Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Apache Ii Score As A Predictor Of Length Of Stay And Outcome In Our Icus, Shahla Siddiqui, Saad Ahmed, Roshan Manasia

Department of Anaesthesia

The APACHE II (acute physiology and chronic health evaluation) is used widely for predicting probability of hospital mortality and length of stay in the ICU. APACHE II forms were available to all ICU residents within 24 hours of admission, and a score was assigned to them. Based on our results the APACHE II score has reliably predicted an outcome of the least amount of length of stay (LOS) in the ICU as well as a 100% probability of being shifted out of the ICU for a score of < 10 (according to international benchmarks). This reliable scoring system can be used for predicting mortality and length of stay and therefore, resource allocation, antibiotic use and ethical decisions regarding counseling families about end of life decisions--all within 24 hours of admissions.

Unanticipated Hospital Admission After Ambulatory Surgery, Mueenullah Khan, Aliya Ahmed, Laila Abdullah, Azmeena Nizar, Aslam Fareed, Fauzia Anis Khan

Department of Anaesthesia

The unplanned admission rate is considered to be an important measure of the quality of ambulatory surgical units. The objective of our study was to evaluate the unanticipated hospital admission rate from the Surgical Day Care (SDC) unit of our university affiliated teaching hospital and to analyze the reasons for admission. A review of all unanticipated admissions over a one-year period was done. The admission rate was calculated and the reasons for admission were analysed. The overall admission rate was 4.93%. Most of the admissions were ordered by the surgeons (97%). The main reasons for admission were patient observation indicated …

Nucleic Acid Sequencing Using Charge-Switch Nucleotides, John G. K. Williams, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

The present invention provides compounds, methods and systems for sequencing nucleic acid using single molecule detection. Using labeled NPs that exhibit charge-switching behavior, single-molecule DNA sequencing in a microchannel sorting system is realized. In operation, sequencing products are detected enabling real-time sequencing as successive detectable moieties flow through a detection channel. By electrically sorting charged molecules, the cleaved product molecules are detected in isolation without interference from unincorporated NPs and without illuminating the polymerase-DNA complex.

Motivated Breast Cancer Screening Behavior And Its Cultural Antecedents, Patricia M. Flynn

Loma Linda University Electronic Theses, Dissertations & Projects

Discrepancies in breast cancer screening behavior exist among various ethnic groups in the United States (Jacobs & Lauderdale, 2001), with Latino American women reporting particularly low screening rates in comparison to Anglo American women (ACS, 2002). Research indicates that behavior is in part influenced by aspects of culture and relevant psychological processes (Betancourt & Lopez, 1993; Betancourt & Fuentes, 2001). This study was designed to investigate the relations among cultural values, attributions regarding the causes for not screening, related emotions, expectancy that screening leads to early detection and value incentive of early detection as determinants of breast cancer screening intention …

Surgical Images: Soft Tissue. Incarcerated Gallbladder In A Parastomal Hernia., Shawn D. St Peter, Jacques Heppell

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Knowledge, Attitude And Practice Of Parturients Regarding Epidural Analgesia For Labour In A University Hospital In Karachi, Mohammed Raheel Minhas, Rehana Kamal, Gauhar Afshan, Hafsa Raheel

Department of Anaesthesia

Objective: To assess the knowledge, sources of knowledge, attitude (fears and misconceptions) regarding Epidural Analgesia (EA) and practices of parturients delivery at Aga Khan University hospital (AKUH).Methods: A hospital based cross sectional study was conducted at the obstetric unit of AKUH, from November to December 2003. A questionnaire was filled through verbal interviews conducted on 448 parturients fulfilling the inclusion criteria.Results: Seventy six percent of the females were aware of epidural analgesia as a labor pain relieving method. However, only 19% availed EA. About 40% had heard about EA from their obstetricians and 64% from friends or relatives. Twenty even …

Medical Technology: Contexts And Content In Science And Technology, Michael A. De Miranda, Mark Doggett, Jane T. Evans

Architectural and Manufacturing Sciences Faculty Publications

No abstract provided.

