Medical Specialties Commons^™

Hypertension As A Chief Complaint In The Emergency Department, Steven P. Frei Md, David B. Burmeister Do, Facep, Jesse F. Coil Do

Department of Emergency Medicine

No abstract provided.

Hormonal Consequences Of Epilepsy And Its Treatment In Men., Kartik Sivaraaman, Scott Mintzer

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: Epilepsy and anticonvulsant medications may substantially alter endocrine homeostasis, including the male reproductive hormonal system.

RECENT FINDINGS: Seizures in medial temporal lobe structures, through their connectivity to the hypothalamus, alter the secretion of gonadotropins. Levels of circulating bioavailable testosterone are affected by changes in the level of binding proteins, which in turn may be affected by seizure medications. The use of older generation medications that induce the cytochrome P450 system is associated with an increase in sex hormone-binding globulin and lower bioactive testosterone. Sexual dysfunction, including decreased libido and decreased potency, and infertility, is seen commonly in …

Antidepressants And Breast And Ovarian Cancer Risk: A Review Of The Literature And Researchers' Financial Associations With Industry, Lisa Cosgrove, Ling Shi, David E. Creasey, Maria Anaya-Mckivergan, Jessica A. Myers, Krista F. Huybrechts

Counseling, School Psychology & Sport Faculty Publication Series

Background

Antidepressant (AD) use has been purported to increase the risk of breast and ovarian cancer, although both epidemiological and pre-clinical studies have reported mixed results [1]–[6]. Previous studies in a variety of biomedical fields have found that financial ties to drug companies are associated with favorable study conclusions [7].

Methods and Findings

We searched English-language articles in MEDLINE, PsychINFO, the Science Citations Index and the Cochrane Central Register of Controlled Clinical Trials (through November 2010). A total of 61 articles that assessed the relationship between breast and ovarian cancer and AD use and articles that examined the effect of …

Role Of Multidetector Computed Tomography (Mdct) In Patients With Ovarian Masses., Fatima Mubarak, Muhammad Shahbaz Alam, Waseem Akhtar, Saima Hafeez, Noureen Nizamuddin

Department of Radiology

Objective:To evaluate the diagnostic accuracy of multidetector 64-slice computed tomography (MDCT) in the diagnosis and differentiation of benign and malignant ovarian masses using histopathology and surgical findings as the gold standard. Material And

Methods:

This study was conducted in Aga Khan University Hospital, Karachi, Pakistan. Data was reviewed retrospectively from 1 November 2008 to 12 December 2009. One hundred Patients found to have ovarian masses on CT scan were included in the study. CT scan was performed in all these Patients after administration of oral and IV contrast. Ovarian masses were classified as benign and malignant on scan findings. …

An Insight Into The Suspected Hba2' Cases Detected By High Performance Liquid Chromatography In Pakistan., Maliha Nusrat, Bushra Moiz, Amna Nasir, Mashhooda Rasool Hashmi

Department of Pathology and Laboratory Medicine

Background:Hemoglobin A2' (delta 16 Gly Arg) is globally the commonest delta chain variant of HbA2. It is clinically and hematologically silent but its sole importance lies in the underestimation of HbA2 quantity during the workup of beta-thalassaemia trait. High performance liquid chromatography (HPLC) identifies it as a small S-window peak with a mean retention time of 4.59 0.03 minutes. This study aims at describing the frequency of detection of HbA2' by HPLC in Pakistan and its confirmation at a molecular level. Potential HbA2' cases were identified by a retrospective review of 10186 HPLC chromatograms in year 2006. Prospective samples …

Com Outlook Spring 2011, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Effects Of Exercise On Brain Activation In Response To Visual Food Cues, Laura Hackett

Kinesiology and Public Health

No abstract provided.

Expect The Unexpected: Researching Pregnant Women’S Social Supports, Amy Ma

Inquiry Journal 2011

No abstract provided.

