Medical Specialties Commons^™

Barriers And Perceptions Regarding Code Status Discussion With Families Of Critically Ill Patients In A Tertiary Care Hospital Of A Developing Country: A Cross-Sectional Study, Ahsan A. Syed, Aysha Almas, Quratulain Naeem, Umer F. Malik, M. Tariq

Department of Medicine

Background: In Asian societies including Pakistan, a complex background of illiteracy, different familial dynamics, lack of patient’s autonomy, religious beliefs, and financial constraints give new dimensions to code status discussion. Barriers faced by physicians during code status discussion in these societies are largely unknown.
Aim: To determine the barriers and perceptions in discussion of code status by physicians.
Design: Questionnaire-based cross-sectional study.
Setting and participants: This study was conducted in the Department of Medicine of The Aga Khan University Hospital, Karachi, Pakistan. A total of 134 physicians who had discussed at least five code statuses in their lifetime were included. …

Importance Of Physical Activity In Women, Minaz Mawani

Department of Medicine

No abstract provided.

Slc11a1 Polymorphisms And Host Susceptibility To Cutaneous Leishmaniasis In Pakistan., Mariam Sophie,, Abdul L Hameed Institute Of Biomedical And Genetic Engineering (Ibge), 24-Mauve Area, G- 9/1, Islamabad, Pakistan., Akhtar Muneer, Azam J. Samdani, Saima Saleem, Abid Azhar

Department of Medicine

Background:The vector-borne cutaneous leishmaniasis (CL) is endemic in several regions of Pakistan mainly affecting poor populations. Host genetic factors, particularly SLC11A1 (solute carrier transmembrane protein) within macrophages, play a crucial role in disease pathology and susceptibility. Association of SLC11A1 with cutaneous leishmaniasis, a neglected tropical disease, is not well established. Inconsistencies have been observed within different populations worldwide with respect to genetic susceptibility. This study was designed to investigate genetic variation(s) in SLC11A1 and to assess possible association with cutaneous leishmaniasis in Pakistan.

Results: Eight polymorphisms (rs2276631, rs3731864, rs2290708, rs2695342, rs201565523, rs17215556, rs17235409, rs17235416) were genotyped across SLC11A1 in …

Havoc In The Gut: Ipilimumab-Induced Prolonged Steroid Dependent Autoimmune Gastroenterocolitis., Abdul Aleem Md, Anam Malik Md, Eric Nellis Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Tct-732 Relationship Between Stent Diameter, Platelet Reactivity, And Adverse Events After Pci: Analysis From The Adapt-Des Study., Björn Redfors, Philippe Généreux Md, Bernhard Witzenbichler Md, Ajay J. Kirtane Md, Thomas Mcandrew, Bruce R. Brodie Md, Michael J. Rinaldi Md, Timothy D. Henry Md, David A. Cox Md, Ernest L. Mazzaferri Md, Ori B. Yehuda, Roxana Mehran Md, Gregg W. Stone Md

Department of Medicine

Background

Small vessel diameter and residual high platelet reactivity (HPR) have both been associated with adverse events after PCI. We sought to determine whether a specific interaction exists between HPR and stent diameter in regard to outcomes after PCI.

Methods

We stratified pts in the prospective ADAPT-DES registry who underwent successful single-lesion PCI with DES according to whether or not they received only small diameter stents (diameter ≤2.5 mm). Pts receiving ≤2.5 mm stents were compared to pts receiving a stent with a diameter >2.5 mm using propensity score (PS) adjusted Cox proportional hazards regression. HPR was defined as P2Y12 …

Tct-733 Association Between Hypertension, Platelet Reactivity, And The Risk Of Adverse Events After Pci: Analysis From The Adapt-Des Study, Björn Redfors, Xin Huang, Bernhard Witzenbichler Md, Shmuel Chen, Yangbo Liu, Bruce R. Brodie Md, Michael J. Rinaldi Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Roxana Mehran Md, Ajay J. Kirtane Md, Ori B. Yehuda, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Sports Cardiology: Core Curriculum For Providing Cardiovascular Care To Competitive Athletes And Highly Active People., Aaron L. Baggish Md, Robert W. Battle Md, James G. Beckerman Md, Alfred A. Bove Md, Phd, Rachel J. Lampert Md, Benjamin D. Levine Md, Mark S. Link Md, Matthew W. Martinez Md, Silvana M. Molossi Md, Phd, Jack Salerno Md, Meagan M. Wasfy Md, Rory B. Weiner Md, Michael S. Emery Md

