Medical Specialties Commons^™

Vital Signs, Spring/Summer 2009, Boonshoft School Of Medicine

Vital Signs

A fifty-six page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles and smaller pieces that focus on faculty, students, milestones and more.

Does Admission Hyperglycemia Predict Intracranial And Extracranial Vasculopathy?, Ather Mohammed Taqui, Ayeesha Kamran Kamal, Saqib Ali Gowani, Bhojo A. Khealani, Shafquat Rozi

Department of Medicine

Objective: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.
Methods: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.
Results: Out of the total of 216 patients, the age of majority of the patients (83.3%) was >50 years …

Diffusion Weighted Image (Dwi) Findings In Methanol Intoxication., Humera Ahsan,, Muhammad Akbar, Aamir Hameed

Department of Medicine

Methanol is a toxic substance with extremely devastating effects upon exposure. The case described suffered from such kind of poisoning. MRI brain demonstrated necrosis bilaterally in the Putamen areas which is a classic hallmark finding. Additional Diffusion weighted imaging showed abnormal signal bilaterally in the putamen areas along with Diffusion positive bilateral lesions (possibly infarctions) in both the frontal and occipital lobes that were not evident on MRI with or without contrast.

Training Tomorrow’S Providers And Expanding Access To Peginterferon/Ribavirin Combination Therapyfor Chronic Hepatatis C In Underinsured/Uninsured Patients: Final Outcomes Of A Pilot, Resident-Initiated, Multidisciplinary, Hepatitis C Clinic, Nicole M. Agostino Do, Suzanne J. Templer Do, Edward Norris Md, Fapm, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Joseph L. Yozviak Do, Facp

Department of Medicine

No abstract provided.

Diffusion Weighted Image (Dwi) Findings In Methanol Intoxication, Humera Ahsan, Muhammad Akbar, Aamir Hameed

Department of Radiology

Methanol is a toxic substance with extremely devastating effects upon exposure. The case described suffered from such kind of poisoning. MRI brain demonstrated necrosis bilaterally in the Putamen areas which is a classic hallmark finding. Additional Diffusion weighted imaging showed abnormal signal bilaterally in the putamen areas along with Diffusion positive bilateral lesions (possibly infarctions) in both the frontal and occipital lobes that were not evident on MRI with or without contrast.

Labrad : Vol 34, Issue 2 - May 2009, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Acute Leukemia Immunophenotyping with Pakistani Perspective
• PAX5: Immunohistochemistry Marker for B cell Lymphoproliferative Disorders
• Understanding the Water Deprivation Test
• Gonadotropins Releasing Hormone (GnRH) Stimulation Test
• Haematology Quiz
• Red Cell Mass Study
• Semen Analysis: An Invaluable Tool for Infertility Work-up
• Foetal Anomaly Scan
• Diagnosis of Helicobacter Pylori Infection
• Hepatitis C Virus (HCV) Genotyping
• Answer to Haematology Quiz

The Physician's Response To Climate Change., Mona Sarfaty, Safiya Abouzaid

Department of Family & Community Medicine Faculty Papers

Climate change will have an effect on the health and well-being of the populations cared for by practicing physicians. The anticipated medical effects include heat- and cold-related deaths, cardiovascular illnesses, injuries and mental harms from extreme weather events, respiratory illnesses caused by poor air quality, infectious diseases that emanate from contaminated food, water, or spread of disease vectors, the injuries caused by natural disasters, and the mental harm associated with social disruption. Within several years, such medical problems are likely to reach the doorsteps of many physicians. In the face of this reality, physicians should assume their traditional roles as …

Oncolog Volume 54, Number 05, May 2009, John Lebas

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

• Targeting Inflammation in Cancer Prevention
• Treating Radiation Necrosis of the Brain
• Preclinical Studies Reveal Effectiveness of Therapies for Pediatric Cancers
• House Call: Protect and Check Your Skin

Addressing Cervical Cancer In Central Appalachia, Baretta R. Casey, Richard A. Crosby, Wallace Bates, Tonya D. Godsey, Mark B. Dignan

Center of Excellence in Rural Health Presentations

Rural women, particularly those residing in Appalachia, have some of the nation’s highest cervical cancer mortality rates. With support from federal and private grants, the University of Kentucky Center for Excellence in Rural Health-Hazard is attempting to address this issue. Eastern Kentucky-based researchers are surveying 18- to 26-year-old female community health center patients and college students about their risk factors for the disease, and then offering them free Gardasil, a vaccine against the virus that causes most cervical cancer cases.

