Diseases Commons^™

Comparing Growth Velocity Of Hiv Exposed And Non-Exposed Infants: An Observational Study Of Infants Enrolled In A Randomized Control Trial In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Natasha Makabilo Laban, Masuzyo Chirwa, Michelo Simunyandi, Luiza Miyanda Hatyoka, Innocent Ngaruye, Najeeha Talat Iqbal, Samuel Bosomprah

Department of Paediatrics and Child Health

Background: Impaired growth among infants remains one of the leading nutrition problems globally. In this study, we aimed to compare the growth trajectory rate and evaluate growth trajectory characteristics among children, who are HIV exposed uninfected (HEU) and HIV unexposed uninfected (HUU), under two years in Zambia.
Method: Our study used data from the ROVAS II study (PACTR201804003096919), an open-label randomized control trial of two verses three doses of live, attenuated, oral RotarixTM administered 6 &10 weeks or at 6 &10 weeks plus an additional dose at 9 months of age, conducted at George clinic in Lusaka, Zambia. Anthropometric measurements …

Comparing Sensitivity And Specificity Of Pacemaker Id Application And Cardiac Rhythm Management Device-Finder Application In Identifying Cardiac Implantable Electronic Device Manufacturer Using Chest Radiograph - An Observational Study, Pirbhat Shams, Muhammad Mehdi, Jamshed Ali, Intisar Ahmed, Sheema Saadia, Sameen Iqbal, Aamir Hameed Khan, Yawer Saeed

Section of Cardiology

Background: Smartphone-based applications to identify cardiac implantable electronic devices (CIED) are extremely useful in circumstances, where urgent device interrogation is needed, and a device identification card is not available. Few studies have provided insights regarding the utility of these applications. We have studied two widely available applications i.e., Pacemaker ID app (PMIDa) or Cardiac Rhythm Management Device-Finder (CRMD-f) to identify device manufacturers in CIEDs.
Methods: 547 patients who underwent CIED implantation from the year 2016-2020 in our institute were enrolled. There were 438 Medtronic and 109 St. Jude's devices. All chest radiographs were de-identified and resized into 225*225 pixels focusing …

Dermatitis Herpetiformis: An Update On Diagnosis, Disease Monitoring, And Management, Christopher N Nguyen, Soo-Jung Kim

Faculty, Staff and Students Publications

Dermatitis herpetiformis (DH), Duhring disease, is caused by gluten sensitivity and affects 11.2 to 75.3 per 100,000 people in the United States and Europe with an incidence of 0.4 to 3.5 per 100,000 people per year. DH is characterized by a symmetrical blistering rash on the extensor surfaces with severe pruritus. The diagnosis continues to be made primarily by pathognomonic findings on histopathology, especially direct immunofluorescence (DIF). Recently, anti-epidermal transglutaminase (TG3) antibodies have shown to be a primary diagnostic serology, while anti-tissue transglutaminase (TG2) and other autoantibodies may be used to support the diagnosis and for disease monitoring. Newly diagnosed …

Acute Generalized Exanthematous Pustulosis Induced By Cetuximab, Sadia Masood, Mohammad Rizwan, Saira Fatima, Palwasha Jalil

Department of Medicine

A wide variety of diseases and drugs can cause cutaneous pustular eruptions. Acute generalized exanthematous pustulosis (AGEP) is a unique drug-induced dermatosis clinically presented as erythematous papular and pustular eruption, usually caused by certain systemic drugs. We are presenting a very rare association of AGEP with a biological agent, cetuximab. A male aged 66 years, who was recently diagnosed with a case of squamous cell carcinoma of glottis, presented in the dermatology clinic with a recent onset of fever and widespread pustular eruption over the face, trunk, and limbs. The eruption was noted after the injection of cetuximab given for …

Covid-19 Newsletter (Vol. 85), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Discrepancy Between Pcr Based Sars-Cov-2 Tests Suggests The Need To Re-Evaluate Diagnostic Assays, Zain Mushtaq, Sadia Shakoor, Akber Kanji, Najma Shaheen, Asghar Nasir, Zeeshan Ansar Ahmed, Imran Ahmed, Syed Faisal Mahmood, Rumina Hasan, Zahra Hasan

