Medical Specialties Commons^™

Septic Arthritis Of The Hip In Children: Aga Khan University Hospital Experience In Pakistan, Muhammad Umer, Pervaiz Hashmi, Tashfeen Ahmad, M Ahmed, Masood Umer

Section of Orthopaedic Surgery

Objective: To present clinical, radiological and bacteriological features and short term outcome of septic arthritis of the hip in children.
Methods: There were 23 male and 16 female children, including 6 neonates and 10 infants with a mean age of 3.9 years. Diagnosis of septic hip was made on clinical grounds, supplemented by X-rays, leukocyte count and the erythrocyte sedimentation rate (ESR). Thirty nine patients with 40 hips were followed for a mean time period of 76 weeks. All patients had a positive joint aspirate (pus) and underwent surgical decompression along with intravenous antibiotic therapy.
Results: Symptoms of pain, fever …

Consanguineous Marriage Resulting In Homozygous Occurrence Of X-Linked Retinoschisis In Girls, Azam Ali, Agha Hassan Feroze, Zulfiqar H. Rizvi, Tausif- Ur -Rehman

Section of Ophthalmology

Purpose: To investigate a family afflicted with X-linked retinoschisis and to determine the pedigree leading to such an occurrence.Design: Observational case series.
Methods: Visual acuities were measured at The Aga Khan University Hospital Ophthalmology clinic. Slit-lamp examination, direct and indirect ophthalmoscopies were performed on each of the seven members of this family. The pedigree was established by appropriate questioning about the rest of their family.
Results: The pedigree revealed the homozygosity of the four daughters for the XLRS mutations borne out of the consanguineous marriage between an affected father and a carrier mother.
Conclusions: This is the first report showing …

Oncolog, Volume 48, Number 10, October 2003, Katie Prout Matias, Mariann Crapanzano, Leslie R. Schrover Phd

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

• 'Hitting Bladder Cancer on All Fronts': Researchers Focus on Improving Therapies and Identifying Biomarkers Restoring Erectile Function in Patients Treated for Prostate Cancer: Efforts across Disciplines Address Physical, Psychological, and Emotional Factors Related to Sexual Potency
• House Call: Note to Self: Get Screened for Colon Cancer
• DiaLog: Sexual Function and Prostate Cancer: The Importance of Realistic Expectations, by Leslie R. Schover, PhD, Professor, Department of Behavioral Science

Helicobacter Pylori Infection And Micronutrient Deficiencies., Javed Yakoob, Wasim Jafri, Shahab Abid

Section of Gastroenterology

It is known that deficiencies of micronutrients due to infections increase morbidity and mortality. This phenomenon depicts itself conspicuously in developing countries. Deficiencies of iron, vitamins A, E, C, B12, etc are widely prevalent among populations living in the third world countries. Helicobacter pylori (H pylori) infection has a high prevalence throughout the world. Deficiencies of several micronutrients due to H pylori infection may be concomitantly present and vary from subtle sub-clinical states to severe clinical disorders. These essential trace elements/micronutrients are involved in host defense mechanisms, maintaining epithelial cell integrity, glycoprotein synthesis, transport mechanisms, myocardial contractility, brain development, cholesterol …

Topographical Expression Of Class Ia And Class Ii Phosphoinositide 3-Kinase Enzymes In Normal Human Tissues Is Consistent With A Role In Differentiation, Soha Salama El Sheikh, Jan Domin, Prakitpunthu Tomtitchong, Paul Abel, Gordon Stamp, El-Nasir Lalani

Department of Pathology and Laboratory Medicine

Background: Growth factor, cytokine and chemokine-induced activation of PI3K enzymes constitutes the start of a complex signalling cascade, which ultimately mediates cellular activities such as proliferation, differentiation, chemotaxis, survival, trafficking, and glucose homeostasis. The PI3K enzyme family is divided into 3 classes; class I (subdivided into IA and IB), class II (PI3K-C2α, PI3K-C2β and PI3K-C2γ) and class III PI3K. Expression of these enzymes in human tissue has not been clearly defined.