Department of Medicine

The last few decades have seen substantial growth in the populations of competitive athletes and highly active people (CAHAP). Although vigorous physical exercise is an effective way to reduce the risk of cardiovascular (CV) disease, CAHAP remain susceptible to inherited and acquired CV disease, and may be most at risk for adverse CV outcomes during intense physical activity. Traditionally, multidisciplinary teams comprising athletic trainers, physical therapists, primary care sports medicine physicians, and orthopedic surgeons have provided clinical care for CAHAP. However, there is increasing recognition that a care team including qualified CV specialists optimizes care delivery for CAHAP. In recognition …

Tct-546 Performance Of The Dual Antiplatelet Therapy (Dapt) Score In The Adapt-Des Study., Sorin J. Brener, Ajay J. Kirtane Md, Michael J. Rinaldi Md, Bernhard Witzenbichler Md, Franz-Josef Neumann Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest Mazzaferri Md, Bruce R. Brodie Md, Roxana Mehran Md, Thomas Mcandrew, Gregg W. Stone Md

Department of Medicine

Background

The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remains in dispute, particularly after 12 months. The DAPT Score was developed from the DAPT trial to identify pts who may benefit the most from extended therapy. We sought to assess the performance of the DAPT risk score in the all-comers Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents (ADAPT-DES) registry, and to test the utility of additional predictors of events on its performance.

Methods

Patients free from ischemic or hemorrhagic events after 1 year of DAPT after successful DES implantation were analyzed. The DAPT score …

Bilateral Moyamoya Disease In A 2-Year-Old Pakistani Male Treated With Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome., Shahvaiz Magsi, Adeel Khoja, Mansoor Ali Merchant Rameez, Ariba Khan, Noman Ishaque

Department of Medicine

Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS), in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness) at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA). …

Clinical Manifestations And Outcomes Of Pulmonary Aspergillosis: Experience From Pakistan., Nousheen Iqbal, Muhammad Irfan, Ali Bin Sarwar Zubairi, Kauser Jabeen, Safia Awan, Javaid Khan

Department of Medicine

Introduction: Pulmonary aspergillosis has variable course of illness, severity and outcomes depending on underlying conditions. There is limited data available on the clinical manifestations and outcome of pulmonary aspergillosis from Pakistan.

Methods: To determine the clinical manifestations and outcome of pulmonary aspergillosis in a tertiary care hospital a retrospective study was conducted from 2004 to 2014 in patients admitted with pulmonary aspergillosis at the Aga Khan University Hospital Karachi, Pakistan.

Results: Of the 280 cases with provisional diagnosis of aspergillosis 69 met the inclusion criteria. The mean age was 45±15.7 years, 48 (69.6%) were men and 21 (30.4%) had diabetes …

Quality Of Life After Stroke In Pakistan, Wardah Khalid, Shafquat Rozi, Tazeen S. Ali, Iqbal Azam Syed, Michael Mullen, Saleem Illyas, Qamarunnisa, Nabila Soomro, Ayeesha Kamran Kamal

Department of Medicine

Background: There is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden.

Methodology: We used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36. In addition; we assessed complications, psychosocial and functional disability of stroke survivors. Following this quantitative survey, …

Comments On The Editorial On Ild Published In The September 2016 Issue Of Jpma, Ali Bin Sarwar Zubairi

Department of Medicine

No abstract provided.

Clinical Outcomes Of Pneumocystis Pneumonia From A Tertiary Care Centre In Pakistan., Ali Bin Sarwar Zubairi, Hira Shahzad, Afia Zafar

Department of Medicine

Objective: To assess the predisposing immunocompromised states, administration of pneumocystis jirovecii pneumonia prophylaxis, the disease course and outcomes of patients with pneumocystis jirovecii pneumonia.

Methods: The retrospective study was conducted at the Aga Khan University Hospital in Karachi. The medical records of patients diagnosed with pneumocystis jirovecii pneumonia from January 1995 to October 2015 were retrieved. Baseline characteristics, clinical course, treatment, and mortality rates were noted. SPSS 19 was used for data analysis.

Results: Of the 37 patients, 24(64.9%) were men and 13(35.1%) were women. The overall mean presenting age was 47.08±16.21 years(range: 19-83 years). Ten (27%) patients were positive …

Cardiac Consequences Of The Heroin Epidemic: Loperamide Causing Torsades De Pointes, Justin L. Guthier Do, Apurva Vyas Md

Department of Medicine

No abstract provided.

Tct-353 Underweight Status, Platelet Reactivity, And 2-Year Clinical Outcomes In Patients Undergoing Pci With Des: An Adapt-Des Study Analysis., Puja B. Parikh Md, Ajay J. Kirtane Md, Giora Weisz Md, Thomas D. Stuckey Md, M Ozgu Ozan Ms, Bernhard Witzenbichler Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Bruce R. Brodie Md, Ernest Mazzaferri Md, Roxana Mehran Md, Gregg W. Stone Md

Department of Medicine

Background

The relationships between underweight status, platelet reactivity, and clinical outcomes after PCI with DES are not well understood.

