Medical Specialties Commons^™

Frequency Of Nsaid Induced Peptic Ulcer Disease, Saeed Hamid, Javed Yakoob, Wasim Jafri, Shanul Islam, Shahab Abid, Muhammad Islam

Section of Gastroenterology

Objective:

To determine the frequency of peptic ulcer disease in patients on nonsteroidal anti-inflammatory drugs (NSAID).

Methods:

Record of eight hundred and twenty consecutive patients undergoing upper gastrointestinal (GI) endoscopy; from January 1998 to December 2000 were reviewed. The endoscopic diagnosis varied from gastritis, peptic ulcer to duodenitis. The use of NSAID was documented by reviewing medical records of patients with peptic ulcer.

Results:

Peptic ulcers were found in 43% (353/820) patients. NSAID associated peptic ulcers were identified in 14.7% (52/353) patients. Diclofenac and aspirin were most common NSAIDs associated with peptic ulcers in 32.7% (17/52) and 30.7% (16/52) patients, …

Incidence And Outcome Of Cardiopulmonary Resuscitation In Patients With Shunted Single Ventricle: Advantage Of Right Ventricle To Pulmonary Artery Shunt., Eric M. Graham, Geoffrey A. Forbus, Scott M. Bradley, Girish S. Shirali, Andrew M. Atz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Immunization Update, Karl M. Hess, Jeffery A. Goad

Pharmacy Faculty Articles and Research

"Immunization represents a very effective primary prevention strategy to curb the rate of vaccine preventable diseases...Pharmacists can play a leading role in vaccination by serving as an advocate, facilitator, and active immunizer. As an advocate, pharmacists provide vaccine education while motivating people to get immunized. As a facilitator, pharmacy’s can host other groups, such as the visiting nurses association, to come into the pharmacy and vaccinate. As an active immunizer, however, pharmacists serve their greatest role by giving immunizations to adolescents and adults."

Socio-Demographic Correlates Of Betel, Areca And Smokeless Tobacco Use As A High Risk Behavior For Head And Neck Cancers In A Squatter Settlement Of Karachi, Pakistan, Samia Mazahir, Rabia Malik, Maria Maqsood, Kanwal Aliraza Merchant, Farida Malik, Atif Majeed, Zafar Fatmi, Muhammad Rizwanulhaq Khawaja, Shehzad Ghaffar

Community Health Sciences

Background

Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of …

Racial Disparity And Socioeconomic Status In Association With Survival In Older Men With Local/Regional Stage Prostate Cancer: Findings From A Large Community-Based Cohort, Xianglin L. Du, Shenying Fang, Ann L. Coker, Corinne Aragaki, Janice N. Cormier, Yan Xing, Beverly J. Gor, Wenyaw Chan

CRVAW Faculty Journal Articles

BACKGROUND

Few studies have examined the outcomes for Hispanic men with prostate carcinoma and incorporated socioeconomic factors in association with race/ethnicity in affecting survival, adjusting for factors on cancer stage, grade, comorbidity, and treatment.

METHODS

We studied a population-based cohort of 61,228 men diagnosed with local or regional stage prostate carcinoma at age 65 years or older between 1992 and 1999 in the 11 SEER (Surveillance, Epidemiology, and End Results) areas, identified from the SEER-Medicare linked data with up to 11 years of followup.

RESULTS

Low socioeconomic status was significantly associated with decreasing survival in all men with prostate carcinoma. …

Follicular Dendritic Cell Sarcoma Of Lymph Node - A Rare Entity, Safoorah Khalid, Nausheen Yaqoob, Shahid Pervez

Department of Pathology and Laboratory Medicine

Follicular dendritic cells (FDC) are non-lymphoid, non-phagocytic accessory cells in the immune system that are essential for antigen presentation and germinal center reaction regulation1. These cells are CD21+, CD35+, CD1a- and S100 protein + and they show desmosomes ultrastructurally.

The most commonly involved sites by FDC tumors are lymph nodes but may arise at a variety of extranodal sites including oral cavity, tonsil, gastrointestinal tract and liver. Most studies represent single case reports or case series.

Our patient presented with tumor in the lymph nodes. Histology revealed tumor cells with abundant eosinophilic cytoplasm, hyperchromatic and pleomorphic nuclei, and prominent nucleoli. …

Maternal And Fetal Complications Of Antiphospholipid Syndrome: A Case Report With Long-Term Follow-Up, Tahira Naru, Mohammad Khurshid, Zafar Nazir

Department of Obstetrics & Gynaecology

We report a case of a 26- year old woman having antiphospholipid syndrome in pregnancy with long-term follow up. She presented with recurrent miscarriages, venous thrombosis, avascular necrosis of femoral head, mid-cerebral artery infarction and skin ulcers. Antiphospholipid syndrome is a recognized disorder of pregnancy. Diagnosis requires a high index of suspicion when evaluating women with recurrent pregnancy losses and vascular thrombosis. A low dose aspirin combined with heparin can reduce morbidity and improves the pregnancy outcome.

