Medical Specialties Commons^™

Splenic Abscess: Outcome And Prognostic Factors, Abdul Rehman Alvi, Shazia Kulsoom, Ghina Shamsi

Section of General Surgery

Objective: To determine the spectrum of presentation, treatment outcome and prognostic factors of splenic abscess in a tertiary care hospital.
Study Design: Case-series.
Place and Duration of Study: Department of General Surgery, the Aga Khan University Hospital, Karachi, from July 1988 to July 2007.
Methodology: The records of 27 patients with splenic abscess, diagnosed from 1988 to 2007, were retrieved through ICD-10 coding system. The demographic data, physical and radiological findings, treatment modalities, bacteriology reports, morbidity and mortality were collected on a proforma.
Results: There were 12 males and 15 females with a mean age of 43.52+/-17.49 years. Common symptoms …

A Unique Variant Of Intestinal Tuberculosis, Abdul Rehman Alvi, Masooma Zaidi

Section of General Surgery

Duodenum is a rare site of involvement in intestinal tuberculosis. We report a 19 years old boy who presented with nonbilious vomiting and weight loss. His workup showed stricture in ascending colon, multiple liver abscesses with pneumobilia on CT scan. Upper GI endoscopy revealed stricture in 2nd part of duodenum distally. He was operated and duodenojejunostomy with limited right hemicolectomy (for stricture in this part of gut) were done. Biopsy report was suggestive of tuberculosis. Antituberculous treatment was started. He responded well and gained 20 kg weight at 3 months follow-up.

Management Of Myelomeningocele, A Sattar M. Hashim, Shahid Ahmed, Rashid Jooma

Section of Neurosurgery

Objective: T To find out best possible protocol to provide productive life to children born with myelomeningocele.
Study design: Descriptive study.
Place & Duration of study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi from December 2001 to December 2006.
Patients and Methods: The medical record of 415 children with myelomeningocele operated at our center was reviewed retrospectively. The surgical & medical management protocol used for different sites of myelomeningocele was studied.
Results: The age of most of the patients at the time of myelomeningocele repair was between 25-30 days; however, children with ruptured myelomeningocele were consistently repaired early. All …

Prosthetic Valve Thrombosis Despite Seemingly-Adequate Anticoagulation: The Dangers Of Transient Lapses In Anticoagulation, Fahim H. Jafary, K. Hassan

Section of Cardiology

We report a 19-year-old woman with thrombosis of a prosthetic mitral valve that was most likely due to a short dip in anticoagulation in the days preceding the event. Interestingly, at presentation the Patient was super-therapeutic, most likely a result of hepatic congestion as the heart began to fail, creating an illusion of thrombosis despite adequate anti coagulation.

Interferon Associated Retinopathy, Hassan Khan, Kamran Hamid, Aga Hassan Feroze

Section of Ophthalmology

We describe a case of retinopathy with swollen optic nerve head (ONH) in a hepatitis C patient treated with combination of interferon and ribavirin. A 33-years old man presented with sudden bilateral visual loss and headache. On examination, the Visual Acuity of right eye and left eye was hand movement and counting fingers respectively. Right fundus showed ONH swelling, healthy macula, with tortuous dilated vessels and small scattered, intra retinal haemorrhages. Retinopathy was only present in the right eye, however, poor vision in both eyes suggested neurovisual involvement.

A Novel And Generalizable Organotypic Slice Platform To Evaluate Stem Cell Potential For Targeting Pediatric Brain Tumors., Shengwen Calvin Li, William Gunter Loudon

Department of Cancer Biology Faculty Papers

Brain tumors are now the leading cause of cancer-related deaths in children under age 15. Malignant gliomas are, for all practical purposes, incurable and new therapeutic approaches are desperately needed. One emerging strategy is to use the tumor tracking capacity inherent in many stem cell populations to deliver therapeutic agents to the brain cancer cells. Current limitations of the stem cell therapy strategy include that stem cells are treated as a single entity and lack of uniform technology is adopted for selection of clinically relevant sub-populations of stem cells. Specifically, therapeutic success relies on the selection of a clinically competent …

Molecular Ablation Of Tgf-Beta Signaling Pathways By Tyrosine Kinase Inhibition: The Coming Of A Promising New Era In The Treatment Of Tissue Fibrosis, Joel Rosenbloom, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

No abstract provided.