Section of Internal Medicine

Objective: We investigated the discrepancy between clinical and PCR-based diagnosis of COVID-19. We compared results of ten patients with mild to severe COVID-19. Respiratory samples from all cases were tested on the Roche SARS-CoV-2 (Cobas) assay, Filmarray RP2.1 (bioMereiux) and TaqPath™ COVID19 (Thermofisher) PCR assays.
Results: Laboratory records of ten patients with mild to severe COVID-19 were examined. Initially, respiratory samples from the patients were tested as negative on the SARS-CoV-2 Roche® assay. Further investigation using the BIOFIRE® Filmarray RP2.1 assay identified SARS-CoV-2 as the pathogen in all ten cases. To investigate possible discrepancies between PCR assays, additional testing was …

A Pilot Study Of Knee And Hip Osteoarthritis Patient Experience With Telemedicine During The Covid-19 Pandemic, Rondy M. Lazaro, Kyle J. Smith, Mohammad H. Bawany, Nathan Barford, Jennifer H. Paul

Advances in Clinical Medical Research and Healthcare Delivery

Objective: The purpose of this pilot study is to examine patients' experience and satisfaction using telemedicine for knee and hip osteoarthritis care during the COVID-19 pandemic.

Methods: Adult patients seen via telemedicine for knee and/or hip osteoarthritis pain completed surveys through the REDCap online platform or pen/paper evaluating their experiences and satisfaction with telemedicine, assessed using yes/no and Likert scale questions. Demographic information was collected from the electronic medical record (EMR).

Results: 32 subjects (9 males, 23 females, mean age 63.2 years [SD = 12.2 years]) completed surveys. 90.6% of subjects stated that they were satisfied with the audio/video quality …

Malnutrition And Liver Disease In A Developing Country, Asra Tus Saleha Siddiqui, Om Parkash, Syeda Amrah Hashmi

Section of Gastroenterology

Malnutrition is a highly prevalent and under recognized condition in developing countries of South Asia. The presence of malnutrition causes a severe impact on patients with liver cirrhosis. The etiology of cirrhosis differs in the South Asian region compared to the West, with hepatitis B and C still being the leading causes and the prevalence of nonalcoholic fatty liver disease increasing over time. Comorbid malnutrition worsens outcomes for cirrhosis patients. Urgent attention to address malnutrition is needed to improve patient outcomes. The etiology and pathophysiology of malnutrition in liver diseases is multifactorial, as reduction in liver function affects both macronutrients …

Effectiveness Of Specialized Nutritious Foods And Social And Behavior Change Communication Interventions To Prevent Stunting Among Children In Badakhshan, Afghanistan: Protocol For A Quasi-Experimental Study, Sajid Bashir Soofi, Gul Nawaz Khan, Shabina Ariff, Arjumand Rizvi, Mohammad Asif Hussainyar, Cecilia Garzon, Martin Ahimbisibwe, Rafiullah Sadeed, Ahmad Reshad

Department of Paediatrics and Child Health

Stunting predominantly occurs during the first 1000 days of life and continues to the age of five years. We will aim to assess the effectiveness of specialized nutritious foods (SNF)and social and behavior change communication (SBCC) strategies during the first 1000 days of life to prevent stunting among children in two rural districts of Badakhshan, Afghanistan. This will be a quasi-experimental pre-post study with the control group utilizing qualitative and quantitative methods. Before launching the program, formative research will be conducted on the acceptability, appropriate use and SBCC strategies needed to support the introduction of intervention package. Repeated cross-sectional baseline …

Gene Expression Profiling Of Mapk Pathway Inhibitor Resistance In Cutaneous Melanoma: Can Bioinformatics Be Used To Select Better Melanoma Cell Lines?, Stephen Luebker