Uterine Perivascular Epithelioid Cell Tumour Presenting As A Cervical Mass, Najamul Sahar Azad, Shahid Pervez, Naila Kayani, Aliya Begum Aziz

Department of Pathology and Laboratory Medicine

Perivascular Epithelioid Cell Tumour (PEComa) also known as myelomelanocytic tumours are uncommon, recently described mesenchymal tumours that include angiomyolipoma, clear cell "sugar" tumour of the lung, lymphangioleiomyoma and tumours composed predominantly of epithelioid cell morphology. A predilection for uterus has been described. However up till now only 14 cases of uterine PEComas have been described. All of these were seen in adult females in the peri and post menopausal age group (from 40-75years), and almost all were located in the region of body of uterus. A single case in the upper cervical region has been reported with uterine PEComatoses. We …

Treponema Denticola In Disseminating Endodontic Infections, F. Foschi, Jacques Izard, H. Sasaki, V. Sambri, C. Prati, R. Müller, P. Stashenko

Department of Food Science and Technology: Faculty Publications

Treponema denticola is a consensus periodontal pathogen that has recently been associated with endodontic pathology. In this study, the effect of mono-infection of the dental pulp with T. denticola and with polymicrobial “red-complex” organisms (RC) (Porphyromonas gingivalis, Tannerella forsythia, and T. denticola) in inducing disseminating infections in wild-type (WT) and severe-combined-immunodeficiency (SCID) mice was analyzed. After 21 days, a high incidence (5/10) of orofacial abscesses was observed in SCID mice mono-infected with T. denticola, whereas abscesses were rare in SCID mice infected with the red-complex organisms or in wild-type mice. Splenomegaly was …

Relief Of Symptoms, Side Effects, And Psychological Distress Through Use Of Complementary And Alternative Medicine In Women With Breast Cancer, Cecile A. Lengacher, Mary P. Bennett, Kevin E. Kip, Lois Gonzalez, Paul Jacobsen, Charles E. Cox

Nursing Faculty Publications

No abstract provided.

Broncho Alveolar Carcinoma (B.A.C.), Ahmed N. Abbasi, Muhammad Irfan, Syed Arsalan Raza

Section of Pulmonary & Critical Care

No abstract provided.

Cervical Cancer Survival By Socioeconomic Status, Race/Ethnicity, And Place Of Residence In Texas, 1995–2001, Katherine S. Eggleston, Ann L. Coker, Melanie Williams, Guillermo Tortolero-Luna, Jeanne B. Martin, Susan R. Tortolero

CRVAW Faculty Journal Articles

Objective: The current study explored whether socioeconomic status (SES), race/ethnicity, and rural residence may be linked to poorer cervical cancer survival by stage at diagnosis.

Methods: Data from 7,237 cervical cancer cases reported to the Texas Cancer Registry from 1995–2001 were used to address the association by stage at diagnosis and cause of death. Zip code-level census data were used to classify residence and to develop a composite variable for SES. Multilevel Cox proportional hazards modeling was used to estimate hazard ratios

(HR) and 95% confidence intervals (CI).

Results: Late stage at diagnosis was a strong predictor …

Phloroglucinol In Irritable Bowel Syndrome, Wasim Jafri, Javed Yakoob, Sajjad Hussain, Nadim Jafri, Muhammad Islam

Section of Gastroenterology

Objective: To determine the efficacy and tolerability of phloroglucinol, an antispasmodic agent in the treatment of Irritable Bowel Syndrome (IBS). Methods: It was an open label (quasi interventional) study. One hundred patients coming to the gastroenterology clinics of Aga Khan University Hospital with IBS as defined by the Rome II criteria were enrolled between February 2004 and September 2004 to participate in the trial and were treated as outpatients. Phloroglucinol (Himont) 50mg orally three times daily was given for two months. Symptoms were assessed before and during treatment using a questionnaire. Results: One hundred patients were enrolled in the study. …

The Science Of Prevention Strategies, Rachel Abrishami, Jeffery A. Goad

Pharmacy Faculty Articles and Research

"From newborn screening for Phenylkentonurea (PKU) and the birth dose of Hepatitis B vaccine to prostate and breast cancer screening and pneumococcal immunization for older adults, the science of health maintenance is multi-tiered and spans the lifetime of an individual. Primary, secondary, and tertiary prevention strategies are used in concert with each other to enable healthcare professionals and their patients to sustain and improve the quality of life."