Primary Vesical Varices: A Cause Of Gross Haematuria, Fauzia Ahmad Bawany, Rajab Ali Ghirano, Syed Raziuddin Bayabani

Section of Urology

We report a case of isolated bladder varices that manifested with sudden onset, gross hematuria, in a 44-year-old male with no co-morbid conditions. Varicosities were discovered on cystoscopy. Conditions to look out for in such a situation are discussed.

Clinical And Quality-Of-Life (Qol) Outcomes In Women Treated By Tension Free Vaginal Tape (Tvt), Raheela Mohsin Rizvi

Department of Obstetrics & Gynaecology

Objectives: To assess subjective success rates, complications and impact on quality of life (QoL) in women treated by Tension Free Vaginal Tape for urinary incontinence.

Methods: A retrospective cohort analysis was made on 30 consecutive women undergoing TVT procedure alone or as concomitant to other pelvic surgical procedures, from June 2004 to October 2007. All the Patients were evaluated by history, clinical examination with POP-Q (pelvic organ prolapse-quantification) scoring for uterovaginal prolapse and urodynamic testing. Improvement of health-related QoL (quality of life) was assessed by incontinence impact questionnaire-short form (IIQ-7) and urogenital distress inventory-short form (UDI-6). The success of surgery …

Correlates Of Soy Food Consumption In Adventist Health Study-2, Yen Ang

Loma Linda University Electronic Theses, Dissertations & Projects

Much has been discussed about the health benefits and risks of soy consumption but very little is known about who the consumers are. Most of what is known has been observed mainly in Asian populations who consume high levels of soy. Very little is known about soy food intake in the western population who typically has low consumption level. The Seventh-Day Adventist cohort in North America is the only population known in the West with soy food intake that is comparable to the Asian population living in the East.

Soy consumers in a population known for its healthier lifestyle and …

State Infant Mortality: An Ecologic Study To Determine Modifiable Risks And Adjusted Infant Mortality Rates., David A. Paul. Md, Amy Mackley, Rnc, Robert G. Locke, Do, John L. Stefano, Md, Charlan Kroelinger, Phd

Department of Pediatrics Faculty Papers

OBJECTIVE: To determine factors contributing to state infant mortality rates (IMR) and develop an adjusted IMR in the United States for 2001 and 2002. DESIGN/METHODS: Ecologic study of factors contributing to state IMR. State IMR for 2001 and 2002 were obtained from the United States linked death and birth certificate data from the National Center for Health Statistics. Factors investigated using multivariable linear regression included state racial demographics, ethnicity, state population, median income, education, teen birth rate, proportion of obesity, smoking during pregnancy, diabetes, hypertension, cesarean delivery, prenatal care, health insurance, self-report of mental illness, and number of in-vitro fertilization …

Use Of Home Remedies And Traditional Medicines For The Treatment Of Common Eye Ailments In Pakistan: A Qualitative Study, Khabir Ahmad, Muhammad Aman Khan, Muhammad Babar Khan, Muhammad Daud Khan, Azam Ali, Clare Gilbert

Department of Surgery Docs

Purpose: Qualitative studies focusing on the use of home remedies and traditional medicines for eye health are lacking. We explored the use of eye remedies and traditional eye medicines (referred to hereafter as “eye remedies/TEM”) in Pakistan’s Abbottabad district.

Material and Methods: We conducted face-to-face key informant interviews with 16 teachers (8 men, 8 women). Participants were asked to list eye remedies/TEM used in their home or in areas where they lived. They were also asked to specify conditions for which each one of them is used. Their responses were noted manually and the interview scripts were translated from Urdu …

Stories, Ethics And The Interpretation Of Meaning: Bearing Witness To Mothers' Stories Of Their Neonatal Intensive Care Unit Experience, Angela Chisum Blackburn

Dissertations

This study grounded in narrative perspectives was conducted to uncover mothers' experience of having a baby in the Neonatal intensive Care Unit (NICU). The purpose of this study was to describe and interpret mothers NICU experiences, and to sensitize health care professionals about the importance of mothers' personal experience stories.

