Medical Specialties Commons^™

Unchain My Heart: Constrictive Pericarditis In The Setting Of Chronic Kidney Disease And Monoclonal Gammopathy Of Undetermined Significance, Neiman Ramjattan Do, Justin L. Guthier Do, Stacey Smith Md, Facp

Department of Medicine

No abstract provided.

Isolated Gastroduodenal Crohn’S Disease, Matthew Sullivan Do, Patrick Hickey Do, Saba Ahmad Md, Jeffrey Brodsky Md, Hiral N. Shah Md, Ronald Bross Md

Department of Medicine

No abstract provided.

Ectopic Cushing Syndrome And Pancreatic Cancer: A Case Report, Mira Mitry Md, Nicole M. Agostino Do, Stacey Smith Md, Facp, Vasudev G. Magaji Md, Ms

Department of Medicine

No abstract provided.

Rare Presentation Of A Massive Intermittent Upper Gastrointestinal Bleed, Bonnie Patek Do, Matthew Sullivan Do, Shashin Shah Md

Department of Medicine

No abstract provided.

Markedly Elevated Ca 19-9 In A Case Of Mirizzi’S Syndrome: An Atypical Presentation, Saba Ahmad Md, Hiral N. Shah Md, Patrick Hickey Do, Matthew Sullivan Do

Department of Medicine

No abstract provided.

Progressive Ataxia In An Aids Patient On Antiretroviral Therapy, Misbahuddin Syed Md

Department of Medicine

No abstract provided.

Microscopic Polyangiitis Presenting With A Pure Sensory Peripheral Symmetric Polyneuropathy, Matthew Sullivan Do, Craig A. Mackaness Do, James Ross Md, Facp

Department of Medicine

No abstract provided.

Chasing The Dragon: A Case Of Inhaled Heroin Overdose Resulting In Stunned Myocardium, Neiman Ramjattan Do

Department of Medicine

No abstract provided.

Adenomyomatous Hyperplasia Of The Ampulla Of Vater Masquerading As Malignancy: A Case Series, Patrick Hickey Do, Saba Ahmad Md, Matthew Sullivan Do, Miriam L. Enriquez Md, Jeffrey Brodsky Md, Hiral Shah Md

Department of Medicine

No abstract provided.

Recurrent Biliary Obstruction Overcome With Metal Biliary Stent Placement In The Surgically Altered Down Syndrome Patient For Congenital Duodenal Atresia, Patrick Hickey Do, Matthew Sullivan Do, Saba Ahmad Md, Hiral Shah Md

Department of Medicine

No abstract provided.

Coronary Artery Dissection After Blunt Chest Trauma., Fahad Shamsi,, Javed Tai, Syedah Saira Bukhari

Department of Medicine

Blunt thoracic trauma may result in cardiac injuries ranging from simple arrhythmias to fatal cardiac rupture. Coronary artery dissection culminating in acute myocardial infarction (AMI) is rare after blunt chest trauma. Here we report a case of a 37-year-old man who had an AMI secondary to coronary dissection resulting from blunt chest trauma after involvement in a physical fight.

Hypertensive Crisis, Burden, Management, And Outcome At A Tertiary Care Center In Karachi, Aysha Almas, Ayaz Ghouse, Ahmed Raza Iftikhar, Munawar Khursheed

Department of Medicine

Objectives:. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi.
Methods: This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included.
Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) …

Clinical, Lifestyle, Socioeconomic Determinants And Rate Of Asymptomatic Intracranial Atherosclerosis In Stroke Free Pakistanis., Ayeesha Kamran Kamal, Farzin Majeed, Omrana Pasha, Hasan Rehman, Muhammad Islam, Iqbal Azam Syed, Muhammad Saleem Ilyas, Munawar Hussain, Kamran Masood, Bilal Ahmed, Sumaira Nazir, Zafar Sajjad, Scott E. Kasner

Department of Medicine

Background: Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region.

