Medical Specialties Commons^™

The Need For Formal Paediatric Resuscitation Training In Pakistan., Adina R., Sheikh Sajjad, Junaid Razzak

Department of Emergency Medicine

No abstract provided.

Precipitating Factors And The Outcome Of Hepatic Encephalopathy In Liver Cirrhosis., Dileep K. Rohra, Jaipal, Ameer A. Khowaja, Khalid Mahmood, Kanya Lal Ahuja

Department of Medicine

No abstract provided.

A Review Of Electroencephalograms Done At The Kenyatta National Hospital, Nairobi, J. O. Jowi, Z. P Kidiga, M. G. Gitau

Internal Medicine, East Africa

Background: Electroencephalogram based studies done elsewhere suggest that epileptiform activity originates predominantly from the left cortical hemisphere. There is evidence that partial epilepsies (focal spike and wave epileptiform discharges on tracings) connotes focal;secondary structural cortical dysfunction.Studies seeking similar findings have not been done locally.

Objective: To review electroencephalograms (BEGs) done at Kenyatta National Hospital (KNH); looking for various types of epileptiform discharges and their cerebral cortex of origin.

Design: Retrospective observational study.

Setting: Kenyatta National Hospital, Nairobi, Kenya- from January 1986 to June 2004

Results: A total10431EEG records were reviewed. Ninety Eight percent of referrals for EEG evaluation was for …

Oncolog Volume 51, Number 02, February 2006, Sunni Hosemann, Ellen Mcdonald Phd

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

• Emergency Care for Cancer Patients
• Bringing Clinical Trials to the Community
• House Call: Understanding the Immune System
• DiaLog: Cognitive Dysfunction in Cancer, by Christina Meyers, PhD, Professor and Chief, Section of Neuropsychology

An Open Study To Assess The Safety And Efficacy Of Heprovac-B Vaccine 10 Mcg-Dose For Adults, Hasnain Ali Shah, Wasim Jafri

Section of Gastroenterology

Heprovac B is a novel recombinant vaccine. There are many vaccines available in Pakistani market but Heprovac B claims to be immunogenic even at 10 meg dose. Aim of the study is to determine whether using 10 meg of Heprovac B vaccine is safe and effective in producing sufficient immunity in Pakistani population. One hundred and twenty five subjects, who fulfilled the Inclusion criteria, were enrolled for the study. Heprovac B was administered in a three-dose regimen given at 0, 1 and 6 months and adverse events were recorded. Immunogenicity was tested by measuring hepatitis B surface antibody one month …

Isolated Tuberculous Thyroiditis As Solitary Thyroid Nodule, Maseeh Uz-Zaman, Riffat Hussain, Muhammad Kashif Mirza, Khalil Ahmed Khan, Ghufran Mohammad Khan, M. Nadeem Ahmad

Department of Radiology

Isolated involvement of the thyroid by tuberculosis is very rare as reported in literature. We are presenting a case of isolated tuberculous thyroiditis presented as a solitary thyroid nodule. The patient was treated with anti-tuberculous regimen and he responded well with disappearance of the nodule and normalization of the thyroid scan.

Magnetic Resonance Imaging (Mri) Findings In White Matter Disease Of Brain, Humera Ahsan, Muhammad Zafar Rafique, Fozia Ajmal, Mohsin Wahid, Muhammad Azeemuddin, Farah Iqbal

Department of Radiology

Demyelinating and dysmyelinating white matter diseases are important components of neurological problems. Recently, Magnetic Resonance Imaging (MRI) has played a key role in diagnoses of white matter diseases. Therefore, the purpose of the current study is to evaluate the usefulness of MRI in determining the type and frequency of white matter disease. We studied 35 patients who visited the Radiology Department of the Aga Khan University Hospital (AKUH) for MRI with suspected demyelinating/dysmyelinating disorder from January 2003 to December 2005. Multiple Sclerosis (MS) (17; 48%) and leukodystrophies (10; 29%) were the most common diseases. The MRI helped identify the sites …

Conjunctival Malignant Melanoma Mimicking As A Chalazion, Sana Shoukat Memon, Roomasa Channa, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

No abstract provided.

