Medical Specialties Commons^™

Unusual Presentations Of Wegener's Granulomatosis: Pitfalls In Early Diagnosis, Syed Mansoor Ahmed Shah, Malik Anas Rabbani, Ambreen Gul, Aasim Ahmad

Section of Nephrology

Wegener's Granulomatosis (WG) is a disorder characterized by necrotizing granulomatous vasculitis that primarily affects the upper and lower respiratory tracts and the kidneys. Although the cause is unknown, there is strong evidence that this is an autoimmune disease and immunosuppressive therapy with cyclophosphamide and corticosteroids efficiently relieves the symptoms and, prevents relapses. We report on four cases of WG that presented with unusual features. The first patient presented with vague joint pain, blackish discoloration of the skin and leg ulcers. The second patient presented as fever of unknown origin and gingival hyperplasia. The third patient presented with hearing loss while …

Department Of Radiology-Annual Executive Summary Report-July 1, 2002 To June 30, 2003, Vijay M. Rao, M.D.

Department of Radiology Administrative Documents and Reports

94 page Department of Radiology Annual Executive Summary Report, July 1, 2002 to June 30, 2003, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Renal Cortical Necrosis: A Case Series Of Nine Patients & Review Of Literature, Syed Sohail Ali, Syed Zulfiqar Rizvi, Suhail Muzaffar, Aasim Ahmad, Akhtar Ali, Sheema H. Hassan

Department of Biological & Biomedical Sciences

Background: The purpose of this study is to review cases of renal cortical necrosis (RCN) which we came across during a period of five years, confirmed on needle biopsy specimens, with literature available so far.
Methods: All renal biopsy records between January 1996 to December 2001 at the Aga Khan University Hospital, Karachi, Pakistan were reviewed to identify patients with histologically proven renal cortical necrosis. Seven patients were also referred by the department of Nephrology, Lady Reading Hospital, Peshawar, Pakistan. Patients' medical records were reviewed for demographic, clinical, and follow up data.
Results: There were total of nine patients identified …

The Role And Regulation Of Heat Shock Protein 27 In Retinal Ischemic Preconditioning, Norris Andrew Whitlock

MUSC Theses and Dissertations

Introduction: Vision loss resulting from retinal ischemia is associated with several systemic and ocular diseases. In the retina, ischemia is thought to lead to neuronal cell death by initiating a series of events that include oxidative stress, glutamate excitotoxicity, and intracellular Ca2+ overload. Attempts to prevent ischemic retinal degeneration have included the use of NMDA receptor antagonists, Ca2+ channel blockers, and antioxidants. These treatments have had limited success due to incomplete retinal protection and development of adverse side-effects. This has caused researchers to look toward endogenous protective mechanisms, such as ischemic preconditioning (IPC) in order to identify new strategies to …

Structural Analyses Of Phycodnaviridae And Iridoviridae, Alan A. Simpson, Narayanasamy Nandhagopal, James L. Van Etten, Michael G. Rossmann

Nebraska Center for Virology: Faculty Publications

The Phycodnaviridae, Iridoviridae and related viruses, with diameters of 1500±2000 A Ê , are formed from large trigonal arrays of hexagonally close-packed capsomers forming the faces of icosahedra [Yan et al. (2000), Nature Struct. Biol. 7, 101-103; Nandhagopal et al. (2002), Proc. Natl Acad. Sci. USA, 99, 14758-14763]. Caspar and Klug predicted that such structures could be assembled from hexameric capsomers [Caspar & Klug (1962), Cold Spring Harbor. Symp. Quant. Biol. 27, 1-24], as was subsequently found in numerous icosahedral viruses. During the course of evolution, some viruses, including the virus families …

Febrile Seizures: Factors Affecting Risk Of Recurrence In Pakistani Children Presenting At The Aga Khan University Hospital, Z Habib, S Akram, S Ibrahim, B Hasan

Department of Paediatrics and Child Health

Objectives: To (a) describe the effect of temperature rise on seizure recurrence in the ER (b) investigate the effect of age, gender, family and developmental history, type, duration and multiple seizures, past history and number of seizures and treatment given (either late or early) on seizure recurrence in the ER and (c) explore prognostic indicators for seizure recurrence.
Methods: Data from 352 children [ages 3-84 months; 220 males (62.5%) 132 females (37.5%)] was taken using chart reviews for the years January 1998-August 2000 inclusive, from the Pediatric department of the Aga Khan University Hospital. Descriptive statistics, Chi-square, and Discriminant …

A Comparison Between Conventional And Holistic Exercise Interventions On Physiological Function In The Elderly, Gavin R. Mccormack