T-Tube Management Of Late Esophageal Perforation, Irfan Qadir, Hasnain Zafar, Mubashir Zareen Khan, Hasanat Mohammad Sharif

Section of General Surgery

Esophageal perforation is a serious condition with a high mortality rate. Management strategy of such a patient depends on the extent of perforation and the time interval between perforation and diagnosis. The use of a T tube to treat delayed esophageal perforation with complete resolution and no need for future definitive surgery has been less frequently described. We adapted this principle in successful management of a 73 year old patient with four days history of fever, shortness of breath, chest pain and radiological evidence of perforation.

The Constant Threat Of Terrorism: Stress Levels And Coping Strategies Amongst University Students Of Karachi, Ayesha Ejaz Ahmed, Komal Masood, Sohni Vicky Dean, Tanzila Shakir, Ahmed Abdul Hafeez Kardar, Usman Barlass, Syed Haider Imam, Mohammad Ghawar Khan Mohmand, Hussain Ibrahim, Imad Saeed Khan, Usman Akram, Farid Hasnain

Department of Psychiatry

OBJECTIVES: To assess the levels of stress in the face of terrorism and the adopted coping strategies, amongst the student population of universities in Karachi

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METHODS: A descriptive, cross sectional study was conducted on undergraduate students from four universities of Karachi. Self-administered questionnaires were filled out by 291 students. Pearson Chi-Square test was used to assess associations between stress levels and different variables at a level of significance of 0.05%

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RESULTS: A total of 65.8% of the students had mild stress levels, 91.5% of university students were exposed to terrorism through television, while only 26.5% students reported personal …

Can We Stop The Stroke Epidemic In Pakistan?, Ismail A. Khatri, Mohammad Wasay

Department of Medicine

No abstract provided.

Helicobacter Pylori: Association With Gall Bladder Disorders In Pakistan, Javed Yakoob, M. R. Khan, Z. Abbas, W. Jafri, R. Azmi, Z. Ahmad, S. Naeem, L. Lubbad

Department of Medicine

Helicobacter species colonise the biliary tract and therefore this study explores the relationship between of Helicobacter pylori and cholecystitis. Bile and gall bladder tissue samples were obtained from 144 Patients who underwent cholecystectomy. Of these, 89 had chronic cholecystitis with cholelithiasis, 44 had gall bladder carcinoma and 11 had gall bladder polyps. Histopathology examination included special staining and immunohistochemistry (IHC), while Helicobacter species (H. pylori, H. bilis and H. hepaticus) were detected by the polymerase chain reaction (PCR). Sequencing and BLAST query of PCR products was undertaken and samples were considered to contain H. pylori if both PCR and IHC …

An Extensible Mathematical Model Of Glucose Metabolism, Caleb L. Adams

Mathematics & Statistics Theses & Dissertations

The American Diabetes Association reports that diabetes is the fifth leading cause of death by disease in the United States. An estimated 23.6 million individuals, or seven percent of the population, have diabetes. Nearly one-third are unaware that they have the disease. The total of the direct and indirect medical costs associated with diabetes in 2007 was projected to be $174 billion, or approximately one out of every ten health care dollars.

One must understand the glucose regulatory system of the healthy body to understand diabetes. Blood glucose concentration returns to a constant level after eating and is maintained during …

Knowledge And Attitudes Of Pakistani Women Towards Anaesthesia Techniques For Caesarean Section, Imtiaz Ahmad, Gauhar Afshan

Department of Anaesthesia

OBJECTIVE: To assess knowledge and attitudes of Pakistani women towards different options of anaesthesia techniques for caesarean section and also to identify their sources of information about them.