Diagnostic Tool For Glanzmann's Thrombasthenia Clinicopathologic Spectrum, Natasha Bahadur Ali, Bushra Moiz, Mohammad Usman Shaikh, Salman Adil, Bushra Rizvi, Yasmeen Rahman

Department of Pathology and Laboratory Medicine

Objective: To platelet aggregometry and describe the clinical spectrum of Glanzmann's thrombasthenia diagnosed by platelet aggregometry.
Study design: A case-series.
Place and duration of study: This study was carried out at the clinical laboratories at the Aga Khan University Hospital, Karachi from January 2003 to January 2006.
Patients and methods: All patients irrespective of age and gender presenting with bleeding symptoms and having normal platelet count were evaluated. Demographic details, relevant clinical history along with results of complete blood count, bleeding time and platelet aggregation studies were retrieved through computerized data base and evaluated for the diagnosis of Glanzmann's thrombasthenia. …

Metachronous Primary Cancers Of Colon And Stomac, Zubair Ahmad, Ayesha Memon, Khurram Minhas

Department of Pathology and Laboratory Medicine

Synchronous or metachronous occurrence of esophageal, gastric and colonic cancers is a very rare occurrence, although there are several case reports in literature. A case of a 41 years old man with metachronous cancers of colon and stomach is reported.

Knowledge, Attitudes And Practices Of Health Care Workers Regarding Needle Stick Injuries At A Tertiary Care Hospital In Pakistan, Afia Zafar, Naveen Aslam, Nosheen Nasir, Riffat Meraj, Vikram Mehraj

Department of Pathology and Laboratory Medicine

OBJECTIVE: To assess the knowledge, attitude and practices of HCWs regarding needle stick injuries at the Aga Khan University Hospital.

METHODS: A cross-sectional study was conducted on medical personnel. A structured pre-tested questionnaire was administered during June-July 2003. The data was analysed by SPSS 13.0. Percentages of the categorical variables were computed and compared by Chi square test at a 5% level of significance. Odds ratios and their 95% CIs were also computed.

RESULTS: Of 80 participants, 29 were doctors and 51 were registered nurses. About 45% reported having a needle stick injury in the past. Frequency of injury was …

A Fatal Case Of Gram Negative Bacterial Sepsis Associated With Disseminated Strongyloidiasis In An Immunocompromised Patient, Naima Fasih, Seema Irfan, Usman Sheikh, M. Sim Beg

Department of Pathology and Laboratory Medicine

We report a fatal case of disseminated strongyloidiasis in a patient with multiple myeloma receiving chemrotherapy. A fifty-seven years old man presented with severe diarrhoea and vomiting, fever, weight loss and dysphagia,due to mouth ulcers. Despite broad-spectrum intravenous antibiotics, albendazole (anti protozoal) and supportive treatment, the patient died of Gram-negative sepsis.

Informed Consent And Some Of Its Problems In Pakistan, Robyna Irshad Khan

Department of Anaesthesia

Informed consent has become an essential element of human subject research. Certain components are essential for a well-understood informed consent. There are problems in procurement of a comprehensive and meaningful consent in the Pakistani research settings. The inefficient healthcare systems, low literacy rate with masses having no concept of individual rights, higher social status enjoyed by physicians inhibiting the patients from questioning them, and unwillingness to hear bad news are some of these factors. Establishing Bioethics education at all levels, encouraging the involvement of families in decision making, using improvisation in procurement of consent are suggested solutions. There needs to …

Sedation-Analgesia In Non Operative Locations: Practice Trends Of Anaesthetists, Fauzia Khan, Khalid Maudood Siddiqui, Rehan Qureshi

Department of Anaesthesia

Sedation/analgesia is a mode of anaesthesia which facilitates an uncomfortable or painful procedure, such as gastrointestinal endoscopy, in a rousable and cooperative patient. The objective of the study was to assess the practice trends for administering sedation analgesia in non operative locations in Aga Khan Hospital, Karachi by anaesthetists. It was a descriptive study which retrospective reviewed anaesthesia records. A total of 41 ASA I-IV cases were reviewed. Non invasive cardiorespiratory monitoring and clinical sedation monitoring were applied. Intravenous Propofol infusion and midazolam boluses were used, singly or in combination with fentanyl boluses. All our patients recovered uneventfully within 5 …

Current Application Of Thoracoscopy In Children., Kuojen Tsao, Shawn D. St Peter, Susan W. Sharp, Abhilash Nair, Walter S. Andrews, Ronald J. Sharp, Charles L. Snyder, Daniel J. Ostlie, G W. Holcomb Iii

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The safety and efficacy of thoracoscopy for thoracic lesions and conditions in children is evolving. Our experience with thoracoscopy has expanded in recent years. Therefore, we reviewed our most recent 7-year experience to examine the current applications for thoracoscopy in children.