Methods: The study is an analytical prospective cross-sectional study of 200 adults from Radiology Departments of two diagnostic centers in Karachi. Eligible participants confirmed the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS) and underwent an interview covering medical, socio demographic, lifestyle and anthropometric evaluation using locally validated and standardized definitions. Magnetic Resonance Images (MRI) were centrally reviewed to detect ICAD using the criterion used …

Diuretic Induced Hyponatremia In Hypertensive Patients., Aysha Almas, Nayla Ahmed, Fareed Khawaja, Aamir Hameed

Department of Medicine

Diuretics are the recommended antihypertensive by several international guidelines. This study was designed to determine the association of hyponatremia in hypertensive patients on diuretic therapy. This was a case control study conducted at the Aga KhanUniversity Hospital, Karachi in adult inpatients (> 18 years) who were known hypertensive. Cases were defined as hypertensives with hyponatremia and controls were defined as hypertensives without hyponatremia. Outcome was hyponatremia. Exposed were those using diuretics. Out of 1800 hypertensive patients sampled by the ICD-9-Coding; 1191 (66%) fulfilled the inclusion criteria. Cases n (%) were 553 (46.4) and controls were 638 (53.5). Among 553 cases …

Quality Of Life In Patients With Thalassemia Major In A Developing Country., Sarah H. Siddiqui, Ruba Ishtiaq, Faiza Sajid, Raihan Sajid

Department of Medicine

Objective: To determine the problems faced by thalassemic patients in their personal, psychological and social life.

Study Design: A cross-sectional multi-centre survey.

Place and Duration of Study: Karachi, Lahore and Quetta Centres of Fatimid Foundation, from October 2009 to October 2010.

Methodology: An indigenously developed Qualifty of Life (QoL) questionnaire modified from SF-36 questionnaire was administered to 101 transfusion dependent subjects suffering from thalassemia major. Variables were analyzed using SPSS version 15 for descriptive statistics.

Results: The mean age of the subjects was 10.5 years ranging from 6 - 21 years. Less than one third of the patients felt that …

Case Report: Nocardia Infection Associated With Ectopic Cushings., Azra Rizwan, Aqiba Sarfaraz, Abdul Jabbar, J. Akhter, Najmul Islam

Department of Medicine

Background: Cushing's syndrome results from exposure to excess glucocorticoids. Ectopic Cushings is endogenous ACTH dependant form of Cushing's associated with markedly raised ACTH and cortisol levels. This leads to an impaired immune response, setting the stage for occurrence of opportunistic infections. Nocardiosis is a gram positive bacterial infection caused by aerobic actinomycetes in genus Nocardia. We report a series of patients diagnosed with ectopic Cushings, having pneumonia with Nocardia spp. In one of these cases, the manifestations of Cushing's disappeared with treatment for Nocardia.

Case Presentation: Two middle aged men of Asian descent presented to the Endocrine clinic: the first …

Age And Site Of Colonic Neoplastic Lesions: Implications Of Screening In South Asia., Manzoor Hussain, A. B. Khalid, Syed Ahsan Ali, Wasim Jafri, Saeed Hamid, Anam Javed, Sana Wahab

Department of Medicine

Objective : To evaluate the Age of patients and the site of Colonic Neoplastic Lesions (CNL) and to determine the appropriate screening strategy for Colorectal Carcinoma (CRC) (sigmoidoscopy versus colonoscopy) in our population.

Methods : This is a cross sectional study. Data of all patients more than 16 years of age who underwent full colonoscopic examination at the Aga Khan University hospital between January 2011 till December 2013 and were diagnosed to have CRC or advanced adenomas (defined as polyp more than 1 cm and/or having villous morphology on histology) was recorded. Lesions found distal to the splenic flexure were …

Chest Pain Observation: Does Post-Discharge Stress Testing Influence Physician Management Decisions?, Yasser K. Khalil Md, Prasant Pandey Md, Melvin H. Schwartz Md, Maida Abdul-Latif Md

Department of Medicine

No abstract provided.

Rapid Door-To-Balloon Time (≤ 30 Minutes) In The Treatment Of Acute St-Elevation Myocardial Infarction (Stemi) Is Associated With Reduced Length Of Hospital Stay And Improved Clinical Outcomes, Yassir Nawaz Md, Ataul Qureshi Md, Navin K. Subrayappa Md, Orlando E. Rivera Rn, Bruce Feldman Do, Nainesh C. Patel Md

Department of Medicine

No abstract provided.

Pulsating Left Breast After Trans-Apical Aortic Valve Implantation: An Ominous Sign, Yassir Nawaz Md, Navin K. Subrayappa Md, Sumit Duggal Md, Ataul Qureshi Md, Muppidi Raghunandan Md

Department of Medicine

No abstract provided.