Methods: In this study, we analysed the immunohistochemical topographical expression profile of class IA (anti-p85 adaptor) and class II PI3K (PI3K-C2α and PI3K-C2β) enzymes in 104 formalin-fixed, paraffin embedded …

Renal Carcinoid Tumour, Z Ahmad, N Yaqoob, S Muzaffar, A S. Hussainy, S H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Renal Teratoma: A Rare Entity, N Yaqoob, Z Ahmed, N Jafri, S Muzaffar, S H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Il-7 Enhances Peripheral T Cell Reconstitution After Allogeneic Hematopoietic Stem Cell Transplantation., Onder Alpdogan, Stephanie J Muriglan, Jeffrey M Eng, Lucy M Willis, Andrew S Greenberg, Barry J Kappel, Marcel R M Van Den Brink

Department of Medical Oncology Faculty Papers

We used clinically relevant murine allogeneic bone marrow transplantation (BMT) models to study the mechanisms by which IL-7 administration can improve posttransplant peripheral T cell reconstitution. After transplant we could distinguish two populations of mature donor T cells: (a) alloreactive T cells with decreased expression of CD127 (IL-7 receptor alpha chain) and (b) nonalloreactive T cells, which express CD127 and undergo homeostatic proliferation. IL-7 administration increased the homeostatic proliferation of nonalloreactive T cells, but had no effect on alloreactive T cells and the development of graft-versus-host disease. Allogeneic transplant of purified hematopoietic stem cells and adoptive transfer of thymocytes into …

Candida Esophagitis: Risk Factors In Non-Hiv Population In Pakistan, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Muhammad Islam, Saeed Hamid, Hasnain Ali Shah, Akbar S. Hussainy

Section of Gastroenterology

AIM:

Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital.

METHODS:

Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied.

RESULTS:

Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and …

Flexible Recording/High Energy Electrode Catheter With Anchor For Ablation Of Atrial Flutter By Radio Frequency Energy, Chien-Suu Kuo, John G. Gurley

Internal Medicine Faculty Patents

An electrode catheter is provided having a predetermined flexibility throughout the entire length or at least at the contact portion, such as the electrode region, to allow for the molding of the contact portion such that it conforms to the shape of the heart at a preselected desired target area, such as the isthmus between the inlet of inferior vena cava and posterior tricuspid annulus. The catheter also includes a guiding sheath that is preferably semirigid and may be pre-shaped with at least one bend or angulation to assist in molding to ensure that the electrode region overlies the desired …

Medical Education Digest, Vol. 5 No. 5 (September 15, 2003), Nova Southeastern University

Medical Education Digest

No abstract provided.

A Null Mutation For Tissue Inhibitor Of Metalloproteinases-3 (Timp-3) Impairs Murine Bronchiole Branching Morphogenesis., Sean E Gill, M Cynthia Pape, Rama Khokha, Andrew J Watson, Kevin J Leco

Obstetrics & Gynaecology Publications

Tissue inhibitors of metalloproteinases (TIMPs) regulate extracellular matrix (ECM) degradation by matrix metalloproteinases (MMPs). We have examined the role of TIMP-3 on ECM homeostasis and bronchiole branching morphogenesis during murine embryogenesis. Employing an in vitro organ culture system, we found decreased bronchiolar branching in null lungs when compared with wild type (WT) counterparts after 2 days in culture. When a synthetic inhibitor of MMPs at low dose was added to the culture system, branching was augmented regardless of genotype. Gelatin and in situ zymography revealed that null lungs exhibited enhanced activation of MMPs throughout lung development. We analysed the impact …

A Varying-Coefficient Cox Model For The Effect Of Age At A Marker Event On Age At Menopause, Bin Nan, Xihong Lin, Lynda D. Lisabeth, Sioban D. Harlow