METHODS: A retrospective review of all patients undergoing a thoracoscopic operation at Children's Mercy Hospital (Kansas City, MO) between January 1, 2000, and June 18, 2007, was performed. Data points reviewed included patient demographics, type of operation, final diagnosis, complications, and recovery.

RESULTS: During the study period, 230 children underwent 231 thoracoscopic procedures. The mean age was 9.6 …

The Expression Of Microrna Mir-107 Decreases Early In Alzheimer's Disease And May Accelerate Disease Progression Through Regulation Of Β-Site Amyloid Precursor Protein-Cleaving Enzyme 1, Wang-Xia Wang, Bernard W. Rajeev, Arnold J. Stromberg, Na Ren, Guiliang Tang, Qingwei Huang, Isidore Rigoutsos, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

MicroRNAs (miRNAs) are small regulatory RNAs that participate in posttranscriptional gene regulation in a sequence-specific manner. However, little is understood about the role(s) of miRNAs in Alzheimer's disease (AD). We used miRNA expression microarrays on RNA extracted from human brain tissue from the University of Kentucky Alzheimer's Disease Center Brain Bank with near-optimal clinicopathological correlation. Cases were separated into four groups: elderly nondemented with negligible AD-type pathology, nondemented with incipient AD pathology, mild cognitive impairment (MCI) with moderate AD pathology, and AD. Among the AD-related miRNA expression changes, miR-107 was exceptional because miR-107 levels decreased significantly even in patients with …

Dilated Cisternae Chyli. A Sign Of Uncompensated Cirrhosis At Mr Imaging, Sachit K. Verma, Donald G. Mitchell, Diane Bergin, Yulia Lakhman, Amy Austin, Manisha Verma, David Assis, Steven K. Herrine, Laurence Parker

Department of Radiology Faculty Papers

Background: To retrospectively determine the frequency of dilated cisterna chyli (CC) on MR images in patients with cirrhosis, and to assess its value as a simple diagnostic imaging sign of uncompensated cirrhosis.

Methods: Study population included 257 patients (149 with pathologically proved cirrhosis and 108 control subjects without history of chronic liver diseases) who had 1.5T MR imaging. Cirrhosis patients were divided into compensated and uncompensated groups. Three independent observers qualitatively evaluated visibility of CC 2mm or greater in transverse diameter, identified as a tubular structure with fluid signal intensity (SI). CC diameters greater than 6 mm were defined as …

In Vitro Analysis Of Tobramycin-Treated Pseudomonas Aeruginosa Biofilms On Cystic Fibrosis-Derived Airway Epithelial Cells, Gregory G. Anderson, Sophie Moreau-Marquis, Bruce A. Stanton, George A. O'Toole

Dartmouth Scholarship

P. aeruginosa forms biofilms in the lungs of individuals with cystic fibrosis (CF); however, there have been no effective model systems for studying biofilm formation in the CF lung. We have developed a tissue culture system for growth of P. aeruginosa biofilms on CF-derived human airway cells that promotes the formation of highly antibiotic-resistant microcolonies, which produce an extracellular polysaccharide matrix and require the known abiotic biofilm formation genes flgK and pilB. Treatment of P. aeruginosa biofilms with tobramycin reduced the virulence of the biofilms both by reducing bacterial numbers and by altering virulence gene expression. We performed microarray analysis …

Inhibition Of Signal Transducer And Activator Of Transcription 3 Expression By Rna Interference Suppresses Invasion Through Inducing Anoikis In Human Colon Cancer Cells, Yu Fan, You-Li Zhang, Ying Wu, Wei Zhang, Yin-Huan Wang, Zhao-Ming Cheng, Hua Li

Dartmouth Scholarship

AIM: To investigate the roles and mechanism of signal transducer and activator of transcription 3 (STAT3) in invasion of human colon cancer cells by RNA interference.

Managing Severe Pneumonia In Children In Developing Countries - Increasing Resistance To First Line Antibiotics Means Recommendations Need Changing, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Nitrated Alpha-Synuclein Immunity Accelerates Degeneration Of Nigral Dopaminergic Neurons., Eric J. Benner, Rebecca Banerjee, Ashley D. Reynolds, Simon Sherman, Vladimir M. Pisarev, Vladislav Tsiperson, Craig Nemachek, Pawel Ciborowski, Serge Przedborski, R. Lee Mosley, Howard Gendelman

Journal Articles: Eppley Institute

BACKGROUND: The neuropathology of Parkinson's disease (PD) includes loss of dopaminergic neurons in the substantia nigra, nitrated alpha-synuclein (N-alpha-Syn) enriched intraneuronal inclusions or Lewy bodies and neuroinflammation. While the contribution of innate microglial inflammatory activities to disease are known, evidence for how adaptive immune mechanisms may affect the course of PD remains obscure. We reasoned that PD-associated oxidative protein modifications create novel antigenic epitopes capable of peripheral adaptive T cell responses that could affect nigrostriatal degeneration.