Neuroleptic Malignant Syndrome: Need For Early Diagnosis And Therapy, Humaira M. Khan, Nadir A. Syed, Mughis Sheerani, Bhojo Khealani, Ayeesha Kamal, Mohammad Wasay

Department of Medicine

Background: Neuroleptic Malignant Syndrome (NMS) is a medical entity that has received little attention in the clinical settings in Pakistan. The aim of our study was to review the predisposing factors, outcomes and characteristics of in-patients diagnosed with NMS.

Methods: We performed a retrospective chart review of all cases (age > 15 years) at a tertiary care center in Karachi between January 01, 1990 and November 30, 2001, diagnosed using ICD 10 coding. Data was collected using a standardized data entry form and statistical analysis was performed using Epi Info 6, Version 6.02.

Results: There were a total of 20 patients …

Guide To A Successful Pregnancy: A Resource Manual For Pregnant And Parenting Young Women In Las Vegas, Nevada Institute For Children's Research And Policy Reports

Nevada Institute for Children's Research and Policy Reports

A Guide to a Successful Pregnancy.

• Are you Pregnant? Taking a pregnancy test
• First steps of Pregnancy: Options of pregnancy, health plans, obtaining medical care such as a doctor
• Months 1, 2, 3: Maintaining a healthy diet, what you should stay away from, exercise, symptoms of danger, and normal symptoms of pregnancy
• Months 4, 5, 6: Following a routine, classes available during pregnancy, normal pregnancy symptoms
• Months 7, 8, 9: Following a routine, normal pregnancy symptoms
• Labor and Delivery: Symptoms of labor, symptoms of danger
• Parenting: Normal symptoms after birth, Routine to follow to return to normal state, Breast feeding …

Effect Of A Paediatric Incentive Spacer And Reinforcement Of Inhalation Technique Training In Preschool Children, Jasminka Murdzoska

Theses : Honours

Incorrect inhaled drug delivery technique is a common problem in paediatric asthma [1-4]. Previously, device technique training has been shown to significantly improve inhaler skills, using subjective methods, namely check-list analysis [5-8]. However, more objective measures are needed to examine more comprehensively the effect of training in preschool children and parents. Resistance to regular asthma therapy is also a frequent problem when attempting to treat young children. Reasoning with young children can be very difficult and parents often have to struggle with their child to achieve compliance [2]. The Funhaler spacer (FH) (Funhaler™; InfaMed, Australia) has been developed in an …

Innate Antiviral Response Targets Hiv-1 Release By The Induction Of Ubiquitin-Like Protein Isg15, Atsushi Okumura, Gengshi Lu, Ian Pitha-Rowe, Paula M. Pitha

Dartmouth Scholarship

The goal of this study was to elucidate the molecular mechanism by which type I IFN inhibits assembly and release of HIV-1 virions. Our study revealed that the IFN-induced ubiquitin-like protein ISG15 mimics the IFN effect and inhibits release of HIV-1 virions without having any effect on the synthesis of HIV-1 proteins in the cells. ISG15 expression specifically inhibited ubiquitination of Gag and Tsg101 and disrupted the interaction of the Gag L domain with Tsg101, but conjugation of ISG15 to Gag or Tsg101 was not detected. The inhibition of Gag-Tsg101 interaction was also detected in HIV-1 infected, IFN-treated cells. Elimination …

Small B Cell Non-Hodgkins Lymphoma In Pakistan, Kanwal Aftab, Yasmin Bhurgri, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective: To study the pattern of small B cell lymphomas in Pakistan.

Methods: This descriptive study was carried out at the Aga Khan University Hospital pathology department including 1721 cases of Non-Hodgkins Lymphoma (NHL) diagnosed during a period of five years (1998-2002) and classified according to REAL/WHO classification. The antibodies used included Leukocyte Common Antigen (LCA), Pan B (CD20, CD79a), Pan T (UCHL-1), Bcl 2, Mib 1(Ki 67) and Cyclin D1 (Dako, Denmark).

Results: Out of the 1721 NHL cases, only 140 (8.1%) could be categorized as small B-cell NHL. The study group comprised small lymphocytic lymphoma/chronic lymphocytic leukemia (58 …

Giardiasis In Patients With Dyspeptic Symptoms, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Saeed Hamid, Hasnain Ali Shah, Lubna Rizvi, Muhammad Islam, Hizbullah Shaikh

Section of Gastroenterology

AIM:

To investigate the prevalence of giardiasis in patients with dyspeptic symptoms.

