Medical Specialties Commons^™

Metanephric Adenoma: A Rare Benign Renal Tumour, Nausheen Yaqoob, Jai Pal Paryani, Naila Kayani, Mohammad Zafar Rafique, Raziuddin Biyabani

Department of Pathology and Laboratory Medicine

Metanephric adenoma is a rare benign renal tumour. We are reporting one histologically proven such case in a 23 year old male from Afghanistan. He presented with severe right flank pain since 3 weeks. Nephrectomy was done and histopathology was consistent with the diagnosis of metanephric adenoma. This novel renal mass has been reported to have benign clinical course despite its symptomatic presentation and large tumour size. There is no distinguishing radiological feature with can differentiate it from malignant tumours. So far, a uniformly benign clinical course has been associated with Metanephric adenoma, but given its relatively recent identification and …

Barnacles, Old Age Marks, Or Just Plain Seborrheic Keratoses., Lawrence Charles Parish, Joseph A. Witkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

Growing older may mean more wrinkles and creaking joints, but why does it also entail an accumulation of barnacles. These brown, somewhat friable, often warty lesions are more common on senior citizens but are not necessarily limited to the chronologically challenged. Seborrheic keratoses (SKs) can be easily recognized (fig 1), but the itching and the occasional scratch-induced dermatitis make them more than a cosmetic nuisance. (fig 2)

SKs can go by a variety of names, ranging from basal cell papillomas, senile warts, and senile keratoses to seborrheic verrucae and verrucous senilis. The various terms provide no more information on their …

Surgical Emphysema In The Neck As A Result Of A Dental Procedure, Moghira Iqbal, Mubasher Ikram, Farhan Raza, Ninette Banday

Section of Otolaryngology, Head & Neck Surgery

We report the development of subcutaneous emphysema in a middle-aged woman that occurred several hours after she had undergone a dental restoration procedure. The patient presented to the emergency department, and she was admitted for observation and prophylactic antibiotic coverage. She recovered in 3 days without further intervention and was discharged.

Role Of Rapid Urease Test And Histopathology In The Diagnosis Of Helicobacter Pylori Infection In A Developing Country, Javed Yakoob, Wasim Jafri, Shahab Abid, Zaigham Abbas, Saeed Hamid, Muhammad Islam, Kashif Anis, Hasnain Ali Shah, Hizbullah Shaikh

Section of Gastroenterology

Background

The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.

Methods

One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard …

Colorectal Carcinoma, Extent And Spread In Our Population. Resection Specimens Give Valuable Information, Zubair Ahmad, Rooma Idrees, Rashid Ahmed, Naila Kayani, Shahid Pervez, Sheema Habibul Hasan

Department of Pathology and Laboratory Medicine

Objective: To acquire information about the extent and spread of colorectal carcinomas in our population by examining colon and colorectum resection specimens received.

Methods: All colon and colorectum resection specimens received in the section of Histopathology, Aga Khan University Hospital, Karachi from January 1, 2003 to July 31, 2003 were included in the study.

Results: Eighty five resection specimens were received during the study period, 69.41% patients were males, and 30.59% were females. The mean age for males was 49 years and for females 48 years. Tumor location was in left colon (58.82%), and in right colon (41.18%). The average …

Encephalopathy Caused By Bartonella Henselae Following Cat Scratch, Joseph L. Yozviak Do, Facp, John Margraf Md, Marcelo Gareca Md

Department of Medicine

No abstract provided.

When Red Lights Look Yellow, Joanne M. Wood, David A. Atchison, Alex Chaparro

Publications

Purpose. Red signals are typically used to signify danger. This study was conducted to investigate a situation identified by train drivers in which red signals appear yellow when viewed at long distances (∼900 m) through progressive-addition lenses.

