Medical Specialties Commons^™

Sick Sinus Syndrome And Chronic Chagas Cardiomyopathy., Sagar Vadhar Do, Benjamin Sanchez Md

Department of Medicine

No abstract provided.

Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir

Marshall Journal of Medicine

Sheehan’s syndrome typically occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and can present with varying degrees of pituitary insufficiency. It is more common in underdeveloped countries, and is frequently diagnosed years after delivery due to its nonspecific signs and symptoms. Failure to lactate is a common initial symptom, while many women also report amenorrhea or oligomenorrhea. This article presents a 26-year-old female with a history of hypertension, who presented to the hospital for diarrhea, vomiting, and dizziness. Her blood pressure was 80/40 mmHg, requiring aggressive fluid resuscitation, after which it remained borderline. Further testing …

The Opioid Crisis., Jennifer Stephens Do

Department of Medicine

No abstract provided.

Col4a2 Is Associated With Lacunar Ischemic Stroke And Deep Ich: Meta-Analyses Among 21,500 Cases And 40,600 Controls, Kristiina Rannikmäe, Vhinoth Sivakumaran, Henry Millar, Rainer Malik, Christopher D Anderson, Mike Chong, Tushar Dave, Guido J Falcone, Israel Fernandez-Cadenas, Jordi Jimenez-Conde, Arne Lindgren, Joan Montaner, Martin O'Donnell, Guillaume Paré, Farid Radmanesh, Natalia S Rost, Agnieszka Slowik, Martin Söderholm, Matthew Traylor, Sara L Pulit, Sudha Seshadri, Brad B Worrall, Daniel Woo, Hugh S Markus, Braxton D Mitchell, Martin Dichgans, Jonathan Rosand, Cathie L M Sudlow

Faculty, Staff and Student Publications

OBJECTIVE: To determine whether common variants in familial cerebral small vessel disease (SVD) genes confer risk of sporadic cerebral SVD.

METHODS: We meta-analyzed genotype data from individuals of European ancestry to determine associations of common single nucleotide polymorphisms (SNPs) in 6 familial cerebral SVD genes (

RESULTS: A locus in

CONCLUSIONS: These results provide evidence of shared genetic determinants and suggest common pathophysiologic mechanisms of distinct ischemic and hemorrhagic cerebral SVD stroke phenotypes, offering new insights into the causal mechanisms of cerebral SVD.

Duodenal Varices: A Rare Cause Of Gastrointestinal Bleeding., Anam Malik Md, Abdul Aleem Md, Eric Nellis Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

An Extensive Chronic Aortic Dissection Presenting With Acute Embolic Stroke., Sijan Basnet, Naba Raj Mainali, Biswaraj Tharu, Rashmi Dhital, Dilli Ram Poudel

Reading Hospital Internal Medicine Residency

Herein, we present a rare case of extensive chronic aortic dissection with extension to bilateral subclavian arteries, bilateral common carotid arteries, right internal carotid artery, bilateral proximal external iliac arteries and simultaneous presentation of acute embolic stroke and seizure. The rarity of this case presentation and the presence of neurological features necessitated a high index of clinical suspicion to reach the definitive diagnosis. This study also demonstrates a unique situation requiring correlation between chronic aortic dissection and multi-organ system dysfunction from chronic ischemia.

Initial Experience Of A Community Gastroenterology Practice With Ultra-Slim Colonoscopy: A Case Series., Rajesh Essrani Md, Patrick Hickey Do, Hiral N. Shah Md, Paola Blanco Md

Department of Medicine

No abstract provided.

No Gastrointestinal Bleed Too Obscure: A Case Series Report Of Small Bowel Phlebectasias., Abdul Aleem Md, Anam Malik Md, Patrick Hickey Do, Anastasia Shnitser Md

Department of Medicine

No abstract provided.

Role Of 68ga-Dodatate Pet/Ct In Staging And Management Of Gastroenteropancreatic Neuroendocrine Tumor Management - A Case Series Report., Abdul Aleem Mbbs, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Gastrointestinal Involvement Of Testicular Germ Cell Tumor: A Case Report And Literature Review., Oluwaseun Shogbesan, Abdullateef Abdulkareem, Asad Jehangir, Sunila Byreddy, Sharon Swierczynski, Anthony A. Donato

Reading Hospital Internal Medicine Residency

Testicular germ cell tumors (GCT) are the commonest solid tumors in young men. Typical presentation is with painless scrotal swelling; however, symptoms related to complications or metastasis may be the initial presentation. Gastrointestinal (GI) metastasis is seen in about 5% of patients with germ cell tumors and presentation is commonly with GI bleed. It is important to have GCT as a differential diagnosis of GI bleed in young men presenting with unexplained anemia as direct questioning about scrotal swelling and genital examination when appropriate will guide further investigation and facilitate prompt diagnosis. We present a case of a 26-year-old man …