Racial Disparities Of Post Stroke Physical Therapy In South Carolina, Aaron E. Embry

MUSC Theses and Dissertations

Background and Purpose: Stroke is a devastating event that drastically changes the lives of many people worldwide. Stroke statistics vary across the United States with the highest rates in the southeast. Physical therapy is often required to return to normal function. Appropriateness for physical therapy is based on individual impairments, thus access to and amount of physical therapy should not differ between races. Methods: Using a South Carolina UB-92 data subset for 2002, univariate analysis is performed against physical therapy and race for ischemic stroke victims. Logistic regression is used to test for differences in access to physical therapy. Multiple …

Novel Implications Of The Kallikrein-Kinin System In Diabetic Vasculopathy: A Proposed Role Of Prekallikrein In The Causation And Development Of Vascular Pathology In Diabetics, Rany Abdallah

MUSC Theses and Dissertations

Despite the clear association between diabetes and atherosclerotic vascular disease, the factors and mechanisms underlying the association between the two diseases are not well understood. Our preliminary studies, based on data obtained from the national Diabetes Control and Complication Trial/Epidemiology of Diabetes and Complications (DCCT/EDIC) cohort of type 1 diabetes subjects, suggest that diabetic atherosclerosis is linked to defects in the Kallikrein-Kinin System (KKS). Our research also found that apoliporotein E (ApoE) knockout mice, which have marked increase in total plasma cholesterol levels and a higher number of atherosclerotic lesions compared to wild type mice, have markedly higher plasma prekallikrein …

Characterization Of Calpain 10 Activity, Expression, And Inhibition, Christopher Joseph Giguere

MUSC Theses and Dissertations

Calpains are a family of Ca^2+-activated, non-lysosomal, cysteine proteases that have been implicated in a variety of physiological and pathological processes. Currently, the family consists of 14 members, of which eight are typical (calpains 1, 2, 3, 8, 9, 11, 12, and 14) and six are atypical (calpains 5, 6, 7, 10, 13, 15), based on the presence or absence of the Ca^2+-binding domain (domain IV), respectively. The atypical calpain have recently gained attention due to studies that have linked human diseases to mutations in specific calpain genes (Type 2 diabetes linked to calpain 10 and Limb Girdle Muscular Dystrophy …

An Assessment Of Noninvasive Measurements Of Arterial Compliance, Andrea D. Boan

MUSC Theses and Dissertations

Arterial stiffness is considered both a risk factor and indicator of cardiovascular disease. The purpose of this study was to examine the associations of cardiovascular risk indicators of arterial compliance among 226 black and white individuals enrolled in an outpatient clinical setting. Data were collected by survey and examination with a computerized arterial pulse waveform analyzer. Arterial stiffness was estimated by indirect estimates of small artery and large artery compliance, as well as pulse pressure. After adjustments for age, race, and gender, logistic regression identified hypertension, end organ damage, and overweight as the strongest predictors for the three arterial stiffness …

Infiltrating Syringomatous Adenoma Of Nipple, Nazia Riaz, Shaista Masood Khan, Romana Idress, Naila Kayani

Section of General Surgery

Infiltrating syringomatous adenoma of the nipple is a rare, benign lesion with distinct clinical and histological features. Origin from ducts of dermal sweat glands has been postulated. Important differential diagnosis include nipple adenoma, tubular carcinoma and adenosquamous carcinoma. Appropriate local management includes accurate diagnosis and complete excision to avoid local recurrences. This report describes the condition in a 39-year-old parous lady.

Department Of Pediatrics, George Magnus Johnson

UND Departmental Histories

This departmental history was written on the occasion of the UND Quasquicentennial in 2008.