Methods. A laboratory study was conducted to investigate the effects of defocus, target size, ambient illumination, and surround characteristics on the extent of the color misperception of train signals by nine visually normal participants. The data from the laboratory study were validated in a field study by measuring the amounts of defocus and the distances at which the misperception of the color of …

Evaluation Of Stature Development During Childhood And Adolescence In Individuals With Familial Hypophosphatemic Rickets, Mauro M. S. Borghi, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

This review was conducted to study the diagnosis, treatment, and growth progression in infants and adolescents with familial hypophosphatemic rickets. The bibliographic search was carried out utilizing the electronic databases MEDLINE, OVID, and LILACS and by direct research within the last 15 years using the keywords rickets, familial hypophosphatemia, vitamin D deficiency, stature growth, childhood, and adolescence. Article selection was done by comparing the evaluation of the growth in patients with familial hypophosphatemic rickets, including the variables that might affect them, for possible future therapeutic proposals. It is concluded that the most significant fact in the treatment of familial hypophosphatemic …

Cardiac Transplant Following Failed Fontan Or Glenn Procedures., Naveen L. Pereira, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Com Outlook Fall 2005, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Dermatophyte Growth And Degradation Of Human Stratum Corneum In Vitro (Pathogenesis Of Dermatophytosis)., Azam J. Samdani

Department of Medicine

Background: This study was carried out to determine growth of dermatophytes using human stratum corneum in vitro and the degrading effect of Keratinases (Proteinases) on stratum corneum for a complete understanding of the host parasite relationship.

Method: Trichophyton rubrum isolates derived from patients with tinea cruris infections were obtained from the Department of Medical Microbiology, University Hospital of Wales, U.K. Human stratum corneum sterilized with ethylene oxide was used as a nitrogen source in agar culture medium plates.

Result: Fungal growth took place in plates which contained human stratum corneum particles while there was no growth in the plates without …

Role Of Computed Tomography In Acute Pancreatitis And Its Complications Among Age Groups, Ishtiaq Ahmed Chishty, Vaqar Bari, Sajida Pasha, Dawar Burhan, Zishan Haider, Zafar Rafique

Department of Radiology

Objective: To determine value of CT scan in diagnosis of acute pancreatitis, its complications and to correlate with severity among different age groups.Methods: The study was carried out from August 2001 to August 2002 at the Radiology Department, Aga Khan University Hospital. A total of 40 patients (33 male and 7 female) with age range from 16-71 years were divided in three groups. Group I was less than 40 years (12 patients), Group II was between 40-60 years (17 patients), and Group III was more than 60 years (11 patients). CT scans were assessed for pancreatic necrosis and its complications. …

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

Oncolog, Volume 50, Number 10, October 2005, Beth Notzon, Rachel Williams, Maurie Markman Md

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

• Cytogenetics: Major Insights from Microscopic Details
• Breaking the News
• House Call: From My Bookshelf to Yours
• DiaLog: Intraperitoneal Chemotherapy: A New Strategy for Advanced Ovarian Cancer, by Maurie Markman, MD, Vice President for Clinical Research

Evaluation Of African-American And White Racial Classification In A Surveillance, Epidemiology, And End Results Cancer Registry, Diva A. Patel, Alicia Knowles, Ann G. Schwartz, Kendra Schwartz

FMPHS Faculty Publications

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry.

Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined.

Results: Most self-identified African Americans and Whites were correctly classified (sensitivity= 98.5%, specificity=99.7%). Males were two times more likely to be misclassified than females [odds …

Frequency Of Irritable Bowel Syndrome In College Students., Wasim Jafri, Javed Yakoob, Nadim Jafri, Muhammad Islam, Qazi Masroor Ali

Section of Gastroenterology

Background:

This study was carried out to investigate the presence of irritable bowel syndrome (IBS) in college students and compare its distribution in the non-medical college and medical college students.

Methods:

We collected data from 508 students by inviting them to fill out a questionnaire based on Rome II criteria for the diagnosis of IBS from November 2001 to February 2004. Two major cities Karachi and Bahawalpur were selected and it was coordinated by the section of Gastroenterology, Department of Medicine, Aga Khan University Hospital and Quaid-e-Azam Medical College, Bahawalpur.

