Medical Specialties Commons^™

Cardiac Transplant Following Failed Fontan Or Glenn Procedures., Naveen L. Pereira, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Near-Infrared Characterization Of Breast Tumors In Vivo Using Spectrally-Constrained Reconstruction, Subhadra Srinivasan, Brian W. Pogue, Ben Brooksby, Shudong Jiang, Hamid Dehghani, Christine Kogel, Wendy A. Wells, Steven P. Poplack, Keith D. Paulsen

Dartmouth Scholarship

Multi-wavelength Near-Infrared (NIR) Tomography was utilized in this study to non-invasively quantify physiological parameters of breast tumors using direct spectral reconstruction. Frequency domain NIR measurements were incorporated with a new spectrally constrained direct chromophore and scattering image reconstruction algorithm, which was validated in simulations and experimental phantoms. Images of total hemoglobin, oxygen saturation, water, and scatter parameters were obtained with higher accuracy than previously reported. Using this spectral approach, in vivo NIR images are presented and interpreted through a series of case studies (n=6 subjects) having differing abnormalities. The corresponding mammograms and ultrasound images are also evaluated. Three of six …

Detection Of Microcracks During Bone Cutting Using Acoustic Emission Techniques, Ashkan Safari, Ger Reilly, Brendan Mccormack

Conference Papers

Surgeons may use a number of cutting instruments such as osteotomes and chisels to cut bone during operative procedures. The initial loading of cortical bone during the cutting process results in the formation of microcracks in the vicinity of the cutting zone with main crack propagation to failure occurring with continued loading; microcracking acts as a stimulus for main crack formation and has also been shown to occur during the propagation of the main crack. It has also been reported that Acoustic Emission (AE) is generated due to microcrack formation and crack growth, prior to, and during final fracture in …

Magnification In Images Produced By Five Popular Digital Lateral Cephalometric Machines, Gretchen Marie Schnepper

Loma Linda University Electronic Theses, Dissertations & Projects

Modern digital lateral cephalometric images are produced by machines that vary in a number of critical features such as: 1) machine geometry, 2) movement (or lack of movement) of the x-ray source, 3) movement (or lack of movement) or x-ray detectors, 4) cephalostat geometry and 5) digital data manipulations by proprietary software. The purpose of this study was to evaluate the magnification characteristics of images produced by five commercial digital lateral cephalometric machines. These digital image magnification characteristics were then compared with images produced by an analog cephalometric machine. The two goals of this study were to: 1) measure the …

Prevention Of Deep Vein Thrombosis And Pulmonary Embolism In The Perioperative Period: A Review, Aliya Ahmed

Department of Anaesthesia

No abstract provided.

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 …

Resonance Frequency Analysis As A Determinant Of Implant Initial Stability, Negar Tabandeh

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: The clinicians' decision regarding immediate loading is largely determined by the assessment of initial stability of the dental implant. Computed tomographic assessment of recipient site bone quality, insertion resistance torque and post-insertion resonance frequency are currently the only objective methods of measurement establishing initial stability.

Purpose: A study was designed to measure resonance frequency of root form dental implants placed in cadaver jaws. The resonance frequency values were compared to previous subjective and objective data reported in prior studies in the series.

Materials and Methods: Resonance frequency measurements were secured using the Osstell ™ mentor unit on 4.0 X …

The Effect Of Electrical Stimulation On Blood Flow In Chronic Wounds In Patients With And Without Diabetes, Daryl J. Lawson

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Only 3% of the U S population is afflicted by diabetes, yet one of the most common chronic wounds is the diabetic ulcer. Decrease in blood flow may be one reason why only 31% of neuropathic diabetic ulcers heal in 20-weeks. The purpose of this investigation was to compare healing rates and blood flow of chronic stage III and IV wounds in people with diabetes and those without diabetes over four weeks of treatment. Blood flow was measured before, during, and after stimulation using one of two different electrical stimulation waveforms in a 32°C room.

Subjects …

Perioperative Anaesthetic Management Of A Patient With Relapsed Aplastic Anaemia, Aliya Ahmed, Abdul Monem

Department of Anaesthesia

Aplastic anaemia occurs due to failure of blood cell production by bone marrow. All blood cell counts are low. Untreated patients may die within one year mainly due to uncontrolled infection due to neutropenia. Anaemia and thrombocytopenia cause troublesome symptoms and necessitate frequent red cell and platelets transfusions. Surgery poses a very high risk for these patients because of the several complications that can occur in the perioperative period. In this paper we report on a patient with relapsed aplastic anaemia who was optimized preoperatively and underwent a total abdominal hysterectomy under general anaesthesia.

