Medical Specialties Commons^™

Ms In Asian Countries, M Wasay, I A. Khatri, B Khealani, M Sheerani

Section of Neurology

This paper reviews all available English language literature on MS from Asian countries published between 1970 and 2005. Although limited data are available, the review reveals that western Asia--including the Middle East--has the highest prevalence of MS across the continent, and that MS in Asia largely resembles conventional MS in western countries. Opticospinal MS (a distinct clinical entity from conventional MS) is more common in eastern Asian regions. Larger epidemiological and genetic studies, with more complete ascertainment in various Asian populations, are needed so that we can understand the diversity of Asian MS.

Knowledge Of Modifiable Risk Factors Of Heart Disease Among Patients With Acute Myocardial Infarction In Karachi, Pakistan: A Cross Sectional Study, Muhammad S. Khan, Fahim H. Jafary, Tazeen H. Jafar, Azhar M. Faruqui, Syed I. Rasool, Juanita Hatcher, Nish Chaturvedi

Community Health Sciences

Background: Knowledge is an important pre-requisite for implementing both primary as well as secondary preventive strategies for cardiovascular disease (CVD). There are no estimates of the level of knowledge of risk factor of heart disease in patients with CVD. We estimated the level of knowledge of modifiable risk factors and determined the factors associated with good level of knowledge among patients presenting with their first acute myocardial infarction (AMI) in a tertiary care hospital in Karachi, Pakistan.Methods: A hospital based cross-sectional study was conducted at the National Institute of Cardiovascular Disease, a major tertiary care hospital in Karachi Pakistan. Patients …

Iodine Uptake Restoration In Thyroid Cancer, Kenneth B. Ain, Gopalakrishnan Venkataraman

Internal Medicine Faculty Patents

A method of expressing a tumor specific therapeutic response element in a cancerous cell is disclosed in which the response element was previously blocked from expression. The method comprises the step of administering an unblocking agent to the cancerous cell harboring a gene encoding the response element, thereby resulting in the expression of the response element.

Low Doses Of Memantine Disrupt Memory In Adult Rats, Catherine Creeley, David Wozniak, Joanne Labruyere, George Taylor, John Olney

Psychology Faculty Works

Memantine, a drug recently approved for treatment of Alzheimer’s disease, has been characterized as a unique NMDA antagonist that confers protection against excitotoxic neurodegeneration without the serious side effects that other NMDA antagonists are known to cause. In the present study, we determined what dose of memantine is required to protect the adult rat brain against an NMDA receptor-mediated excitotoxic process and then tested that dose and a range of lower doses to determine whether the drug in this dose range is associated with significant side effects. Consistent with previous research, we found that memantine confers a neuroprotective effect beginning …

Spontaneous Intracranial Arterial Dissection In The Young: Diagnosis By Ct Angiography, William C. Robertson, Curtis A. Given

Neurology Faculty Publications

BACKGROUND: Spontaneous carotid artery dissections have been rarely reported in children. Diagnosis has traditionally been confirmed by catheter arteriography. More recently diagnosis has been made by magnetic resonance imaging and magnetic resonance angiography; however the sensitivity of these techniques has yet to be determined. The authors are unaware of reports of carotid dissection confirmed by dynamic computed tomography (computerized tomographic arteriography) in the young.

CASE PRESENTATION: We recently evaluated a fourteen year-old male following the development of transient neurologic symptoms. There was no antecedent illness or trauma. Dynamic computed tomography revealed an intracranial dissection involving the supraclinoid segment of the …

Cardiac-Specific Elevations In Thyroid Hormone Enhance Contractility And Prevent Pressure Overload-Induced Cardiac Dysfunction, Maria G. Trivieri, Gavin Y. Oudit, Rajan Sah, Benoit-Giles Kerfant, Hui Sun, Anthony O. Gramolini, Yan Pan, Alan D. Wickenden, Walburga Croteau

Dartmouth Scholarship

Thyroid hormone (TH) is critical for cardiac development and heart function. In heart disease, TH metabolism is abnormal, and many biochemical and functional alterations mirror hypothyroidism. Although TH therapy has been advocated for treating heart disease, a clear benefit of TH has yet to be established, possibly because of peripheral actions of TH. To assess the potential efficacy of TH in treating heart disease, type 2 deiodinase (D2), which converts the prohormone thyroxine to active triiodothyronine (T3), was expressed transiently in mouse hearts by using the tetracycline transactivator system. Increased cardiac D2 activity led to elevated cardiac T3 levels and …

In Search Of The Anglophone Doctor In Jacques Ferron’S Story “Le Petit William”, Vivian C. Mcalister, Christiane I. Mcalister