The University of Michigan Department of Biostatistics Working Paper Series

. It is of recent interest in reproductive health research to investigate the validity of a marker event for the onset of menopausal transition and to estimate age at menopause using age at the marker event. We propose a varying coefficient Cox model to investigate the association between age at a marker event, denned as a specific bleeding pattern change, and age at menopause, where both events are subject to censoring and their association varies with age at the marker event. Estimation proceeds using the regression spline method. The proposed method is applied to the Tremin Trust Data to evaluate …

The Relationship Between Health Status And Hope In Individuals With Hiv Disease, Celine Meera Chohan

All-Inclusive List of Electronic Theses and Dissertations

This study examined the relationship between hope and health status over a two-year period in individuals who were HIV -infected. One hundred and three individuals completed the surveys at entry into the study, at 12 months, and at 24 months. The Health Status Questionnaire (Wu et.al., 1991) measured Cognitive Functioning, Emotional Functioning, and Physical Functioning. Additionally, the Hope Scale (Snyder, 1991) and the Client Information Form were used to collect data. Results suggested hope at entry into the study was a significant predictor of physical functioning initially, at 12 months, and at 24 months. This finding suggests a link between …

Effect Of Low-Carbohydrate, Unlimited Calorie Diet On The Treatment Of Childhood Obesity: A Prospective Controlled Study, James R. Bailes Jr., Misty T. Strow, Joseph Werthammer, Richard A. Mcginnis, Yoram Elitsur

Pediatrics

Background: Childhood obesity has been recognized as the new epidemic in developed countries. Caloric restriction with physical activity is the main therapeutic treatment available for these children. We compared two different dietary protocols to assess treatment efficacy.

Methods: Obese children from the Pediatric Endocrinology clinic were prospectively recruited for the study. Children and their parents were allowed to choose one of two dietary protocols: (1) carbohydrate restricted diet (<30 g/day), with unlimited calories, protein, and fat (High protein, Low CHO Diet), and (2) calorie restricted diet (Low Cal Diet). Anthropometric data were measured at baseline and at the 2 month follow up appointment.

Results: Thirty-seven children completed the study of whom 27 chose High Protein, Low CHO Diet and 10 chose Low Cal diet. No differences in gender ratio, age, or …

The Transformative Effect Of Training In Counselling And Its Application, On The Community Counsellors Themselves, S Naeem, Badar S. Ali, S Mubeen, Iqbal Azam

Department of Psychiatry

Objective: To identify the changes in community counsellors' own level of anxiety and depression as a result of learning counselling skills and to explore their subjective experiences after learning and providing counselling.Design: Quantitative: Repeated Measures. / Qualitative: Focus Group Discussions.SETTING: A lower middle class semi urban community of Karachi, Pakistan.PARTICIPANTS: Twenty-one self selected women from the community.Results: Reduction was seen in the post training scores of anxiety and/or depression in the trainees. As a result of learning and then providing counselling the community counsellors' self esteem, self confidence and sense of competence were enhanced and they developed a more positive …

Rare Complication Of Sinus Venosus-Type Atrial Septal Defect Repair, M Murad, S A. Sami, R Hashmi, V Bari

Department of Radiology

No abstract provided.

Oncolog, Volume 48, Number 09, September 2003, Katie Prout Matias, David Galloway, Jeffrey E. Lee Md

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

• Sentinel Lymph Node Biopsy: Detection of Micrometastases Leads to More Precise Staging of Breast and Melanoma Tumors
• Sentinel Lymph Node Biopsy Shows Promise in Eye and Colon Cancers
• New Research Promotes a More Dynamic View of Adult Stem Cell Differentiation: Hematopoietic Stem Cells May One Day Be Used to Repair Tissue Damage Caused by Radiation Therapy or Chemotherapy
• House Call: Understanding the Buzz over Stem Cells
• DiaLog: Directed Parathyroid Surgery, by Jeffrey E. Lee, MD, Professor, Department of Surgical Oncology

Irritable Bowel Syndrome In Health Care Professionals In Pakistan, Wasim Jafri, Javed Yakoob, Nadim Jafri, Mahesh Maloni, Saeed Hamid, Hasnain Ali Shah, Shahab Abid

