Medicine and Health Sciences Commons^™

Feminizing Genitoplasty In A Young Girl With Glanzmann's Thrombasthenia-Management Of Haemostasis, Kashaf Khalid Turk, Zafar Nazir

Section of Paediatric Surgery

We report peri- and post-operative management of haemostasis in a 11-year old girl with Glanzmann Thrombasthenia (GT) who had feminizing genitoplasty for genital ambiguity due to Congenital Adrenal Hyperplasia (CAH-21 Hydroxylase deficiency). A blend of Glanzmann Thrombasthenia (GT) and DSD 46XX due to CAH is not reported in literature. Surgery particularly genitourinary reconstruction in patients with GT is challenging due to risk of intra and post-operative bleeding. Haemostasis can successfully be achieved with platelet transfusions, antifibrinolytic (Tranexamic acid) and judicious use of recombinant factor VIIa (rFVIIa) even in a resource limited setting.

Association Of Bipolar I Disorder With Conversion Disorder And Syncope- A Retrospective Clinical Study From Pakistan, Qurat Ul Ain Khan, Sana Younus, Hania Hasan, Muhammad Zaman Khan

Pakistan Journal of Neurological Sciences (PJNS)

Bipolar I disorder (BD I) is a chronic mood disorder that begins in early adulthood. Its association with conversion disorder and syncope has not been widely studied, especially in Pakistani population.

Maternal Health Challenges During Covid-19 And Way Forward, Muskaan Dosani, Salima Muhammad Farooq, Shahnaz Shahid Ali

Journal of Asian Midwives (JAM)

The COVID-19 pandemic has affected nearly every country around the globe. Although every individual is at risk of getting the virus, maternal, fetal and newborn clients face specific and potentially unknown challenges which can make them highly compromised. The purpose of this paper is to discuss the maternal health challenges faced by women during COVID-19 and to propose possible strategies using the socio-ecological model (SEM) to promote the physical, social, and mental well-being of women and their infants during the perinatal period. SEM can be used as a framework to plan and implement strategies focusing on health promotion and disease …

Impact Of Order Set Use On Stroke Care, Bilal Nadeem, Edward Waseleski, Meryem Maras-Casey, Sabih Alam, Adnan Faruqui, Michael Gutierrez, Maruthsakhi Molugu, Christina Oricompil, Ashar Mahmood, Katherine Torralba, Fatima Agha, Nour Tlimat, Olu Oyesanmi, Irina Davis, Salman Muddassir, Nikolay Mitzov

West Florida Division GME Research Day 2020

• A case control study on stroke patients was recently completed for a quality improvement (QI) investigation.
• The objective was to determine if the use of either Hemorrhagic or Ischemic Stroke Order Set had an effect on the length of stay (LOS) or adherence to current stroke guideline recommendations

Bedside Point Of Care Ultrasound Diagnosing Bilateral Valve Involvement In Infective Endocarditis, Corey Cole, Alfredo Tirado, Jonathan Schwadron

West Florida Division GME Research Day 2020

Endocarditis is a well known complication of intravenous drug abuse which classically affects the tricuspid valve. It is usually diagnosed by formal echocardiogram and positive blood cultures. Vegetations involving both the mitral and tricuspid valves are rare, occurring in less than 5% of all cases of infective endocarditis. 1 Here we report a case of a patient with vegetations on both valves which was discovered by point of care ultrasound.

End The Glow!, Roli Kushwaha, Anthony Furiato, Justin Mcnamee

West Florida Division GME Research Day 2020

Aortic dissection (AD) is part of a group of acute aortic syndromes consisting of intramural aortic hematoma, penetrating aortic ulcer, and aortic rupture. On its own, the incidence is ~3 to 8 cases per 100,000 per year, and up to 25% of cases are missed. The in-hospital mortality when treated is 27%, and with a 2% increase in mortality/hour. Imaging modalities like CT angiography, TEE, and MRA have made improved diagnosis of the disease, but are costly, potentially harmful, time consuming, and require patient stability when in use (1). The key question we have as emergency department providers is if …

A Case Of Simpson-Golabi-Behmel Syndrome Presenting With Cutaneous Findings, Tessa B. Mullins, Abigail Russell, Chad Johnston