Surgery Publications

The story of ‘Le Petit William’ (Contes anglais, 1964) is based on Ferron’s experiences as a general practitioner in the Gaspé in 1946. A medical event, use of the maternal left lateral position by a sage-femme to deliver a baby boy, becomes allegory. The sage-femme had learned the technique from a visiting Anglophone doctor. A simple joke, which superficially appears to be the story’s culmination, takes on a sombre political tone when considered in the light of the Latin epigraph. Trips to the Gaspé, a review of the history of obstetrics and speculation are used in this paper to understand …

Surgery For Prolactinomas, Ashfaq A. Razzaq, Rashid Jooma

Section of Neurosurgery

A large proportion of prolactin secreting tumours of the pituitary gland are treatable by dopamine agonist drugs. however certain subgroups of these patients are better managed by surgical excision. the indications for surgery in prolactinomas remain controversial and this paper attempts to clarify these with illustrative cases. the factors favouring a surgical approach include poor tolerance of long term medical therapy, progression of visual deficits or recurrence while on medical treatment, cystic change in the tumour with pressure effects, csf fistula secondary to tumour shrinkage and prophylactic surgery in tumours anticipated to cause csf leak following medical therapy. the size …

Cerebral Embolism: Distal Subclavian Disease As A Rare Etiology, Iram Naz, Ziad Sophie

Section of Cardiothoracic Surgery

Subclavian artery occlusive disease is usually secondary to persistent compression caused by thoracic outlet syndrome (TOS) and rarely due to focal atherosclerosis. Emboli from diseased vessel can flow retrograde to the vertebral or carotid arteries to produce ischemic infarct with or without neurological deficit. We are reporting two cases of distal subclavian artery disease presenting with cerebral embolization, an unusual manifestation. Such surgically correctable lesions producing cerebral emboli and stroke needs consideration while evaluating patients with unusual presentation to prevent further occurrence of stroke.

Immunization Update, Karl M. Hess, Jeffery A. Goad

Pharmacy Faculty Articles and Research

"Immunization represents a very effective primary prevention strategy to curb the rate of vaccine preventable diseases...Pharmacists can play a leading role in vaccination by serving as an advocate, facilitator, and active immunizer. As an advocate, pharmacists provide vaccine education while motivating people to get immunized. As a facilitator, pharmacy’s can host other groups, such as the visiting nurses association, to come into the pharmacy and vaccinate. As an active immunizer, however, pharmacists serve their greatest role by giving immunizations to adolescents and adults."

Com Outlook Spring 2006, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Incidence Of Acute Respiratory Infections In Children 2 Months To 5 Years Of Age In Periurban Communities In Karachi, Pakistan, Shaikh Qamaruddin Nizami, Zulfiqar Ahmed Bhutta, Rumina Hasan

Department of Paediatrics and Child Health

Objective: To measure the incidence of acute respiratory infections and burden of respiratory pathogens in children aged two months to five years.
Methods: Four periurban communities in Karachi were selected for the study. The children, identified with fever and cough during community surveillance at regular intervals, were referred to especially established study clinics. These children were diagnosed to have "no pneumonia", "pneumonia" and "severe pneumonia" as per IMCI guidelines. To identify the causative organisms, children with pneumonia and severe pneumonia were investigated with oropharyngeal swabs and blood culture.
Results: Acute respiratory infection was seen in 5884 children during 1st February …

Median Survival Time Of Patients After Transcatheter Chemo-Embolization For Hepatocellular Carcinoma, Zeeshan Haider, Haq Ul, Khalid Munir, M Uzair Usman, Muhammad Azeemuddin

Department of Radiology

Objective: To determine the effect on survival after transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC).Design: Longitudinal cohort study.PLACE AND DURATION OF STUDY: Radiology Department, The Aga Khan University Hospital, Stadium Road, Karachi, from December 1997 to September 2005.PATIENTS AND Methods: Patients undergoing TACE procedure for HCC were prospectively followed. Fortythree patients were enrolled from December 1997 to March 2003 in the study and subjected to chemoembolization therapy. Eight out of 43 patients were excluded from the study, who lost to follow-up. All the patients were followed till their death. Median and mean survival were calculated.Results: The median …

Colorectal Carcinoma, Preoperative Evaluation By Spiral Computed Tomography, Kashif Ashraf, Omer Ashraf, Zeeshan Haider, Zafar Rafique

Department of Radiology

Objectives: To assess the capability of spiral computed tomography (CT) scan in preoperative evaluation of colorectal carcinoma (CRC).Methods: A cross sectional study on 52 patients with recent histopathologic diagnosis of CRC was conducted over a period of one year at the Aga Khan University Hospital, Karachi. All these patients underwent spiral CT with oral and intravenous contrast administration. Surgery was subsequently done in all cases and surgical specimens were sent for detailed pathologic analysis. The radiologic findings on the CT scans were compared with the pathological findings.Results: The results proved that spiral CT had 60% sensitivity and 83% specificity for …