Department Of Pathology History, Jean Holland, Eileen Nelson, Mary Coleman, Cathy Perry, Mary Beth Mcgurran, Ruth Paur, Mary Ann Sens

UND Departmental Histories

This departmental history was written on the occasion of the UND Quasquicentennial in 2008.

History Of The Department Of Internal Medicine, Barb Schuetz, Reed T. Keller, William P. Newman

UND Departmental Histories

This departmental history was written on the occasion of the UND Quasquicentennial in 2008.

Pdgf-Driven Proliferation, Migration, And Il8 Chemokine Secretion In Human Corneal Fibroblasts Involve Jak2-Stat3 Signaling Pathway, Neeraj Vij, Ajay Sharma, Mahesh Thakkar, Sunilima Sinha, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

Purpose: Platelet-derived growth factor (PDGF) is associated with corneal fibroblast migration and proliferation and plays an important role in corneal wound healing. However, the intracellular mechanisms of PDGF-mediated functions in corneal fibroblasts are poorly understood. We tested the hypothesis that PDGF functional activities in the cornea involve the Janus kinase-2/signal transducers and activators of transcription-3 (JAK2-STAT3) signaling pathway and whether PDGF induces the expression of suppressors of cytokine signaling 3 (SOCS3), belonging to the novel family of feedback regulators of cytokine and growth factor activities.

Methods: Human corneal fibroblast (HSF) cultures were used as an in vitro model for functional …

A Versatile Assay For The Identification Of Rna Silencing Suppressors Based On Complementation Of Viral Movement, Jason G. Powers, Tim L. Sit, Feng Qu, T. Jack Morris, Kook-Hyung Kim, Steven A. Lommel

Nebraska Center for Virology: Faculty Publications

The cell-to-cell movement of Turnip crinkle virus (TCV) in Nicotiana benthamiana requires the presence of its coat protein (CP), a known suppressor of RNA silencing. RNA transcripts of a TCV construct containing a reporter gene (green fluorescent protein) (TCV-sGFP) in place of the CP open reading frame generated foci of three to five cells. TCV CP delivered in trans by Agrobacterium tumefaciens infiltration potentiated movement of TCV-sGFP and increased foci diameter, on average, by a factor of four. Deletion of the TCV movement proteins in TCV-sGFP (construct TCVΔ92-sGFP) abolished the movement complementation ability of TCV CP. Other known suppressors of …

Devices In Heart Failure: Potential Methods For Device-Based Monitoring Of Congestive Heart Failure, Shahzeb M Munir, Roberta C Bogaev, Ed Sobash, K J Shankar, Sreedevi Gondi, Igor V Stupin, Jillian Robertson, M Alan Brewer, S Ward Casscells, Reynolds M Delgado, Amany Ahmed

Faculty, Staff and Student Publications

Congestive heart failure has long been one of the most serious medical conditions in the United States; in fact, in the United States alone, heart failure accounts for 6.5 million days of hospitalization each year. One important goal of heart-failure therapy is to inhibit the progression of congestive heart failure through pharmacologic and device-based therapies. Therefore, there have been efforts to develop device-based therapies aimed at improving cardiac reserve and optimizing pump function to meet metabolic requirements. The course of congestive heart failure is often worsened by other conditions, including new-onset arrhythmias, ischemia and infarction, valvulopathy, decompensation, end-organ damage, and …

Isolated Right Temporal Lobe Stroke Patients Present With Geschwind Gastaut Syndrome, Frontal Network Syndrome And Delusional Misidentification Syndromes, Michael Hoffmann

Neurology Faculty Publications

Background: Right temporal lobe lesion syndrome elicitation presents a clinical challenge. Aside from occasional covert quadrantanopias, heralding elementary neurological deficits are absent.Aim: Isolated right and left temporal lobe stroke patients were analyzed for the panoply of known temporal and frontal cognitive and neuropsychiatric syndromes.Methods: Temporal lobe stroke patients were analyzed, derived from a dedicated cognitive stroke registry. Patients were screened by a validated bedside cognitive battery and a neuropsychological test battery, including the Bear Fedio Inventory for diagnosis of the Geschwind Gastaut (GG) syndrome, frontal network syndrome testing (FNS), emotional intelligence testing and delusional misidentification syndromes (DMIS). NIH …