Capital Division GME Virtual Research Day 2020

Simpson-Golabi-Behmelsyndrome is a rare, X-linked recessive syndrome associated with mutations in the genes encoding glypican 3 (GPC3). The majority of cases have been described in pediatric males, with those affected showing manifestations of overgrowth, congenital heart defects, and increased incidence of neoplasia. Due to the X-linked nature of this disorder, penetrance is not well understood in female cases. Very few cases of female presentations of Simpson-Golabi-Behmelsyndrome have been described. We present a case of GPC3 gene mutation suggestive of Simpson-Golabi-Behmelsyndrome in an adult female patient, diagnosed based on genetic testing performed due to a diagnosis of sebaceous carcinoma.

A Case Study On Toxoplasmosis: Ocular Disease, Caleb A. Vass, Elliot Freed

Capital Division GME Virtual Research Day 2020

Toxoplasmosis is an infection caused by the protozoan parasite Toxoplasma gondii. Primary infection by this organism is usually asymptomatic. Some immunocompetent patients infected with this parasite can present as an acute systemic infection but symptoms can also present as ocular disease. In these instances, the ocular disease may be the only symptom, and can be from either an acute infection or a reactivation of the disease.

Training Practitioners On The Effects Of Psychotropic Medication Via A Web-Based Platform, Anita Li

Dissertations

Many individuals diagnosed with autism spectrum disorders (ASD) receive multiple therapeutic services in an attempt to supplement behavioral therapy. These services include pharmacological interventions. Two drugs, risperidone (Risperdal) and aripiprazole (Abilify), are FDA-approved to treat “irritability” in children with ASD. Research shows that the effects of risperidone and aripiprazole on irritability varies greatly across treated individuals. Therefore, individualized monitoring and evaluation must be conducted to provide the physician with data to determine if the medication is resulting in desired changes and effects. Certified behavior analysts are trained in data collection and experience high levels of contact with individuals diagnosed with …

Pinch Span And Force: Normative Data, Requirements For Functional Tasks And Life Roles, And The Influence Of Carpometacarpal Joint Osteoarthritis, Nancy Hock

Dissertations

The three studies that form this dissertation build knowledge related to functional pinch. Study 1 provides normative data for the Baseline® 5-Position Hydraulic Pinch Meter, which may be used in clinical practice. The data collected in this study demonstrate the relationship between lateral pinch strength and age and reveal that strength decreases with age in both males and females. Through examination of the lateral pinch force produced at the 5 different pinch spans, it was found that the strongest lateral pinch strength was produced at 4-5 cm of pinch span. This information can be used by clinicians as they modify …

Exploring Functional Health Literacy In Older Adults With Age-Related Macular Degeneration, Jennifer K. Fortuna

Dissertations

This three-paper dissertation explores functional health literacy (i.e., the ability to access, process and understand health information) in older adults with vision loss caused by age-related macular degeneration (AMD). This research builds scholarship that explores the unique patient education needs of older adults with AMD. The specific aims of this research are to: (1) explore associations between functional health literacy and severity of visual impairment; (2) determine the general readability, suitability and comprehensibility of online patient education materials (PEMs) designed for older adults with AMD; and, (3) assess the overall quality of one PEM that has been simplified based on …

Using Patient Safety Principles To Prevent Patient Harm, Octavia Reed Wynn

Doctoral Dissertations and Projects

While healthcare is intended to promote and restore optimal health and quality of life, it has been realized that patients often experience unintended harm while consuming healthcare services. In a project conducted in a 12-bed intensive care unit, nurses completed a pre-survey to identify a baseline understanding of patient safety principles. They then completed online educational modules designed to teach patient safety principles including patient and family centered healthcare, systems safety, and culture of safety. Following the educational intervention, a postsurvey to assess for increased understanding was administered. Forty-seven nurses completed the presurvey and education showing improved understanding of patient …

Using Screening, Brief Intervention, Referral To Treatment To Address Problematic Alcohol Use At A University Student Health Center, Tajuane H. Dockery