Results:

A total of 508 subjects with males 43 %(220/508) …

Near-Infrared Characterization Of Breast Tumors In Vivo Using Spectrally-Constrained Reconstruction, Subhadra Srinivasan, Brian W. Pogue, Ben Brooksby, Shudong Jiang, Hamid Dehghani, Christine Kogel, Wendy A. Wells, Steven P. Poplack, Keith D. Paulsen

Dartmouth Scholarship

Multi-wavelength Near-Infrared (NIR) Tomography was utilized in this study to non-invasively quantify physiological parameters of breast tumors using direct spectral reconstruction. Frequency domain NIR measurements were incorporated with a new spectrally constrained direct chromophore and scattering image reconstruction algorithm, which was validated in simulations and experimental phantoms. Images of total hemoglobin, oxygen saturation, water, and scatter parameters were obtained with higher accuracy than previously reported. Using this spectral approach, in vivo NIR images are presented and interpreted through a series of case studies (n=6 subjects) having differing abnormalities. The corresponding mammograms and ultrasound images are also evaluated. Three of six …

Bullous Eruption On The Posterior Thigh, James Studdiford, Amber Stonehouse

Department of Family & Community Medicine Faculty Papers

No abstract provided.

Flow Cytometric And Demographic Analysis Of T Cell Acute Lymphoblastic Leukemia In Pakistani Population., M R. Khawaja, S S. Allana, N N. Akbaral, S N. Adil, M. Khurshid, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background: This study was carried out to analyze the proportion of T cell acute lymphoblastic leukemia (TALL) among all acute lymphoblastic leukemia (ALL) in Pakistani population and its correlation with the demographic features. Accuracy of cell surface markers used in flow cytometric analysis of the leukemic cells was also determined.

Methods: Data of 209 consecutive cases of acute lymphoblastic leukemia (ALL) presenting between July 1995 and July 2003 was analyzed. Flow cytometry was performed on all ALL cases using the standard protocols. TALL markers included CD3, CD5 and CD7.

Results: Proportion of TALL among known ALL Pakistani patients was 17.22%. …

The Influence Of Concurrent Cognitive Tasks On Postural Sway In Children, Yvette Blanchard, Shannon Carey, Jocelyn Coffey, Alison Cohen, Trisha Harris, Stephanie Michlik, Geraldine Pellecchia

All PTHMS Faculty Publications

Purpose: The purpose of this study was to examine the influence of concurrent tasks on postural sway in children.

Methods: Nineteen fourth-grade students, while standing on a balance platform, were asked to stand still, count backward, and read second-grade level sentences. The AMTI Accusway System was used to calculate the length of center of pressure path (LCOP), sway range (SR), and variability (SV) in mediolateral (ML) and anteroposterior (AP) directions of sway.

Results: Analysis of variance revealed a main effect of cognitive task condition for SR-AP, SR-ML, SV-AP, and SV-ML. Post hoc comparisons revealed lower values of those four dependent …

The Implications Of “Pay-For-Performance” Reimbursement For Otolaryngology – Head And Neck Surgery, David M. Cognetti, David Reiter

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Objective: To introduce otolaryngologists to outcomes-linked reimbursement ("pay-for-performance"), identify clinical practice implications and recommend changes for successful transition from the traditional "pay-for-effort" reimbursement model. Study design: Policy review Results: Payers are actively linking reimbursement to quality. Since the Institute of Medicine issued its report on medical errors in 1999, there has been much public and private concern over patient safety. In an effort to base health care payment on quality, "pay-for-performance" programs reward or penalize hospitals and physicians for their ability to maintain standards of care established by payers and regulatory groups. More than 100 such programs are operational in …

Methemoglobinemia Induced By Topical Anesthesia During Fiberoptic Endotracheal Intubation, Matthew C. Miller, Michael T. Gaslin, Kathleen Herb, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presentation at 2005 American Academy Of Otolaryngology Head and Neck Surgery Annual Meeting, Los Angeles, CA September 25-28, 2005.

Introduction: Although local anesthetics are usually well tolerated, otolaryngologists need to be aware of the sometimes serious adverse events they can cause. The benzocaine containing sprays Hurricaine and Cetacaine are occasionally associated with the onset of life-threatening methemoglobinemia. The specific treatment for this condition is methylene blue.