Restoration Of Completely Transected Common Bile Duct Continuity Using Single Operator Cholangioscopy, Saad Emhmed Ali, Houssam Mardini, Mohsin Salih, Steven J. Krohmer, Wesam M. Frandah

Internal Medicine

Common bile duct (CBD) injury, ranging from a partial tear to a complete transection, is a major surgical complication of cholecystectomy with significant morbidity and mortality. Proper management of these complex injuries depends on the type and extent of injury and time of recognition. Identifying and repairing injuries during cholecystectomy can prevent development of complications, but this only occurs in about one-third of cases. We report a novel technique to reconnect a transected CBD with assistance of single-operator cholangioscopy.

Resveratrol Increases Cathelicidin Expression And Offers A Novel Approach To Combat Staph Aureus Invasion., Shivtaj Mann Do, Kyle Kreitman Do

Department of Medicine

No abstract provided.

Project Echo: A Telementoring Program For Cervical Cancer Prevention And Treatment In Low-Resource Settings, Melissa S Lopez, Ellen S Baker, Andrea M Milbourne, Rose M Gowen, Ana M Rodriguez, Cesaltina Lorenzoni, Catherine Mwaba, Susan Citonje Msadabwe, José Humberto Tavares, Georgia Fontes-Cintra, Gustavo Zucca-Matthes, Donato Callegaro-Filho, Danielle Ramos-Martin, Icaro Thiago De Carvalho, Robson Coelho, Renato Moretti Marques, Thiago Chulam, Mila Pontremoli-Salcedo, Fernanda Nozar, Veronica Fiol, Mauricio Maza, Sanjeev Arora, Ernest T Hawk, Kathleen M Schmeler

Faculty, Staff and Student Publications

Cervical cancer incidence and mortality rates are significantly higher in low- and middle-income countries compared with the United States and other developed countries. This disparity is caused by decreased access to screening, often coupled with low numbers of trained providers offering cancer prevention and treatment services. However, similar disparities are also found in underserved areas of the United States, such as the Texas-Mexico border, where cervical cancer mortality rates are 30% higher than in the rest of Texas. To address these issues, we have adopted the Project ECHO (Extension for Community Healthcare Outcomes) program, a low-cost telementoring model previously proven …

Black Esophagus With Superimposed Candida In A Patient With B Cell Lymphoma: A Case Study., Christopher Lenivy Do, Patrick Hickey Do, Adam Peyton Do

Department of Medicine

No abstract provided.

A Rare Presentation Of Hsv Type 2 Hepatitis., Jahangir Khan Md, Anam Malik Md, Sandhya Venkataraman Do, Hina A. Sheikh, Amy Slenker Md

Department of Medicine

No abstract provided.

Prevalence Of Noncompliance Of Control Visits In Hypertensivepatients Treated At Primary Referral Hospitals And Related Factors, Nikko Darnindro, Johannes Sarwono

Jurnal Penyakit Dalam Indonesia

Introduction. According to WHO, hypertension is associated with 7.5 million deaths worldwide or 12.8% of all deaths. Meanwhile, based on Riskesdas 2013 in Indonesia, hypertension is still a major health problem with a prevalence of 26.5%. Noncompliance is a major cause of treatment failure of hypertension and risk factors for cardiovascular comorbidity. No previous research has been found that examines patient control compliance in the suburban community. This study aims to analyze the prevalence of patients who did not control after hypertension treatment in primary referral hospitals Methods. This study was a retrospective study, by tracking medical records in patients …

Validity And Reability Test Of Indonesian Version Of World Healthorganization Quality Of Life-Hiv Bref Questionnaire To Measurethe Quality Of Life Patients With Hiv/Aids, Nanda N. Muhammad, Hamzah Shatri, Zubairi Djoerban

Jurnal Penyakit Dalam Indonesia

Introduction. Health-related quality of life among HIV patients can be used as one of several indicators of successful therapy. WHOQOL-HIV BREF questionnaire is one of the instruments used to assess the patients’ quality of life that has been used in many countries, but never been tested for its validity and reliability in Indonesia. This study aims to determine the validity and reliability of the questionnaire WHOQOL-HIV BREF in bahasa Indonesia as a tool for measuring the quality of life of HIV patients. Methods. A cross-sectional study was conducted in HIV Integrated Service Unit Cipto Mangunkusumo General Hospital (RSCM) Jakarta in …

Peripheral Artery Disease Accompanied By Intermittentclaudication In Rural Areas Of Sikka Regency – A Cross Sectionalstudy With Pulse Palpation Methods And Its Risk Factors, Naldo Sofian, Garry Prasetyo, Stephanie Wibisono

