Medical Specialties Commons^™

Loss Of The Tumor Suppressor Genes P53 And Brca1 In Prophylactic Mastectomy Cancer Patients, Garrett Griffith Losh

Presidential Scholars Theses (1990 – 2006)

More importantly, this study has shown that prophylactic mastectomy surgery is a viable and worthwhile treatment to prevent breast cancer recurrence. It is hoped that this information will increase the knowledge of breast cancer. For the same reason, this paper has attempted to explain what cancer is while describing how the genetics of a person cause or contribute to its development. Most of all, it is hoped that this paper will emphasize the severity of this disease in the United States today and tomorrow .

Ureterorenoscopy In Children, K Rasheed, A Memon

Section of Paediatric Surgery

No abstract provided.

Intestinal Obstruction In Adults At The Aga Khan University Hospital, S Q. Hasnain, M Ahmed

Department of Surgery Docs

During the period January, 1987 to June, 1991, 208 adults with mechanical bowel obstruction were managed at The Aga Khan University Hospital (AKUH). Post-operative adhesions accounted for 34% of the cases and were the most frequent cause of intestinal obstruction. External hemia (16%), malignancy (13.5%) and tuberculous stricture (10%) were the next most frequent causes. The predominance of adhesive intestinal obstruction at AKUH shows a trend towards a Western disease pattern. Socioeconomic status was a significant determinant of the cause of obstruction. The proportion of self paying to welfare patients was significantly lower in tuberculous obstruction as compared with adhesive …

Conjoined Twins - A Review Of Literature With Two Case Studies, Naaeem Uz-Zafar Khan, Nadeem Ullah Khan, Khalid Matin, Adnan Zaidi

Department of Emergency Medicine

Two cases of conjoined twins have been reported. A review of literature is given.

Clients' Perceptions Of Preparedness For Discharge Home Following Total Hip Or Knee Replacement Surgery, Cindy H. Nicholson

Masters Theses

This study used a descriptive design to evaluate discharge planning by examining the clients' perception of preparedness for discharge home following total hip or knee replacement surgery. The conceptual framework was based upon the Betty Neuman Systems Model.; This study used Lawton's (1991) "Discharge Preparation Questionairre" to ascertain the clients' perceptions of preparedness in 10 discharge categories. Perceived preparation was measured using a 5 point summated rating scale. The study site was a 42-bed orthopedic unit in a 119 bed acute care hospital in Southeast Michigan. The convenience sample, of 46 adult clients, were interviewed by phone 3 days following …

A Comparison Of Four Muscle Relaxant Techniques And Their Incidence Of Postoperative Myalgia In Ambulatory Patients, William James Garske Jr.

Community & Environmental Health Theses & Dissertations

Postoperative myalgia was measured 24 and 72 hours following the administration of four different anesthetic regimens to 36 patients undergoing outpatient or 23-hour admission procedures. Each patient, ASA class I or II, was to undergo procedures of limited duration, 30 to 90 minutes, and surgical stimulation, including procedures such as knee arthroscopy, hernia repair, and breast biopsy. Anesthesia was induced with propofol 1.5 mg/kg, fentanyl 50 mcg, and maintained with O₂ , N₂O, and isoflurane. Group I (n=20), the control, received no muscle relaxant and was maintained with mask ventilation. Group II (n=5) received succinylcholine 1.5 mg/kg …

A Simple Technique Of Umbilical Port Closure In Laparoscopic Cholecystectomy, A Khan, M N. Siddiqui, M Ahmed

Department of Surgery Docs

No abstract provided.

Retained Stones In The Common Bile Duct: Results Of Management, Kamran Hamid, R Azami, W Jaffery, T Hameed

Department of Surgery Docs

Seventeen patients underwent treatment for retained common bile duct stones. In 7 patients the stones were removed via a T-tube tract using steerable catheters while 5 patients underwent ERCP and sphincterotomy and 5 underwent surgical re-exploration. Considering morbidity, mortality, success rate and patients' stay in the hospital, non-operative modalities should be the treatment of choice for retained common bile duct stones.