Doctoral Dissertations and Projects

Problematic drinking is a public health concern on college campuses. College students who do not have their risky drinking behaviors addressed are at greater risk for developing Alcohol Use Disorder (AUD). Despite known risks associated with drinking on college campuses, many college health centers miss an opportunity to address these behaviors because they lack a systematic process for identifying students at risk and referring them for treatment. This evidence-based project evaluated the effectiveness of using Screening, Brief Intervention, Referral to Treatment (SBIRT) to identify students with risky drinking behaviors and the impact the screening process had on facilitating a referral …

Impact Of Covid-19 On Dental Education In The United States, Parvati Iyer, Kalid Aziz, David M. Ojcius

All Dugoni School of Dentistry Faculty Articles

© 2020 American Dental Education Association Dental institutions in the United States are reeling from the consequences of the novel SARS-CoV2 coronavirus, the causative agent of CODIV-19. As oral health care providers, we have been trained on prevention of aerosol transmissible diseases, but we are still grappling with many unknown factors regarding COVID-19. While the Centers for Disease Control and Prevention (CDC), American Dental Association (ADA), and local state agencies are releasing updates on guidelines for dentists and patients, no official information exists for dental institutions on how to effectively follow the recommended guidelines including “shelter in place” with social …

Does Empathy Decline In The Clinical Phase Of Medical Education? A Nationwide, Multi-Institutional, Cross-Sectional Study Of Students At Do-Granting Medical Schools, Mohammadreza Hojat, Stephen C. Shannon, Jennifer Desantis, Mark R. Speicher, Lynn Bragan, Leonard H. Calabrese

CRMEHC Faculty Papers

PURPOSE: To examine differences in students' empathy in different years of medical school in a nationwide study of students of U.S. DO-granting medical schools.

METHOD: Participants in this cross-sectional study included 10,751 students enrolled in 41 of 48 campuses of DO-granting medical schools in the United States (3,616 first-year, 2,764 second-year, 2,413 third-year, and 1,958 fourth-year students). They completed a web-based survey at the end of the 2017-2018 academic year that included the Jefferson Scale of Empathy and the Infrequency Scale of the Zuckerman-Kuhlman Personality Questionnaire for measuring "good impression" response bias. Comparisons were made on empathy scores among students …

Informing The Creation Of A Financial Literacy Tool For Cal Poly Students, Kelly Michelle Carroll

Communication Studies

This research project examines the wants, needs, and desires of Cal Poly students to inform the creation of a financial literacy tool (tentatively named “MoneySmart”) to be created by another student. The methodologies used to gauge these metrics were a literature review and questionnaire. The literature review aids in understanding research regarding the current state of student financial literacy in the United States, including student attitudes toward the topic. Subsequent findings were used to create the questionnaire, which inquired about students’ financial stress, confidence in their abilities to manage their personal finances, specific interests for the design and contents of …

Artificial Intelligence-Powered Search Tools And Resources In The Fight Against Covid-19., Larry J Kricka, Sergei Polevikov, Jason Y Park, Paolo Fortina, Sergio Bernardini, Daniel Satchkov, Valentin Kolesov, Maxim Grishkov

Department of Cancer Biology Faculty Papers

Emerging technologies are set to play an important role in our response to the COVID-19 pandemic. This paper explores three prominent initiatives: COVID-19 focused datasets (e.g., CORD-19); Artificial intelligence-powered search tools (e.g., WellAI, SciSight); and contact tracing based on mobile communication technology. We believe that increasing awareness of these tools will be important in future research into the disease, COVID-19, and the virus, SARS-CoV-2.

Permanent Pre-Operative Cerebrospinal Fluid Diversion In Paediatric Patients With Posterior Fossa Tumours, Ummey Hani, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Management options for obstructive hydrocephalus in children with posterior fossa tumours have been debated upon throughout the course of neurosurgical practice. Permanent pre-operative CSF diversion via ventricular shunts or endoscopic third ventriculostomy have been employed to prevent the possible persistence of hydrocephalus after tumour removal, but is considered unnecessary and even dangerous amongst a large group of neurosurgeons. In this paper, we have reviewed the literature for the merits and demerits of pre-operative permanent CSF diversion in paediatric patients presenting with posterior fossa tumours.