Theses: Doctorates and Masters

Aging is characterised by a decline in physiological function. The rate of this decline can depend on certain lifestyle factors, genetics, and the environment. Although life expectancy is slowly increasing, there is a need to reduce the time spent in debilitated, and non-independent states by elderly individuals. Preventive measures need to be implemented to reduce dependency and improve the quality of life for elderly individuals. One such preventive and remedial measure is the use of exercise and physical activity. Because limited exercise prescription exists for the elderly population, there is a need to determine the effectiveness of exercise interventions that …

Clarifying The Lower Incidence Of Birth Defects In The Midwest Of Western Australia : A Study Using Capture Re-Capture Methodology, Donna Baker

Theses: Doctorates and Masters

In April 2000 the Western Australian Birth Defects Registry held its 20th Anniversary Scientific Symposium to signify the first 20 years of the Birth Defects Registry in Western Australia. At the Symposium, significant trends and occurrences in birth defects within Western Australia over the past 20 years were addressed. One factor highlighted in the Registry's 1980-1999 report was that birth defects were reported less frequently in rural regions compared with metropolitan areas. Data collected from the metropolitan area is considered by the Birth Defects Registry to be the most accurate. Therefore, incidence rates of birth defects in this area arc …

Fall Risk Assessment : A Prospective Investigation Of Nurses' Clinical Judgement And Risk Assessment Tools In Predicting Patient Falls In An Acute Care Setting, Helen Myers

Theses: Doctorates and Masters

Falls are a significant problem in acute care, hospital settings, and can have serious consequences, especially for older patients. Fall prevention has therefore been recognised as an important area for research and intervention. In order to target interventions and use resources effectively, a major strategy of many fall prevention programmes has been the development and/or use of risk assessment tools to identify patients who are at high risk of falling. Although many tools have been developed, few have been rigorously tested, and there is currently no evidence to support the clinical utility of fall risk assessment tools. There is a …

Current Treatments Of Vitiligo, Azam J. Samdani

Department of Medicine

No abstract provided.

Cutaneous Blood Flow In Type 2 Diabetic Individuals After An Acute Bout Of Maximal Exercise, Sheri R. Colberg, Henri K. Parson, D. Robb Holton, Tanja Nunnold, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

OBJECTIVE - We previously demonstrated a positive association between chronic aerobic exercise and dorsal foot skin blood flow during local heating in type 2 diabetic individuals. Thus, we hypothesized that a prior acute bout of maximal exercise would also have positive effects on postexercise blood now.

RESEARCH DESIGN AND METHODS - Subjects consisted of 32 individuals with type 2 diabetes and 26 nondiabetic control subjects further subdivided based on their physical activity status diabetic exerciser (DE), diabetic sedentary (DS), control exerciser (CE), or control sedentary. Dorsal foot cutaneous blood flow was measured noninvasively by continuous laser-Doppler assessment at baseline and …

Age, Temperature, And Parasitaemia Predict Chloroquine Treatment Failure And Anaemia In Children With Uncomplicated Plasmodium Falciparum Malaria, D.H. Hamer, W.B. Macleod, E. Addo-Yobo, C.P Duggan, B. Estrella, W.W. Fawzi, J.K. Konde-Lule, V. Mwanakasale, Zul Premji, F. Sempertegui, F.P. Ssengooba, K. Yeboah-Antwi, J.L. Simon

Pathology, East Africa

The prevalence of chloroquine-resistant Plasmodium falciparum malaria has been increasing in sub-Saharan Africa and parts of South America over the last 2 decades, and has been associated with increased anaemia-associated morbidity and higher mortality rates. Prospectively collected clinical and parasitological data from a multicentre study of 788 children aged 6-59 months with uncomplicated P. falciparum malaria were analysed in order to identify risk factors for chloroquine treatment failure and to assess its impact on anaemia after therapy. The proportion of chloroquine treatment failures (combined early and late treatment failures) was higher in the central-eastern African countries (Tanzania, 53%; Uganda, 80%; …

Storying The Body : Women's Narratives Through The Lens Of Breast Cancer, Janet A. Griffin

Theses : Honours

What can women's narratives contribute to our understanding of breast cancer and to feminist theories of the body? This thesis explores the meanings women construct to make sense of embodied experiences of breast cancer, and the profound experience of breast loss. Rich contextual data was elicited from in depth, guided conversations with five premenopausal women who have undergone mastectomy. Adopting feminist methodology, biographic-narrative was used to place the body at the heart of inquiry. This thesis explores the personal and theoretical meanings of mastectomy, embedded in the larger story of how these five women experience their breasts, throughout their lives. …

Our Adolescents--Our Future, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Gerontology Institute Publications

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

Oncolog, Volume 48, Number 01, January 2003, David Galloway, Stephanie Deming, Heather Russell