METHODS: A total of 410 women scheduled for elective caesarean section were enrolled after informed written consent in this hospital based cross sectional survey. The women were interviewed preferably in Urdu (national) language according to structured pre coded questionnaire by one of the investigators and the sequence of questions was strictly followed. This survey included pertinent questions to assess knowledge and attitudes of our women towards choices of anaesthesia techniques. The questionnaire …

Multicentric Hepatic Ebv-Associated Smooth Muscle Tumors In An Aids Patient: A Case Report, Investigation Of Mtor Activation And Review Of The Literature, Qi Shen, Wei Feng, Michael S Long, Xiuzhen Duan, Siraya Jaijakul, Cesar A Arias, Robert E Brown, Bihong Zhao

Faculty, Staff and Student Publications

Epstein-Barr virus (EBV) - associated smooth muscle tumors (EBV-SMT) are a rare, recently recognized distinct group of mesenchymal tumors that develop exclusively in patients with immunosuppression. It is believed that tumorigenesis is, at least in part, through the activation of the Akt/mammalian target of rapamycin (mTOR) signal pathway. We describe the clinicopathologic and immunohistochemical features of a multifocal hepatic EBV-SMT in a 34-year-old acquired immunodeficiency syndrome (AIDS) patient and investigate the activation status of the mTOR signal pathway in this tumor. In addition, we provide a review of the literature on the clinicopathologic findings of hepatic EBV-SMT in adult AIDS …

Role Of Antiarrhythmic Drugs: Frequent Implantable Cardioverter-Defibrillator Shocks, Risk Of Proarrhythmia, And New Drug Therapy., Christopher Droogan, Chinmay Patel, Gan-Xin Yan, Peter R Kowey

Department of Medicine Faculty Papers

The implantable cardioverter-defibrillator (ICD) is the standard of care in patients with ischemic and nonischemic cardiomyopathy who are at high risk for arrhythmic events and sudden cardiac death. Although an ICD saves life, ICD shocks are emotionally and physically debilitating. Most patients receive adjuvant antiarrhythmic drug therapy to circumvent episodes of recurrent ventricular and supraventricular arrhythmias. Antiarrhythmic drugs including β-blockers, sotalol, amiodarone, and azimilide are effective at reducing the shock burden. This article describes data supporting the need for and potential risks and benefits of adjuvant antiarrhythmic drug therapy and examines the benefits and pitfalls of the same in ICD-implanted …

Oncolog, Volume 56, Number 04-05, April-May 2011, Zach Bohannan, Bryan Tutt

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

• Understanding and Managing Multiple Endocrine Neoplasia Syndromes: Endocrine tumors caused by multiple endocrine neoplasia syndromes (MEN) pose a dual threat-both from the tumors' potential for growth or metastasis and from their hormonal secretions
• Two-Stage Resection and Improved Chemotherapy Regimens Lengthen Survival for Patients with Lever Metastasis from Colorectal Cancer
• HOUSE CALL: Saving a Life by Donating Stem Cells: Fact about stem cell transplants
• IN BRIEF: Study Reveals How EZH2 Protein Promotes Breast Tumor-Initiating Cell Growth

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 2011), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 2011 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Opening Remarks
• PCOM Updates
• Development News
• Moonlighting in the Big Leagues
• Closing the Gap in Primary Care
• In Love & War
• Driven by Adventure: Nilam Vaughan, DO ’11, recipient of the 2011 Mason W. Pressly Memorial Medal, GA–PCOM
• Stand by the Struggling: Jenna Stokes, DO ’11, recipient of the 2011 Simmy Ginsburg Humanitarian Award
• Class Notes
• In Memoriam
• My Turn Essay

Dual Chamber Pacemaker Implants--A New Opportunity In Pakistan For Children With Congenital And Acquired Complete Heart Block, Awais Ashfaq, Mansoor Ahmed Khan, Mehnaz Atiq, Muhammad Muneer Amanullah

Section of Cardiothoracic Surgery

Implantation of cardiac pacemakers has been practiced for at least five decades with continuous developments of the hardware. The invention of dual chamber pacemakers has initiated a debate concerning its superiority over single chamber ventricular pacemakers. Throughout the world, surgeons have been using dual chambered permanent pacemakers with successful follow ups. However, Pakistan has not yet taken the advantage of such pacemaker devices till now. We report three cases that underwent a dual chamber permanent pacemaker implantation for the first time in children less than 8 kg with successful follow ups.