Methods and Measures: We describe a case report of a 48 year old female who developed a methemoglobin level of 41% after receiving topical benzocaine to her oropharynx. We discuss the case in …

An Experimental Technique For Measurement Of Heat Generated During Bone Sawing, Hamid Khalili Parsa, Ger Reilly, Brendan Mccormack

Conference Papers

Orthopaedic bone cutting processes such as osteotomy and hip arthroplasty involve the cutting of one with the aid of various manual and powered cutting instruments including manual and powered bone saws. The extent of surgically induced bone necrosis at the point of the cutting tool and the bone is mainly due to the frictional heat generated by bone cutting. Bone necrosis has an impact on bone regeneration, and the rate of healing of the bone post operation. The threshold temperature for impaired regeneration of bone is in the range of 44°C to 47°C. Overheating also affects the sharpness life of …

Detection Of Microcracks During Bone Cutting Using Acoustic Emission Techniques, Ashkan Safari, Ger Reilly, Brendan Mccormack

Conference Papers

Surgeons may use a number of cutting instruments such as osteotomes and chisels to cut bone during operative procedures. The initial loading of cortical bone during the cutting process results in the formation of microcracks in the vicinity of the cutting zone with main crack propagation to failure occurring with continued loading; microcracking acts as a stimulus for main crack formation and has also been shown to occur during the propagation of the main crack. It has also been reported that Acoustic Emission (AE) is generated due to microcrack formation and crack growth, prior to, and during final fracture in …

Medical Education Digest, Vol. 7 No. 5 (September/October 2005), Nova Southeastern University

Medical Education Digest

No abstract provided.

Roles Of Na,K-Atpase In Early Development And Trophectoderm Differentiation., Gerald M Kidder, Andrew J Watson

Obstetrics & Gynaecology Publications

Before implantation into the uterine wall, the mammalian embryo undergoes a period of cell division, cell shape change, and cell differentiation leading to the formation of an outer epithelium, the trophectoderm. The trophectoderm is the part of the embryo that initiates uterine contact and, after transformation to become the trophoblast, uterine invasion. Similar to the kidney nephron, the trophectoderm is a transporting epithelium with distinct apical and basolateral membrane domains; its function is to facilitate transepithelial Na+ and fluid transport for blastocoel formation. That transport is driven by Na,K-adenosine triphosphatase (ATPase) localized in basolateral membranes of the trophectoderm. Preimplantation embryos …

Clinical Kidney Transplantation: A 50th Anniversary Review Of The First Reported Series, Vivian Charles Mcalister

Surgery Publications

BACKGROUND: Histories of kidney transplantation rarely mention a series reported by Gordon Murray of Toronto and published by the American Journal of Surgery 50 years ago.

METHODS: The papers and biographies of Gordon Murray were reviewed in the context of knowledge at that time about renal failure management to determine their contribution to transplantation research and to current practice.

RESULTS: Murray proceeded from a unique leadership position in vascular surgery, anticoagulation therapy, and dialysis to undertake a rational series of animal experiments and human trials of kidney transplantation that led him to the practices of graft irrigation, cold storage, pelvic …

Depression In Primary Care: Difficulties And Paradoxes, Haider Naqvi, Murad Moosa Khan

Department of Psychiatry

The presentation of depression in primary care is in many ways different from that seen in psychiatric settings. The process of detection and treatment is also different. This is particularly so in developing countries like Pakistan, which has high prevalence rates of depression but poorly organized primary health care services and primary care physicians (PCPs) who have little psychiatric training, either at undergraduate or postgraduate levels. There is a need to review difficulties faced by primary care physicians in detection and management of depression. It is hoped this would lead to better and more effective management of depression at primary …

Dealing With A Terrorist Attack: A University Hospital Perspective, Muhammad Shahid, Rifat Rehmani, Muhammad Saleem Khan

Department of Emergency Medicine

No abstract provided.

A Case For Case Reports, Saba Sohail

Department of Radiology

No abstract provided.