Oncolog Volume 51, Number 04, April 2006, Sunni Hosemann, Martha Morrison, Therese B. Bevers Md

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

• Redefining Unresectable Disease: Strategies for Treating Liver Metastases from Colorectal Cancer
• Cancer Screening Guidelines Revised: One on One with Dr. Therese Bevers
• House Call; What Is "Breast Self-Awareness"?
• DiaLog: The Revolutionary Cervical Cancer Vaccine, by Therese B. Bevers, MD, Medical Director, Cancer Prevention Center

Sentinel Lymph Node Scintigraphy And Radioguided Dissection In Breast Carcinoma: An Initial Experience At Aga Khan University Hospital, Maseeh Uz Zaman, Shaista Khan, Riffat Hussain, M Nadeem Ahmed

Department of Radiology

Objective: To evaluate the efficacy of SLN biopsy using imaging and gamma probe in breast cancer and to establish this technique at Aga Khan University Hospital.Methods: Thirty two patients (mean age 33-76 yrs) with operable breast carcinoma (4 with post-neo adjuvant therapy) with clinically negative axilla were studied. In 28 patients simultaneous axillary dissection was performed. Sentinel lymph nodes (SLN) scintigraphy was performed a day before surgery by injecting Tc-99m labeled nannocolloid sub-dermally in the peri-areolar region in 24 and peri-tumoral in remaining 8. First lymph node (LN) to appear to on the scan was labeled as SLN and marked …

Socio-Demographic Correlates Of Betel, Areca And Smokeless Tobacco Use As A High Risk Behavior For Head And Neck Cancers In A Squatter Settlement Of Karachi, Pakistan, Samia Mazahir, Rabia Malik, Maria Maqsood, Kanwal Aliraza Merchant, Farida Malik, Atif Majeed, Zafar Fatmi, Muhammad Rizwanulhaq Khawaja, Shehzad Ghaffar

Community Health Sciences

Background

Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of …

The Effect Of An Acute Bout Of Aerobic Exercise On Arterial Stiffness And Wave Reflection In Patients With Coronary Artery Disease, Alyssa L. Borell, Cristin A. Davis

Inquiry Journal 2006

No abstract provided.

We Must Test The Blood For Antigens, Fred W. Markham Jr.

Department of Family & Community Medicine Faculty Papers

No abstract provided.

Significance Of Immunohistochemistry In Accurate Characterization Of Malignant Tumors, Zubair Ahmed, Najamul Sahar Azad, Yasmeen Bhurgari, Rashida Ahmed, Naila Kayani, Shahid Pervez, Sheema Hasan

Department of Pathology and Laboratory Medicine

Background: To determine in a large series of surgical biopsies the role and significance of immunohistochemistry in the adequate and accurate characterization of malignant tumors.

Methods: A retrospective study of 20,000 consecutive surgical biopsies reported in the Section of Histopathology, AKU in 2003. Data was obtained by retrieving the filed surgical biopsy reports in the section.

Results And Conclusions: Out of the 20,000 biopsies, 6534 (32.67%) were neoplastic. 4726 neoplasms (72.33%) were malignant, and 1808 (27.67%) were benign. Immunohistochemistry was performed on 29.49% of malignant tumors, and 4.97% of benign tumors. Immunos were performed on only 2.82% of routine squamous …

The Diagnostic Yield Of Various Tests For Helicobacter Pylori Infection In Patients On Acid Reducing Drugs, Javed Yakoob, Wasim Jafri, Z Abbas, Shahab Abid, Muhammad Islam, Saeed Hamid, Syed H Shah

Section of Gastroenterology

No abstract provided.

Comparison Of Og1rf And An Isogenic Fsrb Deletion Mutant By Transcriptional Analysis: The Fsr System Of Enterococcus Faecalis Is More Than The Activator Of Gelatinase And Serine Protease, Agathe Bourgogne, Susan G Hilsenbeck, Gary M Dunny, Barbara E Murray

Faculty, Staff and Student Publications

The FsrABC system of Enterococcus faecalis controls the expression of gelatinase and a serine protease via a quorum-sensing mechanism, and recent studies suggest that the Fsr system may also regulate other genes important for virulence. To investigate the possibility that Fsr influences the expression of additional genes, we used transcriptional profiling, with microarrays based on the E. faecalis strain V583 sequence, to compare the E. faecalis strain OG1RF with its isogenic mutant, TX5266, an fsrB deletion mutant. We found that the presence of an intact fsrB influences expression of numerous genes throughout the growth phases tested, namely, late log to …

Effects Of Sapk/Jnk Inhibitors On Preimplantation Mouse Embryo Development Are Influenced Greatly By The Amount Of Stress Induced By The Media, Yufen Xie, E. E. Puscheck, D. A. Rappolee