Transjugular Intrahepatic Portosystemic Shunt (Tips); Review Of Initial Experience At Aga Khan University Hospital, Rana Shoaib Hamid, Tanveer-Ul-Haq, Muhammad Azeemuddin, Zafar Sajjad, Ishtiaq Chishti, Basit Salam

Department of Radiology

OBJECTIVE: To retrospectively assess the therapeutic effectiveness and safety of transjugular intrahepafic portosystemic shunt (TIPS) in patients with portal hypertension related complications.

METHODS: Over a period of 7.5 years 19 patients (10 males and 9 females, age range 25-69 years) were referred for TIPS at our radiology department. Thirteen patients suffered from liver cirrhosis while 6 had Budd Chiari syndrome. All patients were evaluated with colour doppler ultrasonography and cross sectional imaging. Shunt procedures were performed under sedation or general anaesthesia through internal jugular approach. Metallic self expandable uncovered stents were placed in 15 patients and covered stent in 1 …

Goldston Syndrome, Zainab Hussain, Imrana Masroor, Qurrat-Ul-Ain Haider, Tariq Alam

Department of Radiology

Goldston syndrome is a rare entity describing the association of polycystic kidneys and Dandy Walker malformation with or without hepatic fibrosis. A 28 years old pregnant woman came to radiology department for the first antenatal scan. Ultrasound showed a single fetus corresponding to 27 week of gestation. The fetal brain revealed deficient vermis with a posterior fossa cyst communicating with the 4th ventricle suggestive of Dandy-Walker malformation (DWM). The kidneys were enlarged, and echogenic containing small cysts with associated amniotic fluid index of 5 cm suggestive of Oligohydramnios. A diagnosis of Goldston syndrome was suggested. These findings were confirmed on …

Primary Hyperparathyrodism In Pregnancy And Review Of Literature, Tahira Naru, Rozilla Sadia Khan, Mohammed Ataullah Khan

Department of Obstetrics & Gynaecology

hyperparathyroidism (PHPT) is rare condition during pregnancy; however, it can carry significant risks to both mother and foetus during and after the pregnancy. The definitive treatment is parathyroidectomy undertaken preferably in the second or early third trimester. A case of asymptomatic PHPT diagnosed and treated by parathyroidectomy in the third trimester is described.

Role Of Breastfeeding And Current Lifestyle On Maternal Long-Term Weight Change, Denise R. Hinds

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Evidence suggests that prolonged and exclusive breastfeeding is associated with health benefits to children and nursing mothers beyond the period of breastfeeding. Studies that support the role of breastfeeding in postpartum weight change primarily focused on short-term weight change (within 12 to 24 months postpartum) (Binns et al. 2003; Lederman 2004; Johnson et al. 2006), while few focused on the association between breastfeeding and long-term weight change (5 years or more postpartum) (Rooney, Schauberger et al. 2005).

Purpose: This study investigated the role of breastfeeding in long-term weight change, specifically 1) whether breastfeeding protects against weight gain, and 2) …

Oncologic Efficacy Is Not Compromised, And May Be Improved With Minimally Invasive Esophagectomy., Adam C Berger, Aaron Bloomenthal, Benny Weksler, Nathaniel Evans, Karen A Chojnacki, Charles J Yeo, Ernest L Rosato

Department of Surgery Faculty Papers

BACKGROUND: Major morbidity and mortality rates continue to be high in large series of transthoracic esophagectomies. Minimally invasive approaches are being increasingly used. We compare our growing series of minimally invasive (combined thoracoscopic and laparoscopic) esophagectomies (MIEs) with a series of open transthoracic esophagectomies.

STUDY DESIGN: We identified 65 patients who underwent an MIE with thoracoscopy/laparotomy (n = 11), Ivor Lewis (n = 2), or 3-hole approach (n = 52). These patients were compared with 53 patients who underwent open Ivor-Lewis esophagectomy (n = 15) or 3-hole esophagectomy (n = 38) over the past 10 years.