Frequency Of Abnormal Pap Smears And Assessment Of Risk Factors For Cervical Cancer In An Out-Patient Clinic, Firdous Jahan, Naheed Nabi, Waris Qidwai, Iqbal Azam

Department of Family Medicine

No abstract provided.

Determining Standard Criteria For Endotracheal Suctioning In The Paediatric Intensive Care Patient: An Exploratory Study [Thesis], Kylie Davies

Theses: Doctorates and Masters

Endotracheal tube (ETT) suction is a common nursing procedure within the paediatric intensive care (PIC) setting. Significant side effects associated with this procedure can dramatically affect the stability of the critically ill ventilated paediatric patient. A comprehensive literature review failed to establish clear standards for determining when the procedure is warranted, especially in the paediatric population. This can present difficulty for the inexperienced paediatric intensive care nurse when assessing a patient's need for ETT suction. The aim of the research was to design an evidence based endotracheal suction assessment tool (ESAT) for use by nurses caring for paediatric patients. The …

The Effect Of Nurse Initiated Paracetamol On Emergency Department Patients With Pain From Low Acuity Injury, Joanne G. Wilson

Theses: Doctorates and Masters

Early identification and management of pain was identified at the commencement of this study as a key area requiring research in emergency departments. Prolonged waiting times for analgesia especially, was highlighted in the National Institute of Clinical Studies emergency department collaborative in 2003. Many barriers exist for a patient to receive analgesia. In Western Australia this is compounded by the legislation which restricts prescribing rights for nurses. Three considerations guided the development of the research project. Firstly, the patient has initial contact with the emergency department from the nurse at triage. Secondly, paracetamol was recognised as a potentially effective analgesic …

Detection And Molecular Epidemiological Analysis Of Acute Gastroenteritis Viruses In The South Of Ireland, Grainne Lennon

Theses

Rotavirus infections are considered to be the most common cause of severe gastroenteritis in children under the age of 5 years, and are responsible for up to 611,000 deaths annually, mainly in developing countries. From 1997 to 1999, 16 hospital laboratories in the Republic of Ireland reported to detection of 4,643 cases of rotaviral disease, while in 2004 and 2005 and increase of 1,600 and 2,251 rotavirus cases were reported. These rotavirus cases have a significant impact on the healthcare system with the minimum cost per case being €728.40. A large percentage of the infections were reported in neonates, suggesting …

Etiology Of Frontal Network Syndromes In Isolated Subtentorial Stroke, Michael Hoffmann, Lourdes Benes Cases

Neurology Faculty Publications

Background: The neurobiology of the frontal network syndrome (FNS) that may occur with isolated subtentorial stroke is unknown.Aim: Evaluate for frontal network syndromes in young people post subtentorial stroke who have recovered neurologically and compare to a stroke lesion group least likely to manifest frontal network syndromes.Methods: Young people (18–49 years) with isolated cerebellar or brainstem subtentorial stroke (ST) that had recovered to independency (Rankin score ࣘ 2) with minimal or no residual neurological deficit (NIHSS ࣘ 4) with neurological recovery enabling resumption of former employment. Comparison was made to age and education matched young people with posterior …

Foreign Accent Syndrome Mimicked By Garcin Syndrome With Spontaneous Resolution, Michael Hoffmann

Neurology Faculty Publications

An English speaking women developed a French accent, without any aphasic syndromes, in conjunction with multiple left sided cranial nerve deficits, temporally related to cranial trauma. Extensive testing with multimodality magnetic resonance imaging, cerebrospinal fluid and laboratory analysis was unremarkable. She was followed over a 3 year period during which her French accent resolved as did the majority of her multiple unilateral cranial neuropathies. The neurological diagnoses included a foreign accent syndrome attributed to a reversible Garcin syndrome.