METHODS AND FINDINGS: Nitrotyrosine (NT)-modified alpha-Syn was detected readily in cervical lymph nodes (CLN) from 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) intoxicated mice. Antigen-presenting cells within the CLN …

Role Of Transient Receptor Potential Canonical-6 (Trpc6) Channel In Metastasis Of Glioblastoma Multiforme, Rajarajeshwari Venkataraman

Electronic Theses and Dissertations

Glioblastoma multiforme (GBM) is one of the extremely fatal brain tumors. The main reason that makes it so lethal is its capability to invade and spread to other parts of CNS producing secondary tumors. Among other factors hypoxia, reduced oxygen availability, is linked to higher metastatic potential of cancers. Hypoxia causes numerous changes in genome and proteome of the cell. These changes help a normal cell to adapt to nutritional deficiency, but the same changes can increase the malignancy and metastasis in tumor cells. Extensive research by a number of curious scientists reveal that various pathways involving numerous proteins cross-talk …

Antidepressant Medications, Amir A. Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Medical Education Digest, Vol. 10 No. 1 (January/February 2008), Nova Southeastern University

Medical Education Digest

No abstract provided.

Accuracy Of Ct Colonography For Detection Of Large Adenomas And Cancers, Daniel C. Johnson, Mei-Hsiu Chen, Alicia Y. Toledano, Jay P. Heiken, Abraham Dachman, Mark D. Kuo, Christine O. Menias, Betina Siewert, Jugesh I. Cheema, Richard G. Obregon, Jeff L. Fidler, Peter Zimmerman, Karen M. Horton, Kevin Coakley, Revathy B. Iyer, Amy K. Hara, Robert A. Halvorsen Jr, Giovanna Casola, Judy Yee, Benjamin A. Herman, Lawrence J. Burgart, Paul J. Limburg

Radiology Publications

Background

Computed tomographic (CT) colonography is a noninvasive option in screening for colorectal cancer. However, its accuracy as a screening tool in asymptomatic adults has not been well defined.

Methods

We recruited 2600 asymptomatic study participants, 50 years of age or older, at 15 study centers. CT colonographic images were acquired with the use of standard bowel preparation, stool and fluid tagging, mechanical insufflation, and multidetector-row CT scanners (with 16 or more rows). Radiologists trained in CT colonography reported all lesions measuring 5 mm or more in diameter. Optical colonoscopy and histologic review were performed according to established clinical protocols …

It's About The People, Edward F. Ansello

Director's Editorials from Age in Action

The Virginia Center on Aging celebrates 30 years and the people who have made accomplishments possible.

Geriatric Training And Education (Gte) Projects, Edward F. Ansello

Director's Editorials from Age in Action

The Geriatric Training and Education (GTE) initiative is supporting 15 different projects in the current fiscal year that are affecting Virginians in each region, from certified nursing assistants to family caregivers of relatives with dementia to long-term care staff helping elders at the end of life.

Tackling Elder Abuse, Edward F. Ansello

Director's Editorials from Age in Action

The Central Virginia Training Alliance to Stop Elder Abuse, Neglect, and Exploitation was selected to pilot a three-year training initiative for criminal justice professionals on elder abuse, neglect, and exploitation. Our overall intention is to improve the expertise of each component in investigating and prosecuting maltreatment against our elders.

Priorities In A Time Of Crisis, Edward F. Ansello

Director's Editorials from Age in Action

Now, amidst economic stress, is the time to defend certain sections of the budget, including the protection of those among us who are least able.

No Wrong Door: Virginia’S Key Strategic Initiative For Long-Term Care, Molly Huffstetler

Case Studies from Age in Action

Educational Objectives

1. Describe the rationale, current activities, and vision for No Wrong Door as it pertains to seniors, adults with disabilities, and their caregivers throughout Virginia.

2. Demonstrate the positive potential for collaboration among local long-term care service providers, both public and private.

3. Illustrate the benefits of coordinating long-term care services for an individual through Virginia’s No Wrong Door.