Silent Hypoxia In Covid-19: What Is Old Is New Again!, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Mental Health Challenges And Psycho-Social Interventions Amid Covid-19 Pandemic: A Call To Action For Pakistan, Salima Farooq, Saima Sachwani, Sonia Ijaz Haider, Sajid Abrar Iqbal, Yasmin Parpio, Humera Saeed

School of Nursing & Midwifery

The increase in death and spread-related coronavirus (COVID-19) has shifted the world focus to the containment of the disease by emphasising measures to prevent spread in the general population. Such a complex, threatening, and unprecedented situation has left the psycho-social wellbeing needs of general public unaddressed. This paper aims to review the current COVID-19 scenario and its effects on the psycho-social wellbeing of people; and an attempt to shed some light on the aforementioned questions. Furthermore, the review will propose some recommendations for overcoming the mental illness issues, during and after the COVID-19 outbreak. We extracted information from reliable published …

The New Future Of Global Spine Journal, Jeffrey C Wang, Karsten Wiechert, Jens R Chapman

Articles, Abstracts, and Reports

No abstract provided.

Medial Femoral Condyle Vascularized Bone Graft For Treatment Of Midshaft Clavicle Recalcitrant Nonunion With Use Of The Transverse Cervical Artery As An Anastomosis., Christopher M Belyea, Jefferson L Lansford, Joseph B Golden, Emily H Shin, Rey D L Gumboc

Articles, Abstracts, and Reports

Vascularized medial femoral condyle bone grafts have been reported to be a reliable treatment for recalcitrant bony nonunions of the extremities. Although clavicle fracture nonunions are rare after treatment with open reduction internal fixation, symptomatic nonunions can be a challenge. The medial femoral condyle vascularized bone graft has been described as a treatment option for clavicle nonunions with the thoracoacromial trunk as the recipient anastomosis site. This case illustrates how the transverse cervical artery and accompanying veins can be used as an anastomosis when the thoracoacromial trunk is inaccessible because of previous surgical- and infection-related scaring. At the final follow-up, …

Robotic Surgery For Gynecologic Cancers: Indications, Techniques And Controversies., Kiran H Clair, Krishnansu S Tewari

Articles, Abstracts, and Reports

Minimally invasive surgery for gynecologic cancers is associated with fewer postoperative complications including less blood loss and quicker recovery time compared to traditional laparotomy. The robotic platform has allowed patients access to minimally invasive surgery due to its increased utilization by gynecologic oncologists. Many surgeons have embraced the robotic platform due to its technological advances over traditional laparoscopy including high-definition 3D optics, wristed instrumentation, camera stability and improved ergonomics. While robotic surgery continues as a mainstay in the management of gynecologic cancers, it remains controversial in regards to its cost effectiveness and more recently, its long-term impact on clinical and …

Supplementary Material To The Manuscript Titled: Mobile Phone Sensors Can Discern Medication-Related Gait Quality Changes In Parkinson's Patients In A Real-World Setting, Niklas König Ignasiak, Albert Pierce, Vincent Berardi, Wilford K. Eiteman-Pang, Cyril Rakovski

Physical Therapy Faculty Data Sets

This file contains the data that was used to classify high and low quality gait patterns in patients with Parkinson's disease. Acceleration and gyroscope data was recorded with a conventional smartphone in a real-world environment. High (i.e. ON medication) and low (i.e. OFF medication) quality labels were given by a human observer according to medication intake times.

Secukinumab Provides Sustained Low Rates Of Radiographic Progression In Psoriatic Arthritis: 52-Week Results From A Phase 3 Study, Future 5., Désirée Van Der Heijde, Philip Mease, Robert B M Landewé, Proton Rahman, Hasan Tahir, Atul Singhal, Elke Boettcher, Sandra Navarra, Xuan Zhu, Gregory Ligozio, Aimee Readie, Shephard Mpofu, Luminita Pricop

Articles, Abstracts, and Reports

OBJECTIVE: To evaluate the effect of secukinumab on radiographic progression through 52 weeks in patients with PsA from the FUTURE 5 study.