The Increasing Number Of Clinical Items Addressed During The Time Of Adult Primary Care Visits, Elmer D. Abbo, Qi Zhang, Martin Zelder, Elbert S. Huang

Community & Environmental Health Faculty Publications

BACKGROUND: Primary care physicians report that there is insufficient time to meet patients' needs during clinical visits, but visit time has increased over the past decade.

OBJECTIVE: To determine whether the number of clinical items addressed during the primary care visit has increased, and if so, whether this has been associated with changes in visit length and the pace of clinical work.

DESIGN: Analysis of non-hospital-based adult primary care visits from 1997 to 2005, as reported in the National Ambulatory Medical Care Survey.

PARTICIPANTS: A total of 46,431 adult primary care visits.

MEASUREMENTS: We assessed changes over time for …

Endovascular Stenting For Carotid Artery Stenosis: Results Of Local Experience At Aga Khan University Hospital, Karachi, Muhammad Azeem Uddin, Tanveer Ul Haq, Ishtiaque Ahmed Chishty, Zafar Sajjad, Basit Salam

Department of Radiology

Objective: To evaluate the results, complications and initial follow-up of patients after percutaneous stent placement for carotid artery disease.Methods: A retrospective study was carried out on patients treated with carotid artery stenting at the Radiology Department of Aga Khan University Hospital, Karachi, from September 2002 to December 2005. The patients were selected according to the institutional guidelines for Carotid Angioplasty and stenting. Preliminary angiogram was performed in all patients followed by stent deployment. Distal protection device was used in 12 patients. All patients underwent pre and post procedure independent neurological examinations. Follow-up consisted of serial duplex ultrasonography and clinical assessment.Results: …

Juvenile Onset Central Nervous System Folate Deficiency And Rheumatoid Arthritis, Mary Kay Koenig, Maria Perez, Sheldon Rothenberg, Ian J Butler

Faculty, Staff and Student Publications

Isolated cerebral folate deficiency was detected in a 13-year-old girl with cognitive and motor difficulties and juvenile rheumatoid arthritis. Her serum contains autoantibodies that block membrane-bound folate receptors that are on the choroid plexus and diminish the uptake of folate into the spinal fluid. Whereas her serum folate exceeded 21 ng/mL, her spinal fluid contained 3.2 ng/mL of 5-methyltetrahydrofolate as a consequence of the autoantibodies diminishing the uptake of this folate.

Analytical Approaches To Detect Maternal/Fetal Genotype Incompatibilities That Increase Risk Of Pre-Eclampsia, Neeta Parimi, Gerard Tromp, Helena Kuivaniemi, Jyh Nien, Ricardo Gomez, Roberto Romero, Katrina Ab Goddard

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

In utero interactions between incompatible maternal and fetal genotypes are a potential mechanism for the onset or progression of pregnancy related diseases such as pre-eclampsia (PE). However, the optimal analytical approach and study design for evaluating incompatible maternal/offspring genotype combinations is unclear.

Methods

Using simulation, we estimated the type I error and power of incompatible maternal/offspring genotype models for two analytical approaches: logistic regression used with case-control mother/offspring pairs and the log-linear regression used with case-parent triads. We evaluated a real dataset consisting of maternal/offspring pairs with and without PE for incompatibility effects using the optimal analysis based …

Labrad : Vol 33, Issue 1 - January 2008, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Diagnosis of Malaria
• Imaging Feature of Synovial Sarcoma in Pediatrics Patients
• Fine Needle Aspiration Biopsy: The best test to differentiate benign from malignant thyroid nodules
• HLA-B27 and Disease Association
• Bacterial Contamination of Blood Components
• Pathology Quiz
• Biochemical Investigations
• Leishmaniasis
• Answers to Quiz
• CD55 and CD59 for the Diagnosis of PNH
• Meeting Report