Validation Of An Immunomagnetic-Electrochemiluminescence Detection System For The Detection Of Escherichia Coli 0157 In Food And Comparison With An Iso Standard Method, Eimear Carney

Theses

Rapid and sensitive methods for detecting Escherichia coli 0157 in contaminated food, water and other biological samples are important in limiting and preventing the spread of this pathogen. Traditional culture based methods for bacterial identification and detection can be time consuming and labour intensive. Modem alternative methods should be faster whilst maintaining sensitivity. Immunomagnetic separation (IMS) methodology has been investigated and appears promising for rapid bacterial detection in unrelated food and environmental samples. In this study, a commercial sensor which combined IMS with electrochemiluminescence (ECL) was evaluated for the detection of E. coli 0157 in unrelated food matrices. Emitted signals …

Prophylactic Defibrillator Implantation—Toward An Evidence-Based Approach, Alan H. Kadish

Office of the President Publications and Research

The author discusses research on using implantable cardioverter-defibrillators for the primary prevention of sudden death.

Estimation Of Subject Specific Icp Dynamic Models Using Prospective Clinical Data, Wayne W. Wakeland, Joe Fusion, B. Goldstein

Complex Systems Faculty Publications and Presentations

We used a prospective clinical trial to generate physiologic data to create subject-specific in silico (computer simulation) models of intracranial pressure dynamics in children with severe traumatic brain injury. The trial included a physiologic challenge protocol with changes in head-of-bed elevation and minute ventilation, applied over multiple iterations to three subjects. Physiologic signals (electrocardiogram, respiration, arterial blood pressure, intracranial pressure [ICP], oxygen saturation) were recorded continuously, along with clinical annotations indicating the precise timing of physiologic challenges. Several parameters within the model of ICP dynamics were estimated for each subject based on the ICP response to the challenges. Estimation was …

Implantable Cardioverter–Defibrillators: Reply, Alan H. Kadish

Office of the President Publications and Research

The author replies to comments on a previously published article discussing implantable cardioverter-defibrillators.

Imposed Constraints On The Smith-Waterman Alignment Algorithm For Enhanced Modeling Of A Single-Molecule Dna Sequencer, Patrick G. Humphrey, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

An effort has been underway to develop a system for de novo sequencing of single DNA molecules with very long reads. The system operates by optically detecting the passage of fluorescently tagged DNA bases through a detection zone. A successful system would be revolutionary with respect to speed, read length, cost and minimized laboratory infrastructure. An important part of system development is modeling of the detection process. In particular, predicting the expected error from a set of sequencing parameters is helpful in system design. This paper describes variations on the Smith-Waterman algorithm for subsequence alignment used in a single-molecule detection …

Drug Related Critical Incidents, F A. Khan, M Q. Hoda

Department of Anaesthesia

Drug related incidents are a common form of reported medical errors. This paper reviews the critical incidents related to drug errors reported from the main operating theatre suite in a teaching hospital in a developing country from January 1997 to December 2002. Each report was evaluated individually by two reviewers using a structured process. During this period, 44 874 anaesthetics were administered; 768 critical incidents were reported, 165 (21%) of which were related to drug errors. Underdosage, side-effect/drug reaction and syringe swap were the most common. A total of 76% were classified as preventable; 56% due to human error and …

Cbct Panoramic Images Vs. Traditional Panoramic Radiographs, Sunny Young Hutchinson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this research was to compare the accuracy of angular measurements of the panoramic image of the Newtom 9000™ Cone Beam Computed Tomography (CBCT) with the Sirona™ Orthophos panoramic unit. The study was separated into three parts: phantom study, patient study, and archform study. The phantom study used fabricated phantom typodonts to compare angular measurements between the Newtom 9000™ panoramic image and the Sirona™ panoramic radiograph. Accuracies of the measurements were then determined by comparing the values to the actual phantom typodont. No marked differences in angular measurements were recorded for the phantom typodont using either of the …

Case Of Inhaled Prostaglandin E1 Used To Improve Hypoxia In Ards, Shahla Siddiqui, Salwa Zubair, F Hameed Khan

Department of Anaesthesia

No abstract provided.