Section of Gastroenterology

Objective: To evaluate the symptomatology of irritable bowel syndrome (IBS) among health care professionals attending an IBS symposium in a tertiary care university hospital. Method: A questionnaire designed to incorporate Manning and Rome II criteria was distributed among participants of an IBS symposium, most of them were health care professionals. A total of 100 questionnaires were distributed, 41 had symptoms fulfilling criteria of IBS. In these patients male: female ratio was 28:13 with age range 18-68. Results: The predominant symptom was abdominal pain 87.8 % (36/41) which was aggravated post-prandially 72.2% (29/41), relieved following defecation in 87 % (35/41) with …

Extrarenal Wilms' Tumor, M Yunus, R Hashmi, S H. Hasan, H M. Brohi

Department of Radiology

No abstract provided.

Intensive Care Medical Procedure : Ptsd Symptoms In Children, Ludmila Zaytsev

Loma Linda University Electronic Theses, Dissertations & Projects

Studies indicate that medical procedures may cause post-traumatic stress (PTS) symptoms (fear, avoidance, sleep disturbances, irritability, concentration difficulties. hypervigilance). It has been suggested that administration of midazolam hydrochloride, a sedative/amnesic medication commonly used in the Pediatric Intensive Care Units (PICU), may help decrease if not prevent the development of PTS symptoms. This study examined if PTS symptoms were related to procedural invasiveness (PI) and whether midazolam had a moderating effect on the development and intensity of PTS symptoms in children. English-speaking children ages 8-16 (N=20) who had been in the PICU for at least 3 days were recruited at Loma …

The Psychological Characteristics Of Obese Children, Thomas Taylor Mitchell

Loma Linda University Electronic Theses, Dissertations & Projects

Several studies along with the surgeon general of the United States have identified obesity as a national health issue. Research indicates that adult obesity treatment has relatively poor long-term effects. Consequently increased attention has been given to addressing obesity in children. This focus is particularly vital due to the fact that children are one of the populations showing the most rapid increase in overweight and obesity. The purpose of this study was to identify the some of the unique psychological characteristics of obese children by analyzing the intake data of children and adolescents attending the Loma Linda University Growing Fit …

The Radiopacity Of 29 Resin Restorative Materials Compared To Enamel, Peter Lubisich Iv

Loma Linda University Electronic Theses, Dissertations & Projects

The radiodensity of a composite resin can greatly influence a clinician's ability to analyze a restoration for failure. The purpose of this study was to determine the relative radiopacities of 29 resin restorative materials compared to enamel, and to verify the comparable radiopacity between shades of 23 of the restorative composite resin materials. Composite resin discs measuring >5mm in diameter and 2 mm in thickness were made and polymerized. Radiographs were taken of the composite resin discs, which included an aluminum step wedge for calibration and a densitometer was used to measure the radiodensity of the composite resin samples. The …

Assessment Of Alveolar Bone Density Using Implant Insertion Resistance Torque, Scott Sangmoo Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Implant stability during healing is a pre-requisite for successful osseointegration. In the case of early or immediate implant loading, it is necessary to achieve high level of stabilization during surgical placement. Fixture stabilization can be measured by resonance frequency analysis or implant insertion resistance torque measurement. The aim of this study is to correlate pre-operative radiographic bone density to implant insertion resistance torque in human cadaver jaw bone.

Materials & Methods: Sixty-four implant osteotomy sites in human cadaver jaw bones were previously examined radiographically using quantitative computed tomography (QCT) and quantitative cone-beam computed tomography (QCBCT). Forty-two implant insertion sites …

Quantification Of Bone Deposition In Onlay Bone Grafting, Gregory Alan Kammeyer

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to quantitatively evaluate; 1) mandibular posterior mono-cortical block onlay bone graft success rates 2) the amount of grafted bone retained after initial resorption in radiographic projections. Seven consecutive patients with 14 mandibular posterior implant sites requiring bone augmentation for implants of a standard 3.8mm x 10mm dimension were sought. Mono-cortical block bone grafts from the ipsilateral ascending ramus were placed then observed with two standardized CT scans, dividing them into two groups: Group A had the first CT at 4 weeks after graft placement and a second taken before Prosthodontic reconstruction, 36.7 weeks later. …