Theses & Dissertations

Melanoma is the deadliest form of skin cancer, and incidence has continued to increase. Half of all melanomas have a BRAF V600E mutation and respond to MAPK pathway inhibitors, including BRAF inhibitor therapy or BRAF/MEK inhibitor combination therapy, but nearly all patients develop treatment resistance. Melanoma cell lines produce variable results as models of MAPK pathway inhibitor resistance. To better understand how the genomic similarity of a melanoma cell line to patient-derived tumors affects resistance mechanisms, differences in DNA mutations and copy-number alterations were compared between melanoma cell lines profiled by the Cancer Cell Line Encyclopedia and cutaneous melanoma tumors …

Unveiling And Addressing Implementation Barriers To Routine Immunization In The Peri-Urban Slums Of Karachi, Pakistan: A Mixed-Methods Study, Amna Tanweer Yazdani, Ameer Muhammad, Muhammad Imran Nisar, Uzma Khan, Yasir Shafiq

Department of Paediatrics and Child Health

Background: Great disparities in immunization coverage exist in Pakistan between urban and rural areas. However, coverage estimates for large peri-urban slums in Sindh are largely unknown and implementation challenges remain unexplored. This study explores key supply- and demand-side immunization barriers in peri-urban slums, as well as strategies to address them. It also assesses immunization coverage in the target slums.
Methods: Conducted in four peri-urban slums in Karachi, this mixed-methods study consists of a baseline cross-sectional coverage survey of a representative sample of 840 caregivers of children aged 12-23 months, and 155 in-depth interviews (IDIs) through purposive sampling of respondents (caregivers, …

Covid-19 Newsletter (Vol. 84), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Adipose Tissue Hyaluronan Production Improves Systemic Glucose Homeostasis And Primes Adipocytes For Cl 316,243-Stimulated Lipolysis, Yi Zhu, Na Li, Mingyang Huang, Mason Bartels, Sophie Dogné, Shangang Zhao, Xi Chen, Clair Crewe, Leon Straub, Lavanya Vishvanath, Zhuzhen Zhang, Mengle Shao, Yongjie Yang, Christy M Gliniak, Ruth Gordillo, Gordon I Smith, William L Holland, Rana K Gupta, Bingning Dong, Nathalie Caron, Yong Xu, Yucel Akgul, Samuel Klein, Philipp E Scherer

Faculty, Staff and Students Publications

Plasma hyaluronan (HA) increases systemically in type 2 diabetes (T2D) and the HA synthesis inhibitor, 4-Methylumbelliferone, has been proposed to treat the disease. However, HA is also implicated in normal physiology. Therefore, we generated a Hyaluronan Synthase 2 transgenic mouse line, driven by a tet-response element promoter to understand the role of HA in systemic metabolism. To our surprise, adipocyte-specific overproduction of HA leads to smaller adipocytes and protects mice from high-fat-high-sucrose-diet-induced obesity and glucose intolerance. Adipocytes also have more free glycerol that can be released upon beta3 adrenergic stimulation. Improvements in glucose tolerance were not linked to increased plasma …

Gum Chewing, Added To Conventional Feeding, Reduces Risk Of Post-Operative Ileus After Elective Hip And Knee Arthroplasty Procedures In Elderly Population: A Protocol For A Parallel Design, Open-Label, Randomized Controlled Trial, Obada Hussein Hasan, Laraib Mazhar, Ahsun Jiwani, Dilshad Begum, Riaz Hussain Lakdawala, Shahryar Noordin

Department of Medicine

Introduction: Postoperative ileus (poi) is defined as a temporary cessation of bowel movement after a surgical procedure. Cessation of bowel movement not only leads to disturbing constipation but also may lead to nausea, loss of appetite, and food intolerance. Literature reports "sham feeding" (gum-chewing) effect as an increase in chewing and saliva which enhances the gastric emptying and overall motility of gut as a cephalic phase of digestion. Therefore, we aim to assess the effect of adding gum-chewing to the conventional postoperative feeding regimen on restoring postoperative bowel function and length of stay in hospital of patients undergoing elective hip …