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Putting an End to the Waiting: Diagnosis Clinic Finds Answers for Patients When Cancer Is Suspected
• The Center for Research on Minority Health: Working with the Community to End Health Disparities
• Collaboration Between M. D. Anderson, University of Puerto Rico to Address Cancer in Minority Populations
• House Call: Diagnostic Imaging Tests: How They Work and What to Expect

Digest Of The Philadelphia College Of Osteopathic Medicine (Winter 2003), Philadelphia College Of Osteopathic Medicine

Digest

The Winter 2003 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• Student Research Prominent on PCOM Campus
• The Man who Launched a Thousand Careers
• The Next Generation of PCOM Leadership Emerges
• Alumni Association Revitalization
• Cover Story: Reaching Out
• Class Notes
• 56th Annual Alumni /Survivors Dinner Dance Awards
• In Memoriam
• My Turn
• PCOM Alumni Weekend 2003
• PCOM Events

Physician Assistant Class Of 2003, Philadelphia College Of Osteopathic Medicine

All Yearbooks

Includes the White Coat Ceremony, Retreat at Camp Ockanickon, National Physician Assistant Day, Challenge Bowl Jeopardy, Halloween, Classroom candids, Christmas Party, PCOM Prom Night, Physician Assistant National Convention, Alumni Reception.

Functional Implications In Apoptosis By Interferon Inducible Gene Product 1-8d, The Binding Protein To Adenovirus Preterminal Protein, Insil Joung, Peter C. Angeletti, Jeffrey A. Engler

Nebraska Center for Virology: Faculty Publications

Adenovirus (Ad) precursor to the terminal protein (pTP) plays an essential roles in the viral DNA

replication. Ad pTP serves as a primer for the synthesis of a new DNA strand during the initiation

step of replication. In addition, Ad pTP forms organized spherical replication foci on the nuclear

matrix (NM) and anchors the viral genome to the NM. Here we identified the interferon inducible

gene product 1-8D (Inid) as a pTP binding protein by using a two-hybrid screen of a HeLa cDNA

library. Of the clones obtained in this assay, nine were identical to the Inid, a 13-kDa polypeptide …

Structure And Functional Effects Of Age-Related Posttranslational Modifications Of Aquaporin 0 In The Normal Human Lens, Lauren Elizabeth Smith-Ball

MUSC Theses and Dissertations

Aquaporin 0 (AQP0, MIP), a water channel protein found in the ocular lens fiber cells, has been proposed to maintain osmotic homeostasis by contributing to an internal circulatory system within the avascular lens. The formation of cataracts in patients with mutations in the AQP0 gene and in heterozygous AQP0 deficient mice suggests that AQP0 is necessary for establishing and preserving lens transparency. Previous structural characterization of AQP0 revealed that the C-terminus, a putative regulatory domain, is subject to many age-related posttranslational modifications. The goal of the present study was to map the spatial distribution of posttranslationally modified forms of AQP0 …

Pre-Verbal Trauma, Dissociation And The Healing Process, Dorothy Dreier Scotten

Educational Studies Dissertations

This qualitative research study examines some of the ways in which the healing process takes place in adults who have experienced dissociation, and who have most likely been psychologically traumatized before full language development. The impact of early trauma on human cognitive, socio-emotional, and spiritual development are explored within the context of participant narratives in order to develop an understanding of what may be helpful in developing effective teaching strategies for clinical and teacher education. In-depth interviews were conducted with four adult persons who had been diagnosed with Dissociative Identity Disorder. All had histories of infant psychological trauma and all …

Bidirectional Cavopulmonary Shunt For Cyanotic Heart Disease: Surgical Experience From A Developing Country, G. Khan, S. S. Ali, Saulat H. Fatimi

Section of Cardiothoracic Surgery

Objective: The importance of bidirectional cavopulmonary anastomosis for palliation of complex cyanotic con-genital heart disease is widely recognized. This study was conducted to highlight our surgical experience withthis procedure in a developing country.
Methods: A retrospective study was conducted using medical records at the Aga Khan University Hospital,Karachi, Pakistan. Clinical findings at presentation, anatomical defects seen on transthoracic echocardiography,pre-operative McGoon index, cardiopulmonary bypass time, use of cardioplegia,post-procedure oxygen satura-tions and complications were evaluated.
Results: A total of 8 patients underwent bidirectional cavopulmonary anastomosis. There were 6 males (75%)and 2 females (25%). Ages and weights atoperation averaged 5.7 ± 3.7 …

The Prevalence Of Silent Kidney Stones: An Ultrasonographic Screening Study, Buchholz Niels-Peter, Farhat Abbas, R Khan, Jamsheer J. Talati, M Afzal, I Rizvi