Pilot Study To Assess Benefit Of Virtual Reality Game System, Wii, On Balance And Gait In Persons With Parkinson's Disease, Peter J. Barbour Md, Amy L. Kerstetter Pt, Allyn Danni Pt, Ncs, Atp, Mscs, Jolene Hammer Pt, Michael J. Weiss Mph, Sandra M. Tremblay Pt, Ms, Cws, Mscs

Department of Medicine

No abstract provided.

An Uncommon Complication During Trans-Aortic Valve Replacement, Sanjeev Nair Md, Yassir Nawaz Md, Nainesh C. Patel Md, David A. Cox Md, William Combs Md, Raymond L. Singer Md, J Patrick Kleaveland Md

Department of Medicine

No abstract provided.

The Effect Of Shortening Door To Balloon Time (<90 Minutes) In Stemi Patients Transferred From Outside Hospitals, Ataul Qureshi Md, Yassir Nawaz Md, Navin K. Subrayappa Md, Orlando E. Rivera Rn, Nainesh C. Patel Md

Department of Medicine

No abstract provided.

Unique Diagnostic Challenges Of Cushings From Large Bilateral Adrenal Adenoma And Mifepristone Utilization For Hypercortisolism Prior To Surgery, Vasudev G. Magaji Md, Ms, Sarah Park Do, Maura Bucciarelli Do, Katie Mastoris Do, Scott Beman Md

Department of Medicine

No abstract provided.

Diabetes Insipidus In Patient With Bodydysmorphic And Eating Disorder, Vasudev G. Magaji Md, Ms, Gretchen Perilli Md

Department of Medicine

No abstract provided.

Rare Case Of Klinefelters Syndrome With 48xxyy, Vasudev G. Magaji Md, Ms, Deborah Feden Crnp, Gretchen Perilli Md

Department of Medicine

No abstract provided.

1,25 Oh Vitamin D Mediated Hypercalcemia In A Patient With Malignancy Without Lymphoma (Poster), Katie Mastoris Do, Sarah Park Do, Vasudev G. Magaji Md, Ms

Department of Medicine

No abstract provided.

Mechanical Thrombectomy Versus Intrasinus Thrombolysis For Cerebral Venous Sinus Thrombosis: A Non-Randomized Comparison., Fazeel M. Siddiqui, Chirantan Banerje, Susanna M. Zuurbier, Qing Hao, Chul Ahn, Glenn L. Prid, Mohammad Wasay, Charles B.L.M. . Majoie, David Liebeskind, ,Mark Johnson, Jan Stam

Department of Medicine

Small retrospective studies have shown the benefit of endovascular treatment with intrasinus thrombolysis (IST) or mechanical thrombectomy (MT) with/without IST (MT ± IST) in cases of multifocal cerebral venous thrombosis (CVT). Our study compares the mortality, functional outcome and periprocedural complications among patients treated with MT ± IST versus IST alone. We reviewed clinical and angiographic findings of 63 patients with CVT who received endovascular treatment at three tertiary care centers. Primary outcome variables were discharge mortality and neurological dysfunction, and intermediate (three months) and long-term (>six months) morbidity. The modified Rankin scale (mRS) was used to assess morbidity. …

Myocarditis Complicating Plasmodium Vivax Malaria., Noreen Nasir, Saima Lalani, Zahra Aziz Samani, Aysha Almas

Department of Medicine

Myocarditis complicating Plasmodium vivax malaria is an extremely rare complication. We report this development in a young girl who was diagnosed to have P. vivax malaria on the basis of peripheral smear. While undergoing antimalarial treatment, she developed respiratory distress requiring invasive mechanical ventilation and inotropic support due to cardiogenic shock secondary to myocarditis. Cardiovascular complications are well recognized with Plasmodium falciparum malaria. Nevertheless, a high index of suspicion should be maintained for the same in Plasmodium vivax infection especially if symptoms of heart failure develop in a young patient.

Refeeding Syndrome In A Young Girl With Anorexia Nervosa., Om Parkash, Adil Ayub, Shahab Abid

Department of Medicine

We report the case of a 20-year-old anorexic girl (BMI=12.9), who was misdiagnosed the first time and developed severe electrolyte imbalances due to lack of awareness about refeeding syndrome. Few cases of RS have been reported in literature and protocols have been suggested for prevention and management of this syndrome, including the awareness of circumstances in which it is most likely to develop, refeeding slowly and building-up micronutrient content over several days. Improved awareness and understanding of refeeding syndrome along with a well-coordinated plan are vital in delivering safe and effective nutritional rehabilitation. We suggest a slow and gradual increase …