The NICU experience began with mothers' birth experience or the incident that led up to her infant requiring care in the NICU and her experience extended beyond the NICU with future concerns about the health and wellbeing of her baby.

Stories of mothers' experience were gleaned from data generated from …

Antimicrobial Resistance Profile Of Methicillin Resistant Staphylococcal Aureus From Skin And Soft Tissue Isolates, Faiza Idrees, Kauser Jabeen, Muhammad Shoaib Khan, Afia Zafar

Department of Pathology and Laboratory Medicine

OBJECTIVES: To evaluate resistance rates in methicillin resistant Staphylococcus aureus (MRSA) against clindamycin, cotrimoxazole, tetracycline, fusidic acid, rifampicin and chloramphenicol isolated from skin and soft tissue infections (SSTI).

METHODS: Descriptive analysis of SSTI samples yielding MRSA in clinical laboratory of a tertiary care center; receiving specimens across Pakistan from January 2005 to June 2007.

MICROBIOLOGICAL METHODS: MRSA were identified using standard microbiological techniques. Susceptibility testing was performed by disc diffusion according to Clinical Laboratory Standards Institute (CLSI) against fusidic acid, tetracycline, cotrimoxazole, clindamycin, rifampicin and chloramphenicol. Minimum inhibitory concentrations (MIC) of rifampicin were determined using agar dilution method according to …

Differences In Responses Of Platelets To Fluid Shear Stress In Patients With Peripheral Artery Disease (Pad) And Coronary Artery Disease (Cad)., Vijay Nambi, Kay T Kimball, Paul Bray, Angela L Bergeron, Shawna L Johnson, Joel D Morrisett, Changyi Chen, Peter H Lin, Alan B Lumsden, Christie M Ballantyne, Jing-Fei Dong

Cardeza Foundation for Hematologic Research

Information on differences in platelet function between patients with peripheral arterial disease (PAD) and patients with coronary artery disease (CAD) is limited. We sought to examine the differences in the platelets response to shear stress in patients with PAD compared to those with CAD. Men with symptomatic PAD (ankle brachial index [ABI] < 0.9; n = 29) were compared with similarly aged men with CAD (post coronary artery bypass grafting; n = 40) but without PAD. All participants were on aspirin, and none were on clopidogrel. We measured changes in shear-induced platelet aggregation (SIPA) and shear-induced P-selectin expression (SIPE) under fluid shear rates of 5000 and 10,000 s(-1)which are typically found in arterioles and stenosed arteries, respectively. Aggregation was also induced by a combined stimulation of collagen, fluid shear stress, and adenosine diphosphate (ADP) or epinephrine using a platelet function analyzer (PFA-100) as well as optical aggregometry (arachidonic acid, collagen and epinephrine). Analyses of covariance adjusted for age, aspirin dose, and statin use were used to estimate differences between the groups. Values of SIPA at fluid shear rates of 5000 and 10,000 s(-1) were significantly higher in the PAD group, while there were no differences between the PAD and CAD groups in SIPE at both fluid shear rates. However, baseline shear-induced P-selectin expression was higher in patients with PAD than CAD (mean fluorescence intensity [MFI] = 2.93 +/- 1.37 vs.1.94 +/- 0.67; p = 0.01), while the percentage increases in SIPA and SIPE at fluid shear rates of 5000 and 10,000 s(-1) were significantly higher in patients with CAD when compared to PAD (p < 0.001 for all comparisons). Although there were several similarities in platelet function between men with PAD and men with CAD, significant differences in platelet responses to shear stress were observed in men with PAD when compared to those with CAD. Although the mechanism for these observed differences are not clear, we hypothesize that in vivo platelet activation in PAD patients may contribute to the differences and will need to be further investigated.

