabani

Theses and Dissertations

Profesioni universal i infermierit, shumë i respektuar dhe i nderuar nga të gjithë, historikisht është parë si mëshirim i vlerave humane në shërbim të individit dhe të kolektivit, si një mision I lartë për të ndihmuar ata që vuajnë nga sëmundjet. Personeli infermieror, në aktivitetin për të kryer kujdesin infermieror, aplikon tërë kapacitetin profesional e shpirtëror për parandalimin e kurimin e sëmundjeve, për tu shërbyer atyre që kanë nevojë për ndihmë jo vetëm mjekësore por edhe shpirtërore, psikologjike e morale. Sa më të përgaditur profesionalisht të jenë infermierët, aq më i kualifikuar e rezultativ është shërbimi dhe aq më të …

Kujdesi Infermieror Tek Pacientët Me Hipertensioni Arterial, Endrin Sahiti

Theses and Dissertations

Hipertensioni po bëhet një epidemi globale dhe kërcënim për popullatën botërore. Ky studim ndër-sekcional u krye me pacientët me hipertension arterial që gravitojnë në QKMF e Lipjanit

për të studiuar njohuritë, qëndrimet dhe praktikat në lidhje me hipertensionin.

Metodat: Një total prej 30 të intervistuarve të moshës 18 vjeç e lart u zgjodhën me anë të marrjes të rastësishme të mostrave. Të dhënat u mblodhën duke përdorur një pyetësor të strukturuar të drejtuar nga intervistuesit me zgjedhje përgjigjesh në shkallën Likert.

Rezultatet Të gjithë të intervistuarit ishin me moshën mesatare 54.5 vjeç [Devijimi Standard (SD) = 11.828]. Prej pacienteve te …