Comparison Of Auto-Adjusting And Fixed Level Continuous Positive Airway Pressure Therapy In Patients With Mild To Moderate Obstructive Sleep Apnoea Hypopnoea Syndrome, Geraldine Nolan

Masters

Obstructive Sleep Apnoea Hypopnoea syndrome (OSAHS) is a potentially serious medical disorder associated with increased morbidity and mortality. It is estimated to affect 4% of males and 2% of females between the ages of forty and sixty. Nasal continuous positive airway pressure (CPAP) is the first choice treatment for this condition and it is extremely effective at controlling OSAHS. However, not all patients can tolerate this therapy, in particular those within the mild to moderate category, and there are also many others who are unable to comply with the minimum usage requirements of at least four hours every night. A …

Anaesthesia For Surgical Correction Of Scoliosis With Spinal Cord Monitoring--A Case Series, M Q. Hoda, S U. Zafar

Department of Anaesthesia

Objective: To share our experience of anaesthetic management of scoliosis with intra-operative somatosensory evoked potential monitoring and wake up test.Methods: All the cases of scoliosis surgery scheduled during a period of two years in which SSEP and intra-operative wake-up test was planned were included in the study. The patient in which intra-operative wake-up test was not planned were excluded from this case series.Results: We managed a series of sixteen cases of scoliosis in our hospital. Eleven patients were female and five were male with the age ranging from six to twenty two years. SSEPs were monitored throughout the procedure and …

Beyond Bloodletting: Fda Gives Leeches A Medical Makeover, Carol Rados

Harold W. Manter Laboratory of Parasitology: Library Materials

In June 2004, the Food and Drug Administration cleared the first application for leeches (Hirudo medicinalis) to be used in modern medicine as medical devices. By definition, a medical device is an article intended to diagnose, cure, treat, prevent, or mitigate a disease or condition, or to affect a function or structure of the body, that does not achieve its primary effect through a chemical action and is not metabolized.

Cultural Value Orientations, Attributions, And Breast Cancer Screening Behaviors, Patricia M. Flynn

Loma Linda University Electronic Theses, Dissertations & Projects

Discrepancies in breast cancer screening behavior exist among various ethnic groups in the United States (Jacobs & Lauderdale, 2001), with Latino American women reporting particularly low screening rates in comparison to Anglo American women (ACS, 2002). Research indicates that behavior is in part influenced by aspects of culture and relevant psychological processes (Betancourt & Lopez, 1993; Betancourt & Fuentes, 2001). This study was designed to investigate the relations among cultural values, attributional processes, and breast cancer screening behavior among Anglo and Latino women. This study also investigated the influence of acculturation among Latino women in relation to the other study …

Prevalence Of Degenerative Joint Disease In A Pre-Orthodontic Adolescent Sample, Marie Mansour

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this research was to determine a prevalence of degenerative joint disease in our pre-orthodontic adolescent patients age ten through seventeen. The prevalence was assessed according to gender. Severity of DJD was established for each patient and a "red flag" for diagnosis was identified. The purpose was also to establish norms for joint space for patients with and without degenerative joint disease. Correlations to distal condyle position and angle classification were described. 123 consecutive patients, 77 female and 46 male T1 NewTom records were reviewed. Severity of DJD was classified according to none, mild, moderate, and severe. Sagittal …

Cone Beam Ct And Digital Radiography. A Comparative Study Of P/A Cephalometrics., Michael John Erickson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine if Rickett's posterio-anterior (P/A) cephalogram measurements could be obtained from Cone Beam Computerized Tomographic (CBCT) images taken on the NewTom QR-DVT 9000™.

Fifteen frontal cephalometric radiographs were chosen for good image quality, with no regard for patient age or gender. Each cephalogram was traced three times by the same operator using ZeroBase™ software. Landmarks were located and measured according to the Rickett's frontal analysis technique. Methods were devised for obtaining analogous measurements using CBCT images on the same group of patients.

Measurements obtained using CBCT correlated well with those obtained using the …

Flash Artifact Suppression In Two-Dimensional Ultrasound Imaging, Richard Yung Chiao, Gregory Ray Bashford, Mark Peter Feilen, Cynthia Andrews Owen

Biomedical Imaging and Biosignal Analysis Laboratory

Flash artifacts in ultrasound flow images are suppressed to achieve enhanced flow discrimination. Flash artifacts typically occur as region of elevated signal strength (brightness or equivalent color) within an image. A flash suppression algorithm included the steps of estimating the flash within an image and then suppressing the estimated flash. The mechanism for flash suppression is spatial filtering. An extension of this basic method used information from adjacent frames to estimate the flash and/or to smooth the resulting image sequence. Temporal information from adjacent frames is used as an adjunct to improve performance.

Negative Pressure Pulmonary Edema: Case Report, S M. Abbas, M Q. Hoda

Department of Anaesthesia

No abstract provided.