Using Thermoluminescent Dosimeters To Measure The Dose From High And Low Energy X-Ray Sources, Wesley Leon Boyd

UNLV Theses, Dissertations, Professional Papers, and Capstones

This work focused on using thermoluminescent dosimeters (TLDs) to measure the doses from two x-ray sources, a CT scanner and a linear accelerator (linac). In addition ion chambers were used to determine the isodose contours from the operation of the linac. 1mm x 1mm x 1mm TLD-100 microcubes were placed in a Lawrence Livermore National Laboratory (LLNL) torso phantom and irradiated using a Toshiba Aquilion One 320-Slice CT Scanner. Different thicknesses of shielding composed of antimony and bismuth powder suspended in an ethylene copolymer were used to shield the phantom and the dose reduction was measured. The dose reduction ranged …

Us And Mr Imaging Features Of Benign Cystic Mesothelioma Of The Liver: A Diagnostic Dilemma, Sachit K. Verma, Donald G. Mitchell, Oksana H. Baltarowich, Diane Bergin, Raphael Rubin

Department of Radiology Faculty Papers

Cystic mesotheliomas are benign neoplasms, often seen in the parietal and visceral peritoneum, omentum and pelvic organs, and are exceedingly rare in the liver. It is however important to be familiar with the radiological findings of this tumour because the signal-intensity and enhancement pattern of this tumor are unusual and not typical for any of the more frequently seen mass lesions. In our patient, characteristic imaging findings on dynamic contrast-enhanced MRI and histopathological confirmation with appropriate immunohistochemical markers facilitated a correct diagnosis. We herein describe the clinical, imaging and histopathological features, pathogenesis, differential diagnosis and treatment of benign cystic mesothelioma …

Use Of Triple-Site Ventricular Pacing In A Patient With Severe Congestive Heart Failure And Atrial Fibrillation., Faizel Osman, Jeilan Mohamed, G. Andre' Ng

Internal Medicine, East Africa

Cardiac resynchronization therapy (CRT) has become an accepted treatment for selected patients with drug-resistant heart failure. Data for patients in atrial fibrillation (AF) remains limited but suggests benefit in these patients too. We report the case of an 82-year-old patient with heart failure, VVIR permanent pacemaker, and permanent AF who had an upgrade to triple-site CRT implantation with good clinical response. Triple-site ventricular pacing may enhance the chance of response and LV reverse remodeling and should be considered in AF patients undergoing CRT implantation.

Basement Membrane Proteoglycans: Modulators Par Excellence Of Cancer Growth And Angiogenesis., Renato V. Iozzo, Jason J. Zoeller, Alexander Nyström

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Proteoglycans located in basement membranes, the nanostructures underling epithelial and endothelial layers, are unique in several respects. They are usually large, elongated molecules with a collage of domains that share structural and functional homology with numerous extracellular matrix proteins, growth factors and surface receptors. They mainly carry heparan sulfate side chains and these contribute not only to storing and preserving the biological activity of various heparan sulfate-binding cytokines and growth factors, but also in presenting them in a more "active configuration" to their cognate receptors. Abnormal expression or deregulated function of these proteoglycans affect cancer and angiogenesis, and are critical …

Photochemical Delivery Of Bleomycin In Malignant Glioma Cells, Joseph William Blickenstaff Iii

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite continued efforts, glioblastoma multiforme (GBM) remains an incurable form of primary brain cancer. Surgical resection followed by radiation treatment and chemotherapy have been the most effective modalities in prolonging median survival time to 14 months. This research aims to study the response of two different cell culture models to a novel drug delivery method termed photochemical internalization (PCI). PCI is a technique to improve the utilization of macromolecules (e.g. the chemotherapeutic drug bleomycin) in site-specific cancer therapy. This concept is based on the use of specially designed photosensitizers (e.g. aluminum phthalocyanine disulfonate; AlPcS _2a ) which preferentially localize in …

Does Admission Hyperglycemia Predict Intracranial And Extracranial Vasculopathy?, Ather Mohammed Taqui, Ayeesha Kamran Kamal, Saqib Ali Gowani, Bhojo A Khealani, Shafquat Rozi

Community Health Sciences

Objective: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.
Methods: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.
Results: Out of the total of 216 patients, the age of majority of the patients (83.3%) was >50 years …

To Evaluate The Role Of Sonography As An Adjunct To Mammography In Women With Dense Breasts, Imrana Masroor, Mohammad Nadeem Ahmed, Sajida Pasha

Department of Radiology

OBJECTIVE: To assess the role of sonography as an adjunct to mammography in women with dense breast tissue by determining yield and validity of sonography using histopathology/follow-up mammography as gold standard.