METHODS: Patients with active PsA, stratified by prior anti-TNF use (naïve or inadequate response), were randomized to s.c. secukinumab 300 mg load (300 mg), 150 mg load (150 mg), 150 mg no load regimens or placebo at baseline, at weeks 1, 2 and 3 and every 4 weeks starting at week 4. Radiographic progression was assessed by change in van der Heijde-modified total Sharp score (vdH-mTSS; mean of two readers). Statistical analysis used a linear mixed-effects model (random …

Novel Application Of Vinylpolysiloxane Hearing Aid Impression Mold As Patient-Specific Bolus For Head And Neck Cancer Radiotherapy., Anne Elizabeth Gunter, John Burgoyne, Min Park, Namou Kim, Daliang Cao, Vivek Mehta

Articles, Abstracts, and Reports

Hearing aid impression material composed of vinylpolysiloxane is an ideal bolus material which may be used to aid in delivery of adjuvant radiation to complex surgical defects of the head and neck. It is affordable, easily accessed, and efficient.

Disillusionment And Fear: The Impact Of Zambia’S Religio-Political Climate On Sexual And Reproductive Health Organisations, Margaret Anderson

Southern African Journal of Policy and Development

Various trends affect the operations of civil society organisations related to sexual and reproductive healthcare (SRH) in Zambia. Firstly, there is a dramatic unmet need for SRH services, and organisations are scrambling to meet this need in the face of many barriers. This is coinciding with increasing political repression on civil society, especially targeting civil society organisations (CSO) with politically sensitive underpinnings. A Christian demographic and institutional revival is reshaping the social and moral framework of the Republic. This research investigates the context of SRH organisations in Zambia and assesses how organisations related to SRH are impacted by the religious-political …

Risk Perception, Behavioural Response To Covid-19, And The Mediating Role Of Information Sources In Zambia, Byrne Kaulu, Edna Kabala, Rosemary Mapoma, Christopher Munyonzwe

Southern African Journal of Policy and Development

The role of information sources in mediating the relationship between behavioural responses to COVID-19 and its determinants has hardly been studied. This study fills the knowledge gap with a focus on Zambia, a middle-income country. Data was collected using an online questionnaire. The key independent variables were risk perception of COVID-19, risk perception of the health care system (local and global), and risk perception of the big five global health problems (HIV/AIDS, cancer, injury from road traffic accidents, influenza, and diabetes). Risk perception of the health care system was measured by looking at whether or not the respondents trust the …

Kujdesi Infermieror Tek Pacientët Me Apendiks Akut, Agnesa Sahiti

Theses and Dissertations

Apendiksi akut është një zgjatje vermiforme e cecumit ( një tub i hollë i verbër ). Cecum është pjesa e parë e kolonës në formë qese e vendosur në anën e poshtme të djathtë të barkut. Për shkak se cecumi është një thes, ai quhet edhe zorrë e verbër. Eshtë rreth 5-10 cm në gjatësi. Diametri i shëndetshëm i apendiksit nuk kalon 6mm..Emri zyrtar i apendiksit është “appendix veriform” që do të thotë shtojcë e ngjashme me krimbin. Në vitin 1886, ishte Reignald Fitz në Boston, që identifikoi saktë apendiksin si shkakun kryesor të inflamacionit të kuadratit të poshtëm.Ai e …

Kujdesi Infermieror Në Menaxhimin E Rasteve Të Tuberkulozit Gjatë Periudhës Së Trajtimit, Lauretë Etemi

Theses and Dissertations

Tuberkulozi është një sëmundje ngjitëse që shkaktohet nga bakteria Mycobacterium tuberculosis dhe ai shfaqet zakonisht në mushkëri.

Tuberkulozi mund të shfaqet edhe në organe të tjera të trupit, si për shembull në gjendrat limfatike, në kocka, në organet e urinimit dhe ato gjenitale, në organet e brendshme, në sistemin qendror nervor, në lëkurë ose edhe si infeksion i përgjithshëm.

Njeriu mund të preket nga tuberkulozi kur ai është në të njëjtin ambient me një person të sëmurë nga tuberkulozi. Rrezikun më të madh të marrjes së sëmundjes e kanë ata që jetojnë në të njëjtën familje dhe ata njerëz të …