Research In Home-Care Telemedicine: Challenges In Patient Recruitment, Usha Subramanian, Faith Hopp, Julie Lowery, Peter Woodbridge, David Smith

Social Work Faculty Publications

This study reports challenges in recruiting patients for a randomized controHed trial of home-care telemedicinae. Descriptive statistics on patient eligibility for home-care telemedidne services and patient refusals for participation are provided. Frequency counts of reasons for study exclusion and participant refusal and Chi-square tests to compare race and age-related differences are given. Of 302 home-care patients reviewed, 197 (65.2%) did not meet inclusion criteria. The most common reasons for study exclusion were patients either needing <2 visits per month (n = 59, 30%) or >3 skilled nurse visits per week (n = 46, 23.4%). Of the eligible patients (n = 105), 79 …

Diagnostic Surgical Pathology: The Importance Of Second Opinion In A Developing Country, Z. Ahmed, N. Yaqoob, S. Muzaffar, N. Kayani, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To review the cases sent to the section of histopathology, Aga Khan Universty (AKU) for second opinion and see whether there are significant differences in the original outside diagnosis and the subsequent diagnosis submitted by us.

Methods: A retrospective study of all consecutive cases for second opinion in the form of paraffin blocks from 1st Novemver 2001 to 31st July 2002. The primary submitted diagnosis in each case was compared with the subsequent AKU diagnosis.

Results: The study included a total of 381 cases. However, in 45 cases (11.81%), initial histopathological diagnosis was not provided. Out of the remaining …

Effect Of Anti-Tgfß1 And Pycnogenol® On Scar Formation In Rats, Pilseong Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Wound healing is a complex biologic process that involves chemotaxis and division of cells, neovascularization, synthesis of extracellular matrix proteins, and remodeling of the repaired tissues. Of equal importance is the restoration of normal tissue structure and function without scar formation. The aim of this study was to find out the clinical effects of anti-TGFß1 and Pycnogenol® on scarless wound healing on rat skin.

An acute incision wound model was used with 20 healthy rats. Four incisions were made on each rat's skin and 4 different variables were applied by local infiltration. The four variables were anti-TGFß1, Pycnogenol®, PBS, and …

Effect Of Ketorolac On Postoperative Pain Relief In Dental Extraction Cases--A Comparative Study With Pethidine, S M. Abbas, R S. Kamal, G Afshan

Department of Anaesthesia

Objective: To compare the analgesic efficacy and side effects of ketorolac with pethidine in a day care procedure.STUDY Design: Single dose, double blind, case matched study.Methods: Sixty patients were divided into group A and group B, who received either ketorolac 30 mg or Pethidine 0.8 mg/kg ( both IN ) respectively at the time of induction of general anaesthesia. Patients were assessed in recovery room for pain according to visual analogue scale and any side effects. Amount of rescue analgesia required by both groups were also recorded. Odds Ratio and and Chi Square test were used for statistical analysis.Results: Statistical …

Neural Correlates Of Art Therapy As Indicated Through Electroencephalography, Kerry A. Kruk

EVMS School of Health Professions Theses & Dissertations

Quantitative electroencephalograph (QEEG) reports of 14 healthy women participants engaged in art making in response to two general art therapy directives were generated and compared at Eastern Virginia Medical School. A Cadwell Easy-II 32-channel digital EEG and Physiometrx E-net which contains placements according to the International 10-20 system were used to collect brainwave activity. This study explored the effects of clay sculpting and marker drawing conditions on neural activity in the right and left frontal and parietal cortices.

One aim of the study was to illuminate what Lusebrink (1990) suggested - that different types of media and processes elicit different …

Chemical And Biological Warfare Preparing To Meet The Threat, S Sophie, S U. Haq, M R. Khan

Department of Anaesthesia

No abstract provided.

Qtc Is Associated With Obesity And Physical Activity Level For African American Females, C. Jayne Brahler

Health and Sport Science Faculty Publications

Long QT syndrome (LQTS) is an independent risk factor for cardiovascular or ischemic disease mortality. Obesity as a cause for acquired LQTS in otherwise healthy individuals is rapidly gaining the attention of the scientific community. African American people have a higher incidence of obesity compared to Caucasians, yet race-specific information is not available for their prevalence of LQTS. Chronic physical activity can help reduce the incidence of obesity, yet little is known about the effects of chronic physical activity on acquired LQTS. Subjects in this study were a volunteer sample of African American mothers (21-53 yr, n = 44) and …