Medical Specialties Commons^™

Helicobacter Pylori Infection: Approach Of Primary Care Physicians In A Developing Country, Shahid Ahmed, Mohammad Salih, Wasim Jafri, Syed H Shah, Saeed Hamid

Section of Gastroenterology

Background:The aim of the study was to assess the knowledge and practices of primary care physicians in diagnosis and management of Helicobacter pylori ( H. pylori) infection in developing country.

Methods: This convenient sample based, cross sectional study was conducted in primary care physicians of Karachi, Pakistan from March 2008 to August 2008 through a pretested self-designed questionnaire, which contained 11 items pertaining to H. pylori route of transmission, diagnosis, indication for testing, treatment options, follow up and source of information.

Results: Out of 509 primary care physicians, 451 consented to participate with the response rate of 88.6%. Responses …

Physical And Functional Interaction Between The Dopamine Transporter And The Synaptic Vesicle Protein Synaptogyrin-3, Loreto A Egaña, Rolando A Cuevas, Tracy B Baust, Leonardo A Parra, Rehana K Leak, Sarah Hochendoner, Karina Peña, Marisol Quiroz, Weimin C Hong, Mario M Dorostkar, Roger Janz, Harald H Sitte, Gonzalo E Torres

Faculty, Staff and Student Publications

Uptake through the dopamine transporter (DAT) represents the primary mechanism used to terminate dopaminergic transmission in brain. Although it is well known that dopamine (DA) taken up by the transporter is used to replenish synaptic vesicle stores for subsequent release, the molecular details of this mechanism are not completely understood. Here, we identified the synaptic vesicle protein synaptogyrin-3 as a DAT interacting protein using the split ubiquitin system. This interaction was confirmed through coimmunoprecipitation experiments using heterologous cell lines and mouse brain. DAT and synaptogyrin-3 colocalized at presynaptic terminals from mouse striatum. Using fluorescence resonance energy transfer microscopy, we show …

An Adrenal Beta-Arrestin 1-Mediated Signaling Pathway Underlies Angiotensin Ii-Induced Aldosterone Production In Vitro And In Vivo., Anastasios Lymperopoulos, Giuseppe Rengo, Carmela Zincarelli, Jihee Kim, Stephen Soltys, Walter J Koch

Center for Translational Medicine Faculty Papers

Aldosterone produces a multitude of effects in vivo, including promotion of postmyocardial infarction adverse cardiac remodeling and heart failure progression. It is produced and secreted by the adrenocortical zona glomerulosa (AZG) cells after angiotensin II (AngII) activation of AngII type 1 receptors (AT(1)Rs). Until now, the general consensus for AngII signaling to aldosterone production has been that it proceeds via activation of G(q/11)-proteins, to which the AT(1)R normally couples. Here, we describe a novel signaling pathway underlying this AT(1)R-dependent aldosterone production mediated by beta-arrestin-1 (betaarr1), a universal heptahelical receptor adapter/scaffolding protein. This pathway results in sustained ERK activation and subsequent …

Primary Cardiac Tumors., Suraj Maraj, Md, Gregg S. Pressman, Md, Vincent M. Figueredo, Md

Division of Cardiology Faculty Papers

Primary cardiac tumors are a rare entity compared to tumors that metastasize to the heart. Patients with such tumors may be asymptomatic. Many cases are found incidentally during evaluation of an unrelated medical condition. It is important for the clinician to have a high index of suspicion when evaluating a patient presenting with signs and systemic symptoms concerning possible malignancy, plus cardiac specific symptoms or complications. These can include new onset dyspnea, congestive heart failure, arrhythmias or murmurs varying with body positions. Imaging, particularly the use of echocardiography, remains the cornerstone of diagnosis, and may be combined with new imaging …

Esat6-Induced Ifngamma And Cxcl9 Can Differentiate Severity Of Tuberculosis., Zahra Hasan, Bushra Jamil, Mussarat Ashraf, Muniba Islam, Muhammad S Yusuf, Javaid A Khan, Rabia Hussain