Spectrum Of Cutaneous Appendage Tumors At Aga Khan University Hospital, N Yaqoob, Z Ahmad, S Muzaffar, M S. Gill, I N. Soomro, S H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To determine the frequency of various types of cutaneous appendage tumors in our practice.
Method: This is a partly retrospective and partly prospective study conducted at the Department of Pathology, Histopathology Section, The Aga Khan University Hospital, Karachi between 1st January 1997 and 31st December 2001.
Results: One hundred sixty six skin appendage tumors were diagnosed during the study period. 87.3% were benign, while 12.6% were malignant. Male female ratio was almost equal. Mean age was 41.72 years. 37.34% showed eccrine differentiation, 14.45% showed apocrine differentiation and 41.56% showed pilosebaceous differentiation, 6.62% exhibited mixed differentiation. The 5 commonest tumors …

Sart Influences Sars Expression In Staphylococcus Aureus, Katherine A. Schmidt, Adhar C. Manna, Ambrose L. Cheung

Dartmouth Scholarship

Staphylococcus aureus is a gram-positive pathogen that is capable of expressing a variety of virulence proteins in response to environmental signals. Virulence protein expression in S. aureus is controlled by a network of regulatory loci including sarA and agr. The sarA/agr network is associated with the expression of cell wall-associated adhesins during exponential growth and the expression of secreted enzymes and toxins in the transition to post-exponential growth. A number of sarA homologs, including sarT and sarS, have been identified in the S. aureus genome. Previous studies have shown that sarA influences expression of both sarT and sarS in the …

A Comparison Of Morphine And Nalbuphine For Intraoperative And Postoperative Analgesia, F N. Minai, F A. Khan

Department of Anaesthesia

Introduction: Short acting narcotics are not available in Pakistan and the supply of drugs like morphine and pethidine is short and erratic; therefore there is a need for investigating acceptable alternatives for analgesia, to be used for balanced anaesthesia.Objective: We studied the agonist-antagonist narcotic nalbuphine compared to morphine, for intra and postoperative pain relief in total abdominal hysterectomies.Methods: In a randomised double blind trial, fifty ASA I and II patients in two groups of twenty five each were given equianalgesic doses of morphine and nalbuphine. Hemodynamic stability, intraoperative analgesia, recovery profiles, incidence of side effects and need for postoperative supplements …

Laparoscopic Appendicectomy At The Aga Khan Hospital, Nairobi, S. C. Patel, G. F. Jumba, S. Akmal

General Surgery, East Africa

Objective: To evaluate our experience of laparoscopic appendicectomy at the Aga Khan Hospital, Nairobi over a six year period from the inception of the technique and to assess its advantages and disadvantages.

Design: Case series study.

Setting: The Aga Khan Hospital, Nairobi.

Patients: One hundred and six cases operated on from May 1996 to June 2002. Main outcome measures: Clinical presentation, age and sex demographics, average hospital stay, operating time, intra-operative and post-operative complications and outcome.

Results: There was a female preponderance with a female to male ratio of 2:3:I. Mean age was 30.6 years. There was a slightly more …

Radiation Effects On Dopamine-Mediated Prepulse Inhibition In The C57bl/6 Mouse, Cara Nicole Zuccarelli Miller

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the effects of proton and gamma radiation on a dopamine-dependent sensory gating mechanism: prepulse inhibition of the startle reflex. The purpose of this research was to describe potential hazards of proton radiation to the central nervous system in long-term space fight and for proton therapy patients. Results from previous research indicate that startle behavior is modified by proton and iron radiation. Forty-eight 10-½ week old, male C57BL/6 mice were used to characterize the optimal parameters for the model (prepulse duration, probe duration, and stimulus-onset-asynchrony). Three hundred and fifty two mice were used to characterize the time course …