Jurnal Penyakit Dalam Indonesia

Introduction. There are few studies regarding peripheral artery disease (PAD by intermittent claudication) on adults in Indonesia, including its risk factors. This study aims to determine relationship and comparison of PAD accompanied by intermittent intermittent claudication risk factors in adult, especially in rural areas of Sikka regency, Flores, measured by pulse palpation. Methods. A cross sectional study in 3 primary healthcare working areas in Sikka regency and consecutive sampling had been done. Interview of risk factors was conducted and blood pressure was taken from all four extremities in supine position. Ankle brachial index (ABI) value was defined as systolic blood …

Apakah Hemodialisis Tiga Kali Seminggu Lebih Baik?, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Clinical Features And Quality Of Life In End Stage Renal Diseasepatients Undergoing Hemodialysis Twice A Week Compared Tothrice A Week, Fitri Imelda, Endang Susalit, M Bonar M. Marbun

Jurnal Penyakit Dalam Indonesia

Introduction. National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NFK-KDOQI) recommends thrice weekly hemodialysis (HD) However, in Indonesia, most patients are given HD twice a week. Therefore it is necessary to investigate the clinical features and quality of life in End Stage Renal Disease (ESRD) patients undergoing twice-weekly HD. This study aimed to identify the clinical features and the quality of life in ESRD patients undergoing hemodialysis twice a week. Methods. A cross-sectional study was conducted in ESRD patients undergoing twice-weekly HD and thrice-weekly HD at Cipto Mangunkusumo Hospital and some private hospitals in Jakarta. Blood samples were obtained for …

Diagnosis And Treatment Of Celiac Disease, Harini Oktadiana, Murdani Abdullah, Kaka Renaldi

Jurnal Penyakit Dalam Indonesia

Celiac disease is a reversible, proximal immune enteropathy resulting from the interaction of dietary gluten with the intestinal immune system. Celiac disease can produce varied manifestations and may develop at any age. New cases have increased substantially, due to increase awareness and better diagnostic tools. Standard diagnosis of celiac disease is based on positive serologic tests and histopathologic examination of duodenal biopsies. Treatment of celiac disease with free gluten diet will improve symptoms, quality of life, reduce risk of malignancy and complication. Nowadays, treatment strategy of celiac disease with non-dietary therapies is still underdevelopment.

Conformance Level Of Histopathological Examination In Biopsypre Colonoscopy Compared To Histopathological Examinationin Surgery With Tumors In The Colon At The Endoscopy Andgastrointestinal Centre Of Rscm, Ifransyah Fuadi, Dadang Makmun, Ening Krisnuhoni

Jurnal Penyakit Dalam Indonesia

Introduction. Level of agreement comparison between biopsy per colonoscopy examination is used to measure of the quality of a colonoscopy examination and needed to be identified. This study aims to identify level of agreement comparison between histopathologic examination of biopsy per colonoscopy and histopathologic examination per surgical. Methods. A cross sectional study was conducted by using medical records from patients with colon tumor who had undergone histopathologic examination with biopsy per colonoscopy and then confirmed by surgical procedure in PESC RSPUN dr. Cipto Mangunkusumo between 1st January, 2006 31st December, 2015. Level of agreement calculated using comparative agreement category test …

Reliability And Validity Test Of Indonesian Version Short Form12 Quality Of Life Questionnaire In Rheumatoid Arthritis Patient, Nabil Mubtadi Falah, Rudi Putranto, Bambang Setyohadi

Jurnal Penyakit Dalam Indonesia

Introduction. Rheumatoid Arthritis is a chronic disease requiring a long-term medication affecting quality of life. Short Form 12 is a generic questionnaire to assess patients quality of life and has been validated in England. This study was designed to test reliability and validity of Indonesian version of SF-12 questionnaire. Methods. Sixty-five patients with clinically diagnosed RA using ACR/EULAR criterion were interviewed using Short Form 36 and Short Form 12 questionnaire. Validity was assessed with construct validity and external validity, while reliability tested with internal consistency and test-retest method. Results. Short-Form 12 (Indonesian Version) did not proved having a good validity, …

Diagnosis And Treatment Of Conn Syndrome: A Case Study, Muhammad Syah Abdaly, Juliyanti Juliyanti, Maruhum Bonar Marbun

Jurnal Penyakit Dalam Indonesia

Acute neuromuscular disorder is a commonly found medical condition, which may prove to be fatal in certain conditions. Hypokalemia is one possible cause of neuromuscular disorder. In patient with hypokalemia accompanied with hypertension, primary hyperaldosteronism might be the primary cause. Primary hyperaldosteronism (Conn syndrome) is clinically known as a triad, which is consists of hypertension, hypokalemia, and metabolic alkalosis. In this article, the case of a patient with neuromuscular disorder is presented, and after evaluation, it was found that the patient was suffered from the Conn syndrome

Effects Of Once-Weekly Exenatide On Cardiovascular Outcomes In Type 2 Diabetes, Rury R Holman, M Angelyn Bethel, Robert J Mentz, Vivian P Thompson, Yuliya Lokhnygina, John B Buse, Juliana C Chan, Jasmine Choi, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Steven P Marso, Peter Öhman, Neha J Pagidipati, Neil Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez

Faculty, Staff and Student Publications

BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown.

METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy.

RESULTS: …

A Case Of Rituximab-Induced Necrotizing Fasciitis And A Review Of The Literature., Abdullateef Abdulkareem, Ryan S D'Souza, Anthony Donato, Oluwaseun Shogbesan

Reading Hospital Internal Medicine Residency

Necrotizing fasciitis is a fulminant soft tissue infection characterized by rapid progression and high mortality. Rituximab is a generally well-tolerated immunosuppresive medication used for B-cell malignancies and some rheumatological disorders. We report a case of a 69-year-old male with chronic lymphocytic leukemia who suffered necrotizing fasciitis of his left lower extremity secondary to

Use Of Dark Chocolate For Diabetic Patients: A Review Of The Literature And Current Evidence, Syed Raza Shah, Richard Alweis, Najla Issa Najim, Amin Muhammad Dharani, Muhammad Ahmed Jangda, Maira Shahid, Ahmed Nabeel Kazi, Syed Arbab Shah

Internal Medicine Faculty Publications

Dietary changes are a major lifestyle factor that can influence the progression of chronic diseases such as diabetes. Recently, flavanols, a subgroup of plant-derived phytochemicals called flavonoids, have gained increasing attention, due to studies showing an inverse correlation between dietary intake of flavanols and incidence of diabetes. Flavanoids in the cocoa plant may ameliorate insulin resistance by improving endothelial function, altering glucose metabolism, and reducing oxidative stress. Oxidative stress has been proposed as the main culprit for insulin resistance. The well-established effects of cocoa on endothelial function also points to a possible effect on insulin sensitivity. The relationship between insulin …

Impact Of Vitamin A And Carotenoids On The Risk Of Tuberculosis Progression, Omowunmi Aibana, Molly F Franke, Chuan-Chin Huang, Jerome T Galea, Roger Calderon, Zibiao Zhang, Mercedes C Becerra, Emily R Smith, Alayne G Ronnenberg, Carmen Contreras, Rosa Yataco, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Low and deficient levels of vitamin A are common in low- and middle-income countries where tuberculosis burden is high. We assessed the impact of baseline levels of vitamin A and carotenoids on tuberculosis disease risk.

METHODS: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary tuberculosis case patients in Lima, Peru. We defined case patients as human immunodeficiency virus (HIV)-negative HHCs with blood samples in whom tuberculosis disease developed ≥15 days after enrollment of the index patient. For each case patient, we randomly selected 4 controls from among contacts in whom tuberculosis …

Control Of Hypertension Among Diabetic Patients In A Referral Hospital In Tanzania: A Cross-Sectional Study, Semvua B. Kilonzo, Daniel W. Gunda, Fatma Bakshi, Fredrick Kalokola, Henry A. Mayala, Hollo Dadi

Internal Medicine, East Africa

BACKGROUND: Hypertension is common among diabetic patients. The co-existence of two conditions carries an excessive risk of severe complications and mortalities. Limited information exists on the determinants of poor hypertension control among these patients. We aimed at determining the prevalence and factors associated with poor hypertension control in these patients.

METHODS: Data of diabetic patients who were also hypertensive attending an outpatient clinic from 1 August 2015 to 31 December 2015 at Bugando Medical Centre were retrospectively analyzed. Uncontrolled hypertension was defined as a blood pressure of ≥130mmHg and/or ≥80mmHg systolic and diastolic respectively. A designed questionnaire was used to …

Persistence Of Macrocytosis After Discontinuation Of Zidovudine In Hiv-Infected Patients, Inski Yu, Richard N. Greenberg, Timothy N. Crawford, Alice C. Thornton, Thein Myint

Internal Medicine Faculty Publications

The duration of macrocytosis after stopping zidovudine (ZDV) is unknown. Among 104 HIV-infected patients treated with ZDV for more than 1 year, 84 patients had macrocytosis at ZDV discontinuation. The median mean corpuscular volume (MCV) was 114.6 fL (range 100-128 fL). Patients were divided into 2 groups: those who did (resolved macrocytosis, n = 36) and did not (persistent macrocytosis, n = 48) normalize MCV at 3 to 6 months after ZDV discontinuation. Alcohol use (P = .02), smoking (P = .03), and lower (but within normal range) folic acid levels (P = .05) were related to …