Department of Pathology and Laboratory Medicine

Background: Protective responses against Mycobacterium tuberculosis are dependent on appropriate T cell and macrophage activation. Mycobacterial antigen six kDa early secreted antigenic target (ESAT6) and culture filtrate protein 10 (CFP10) can detect M. tuberculosis specific IFNgamma responses. However, most studies have been performed in non-endemic regions and to study pulmonary tuberculosis (PTB). We have studied ESAT6 and CFP10 induced cytokine and chemokines responses in PTB and extrapulmonary (EPul) TB.
Methodology: IFNgamma, IL10, CXCL9 and CCL2 responses were determined using an ex vivo whole blood assay system in PTB (n = 30) and EPulTB Patients with limited (LNTB, n = …

Com Outlook Spring 2009, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Peer-Led Team Learning: A Prospective Method For Increasing Critical Thinking In Undergraduate Science Courses, Ian J. Quitadamo, C. Jayne Brahler, Gregory J. Crouch

Physical Therapy Faculty Publications

This study examined the impact of peer-led team learning (PLTL) on critical thinking gains in science and math courses at a research university in the Pacific Northwest.

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith M. Williams, Carlos J. Crespo, Joan Dorn

Community Health Faculty Publications and Presentations

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Nano-Formulation And Controlled Delivery Of Low Solubility Anticancer Drugs, Anshul Agarwal

Doctoral Dissertations

Optimal drug delivery and reduction of systemic adverse effects have been age old problems in chemotherapeutics in all types of human cancer. During chemotherapy, using water insoluble drugs like paclitaxel and tamoxifen, it has been realized that better formulations are needed for more specific and controlled drug delivery of these agents. In a novel approach to form high content stable nanocolloids of these drugs with controllable release rate, a sonicated layer-by-layer (LbL) polyelectrolyte coating technology is suggested. The desired features of pharmaceutical carriers for intravenous administration include their small size and biodegradability, good loading capacity for a given drug, high …

Entitlements: Not Just A Health Care Problem, Andrew G. Biggs

The University of New Hampshire Law Review

[Excerpt] “A new consensus on entitlement reform has developed in Washington: rising per-capita health care spending is the only real crisis besetting the government‘s entitlement programs, while America‘s aging population and Social Security play minor roles at best. Some cite this view to shift the policy emphasis from entitlement cost control to the restructuring of the U.S. health sector, including private health care. But this new consensus is flawed. Using standard accounting practices and including all major government entitlement programs, population aging will play an equal role with health care cost growth over the next seventy-five years and a significantly …

Younger Neurosurgoens —Ambitions, Evircilions Or Dilemma?, Amit Agrawal

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Clinical Evaluation 32 Patients With Jme In Southern Khorasan, Hamid Riasi, Fariba Nakhaei, Kavian Ghandehari, Frood Salehi, Zahra Toraby, Mojtaba Teimoori

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Intrathecal Use Of Polyrnyxinb For Multiresistant Acineobacter Meningitis, Atta-Ul Aleem Bhatti, Aslam Khan, Syed Ather Enam, Rashid Jooma

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

16th Annual Psn Meeting, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Central Corneal Thickness Of Pakistani Adults, Roomasa Channa, Fazia Mir, Mahnaz Naveed Shah, Azam Ali, Khabir Ahmad

Section of Ophthalmology

Objective: To determine the average central corneal thickness (CCT) of healthy adults in the ophthalmology clinic of a tertiary care hospital of Pakistan.
Methods: This was a cross-sectional study conducted in the ophthalmology clinics of Aga Khan University Hospital, Karachi Pakistan. One hundred normal subjects (200 eyes) were studied. An ultrasound pachymeter was used to measure CCT.
Results: The mean (+/- SD) age of the study population was 44.29 +/- 15.18 years with a median of 47 years (range: 16-73). Twenty three percent of the subjects had diabetes mellitus, 29% hypertension and 6% had history of ischaemic heart disease. The …

Gender Differences And Delay In Presentation Of Childhood Squint, Tanveer Anjum Chaudhry, Aziz Khan, Muhammad Bilal Salman Khan, Khabir Ahmad