Department of Obstetrics and Gynecology Research Publications

Stress-activated protein kinase/c-Jun kinase (SAPK/JNK) is thought to be necessary for preimplantation embryonic development (Maekawa et al., 2005). However, media increases SAPK/JNK phosphorylation and these levels negatively correlate with embryonic development (Wang et al., 2005). Culture-induced stress could confuse analysis of the role of SAPK in development. In this study, we tested how SAPK/JNK inhibitors influence embryonic development in optimal and non-optimal media and define the contribution of cell survival and proliferation to the embryonic response to these media. SAPK/JNK inhibitors retard embryonic development in suboptimal Ham’s F10, but improve development in optimal potassium (K+) simplex optimized media (KSOM) +AA. …

Cationic Amino Acid Transport Across The Blood-Brain Barrier Is Mediated Exclusively By System Y+, Robyn L. O'Kane, Juan R. Viña, Ian Simpson, Rosa Zaragozá, Ashwini Mokashi, Richard A. Hawkins

Publications and Research

Cationic amino acid (CAA) transport is brought about by two families of proteins that are found in various tissues: Cat (CAA transporter), referred to as system y+, and Bat [broad-scope amino acid (AA) transporter], which comprises systems b0,+, B0,+, and y+L. CAA traverse the blood-brain barrier (BBB), but experiments done in vivo have only been able to examine the BBB from the luminal (blood-facing) side. In the present study, plasma membranes isolated from bovine brain microvessels were used to identify and characterize the CAA transporter(s) on both sides of the BBB. From these studies, it was concluded that system y+ …

Successful Treatment Of Depot Medroxyprogesterone Acetate-Related Vaginal Bleeding Improves Continuation Rates In Adolescents, Kristin M. Rager, Amy Fowler, Hatim A. Omar

Pediatrics Faculty Publications

High discontinuation rates for depot medroxyprogesterone acetate (DMPA) in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP) raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% …

Racial Disparity And Socioeconomic Status In Association With Survival In Older Men With Local/Regional Stage Prostate Cancer: Findings From A Large Community-Based Cohort, Xianglin L. Du, Shenying Fang, Ann L. Coker, Corinne Aragaki, Janice N. Cormier, Yan Xing, Beverly J. Gor, Wenyaw Chan

CRVAW Faculty Journal Articles

BACKGROUND

Few studies have examined the outcomes for Hispanic men with prostate carcinoma and incorporated socioeconomic factors in association with race/ethnicity in affecting survival, adjusting for factors on cancer stage, grade, comorbidity, and treatment.

METHODS

We studied a population-based cohort of 61,228 men diagnosed with local or regional stage prostate carcinoma at age 65 years or older between 1992 and 1999 in the 11 SEER (Surveillance, Epidemiology, and End Results) areas, identified from the SEER-Medicare linked data with up to 11 years of followup.

RESULTS

Low socioeconomic status was significantly associated with decreasing survival in all men with prostate carcinoma. …

Holistic Health: Does It Really Include Mental Health?, Kimberly K. Mcclanahan, Marlene B. Huff, Hatim A. Omar

Pediatrics Faculty Publications

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities …

The Growing Burden Of Chronic Kidney Disease In Pakistan, Tazeen H. Jafar

Section of Nephrology

No abstract provided.

Clinical Holistic Medicine: Holistic Sexology And Acupressure Through The Vagina (Hippocratic Pelvic Massage), Søren Ventegodt, Birgitte Clausen, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

Many gynecological and sexological problems (like urine incontinence, chronic pelvic pains, vulvodynia, and lack of lust, excitement, and orgasm) are resistant to standard medical treatment. In our work at the Research Clinic for Holistic Medicine in Copenhagen, we have found that vaginal acupressure, or Hippocratic pelvic massage, can help some of these problems. Technically, it is a very simple procedure as it corresponds to the explorative phase of the standard pelvic examination, supplemented with the patient's report on the feelings it provokes and the processing and integration of these feelings. Sometimes it can be very difficult to control the emotions …

Trans-Mastoid Approach To Otogenic Brain Abscess, Ashfaq A. Razzaq, Rashid Jooma, Shahid Ahmed

Section of Neurosurgery

The treatment of otogenic brain abscess initially involves excision or aspiration of the abscess through a temporal or sub-occipital route depending on its location. This is followed by a mastoidectomy by the ENT surgeon to eradicate the primary source of infection. During the last three years, we have approached such lesions through a mastoidectomy followed by excision of the abscess through the same approach. This trans-mastoid approach is technically feasible in following the tract of suppuration, and clearing the cause and effect of pathology, at the same sitting. This paper describes our initial experience with the trans-mastoid approach to otogenic …