METHODS: It was a descriptive analytical study conducted at the Radiology Department of Aga Khan University Hospital, from September 2005 to April 2007. A total of 76, mammographically dense breasts were evaluated with ultrasound. Of these 32 had palpable lumps on mammography, and were excluded from the study. A total of 44 patients had either symptoms of vague nodularity, nipple discharge, mastalgia or had no symptoms and the mammograms …

Defining An Emerging Epidemic: Hcv Seroprevalence In A Large, Tertiary-Care Health Network In Pennsylvania, Margaret Hoffman-Terry Md, Facp, Joseph L. Yozviak Do, Facp, K Nadeem Ahmed Md, Sherrine Eid Mph, Timothy J. Friel Md, Kimberly A. Pacella, Luther Rhodes Iii Md

Department of Medicine

No abstract provided.

The Pakistan Risk Of Myocardial Infarction Study: A Resource For The Study Of Genetic, Lifestyle And Other Determinants Of Myocardial Infarction In South Asia, Danish Saleheen, Moazzam Zaidi, Asif Rasheed, Usman Ahmad, Abdul Hakeem, Muhammed Murtaza, Waleed Kayani, Rashid Jooma, Nadir Khan, Nabi Shah, Asad Ali Shah, Maria Samuel, Farina Hanif, Madiha Yameen, Sobia Naz, Aisha Sultana, Aisha Nazir, Shehzad Raza, Muhammad Shazad, Sana Nasim, Muhammad Ahsan Javed, Syed Saadat Ali, Mehmood Jafree, Muhammad Imran Nisar, Altaf Hussain, Ayeesha Kamran Kamal, Philippe M. Frossard

Department of Biological & Biomedical Sciences

The burden of coronary heart disease (CHD) is increasing at a greater rate in South Asia than in any other region globally, but there is little direct evidence about its determinants. The Pakistan Risk of Myocardial Infarction Study (PROMIS) is an epidemiological resource to enable reliable study of genetic, lifestyle and other determinants of CHD in South Asia. By March 2009, PROMIS had recruited over 5,000 cases of first-ever confirmed acute myocardial infarction (MI) and over 5,000 matched controls aged 30-80 years. For each participant, information has been recorded on demographic factors, lifestyle, medical and family history, anthropometry, and a …

Pattern Of Benzodiazepine Use In Psychiatric Outpatients In Pakistan: A Cross-Sectional Survey., Syed Ahmer, Sumera Salamat, Rashid Am Khan, Saleem Perwaiz Iqbal, Imran Ijaz Haider, Ayesha Shabaz Khan, Mohsan Zafar

Department of Psychiatry

Background: Benzodiazepines (BDZ) are the largest-selling drug group in the world. The potential of dependence with BDZ has been known for almost three decades now. In countries like Pakistan where laws against unlicensed sale of BDZ are not implemented vigorously the risk of misuse of and dependence on these drugs is even higher. Previous studies have shown that BDZ prevalence among Patients/visitors to general outPatient clinics in Pakistan may be as high as 30%. However, no research has been carried out on the prevalence of BDZ use in psychiatric Patients in Pakistan. Methods: We carried out a cross-sectional survey over …

Nonlinear Tube-Fitting For The Analysis Of Anatomical And Functional Structures, Jeff Goldsmith, Brian S. Caffo, Ciprian Crainiceanu, Daniel Reich, Yong Du, Craig Hendrix

Johns Hopkins University, Dept. of Biostatistics Working Papers

We are concerned with the estimation of the exterior surface of tube-shaped anatomical structures. This interest is motivated by two distinct scientific goals, one dealing with the distribution of HIV microbicide in the colon and the other with measuring degradation in white-matter tracts in the brain. Our problem is posed as the estimation of the support of a distribution in three dimensions from a sample from that distribution, possibly measured with error. We propose a novel tube-fitting algorithm to construct such estimators. Further, we conduct a simulation study to aid in the choice of a key parameter of the algorithm, …

Compositions And Methods For Detecting And Treating Atherosclerosis, Nancy R. Webb, Frederick C. De Beer

Internal Medicine Faculty Patents

Methods for detecting atherosclerotic plaque and quantifying the amount of Group V sPLA₂ in plasma are disclosed. These methods can be used to assess the risk of cardiovascular pathology in a patient.

Implications For Child Welfare Teaching And Human Services Personnel Perspectives Experiences Of Children With Special Needs, Sarah Huesmann

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.