Section of Ophthalmology

Objective: To assess gender differences and delay in presentation of childhood squint in a tertiary care hospital.
Methods: It was a series of children presenting with squint at the Aga Khan University Hospital, Karachi, Pakistan. We retrospectively studied the cases presenting between February 2000 and July 2007.
Results: A total of 107 children with squint were seen. Of these, 55 (52.4%) were girls. A statistically significant difference was observed between the mean age at presentation (+/- SD) of boys and girls (3 years and 5 months vs 4 years and 5 months p: < 0.05). Girls had a greater mean (SD) and median (range) delay in squint presentation than had boys (2 year 4 months +/- 3 years vs 3 years +/- 2 year 8 months) and 2 year 3 months (1 month to 12 years) vs 1 year 3 months (1 month to 14 years), respectively. Overall amblyopia was present in 25.3% (23/91) children. Girls also had a higher burden of amblyopia compared with their male counterparts though the difference was not statistically significant (P = 0.09).
Conclusion: There was a significant gender difference …

Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions (Part 1), Muhammad Shahzad Shamim, Ather Enam, Rushna Pervez Ali, Syed Faizan Ali, Mohammad Wasay

Section of Neurosurgery

No abstract provided.

Asian Cerebral Venous Thrombosis Registry: Study Protocolv, Mohammad Wasay, Ayeesha Kamal, Bhojo Khealani

Department of Medicine

Introduction:

Cerebral venous thrombosis (CVT) is a well known but poorly reported entity. Most of the studies and registries related to CVT are reported from European countries. No large multi-center or multi- national data base or registry has been reported from Asian countries. CVT is not uncommon in Asia especially in south Asian subcontinent including India, Pakistan and Bangladesh. One study reported from India that CVT accounted for half of all strokes in the young and 40% of strokes in women. Review of CVT cases from Asian countries is suggestive of differences in risk factors profile and outcome in these …

Moyamoya Disease: A Clinical Spectrum, Literature Review And Case Series From A Tertiary Care Hospital In Pakistan., Sana Shoukat, Ahmed Itrat, Ather M. Taqui, Moazzam Zaidi, Ayeesha Kamran Kamal

Department of Medicine

Background: Moyamoya is a rare cerebrovascular disease of unknown etiology. The data on moyamoya disease from Pakistan is sparse. We report a case series of 13 patients who presented with moyamoya disease to a tertiary care hospital in Pakistan with a national referral base.

Methods: We conducted a retrospective review of thirteen patients who presented to The Aga Khan University and diagnosed with "Moyamoya Disease" during the period 1988 – 2006. These patients were identified from existing hospital database via ICD-9 codes. A predesigned questionnaire containing information about clinical presentation, management and neuroimaging was administered to all identified patients. Results: …

Fight Against Chronic Diseases (High Blood Pressure, Stroke, Diabetes And Cancer) In Pakistan; Cost-Effective Interventions, Mohammad Wasay, Abdul Jabbar

Department of Medicine

No abstract provided.

Antiretroviral Therapy Dose Adjustments Based On Calculated Creatinine Clearance, J. Shavadia, G. Tesfaldet, Majid Twahir

Internal Medicine, East Africa

Background: Whereas therapy for HIV is dependent on level of creatinine clearance, most laboratories locally only report an absolute creatinine value. There is likelihood that the patients already on antiretroviral therapy (ART) may have required dosage adjustment at the time of initiation of therapy or sometime during ongoing therapy. This paper explores a group of patients who are already on ART to determine their creatinine clearance and assess the need for ART dose adjustment.