RESULTS: The MIE and …

Response To An Abnormal Ovarian Cancer-Screening Test Result: Test Of The Social Cognitive Processing And Cognitive Social Health Information Processing Models, Michael A. Andrykowski, Edward J. Pavlik

Behavioral Science Faculty Publications

All cancer screening tests produce a proportion of abnormal results requiring follow up. Consequently, the cancer-screening setting is a natural laboratory for examining psychological and behavioural response to a threatening health-related event. This study tested hypotheses derived from the social cognitive processing and cognitive-social health information processing models in trying to understand response to an abnormal ovarian cancer (OC) screening test result. Women (n = 278) receiving an abnormal screening test result a mean of 7 weeks earlier were assessed prior to a repeat screening test intended to clarify their previous abnormal result. Measures of disposition (optimism, informational coping style), …

Eating For Two: A Study Of The Effects Of Obesity Upon The Health Of Pregnant Women And Their Infants, Michael Cochran-Boucher

Inquiry Journal 2011

No abstract provided.

Comparisons Of Three Analytical Techniques For Measuring Absolute And Relative Temperature Changes During Ultrasound Treatment, Michael G. Miller

Dissertations

Ultrasound is a thermal modality that utilizes acoustic energy to promote heating. While there are many factors that affect heating of body tissues, the effects of skinfold thickness and skin temperature upon ultrasound heating have not been studied extensively. In addition, while temperature typically follows a linear trend, past research typically uses ANOVA or regression analysis to examine this relationship; but these models examine the within-subject effects (time) and between effects (usually groups) at the group level, not the individual level. Therefore, the purposes of this study are to determine if skin temperature and skinfold thickness are predictors for intramuscular …

An In Vitro Evaluation Of Microleakage In Class V Preparations Restored With Hybrid Versus Silorane Composites., Fahad Umer, Farah Naz Farid, Farhan Raza Khan

Section of Dental-Oral Maxillofacial Surgery

Aim: To compare the difference in microleakage values using conventional and new low-shrink Silorane composites using the dye penetration method. Background: With improvement in adhesive technology, problems associated with composites have been largely overcome. However, microleakage due to polymerization shrinkage still remains a challenge. New Silorane-based composites are alleged to have less than 1% polymerization shrinkage, which would potentially decrease the microleakage, and hence, resolve this longstanding issue. Materials And Methods: The teeth were randomly divided into three groups (A,B, and C). Group A was restored with conventional composite (Valux() Plus), with a total-etch protocol, Group B was restored with …

The Challenge Of Communicating Cardiovascular Risk Information To Our Patients., Samuel S Gidding

Department of Pediatrics Faculty Papers

Each of the major cardiovascular risk factors presents unique challenges to the clinician caring for children.  Dyslipidemia and hypertension are silent and require measurement; the challenge is first risk classification and then communicating strategies for treatment, with attendant cost, in the absence of perceptible disease morbidity.  Obesity and physical inactivity, while generally obvious to the patient, require change in lifestyle for successful management; the challenge is to convince the patient to make that change.  Diabetes mellitus is a significant disease requiring complex management strategies for the patient to execute; the challenge is to add cardiovascular risk reduction strategies to the …

Evaluation Of The Reproductive And Developmental Risks Of Caffeine., Robert L Brent, Mildred S Christian, Robert M Diener

Department of Pediatrics Faculty Papers

A risk analysis of in utero caffeine exposure is presented utilizing epidemiological studies and animal studies dealing with congenital malformation, pregnancy loss, and weight reduction. These effects are of interest to teratologists, because animal studies are useful in their evaluation. Many of the epidemiology studies did not evaluate the impact of the "pregnancy signal," which identifies healthy pregnancies and permits investigators to identify subjects with low pregnancy risks. The spontaneous abortion epidemiology studies were inconsistent and the majority did not consider the confounding introduced by not considering the pregnancy signal. The animal studies do not support the concept that caffeine …