Comparison Of Different Methods Of Assessing Ridge Width Prior To Implant Placement, Lung-Cheng Chen

Loma Linda University Electronic Theses, Dissertations & Projects

The aim of this study was to compare the following 3 methods of assessing alveolar ridge dimensions prior to placement of dental implants: 1) ridge mapping measurement before surgical flap reflection using a caliper; 2) direct caliper measurement following surgical exposure of the bone, and 3) measurement using images from cone beam computerized tomography.

Sixteen subjects having 25 sites for planned implant placement or ridge augmentation were recruited. An acrylic stent was fabricated for each patient. The stent provided 3 buccal/lingual pairs of consistent measurement points for each implant site, located 4, 7 and 10 mm from the summit of …

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 …

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.

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.

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 …

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 …

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

Department of Anaesthesia

No abstract provided.

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 …

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 …

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.

Effect Of Four-Day Psyllium Supplementation On Bowel Preparation For Colonoscopy:A Prospective Double Blind Randomized Trial [Isrctn76623768], Walter A. Salwen, Marc D. Basson

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Patients with new onset constipation or presumed hemorrhoid bleeding frequently require the use of both fiber supplements and diagnostic colonoscopy. We sought to determine whether preliminary fiber supplementation would alter the tolerability or efficacy of a standard bowel preparation for colonoscopy

Methods

A prospective, double blind, randomized trial was designed to compare a short course of a psyllium-based supplement versus placebo prior to a colon lavage. Patients were given an unlabeled canister of powder, and instructed to take 1 tablespoon with 8 oz of water bid for 4 days before colonoscopy. A 4-liter polyethylene based glycol lavage was …

Peri-Operative Management Of A Patient With Uncontrolled Polycythemia Vera For Above Knee Amputation, A Ahmed, K A. Shah

Department of Anaesthesia

No abstract provided.

Measured Effects Of Rapid Palatal Expansion On Nasal Cavity Volume Utilizing Cbct, Jon Neal Robinson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate and predict the expected changes that occur in the nasal cavity volume following rapid palatal expansion. Eighteen subjects (11 female, 7 male), ages 9 to 18, requiring rapid palatal expansion in conjunction with comprehensive orthodontic treatment, were selected for the study. Rapid palatal expansion was accomplished using the standard, banded hyrax appliance. Three-dimensional cone beam computed tomograms using the NewTom 9000™ were acquired before and after expansion. Serial coronal slices of the nasal cavity were made using the QV9000™ software program. The resultant serial images were imported into 3-D Doctor™ for analysis …

Midazolam And Thiopentone Co-Induction: Looking For Improvement In Quality Of Anaesthesia, M A. Khan, F A. Khan

Department of Anaesthesia

Objective: To evaluate improvement in quality of anaesthesia induction using thiopentone and midazolam for co-induction of anaesthesia. An additional end point was taken as loss of response to a tetanic stimulation (50 Hz) delivered for 5 seconds after the loss of verbal contact and eyelash reflex.Methods: Ninety ASA I and II patients, within the age range of 20-60 years were studied. Patients were randomly divided into three equal groups; A, B and group C.Results: Onset of induction and loss of response to a tetanic stimulation was achieved earlier in group B as compared to the other study groups (p < 0.05).CONCLUSION: Co-induction with midazolam 0.02 mg x kg(-1) followed by thiopentone 3 mg x kg(-1) was superior to other two groups. Induction of anaesthesia in this group was found to be smoother and faster, provided better hemodynamic stability, better airway maintenance and with lesser incidence of untoward effects.

The Radiopacity Of 29 Resin Restorative Materials Compared To Enamel, Peter Lubisich Iv

Loma Linda University Electronic Theses, Dissertations & Projects

The radiodensity of a composite resin can greatly influence a clinician's ability to analyze a restoration for failure. The purpose of this study was to determine the relative radiopacities of 29 resin restorative materials compared to enamel, and to verify the comparable radiopacity between shades of 23 of the restorative composite resin materials. Composite resin discs measuring >5mm in diameter and 2 mm in thickness were made and polymerized. Radiographs were taken of the composite resin discs, which included an aluminum step wedge for calibration and a densitometer was used to measure the radiodensity of the composite resin samples. The …

A Comparison Of Morphine And Nalbuphine For Intraoperative And Postoperative Analgesia, F N. Minai, F A. Khan

Department of Anaesthesia

Introduction: Short acting narcotics are not available in Pakistan and the supply of drugs like morphine and pethidine is short and erratic; therefore there is a need for investigating acceptable alternatives for analgesia, to be used for balanced anaesthesia.Objective: We studied the agonist-antagonist narcotic nalbuphine compared to morphine, for intra and postoperative pain relief in total abdominal hysterectomies.Methods: In a randomised double blind trial, fifty ASA I and II patients in two groups of twenty five each were given equianalgesic doses of morphine and nalbuphine. Hemodynamic stability, intraoperative analgesia, recovery profiles, incidence of side effects and need for postoperative supplements …