METHODS:

Clinical records of consecutive patients who attended Gastroenterology Department at Aga Khan University Hospital from January 2000 to June 2003 and had esophagogastroduodenoscopy (EGD) with duodenal biopsies and international classification of diseases 9th revision with clinical modifications (ICD-9-CM) coded with giardiasis were studied.

RESULTS:

Two hundred and twenty patients fulfilled the above criteria. There were 44% (96/220) patients who were giardiasis positive, 72% (69/96) of them were males and 28% (27/96) of them were females. There were 65% (81/124) males and 35% (43/124) females who were giardiasis …

Role Of Rapid Urease Test And Histopathology In The Diagnosis Of Helicobacter Pylori Infection In A Developing Country, Javed Yakoob, Wasim Jafri, Shahab Abid, Zaigham Abbas, Saeed Hamid, Muhammad Islam, Kashif Anis, Hasnain Ali Shah, Hizbullah Shaikh

Section of Gastroenterology

Background

The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.

Methods

One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard …

Encephalopathy Caused By Bartonella Henselae Following Cat Scratch, Joseph L. Yozviak Do, Facp, John Margraf Md, Marcelo Gareca Md

Department of Medicine

No abstract provided.

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

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Frequency Of Irritable Bowel Syndrome In College Students., Wasim Jafri, Javed Yakoob, Nadim Jafri, Muhammad Islam, Qazi Masroor Ali

Section of Gastroenterology

Background:

This study was carried out to investigate the presence of irritable bowel syndrome (IBS) in college students and compare its distribution in the non-medical college and medical college students.

Methods:

We collected data from 508 students by inviting them to fill out a questionnaire based on Rome II criteria for the diagnosis of IBS from November 2001 to February 2004. Two major cities Karachi and Bahawalpur were selected and it was coordinated by the section of Gastroenterology, Department of Medicine, Aga Khan University Hospital and Quaid-e-Azam Medical College, Bahawalpur.

Results:

A total of 508 subjects with males 43 %(220/508) …

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 …

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

Flow Cytometric And Demographic Analysis Of T Cell Acute Lymphoblastic Leukemia In Pakistani Population., M R. Khawaja, S S. Allana, N N. Akbaral, S N. Adil, M. Khurshid, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background: This study was carried out to analyze the proportion of T cell acute lymphoblastic leukemia (TALL) among all acute lymphoblastic leukemia (ALL) in Pakistani population and its correlation with the demographic features. Accuracy of cell surface markers used in flow cytometric analysis of the leukemic cells was also determined.

Methods: Data of 209 consecutive cases of acute lymphoblastic leukemia (ALL) presenting between July 1995 and July 2003 was analyzed. Flow cytometry was performed on all ALL cases using the standard protocols. TALL markers included CD3, CD5 and CD7.

Results: Proportion of TALL among known ALL Pakistani patients was 17.22%. …

Prognostic Indicators In Patients With Primary Intraventricular Haemorrhage, Bilal Hameed, Bhojo A. Khealani, Tahseen Mozzafar, Mohammad Wasay

Department of Medicine

Objectives: Primary intraventricular haemorrhage (PIVH) is a rare clinical entity. We sought to evaluate risk factors, clinical and radiological features, and outcome of patients with PIVH.

Materials and Methods: Cases of PIVH were identified from cohort of patients with non traumatic intracerebral haemorrhage (ICH) by reviewing the radiological data. Their charts were reviewed and demographic, clinical, radiological and laboratory data was recorded and analyzed. Chi square and t test were used to determine predictors of poor outcome.

Results: Fifteen of 677 (2%) patients with ICH had PIVH. Nine (60%) were men. Median age was 56 years. Predisposing factors included hypertension …

Rapidly Developing Optic Neuritis Secondary To Ethambutol: Possible Mechanism Of Injury, Sajjad Ali, Uzma Usman, Mohammad Wasay

Department of Medicine

Optic neuritis has been described among the toxic effects of Ethambutol. This side effect is dose related. The mean duration of Ethambutol induced optic neuritis (EON) is three months. We report a case of EON after few days of exposure to Ethambutol and the symptoms resolved after discontinuation of Ethambutol. This most likely represents an idiosyncratic reaction which is different as compared to dose related optic neuritis.

Ponderal Index, Jabeen Fayyaz

Department of Emergency Medicine

No abstract provided.