Detection Of Subclinical Rheumatic Heart Disease In Children Using A Deep Learning Algorithm On Digital Stethoscope: A Study Protocol, Fatima Ali, Babar Hasan, Huzaifa Ahmad, Zahra Hoodbhoy, Zainab Bhuriwala, Muhammad Hanif, Shahab U. Ansari, Devyani Chowdhury

Department of Paediatrics and Child Health

Introduction: Rheumatic heart diseases (RHDs) contribute significant morbidity and mortality globally. To reduce the burden of RHD, timely initiation of secondary prophylaxis is important. The objectives of this study are to determine the frequency of subclinical RHD and to train a deep learning (DL) algorithm using waveform data from the digital auscultatory stethoscope (DAS) in predicting subclinical RHD.
Methods and analysis: We aim to recruit 1700 children from a group of schools serving the underprivileged over a 12-month period in Karachi (Pakistan). All consenting students within the age of 5-15 years with no underlying congenital heart disease will be eligible …

Occlusive Pulmonary Artery Thrombosis In A Healthy Neonate With No Identifiable Risk Factors, Cynthia Laviolette, Jason Turner, Latasha Lewis, Song-Gui Yang, Tim Pettitt, Kurt D Piggott

Faculty, Staff and Student Publications

Pulmonary artery thrombosis is reported in neonates with risk factors for hypercoagulability. No consensus exists regarding standard therapy for this condition. We present a neonate, with no risk factors for thrombosis, who was admitted after birth to the Pediatric Cardiac Intensive Care Unit with an occlusive left pulmonary artery thrombus.

Covid-19 Newsletter (Vol. 83), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Resilience And Its Associated Factors In Head And Neck Cancer Patients In Pakistan: An Analytical Cross-Sectional Study, Nida Zahid, Wajeeha Zahid, Wardah Khalid, Syed Iqbal Azam, Mubasher Ikram, Aneesa Hassan, Haissan Iftikhar, Shireen Shehzad Bhamani, Adnan Jabbar, Shabbir Akhtar, Moghira Siddiqui, Mohammad Sohail Awan, Nargis Asad, Khabir Ahmad

Department of Surgery Docs

Introduction: The study aimed to assess resilience and its associated factors in head and neck cancer patients, post-treatment in a low middle income country (LMIC) such as Pakistan.
Methods: An analytical cross-sectional study was conducted from November 2019 to May 2020 among head and neck cancer patients aged at least 18 years at the largest private tertiary care hospital, in Karachi, Pakistan. Information regarding their resilience scores was collected through Wagnild and Young's Resilience scale that comprises of 14 items (RS-14). Moreover, depression and anxiety were also assessed via Hospital Anxiety and Depression Scale (HADS) and social support was assessed …

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …

Polyploid Giant Cancer Cells And Ovarian Cancer: New Insights Into Mitotic Regulators And Polyploidy†, Joanne S Richards, Nicholes R Candelaria, Rainer B Lanz

Faculty, Staff and Students Publications

Current first-line treatment of patients with high-grade serous ovarian cancer (HGSOC) involves the use of cytotoxic drugs that frequently lead to recurrent tumors exhibiting increased resistance to the drugs and poor patient survival. Strong evidence is accumulating to show that HGSOC tumors and cell lines contain a subset of cells called polyploidy giant cancer cells (PGCCs) that act as stem-like, self-renewing cells. These PGCCs appear to play a key role in tumor progression by generating drug-resistant progeny produced, in part, as a consequence of utilizing a modified form of mitosis known as endoreplication. Thus, developing drugs to target PGCCs and …

Post Tuberculosis Radiological Sequelae In Patients Treated For Pulmonary And Pleural Tuberculosis At A Tertiary Center In Pakistan, Syed Muhammad Zubair, Mariyam Gohar Ali, Muhammad Irfan