Methods

ADAPT-DES was a prospective, multicenter study of 8582 pts treated with aspirin and clopidogrel in whom routine measurement of P2Y12 reaction units (PRU) by VerifyNow testing was performed following successful DES implantation. Pts were classified according to the following body mass index (BMI) groups: Underweight (BMI/m2), normal weight (20 kg/m2 ≤ BMI/m2), overweight (25 kg/m2 ≤ BMI/m2), and obese (BMI ≥30 kg/m2).

Results

Underweight pts were more often female, smokers, had higher rates of peripheral arterial disease and renal insufficiency, …

Tct-352 Proportion Of Ischemic Risk After Pci Mediated By High Platelet Reactivity On Clopidogrel: Analysis From The Adapt-Des Study., Björn Redfors, Ori Ben-Yehuda Md, Sheng-Hsuan Lin, Ariel Furer, Ajay J. Kirtane Md, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Akiko Maehara Md, Philippe Généreux Md, Gennaro Giustino Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Girma M. Ayele, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Tct-237 Outcomes After Successful Pci Of Severely Calcified Lesions Using Rotational Atherectomy, Cutting Balloon, Or Balloon Angioplasty Only Before Second-Generation Drug-Eluting Stent Implantation., Björn Redfors, Philippe Généreux Md, Akiko Maehara Md, Ajay J. Kirtane Md, Rushad Dordi, Bernhard Witzenbichler Md, Giora Weisz Md, Thomas D. Stuckey Md, Michael J. Rinaldi Md, Franz-Josef Neumann Md, D Christopher Metzger Md, Timothy D. Henry Md, David A. Cox Md, Peter L. Duffy Md, Ernest L. Mazzaferri Md, Claire Litherland Ms, Roxana Mehran Md, Gary Mintz, Gregg W. Stone Md

Department of Medicine

No abstract provided.

Primary Malignant Pleural Effusion With A Profound Type B Lactic Acidosis, Rachel Kinney Do, Christine Saraceni Do, Eliot L. Friedman Md

Department of Medicine

No abstract provided.

An Unusual Pathogen Causing Native Valve Endocarditis., Aneela Hussain, Nosheen Nasir, Bushra Jamil

Department of Medicine

No abstract provided.

Increased Level Of Morning Surge In Blood Pressure In Normotensives: A Cross-Sectional Study From Pakistan, Aysha Almas, Fatehali Tipoo Sultan, Khawar Kazmi

Department of Medicine

Objective: To determine the mean morning surge (MS) in blood pressure, the frequency of increased morning surge in normotensive subjects, and to compare those with morning surge with those without MS.
Study Design: A cross-sectional, comparative study.
Place and Duration of Study: The Department of Medicine, The Aga Khan University Hospital, Karachi, from April 2011 to March 2012.
Methodology: Adult normotensive healthy volunteers aged 35 to 65 years were inducted. Their ambulatory blood pressure (ABP) was measured over a 24-hour period, using digital ambulatory blood pressure monitors. Morning surge was calculated as the average of four readings after waking …

Not All That Wheezes Is Asthma, Areeb Zamir Md, Noor Salam Md, Andy Iriza Do, Andres Zirlinger Md

Department of Medicine

No abstract provided.

Successful Overtube Assisted Ercp: A Single-Center Case Series, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md, Tanveer Imam Md

Department of Medicine

No abstract provided.

Closing The Gap: Deployment Of An Over-The-Scope Clip After Colonic Endoscopic Mucosal Resection, Matthew Sullivan Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Dome-Type Carcinoma Of The Ascending Colon: A Case Report, Patrick Hickey Do, Shanth A. Goonewardene Md, Shashin Shah Md, Hiral N. Shah Md, Anthony G. Auteri Md

Department of Medicine

No abstract provided.

Idiopathic Hyperammonemia And Rituximab Therapy, Samer Bolis Do, Daniel Schwed-Lustgarten, James Ross Md, Facp

Department of Medicine

No abstract provided.

Hemophagocytic Lymphohistiocytosis, An Overlooked Culprit Of Disseminated Intravascular Coagulation, Shivtaj Mann Do

Department of Medicine

No abstract provided.

Erdheim-Chester Disease And Neuroendocrine Gastrointestinal Neoplasms, Samer Bolis Do, Patrick Hickey Do, Hiral N. Shah Md, Shashin Shah Md

Department of Medicine

No abstract provided.

Ampullary Carcinoid: A Case Report, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Adenovirus Induced Rhabdomyolysis Causing Hemodialysis Dependent Acute Renal Failure, Deepika Jain Md, Andres Zirlinger Md, Matthew J. Miles Do

Department of Medicine

No abstract provided.

Appearances Can Be Deceiving - Colon Cancer Mimicking Ileocolitis, Abdul Aleem Md, Muhammad Qasim Md, Patrick Hickey Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.