Objective: To determine the proportion of stable HIV outpatients who have a documented creatinine clearance (CrCI) and the proportion requiring antiretroviral drug dose adjustments depending on …

Visual Impairment And Eye Care Among Older Americans: Secondary Analysis Of The Behavioral Risk Factor Surveillance System (Brfss), Amy L. Freeland

Dissertations

The aim of this three-paper format dissertation is to explore three topics relevant to public health and vision loss. The three papers are independent studies, yet build upon each other by first describing the population of people aged 40 years and older in the United States in terms of visual impairment, diagnosed eye disease/injury, and their use of eye care, and then next exploring the factors that influence eye care use for both the general population and the subpopulation of people with diagnosed diabetes. The first paper provides a state-level examination of the characteristics of people aged 40 years and …

Long-Distance Delivery Of Bacterial Virulence Factors By Pseudomonas Aeruginosa Outer Membrane Vesicles, Jennifer M. Bomberger, Daniel P. Maceachran, Bonita A. Coutermarsh, Siying Ye, George A. O'Toole, Bruce A. Stanton, Frederick M. Ausubel

Dartmouth Scholarship

Bacteria use a variety of secreted virulence factors to manipulate host cells, thereby causing significant morbidity and mortality. We report a mechanism for the long-distance delivery of multiple bacterial virulence factors, simultaneously and directly into the host cell cytoplasm, thus obviating the need for direct interaction of the pathogen with the host cell to cause cytotoxicity. We show that outer membrane–derived vesicles (OMV) secreted by the opportunistic human pathogen Pseudomonas aeruginosa deliver multiple virulence factors, including β-lactamase, alkaline phosphatase, hemolytic phospholipase C, and Cif, directly into the host cytoplasm via fusion of OMV with lipid rafts in the host plasma …

Oncolog Volume 54, Number 04, April 2009, Sunita Patterson, Sunni Hosemann

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

• Rebuilding What Cancer Has Ravaged
• Organ-Confined Prostate Cancer
• House Call: Integrative Medicine: Understanding Complementary and Alternative Therapies

Digest Of The Philadelphia College Of Osteopathic Medicine (Summer 2009), Philadelphia College Of Osteopathic Medicine

Digest

The Summer 2009 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates and Kudos
• Development News
• GA-PCOM Mason W. Pressly Memorial Medal
• Crisis in the ER: Repairing the Nation’s Health Care Safety Net
• Challenges
• Finding Answers
• Physician Assistants Ease Burden
• Primary Care Physicians Are Key
• PCOM Provides Leadership
• Reunion Years Roundtable
• The Inspiration Behind the Simmy Ginsburg Humanitarian Award
• Class Notes
• In Memoriam
• My Turn Essay
• PCOM Events

Using Internet‐Based Vignette Methods To Understand Elder Residential Choices, Francis G. Caro, Teck Ho, Daniel Mcfadden, Alison Gottlieb, Christine Yee, Taizan Chan, Joachim Winter

Gerontology Institute Publications

This paper illustrates an innovative method of administering fractional factorial surveys (vignettes) using the internet. The approach makes it possible to use video clips to deliver information. The method also provides subjects with interactive options before making judgments. A study to determine the views of older people regarding residential options is used to illustrate the method. The study found that the following characteristics of vignette persons affected subject recommendations: personal introduction, functional status, social network, and current housing characteristics. However, characteristics of retirement community features and personal financial status did not affect recommendations.

Children's Health Insurance Program: The Dynamics Of Federalism And Health Care Policy, Erik White

Political Science Theses and Capstones

On February 4^th, 2009, President Obama signed into law the reauthorization of the Children Health Insurance Program. The federal government will now spend 30 billion dollars towards the goal of ensuring that more children in the United States are insured. I investigate this particular health care policy and look at the different dynamics that affect the ultimate goal of universal health insurance for children. Because this program allows for state flexibility under broad federal guidelines, one is able to look at individual states, and their particular actions and characteristics, to determine the best approach to insuring the most …

Cerebral Palsy In Adolescents, Rehan Ali, Shakeel Ahmed, Maqbool Qadir

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Changing Patterns Of Visual Hallucinations, Mubashira Hashmi, Ashfaq A. Sharif, Shaista A. Siddiqui, Muhammad Shahid Mustafa

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Gliosarcoma, Rafael Cincu, Juan F. Martín Lázaro, José Luis Capablo Liesa, Jose Eiras

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.