Section of Pulmonary & Critical Care

Treating tuberculosis (TB) is not the end of the disease because of the wide spectrum of post TB sequelae associated with the disease. There is insufficient data on post TB radiological sequelae. The aim of this study is to evaluate the post TB radiological sequelae on chest x-rays in patients who had completed the treatment for pulmonary and pleural TB at a tertiary care hospital of a high TB burden country. This is a retrospective cross-sectional study conducted on patients treated for pulmonary and pleural TB. Adult patients (18 years or above) with a clinical or microbiological diagnosis of pulmonary …

Functional Outcomes And Complications Of Total Hip Arthroplasty With Dual Mobility Cup : An Audit, Muhammad Younus Khan Durrani, Javeria Saeed, Masood Umer, Pervaiz Hashmi

Section of Orthopaedic Surgery

Objective: To determine the functional outcomes in total hip arthroplasty with a dual mobility cup, performed in our hospital.
Methods: After receiving an exemption from the Ethics review committee of the hospital, data collection for audit was started in January 2019. Records from July 2016 to June 2018 were included. All patients who underwent total hip arthroplasty with dual mobility prosthesis without any age limit were included. A proforma was prepared to collect the required information. Data was entered and analyzed on SPSS v. 21.
Results: Two hundred and ten patients were included, 114 females and 96 males. Of the …

Aging Gracefully - Orthocon 2021, Masood Umer, Haroon Ur Rashid, Rizwan Haroon Rashid

Section of Orthopaedic Surgery

No abstract provided.

Our Experience Of Treating Adult Bone Lymphoma, A Retrospective Cross-Sectional Study In A Tertiary Care Center, Aga Khan University Hospital, Karachi, Masood Umer, Muhammad Younus Khan Durrani, Javeria Saeed, Nasir Ud Din

Section of Orthopaedic Surgery

Objective: To determine the experience at the Aga Khan University Hospital in diagnosing and treating adult patients with primary lymphoma of bone.
Methodology: All patients with Primary lymphoma of bone (PLB) that were diagnosed and/or treated at Aga Khan University Hospital, Karachi from 2005 to 2019 were included as part of this study.
Results: There were 17 patients with PLB including 13 (76.5%) males and 4 (23.5%) females with a mean age of 44 ± 16.5 years. Nine patients were between 30-59 years of age at diagnosis. The mean follow-up time of patients was 80±46.7 months. Six patients had tumours …

Our Experience Of Mega-Prosthesis In Bone Tumours: A Retrospective Cross-Sectional Study In A Tertiary Care Hospital, Masood Umer, Eraj Khurshid Khan, Javeria Saeed

Section of Orthopaedic Surgery

Objective: To evaluate the oncological and functional outcomes of bone tumour patients who underwent reconstruction with mega prosthesis.
Methodology: A retrospective study was conducted in the department of Orthopaedics Aga Khan University Hospital, Karachi. All the paediatric and adult age group patients diagnosed with malignant, benign and metastatic bone tumours and meeting the inclusion criteria were selected and analysed. Retrospective data was collected from January 2008-January 2018.
Results: Sixty-two patients, 30 (48.4%) females and 32 (51.6%) males. were included in the study. Of these 57 (92%) cases had involvement of the lower limb. The mean age was 36.95±19.1 years with …

Frequency Of Primiparous Mother Initiated Breastfeeding Earlier After Birth And Factors Associated With It In Sindh, Pakistan: A Secondary Analysis, Asma A. Bham, Sucheta Sharma, Akash Sardool, Umer F. Mujahid, Amrat Ayaz, Komal Valliani, Nawaal Maredia

Community Health Sciences

Background: Initiation of breastfeeding within one hour after delivery plays a vital role in a newborns life by not only increasing their survival rate but also reducing many life-threatening diseases in the newborn. The aim of the study was to determine frequency of early initiation of breastfeeding among primiparous mothers in a rural district of Thatta, Pakistan.
Methods: This study was conducted using survey data extracted from a cross-sectional study conducted in 2019 on prevalence of exclusive breastfeeding and factors associated with it among women in Thatta. The outcome was early initiation of breastfeeding. To determine factors associated with it, …