Harpoon Extraction Of A Common Bile Duct Stone Impacted At The Ampulla Of Vater With Needle-Knife Sphincterotome., Vivian Mcalister, Andre Roy, Ron Passi

Data and Test Instruments

The urgency of dealing with impacted ampullary stones is underlined in the first case reported by Opie6 at the autopsy of a young woman. Impacted ampullary stones that prevent papillary cannulation and standard sphincterotomy make up less than 5% of common bile duct stones seen at ERCP.3 Several series suggest the safe use of needle-knife sphincterotomy to create a choledochoduodenal fistula or to allow subsequent standard sphincterotomy in this situation. These series have also reported failure to extract the stone so that surgical removal was required.3,4Successful sphincterotomy may facilitate the early diagnosis of tumors that cause the ampulla to bulge. …

Penile Constrictive Band Injury, Zafar Nazir, Khalid Rasheed, Farhat Moazam

Section of Paediatric Surgery

Penile strangulation caused by a thread or human hair is an uncommon cause of urethral injury described in paediatric piactice. Five children presented with this entity to the Aga Khan University Hospital, Karachi between August, 1991 and August, 1992. Three children had uneventful recoveries after removal of the contricting agent. Two patients developed urethrocutaneaus fistulae and partial amputation of the penis because of late presentation Early recognition and removal of the constricting agent is necessary to prevent serious complications

Colorectal Cancer., Lester Rosen Md, Facs

Department of Surgery

No abstract provided.

Vocal Cord Paralysis Following Endotracheal Intubation, S Akhtar, Tanveer Janjua, Jameel Hyder

Section of Otolaryngology, Head & Neck Surgery

No abstract provided.

Re: Recertification., Geoffrey G. Hallock Md

Department of Surgery

No abstract provided.

The Effects Of Orthopaedic Surgery And Dorsal Rhizotomy On Selected Gait Characteristics Of Cerebral Palsy Children, Danielle M. Lanoue

Rehabilitation Sciences Theses & Dissertations

Surgical management of cerebral palsy children typically involves multiple orthopaedic surgeries in order to achieve and maintain the maximum functional level of ambulation. Orthopaedic intervention to address lower extremity spasticity often includes: muscle lengthenings, muscle releases and tendon transfers. The most recent advance in management of lower extremity spasticity has been through a neurosurgical approach; selective dorsal rhizotomy. The long term effects of dorsal rhizotomy are still being investigated. Through the use of instrumented gait analysis, the specific objective results of both of these types of surgeries can be investigated. The purpose of this retrospective study was to examine the …

An Unusual Presentation Of Ischiorectal Abscess, K Hameed, R Maniar

Department of Surgery Docs

No abstract provided.

Role Of Thymectomy In Myasthenia Gravis, Sohaila Mohsin Ali, Aziz Sonawalla, Irfan Altafullah, Hizbullah Sheikh

Section of Urology

Thirteen patients with myasthenia gravis underwent total thymectomy between January, 1988 and December, 1991. The duration of symptoms prior to surgery varied from 2 months to 20 years. In a follow-up ranging from 2 months to 4 years, 11 patients showed a significant improvement with either complete discontinuation of medication of a marked reduction in doses. One patient with a small benign thymoma showed some improvement but subsequently required stepping up of anticholinesterase medication and addition of steroids and immune suppressants; another patient with atrophic thymic tissue had complete remission after thymectomy but developed myasthenic symptoms six months later requiring …

Letter To The Editor., Wanda W. Young Scd, Stanley J. Smith Md, Facs, Joseph C. Young Md, Facs, Michael Rhodes Md, Facs

Department of Surgery

No abstract provided.

Congenital Pyloric Atresia And Epidermolysis Bullosa, Zafar Nazir, Zeba Batool Attar, Farhat Moazam

Section of Paediatric Surgery

Congenital pyloric atresia with epidermolysis bul­losa is recognized as a rare but distinct entity which is uniformly fatal^1,2. Until 1990 only 20 cases have been reported in the English literature^3,4. We present an additional case managed at the Aga Khan University Hospital to demonstrate the difficulties encountered in the management of such infants.

Heterogeneity Of Methotrexate Binding In Human Colon Tumor Cells, M P. Iqbal, N Mehboobali, M A. Waqar, M Ahmed

Department of Biological & Biomedical Sciences

[3H]-methotrexate binding at pH 5.0 and pH 7.2 by the cytosol of tumor tissues and the surrounding normal areas of the gastrointestinal tract of patients suffering from colon or gastric cancer has been used to identify in these cells the presence of a binder of methotrexate having low-affinity for this drug in addition to the enzyme dihydrofolate reductase. Scatchard analysis of the [3H]-methotrexate binding data by a colon tumor sample also reveals that there are two binders of this drug present in the cytosol of these cells. The association constant (Kass) for one binder of methotrexate is = 5.6 x …

In Defense Of Intrauterine Repair Of Cleft Lip., Geoffrey G. Hallock Md

Department of Surgery

No abstract provided.

Save A Life- Diagnose Subarachnoid Haemorrhage!, Rashid Jooma, Iqtidar H. Bhatti

Section of Neurosurgery

No abstract provided.