Section of Urology

Objective: Silent and not yet discovered stones of the upper urinary tract are potentially dangerous, since in due course they may cause infection, obstruction and renal damage. The aim of this study was to determine the prevalence of such silent kidney stones in a representative Pakistani population of Karachi.
Subjects and Methods: We studied 201 consecutive subjects at our hospital who underwent additional kidney screening whilst undergoing abdominal ultrasound. All these subjects did not have a history or symptoms of urolithiasis.
Results: We found silent kidney stones in 3% of subjects. All stone bearers were males. Most stones were in …

Optimization Of Low Pre-Operative Hemoglobin Reduces Transfusion Requirement In Patients Undergoing Transurethral Resection Of Prostate, Hammad Ather, Nuzhat Faruqui, F. Abid

Section of Urology

Objective: To identify factors that influence peri-operative hemorrhage in view of reducing the need for transfusions in patients undergoing trans uretheral resection of prostate (TURP).
Methods: All patients undergoing TURP between January 1997 and December 1999 were identified using lCD 9CM coding and indexing system. Overall 430 patients were identified, however, 384 charts were included and reviewed for demographics, pre and intra-operative data and post-operative morbidity. Patients were divided into two groups on the basis of presence of significant hemorrhage.
Results: Overall 384 patients were analyzed. Nineteen patients had hemorrhage - group I whereas 365had no significant hemorrhage …

Use Of Heart Rate Reserve And Rating Of Perceived Exertion To Prescribe Exercise Intensity In Diabetic Autonomic Neueropathy, Sheri R. Colberg, David P. Swain, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

Objective- Individuals with diabetic autonomic neuropathy (DAN) exhibit an increased resting heart rate but depressed maximal heart rate. Thus, the purpose of this study was to examine the validity of using either percent of heart rate reserve (HRR) or a rating of perceived exertion (RPE) scale to prescribe exercise intensity in diabetic individuals both with and without DAN.

Research Design and Methods-The subjects consisted of 23 individuals with type 2 diabetes, ages 45-75 years, with (DAN; n=13) or without (No DAN; n=10) clinical signs of DAN, as assessed by heart rate variability using the expiration-to-inspiration ratio of the …

Are Our People Health Conscious? Results Of A Patients Survey In Karachi, Pakistan, Waris Qidwai, D Saleheen, S Saleem, M Andrades, Iqbal Azam

Department of Family Medicine

BACKGROUND: Life style is known to influence health and may be responsible for certain diseases. There is a need to document the life style on health among the Pakistani population.
METHODS: The study was conducted on patients visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the life style on health. The ethical requirements for conducting the study were met.
RESULTS: 393 patients were surveyed. The majority were young married men, in either private or government service. Preference for consumption of fats/oils, sweets, spicy foods, …

All In Due Time: Perspectives On Childbirth From Deaf Parents, Rsa Region V Project

Course Materials

Six Deaf couples discuss their experiences of giving birth. The stories they share represent a variety of factors and complications that occurred before, during, and after the births of their children.

Increased Risk Of Cervical Canal Infections With Intracervical Foley Catheter, S Siddiqui, Nf Zuberi, Afia Zafar, Rn Qureshi

Department of Obstetrics & Gynaecology

OBJECTIVE: To evaluate the effect of intracervical Foley catheter insertion, for the induction of labor, on cervical canal infection.
DESIGN: A prospective interventional study with paired analysis.
PLACE AND DURATION OF STUDY: The study was conducted in the department of Obstetrics and Gynecology at the Aga Khan University, Karachi, between June 1 and August 31, 2002.
SUBJECTS AND METHODS: In 45 women undergoing cervical ripening with intracervical Foley catheter for the induction of labour at term, cervical swabs were taken for culture and sensitivity before its insertion and again after its spontaneous expulsion or removal.
RESULTS: Intracervical …

The Role Of Meat, Poultry, And Fish Consumption In The Occurrence Of Rheumatoid And Other Forms Of Arthritis, Asnake Hailu

Loma Linda University Electronic Theses, Dissertations & Projects

Rheumatoid arthritis and other forms of arthritis or rheumatism are now the leading cause of disability in the United States. The etiology and pathogenesis are less understood and available treatment options are not always satisfactory. This dissertation measures the prevalence and cumulative incidence of rheumatoid arthritis and other forms of arthritis or rheumatism, and examines any associations with current and lifetime consumption of meat, poultry, and fish (meat) using the Adventist Health Study and the Adventist Mortality Study databases. From these databases, it was possible to reconstruct a prospective cohort, obtain self-reported information on demographic characteristics, arthritis, rheumatoid arthritis, other …

Communication Skills Of Family Physicians In A Doctor-Patient Consultation, Waris Qidwai, Si Karim, Fm. Irfan

Department of Family Medicine

No abstract provided.