The Ability And Safety Of Community-Based Health Workers To Safely Initiate Lifesaving Therapies For Pre-Eclampsia In Ogun State, Nigeria: An Analysis Of 260 Community Treatments With Mgso4 And/Or Methyldopa, Akinmade A. Adepoju, Marianne Vidler, Adebayo A. Akadri, Ebun Jaiyesimi, Chimaobi C. Nwankpa, Oluwafayokemi O. Odubena, Sumedha Sharma, Larry Li, Domena Tu, Zulfiqar Ahmed Bhutta

Woman and Child Health

Objectives: To evaluate community-based health workers' ability to identify cases of hypertension in pregnancy, safely deliver methyldopa and magnesium sulphate and make referrals when appropriate.
Study design: This was part of Nigeria Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial (NCT01911494). Community-based Health Workers (CHW) recruited pregnant women from five Local Government Areas (clusters) and used mobile health aid for clinical assessment of pre-eclampsia.
Main outcome measures: The primary outcome was the number of adverse events that occurred after the administration of magnesium sulphate and/or methyldopa to pregnant women by CHWs.
Findings: Of 8790 women receiving mobile …

Variances In Bcg Protection Against Covid-19 Mortality: A Global Assessment, Zouina Sarfraz, Azza Sarfraz, Krunal Pandav, Sarabjot Singh Makkar, Saman Hasan Siddiqui, Gaurav Patel, Tania Platero-Portillo, Bishnu Mohan Singh, Mohamed Iburahim Haja Maideen, Deepika Sarvepalli, Muzna Sarfraz

Department of Paediatrics and Child Health

The BCG vaccine is known to impart nonspecific immunological benefits alongside conferring protection to tuberculosis in endemic regions. It is also known to protect against bladder cancer and other respiratory tract infections. During the coronavirus disease 2019 (COVID-19) pandemic, the BCG vaccine has gained attention due to its role in conferring protective immunity. We demonstrate the potential immunological protective mechanisms that play a role against COVID-19. We conduct a global assessment of the countries that have the highest and lowest mortality rates determined by an a priori methodology. Lastly, we discuss the potential limitations of incorporating BCG vaccines as potential …

An Audit Of Gynae-Oncology Practices In Ovarian Cancer Treatment Based On Enhanced Recovery After Surgery (Eras) Protocol Amongst Two Gynae-Oncology Units, In Uk And In Pakistan, Uzma Chishti, Munazza Akhtar, Aliya Aziz, Amber Ahmed, Desmond Pj Barton

Department of Obstetrics & Gynaecology

Objective: To compare peri-operative practices and complications in ovarian cancer patients undergoing upfront surgery for primary disease under enhanced recovery after surgery protocol and traditional practices.
Methods: The retrospective cross-sectional study was done at the gynaecology departments of St Georges Hospital, United Kingdom, and the Aga Khan Hospital, Pakistan, and comprised data of an equal number of ovarian cancer patients from each centre who underwent ovarian cancer surgery from January 2015 to December 2016. The former centre practiced the enhanced recovery after surgery protocol, while the latter centre followed traditional practices. Data was analysed using SPSS 19.|
Results: Of the …

Orofacial Manifestations Of Lyme Disease: A Systematic Review, Brenda Bradshaw, Kelsey M. Jones, Joleen M. Westerdale-Mcinnis, Holly Gaff

Dental Hygiene Faculty Publications

Purpose: Orofacial manifestations of Lyme disease can affect head and neck anatomical structures that are frequently examined by dental professionals. The purpose of this systematic review was to examine the literature for types and frequencies of orofacial manifestations documented in populations in the United States (US) with Lyme disease.

Methods: Four electronic databases (Dentistry and Oral Sciences, PubMed, Cinahl Plus, and Medline) were systematically searched during the summer of 2019 using keywords and MeSH terms to identify relevant studies. Search term alterations and synonyms were cross-checked using the US National Library of Medicine Unified Medical Language System Metathesaurus. Full-text, English …