Susceptibility Of Hepatic Microcirculation To Reperfusion Injury: A Comparison Of Adult And Suckling Rats., Alan M. Yahanda Md, Facs, C N Paidas, M G Clemens

Other Specialties

Primary graft failure and vascular thromboses are frequent complications of liver transplantation, yet the mechanisms responsible remain unclear. Previous work from our laboratory has shown that hepatic reperfusion injury results in damage at the microvessel level. The present study was performed to determine whether an increased susceptibility of immature animals to microvascular injury during reperfusion might be a contributing factor in these complications. Suckling (35 to 50 g) or adult (250 to 400 g) rats were subjected to 30 or 60 minutes of hepatic ischemia to the left and median lobes followed by 90 minutes of reperfusion. Control animals were …

Extracorporeal Shock Wave Lithotripsy, Jamsheer J Talati

Section of Urology

After circumcision the first operations done on man were for bladder stone. Done by charlatans the operation often resulted in loss of life and caused the early lithotomists to maintain a peri­patetic existence, vanishing from the town the night after surgery was performed. About two centuries ago stones became a common disease amongst kings: surgeons took over from the charlatans and commenced blind skilful mechanical lithotripsy where a curved instrument was introduced per urethram, its jaws opened to engage the stone which was then crushed by a mechanical (screw driven) closure of the jaws. Now-a-days urinary bladder lithotripsy is done …

Three Cheers For Elective Hysterectomy, Mary Guinan

School of Public Health Faculty Research

Hysterectomy is the second (after cesarean section) most commonly performed major surgical procedure in the United States today.1 About [650,000 American women will have hysterectomies in 1989. Thirty-seven percent of all US women will have had a hysterectomy by the time they reach age 60. The number of hysterectomies increased dramatically Born 1965 to 1975, but then leveled off and decreased to the present level of about 7 per 1000 women. The ~ghest rates occur in women aged 35 to 44 years, the age group the so called baby boomers are now entering in large numbers. Therefore, if the age-specific …

Medical Student, Resident, And Faculty Use Of A Computerized Literature Searching System, Ronald J. Markert, Anthony J. Parisi, H. Verdain Barnes, Steven Cohen, Kim X. Goldenberg, Lawrence E. Mieczkowski, Margaret M. Dunn

Department of Surgery Faculty Publications

The experiences of medical students, residents, and faculty with a computerized literature searching system were evaluated. Third-year medical students, internal medicine and family practice residents, and full-time and voluntary faculty at one medical school had the opportunity to use a full-text and bibliographic medical literature retrieval system free of charge for an eleven-month period. Subjects conducted nearly nine thousand literature searches over a period of 942 system hours. Questionnaire data showed that participants could learn to use and would use an electronic information system, felt capable of using the system, utilized the system for a variety of purposes and in …

The Radial Forearm Donor Site: A Locus Minoris Resistentiae., Geoffrey G. Hallock Md

Department of Surgery

No abstract provided.

A Scarcity Of Organs, Judith Areen

Journal of Legal Education

No abstract provided.

Nutritional Parameters Predicting Postoperative Infections, Jamsheer Talati, M. Shameem, Mohammad Khurshid

Department of Surgery Docs

Thirteen nutritional parameters viz body mass index (BMI), mid arm circumference (MAC), mid calf circumference (MCC), triceps skin fold thickness (TST), abdominal skin fold thickness (ASFT), abdominal girth at umbilicus (AG U), haemoglobin (Hb), total leucocytes count (WBC), absolute lymphocyte count (ALC), serum proteins (Prot.), serum albumin (AIb), serum total iron binding capacity (TIBC) and serum iron (Fe) were estimated in 52 (36 male and 16 female) consecutive patients admitted to a surgical service at the Abbasi Shaheed Hospital, Karachi. Nine males and one female developed surgical infections whilst the wounds of 27 males and 15 females healed by primary …

Dexamethasone And The Serious Head Injury, Rashid Jooma

Section of Neurosurgery

No abstract provided.

A Comparison Of Myofascial Release And Ultrasound In The Treatment Of Musculoskeletal Pain, Dianna Lynn Bishop

Community & Environmental Health Theses & Dissertations

The purpose of this study was to evaluate the effectiveness of myofascial release (MFR) compared to ultrasound (US) in treating musculoskeletal pain. Data in the form of number of trigger points, active range-of-motion of the affected joint, pain scale measurement, and a Treatment Response Questionnaire score, were collected.

The Mann-Whitney U value supported that the MFR group outranked the US group 47 percent when ranking the percent change in trigger point number from pre to post treatment.

The Mann-Whitney U value supported that the MFR group outranked the US group in pain scale measurement. Kruskal-Wallis H value supported that MFR …