Medical Specialties Commons^™

Comparing Margin Diameter And Margin Index In Predicting Residual Disease Following Partial Mastectomy, P85, Daniel F. Barnas Md, Aaron D. Bleznak Md, Facs, Anna Widmyer Md, Elizabeth Dellers Md, Heiwon Chung Md, Facs

Department of Surgery

No abstract provided.

The Role Of Lumbar Puncture And Pressure.Lowering Therapy For Transverse Dural Sinus Thrombosis, Joshua Grant, Andrew Carey, Curtis Margo, Murtagh Reed, Mitchell Drucker

Ophthalmology Faculty Publications

Transverse (lateral) sinus thrombosis is a well-known complication of acute otitis media and mastoiditis in the pediatric and adult population. Thrombosis involving the transverse sinus can ultimately cause elevation of intracranial pressure (ICP) as a result of decreased cerebrospinal fluid absorption. If treatment to lower ICP is not undertaken, it can lead to ophthalmological complications including irreversible vision loss. The following case report describes an 11-year-old girl who was diagnosed with AOM by her pediatrician and subsequently presented to the emergency department complaining of nausea, vomiting, headache, and diplopia.

Lateral Access Surgery For The Thoracolumbar Spine, Luiz Pimenta, William Smith, William Taylor, Juan Uribe

Neurosurgery and Brain Repair Faculty Publications

No abstract provided.

Plac1 Expression Decreases In Chorionic Villi In Response To Labor, Yahdira M. Rodriguez-Prado, Xiaoyuan Kong, Michael E. Fant

Pediatrics Faculty Publications

PLAC1 (Placenta-Specific 1) is a recently described, trophoblast-expressed gene essential for normal placental development. The protein localizes to the microvillus membrane surface of the syncytiotrophoblast in direct proximity to the maternal compartment. Although its role has not been defined, increased circulating levels of human PLAC1 mRNA in maternal blood are associated with preeclampsia. Furthermore, PLAC1-null mice exhibit decreased viability in the peripartum period suggesting a role in pregnancy maintenance late in gestation. We examined PLAC1 gene expression in the human placenta during normal pregnancy and pregnancies associated with maternal diabetes and preeclampsia using quantitative, real time PCR (q-RT-PCR). Although …

Complex Cytogenetic Rearrangements At The Durs1 Locus In Syndromic Duane Retraction Syndrome, Hagit N. Baris, Wai-Man Chan, Caroline Andrews, Doron M. Behar, Diana J. Donovan, Cynthia C. Morton, Judith Ranells, Tuya Pal, Azra H. Ligon, Elizabeth C. Engle

Pediatrics Faculty Publications

No abstract provided.

Fishing-Injury-Related Flexor Tenosynovitis Of The Hand: A Case Report And Review, Danny A. Young-Afat, Deniz Dayicioglu, John C. Oeltjen, Audene P. Garrison

Surgery Faculty Publications

Hand infections occurring after fishing and other marine-related activities may involve uncommon bacteria that are not susceptible to the conventional or empiric antibiotic therapy used to treat soft tissue infections. Therefore appropriate treatment is often delayed and could lead to severe hand damage. An illustrative case of fishing-related injury leading to complicated tenosynovitis and horseshoe abscess caused by Mycobacterium marinum and its treatment course is outlined. Laceration of the skin during boating is fairly common. Because of the rarity of some of the bacteria, referrals to the appropriate specialist including hand surgeons and infectious disease specialists should occur in early …

A Randomized Control Trial To Assess The Effect Of Aketamineinfusion On Tourniquet Hypertension During General Anaesthesia In Patients Undergoing Upper And Lower Limb Surgery, Joyce Atieno Ongaya

Master of Medicine in Anaesthesiology

Background: Tourniquet hypertension arising from tourniquet inflation remains of primary concern to the anaesthetist. One drug commonly used to manage tourniquet hypertension is ketamine. Several studies show that ketamine attenuated the blood pressure rise associated with tourniquet inflation. None of the studies carried out examined the effect of ketamine on tourniquet hypertension for a period of more than one hour or an infusion of the same. Objective: To compare the effect of an intravenous infusion of ketamine, versus placebo on tourniquet induced hypertension in patients undergoing upper and lower limb surgery under general anaesthesia Study design: Single blinded Randomized Controlled …

Expression Of Mismatch Repair Proteins In Colorectal Cancer At Aga Khan University Hospital, Nairobi, Charles M. Wahome

Master of Medicine in Anatomic Pathology

Introduction: Microsatellite instability is one of three molecular pathways described in the pathogenesis of colorectal carcinoma. The presence of microsatellite instability in patients with colorectal cancer has implications for prognosis and family counselling. Deficiency in mismatch repair genes leads to microsatellite instability and this can be reliably demonstrated in formalin fixed paraffin embedded tissue by methods, which include immunohistochemistry for the detection of mismatch repair proteins. Local data show a disproportionately large number of younger patients with colorectal cancer compared to that documented in Caucasians. Colorectal cancer in younger ages is often attributed to deficient mismatch repair. The objective of …

Bmp7 Gene Transfer Via Gold Nanoparticles Into Stroma Inhibits Corneal Fibrosis In Vivo, Ashish Tandon, Ajay Sharma, Jason T. Rodier, Alexander M. Klibanov, Frank G. Rieger, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

This study examined the effects of BMP7 gene transfer on corneal wound healing and fibrosis inhibition in vivo using a rabbit model. Corneal haze in rabbits was produced with the excimer laser performing -9 diopters photorefractive keratectomy. BMP7 gene was introduced into rabbit keratocytes by polyethylimine-conjugated gold nanoparticles (PEI2- GNPs) transfection solution single 5-minute topical application on the eye. Corneal haze and ocular health in live animals was gauged with stereo- and slit-lamp biomicroscopy. The levels of fibrosis [a-smooth muscle actin (aSMA), F-actin and fibronectin], immune reaction (CD11b and F4/80), keratocyte apoptosis (TUNEL), calcification (alizarin red, vonKossa and osteocalcin), and …

Effectiveness Of Sequential V. Standard Triple Therapy For Treatment Of Helicobacter Pylori Infection In Children In Nairobi, Kenya, Ahmed Laving, Rose Kamenwa, Shahin Sayed, Andrew Nyerere Kimang'a, Gunturu Revathi

Paediatrics and Child Health, East Africa

Background: Once the diagnosis of Helicobacter pylori is confirmed, treatment requires at least two antibiotics and an acid inhibitor for a minimum of seven days. Unfortunately, treatment failures are being frequently reported. Treatment regimens that include sequential administration of antibiotics with acid inhibitors have been developed to try and increase the rate of eradication.

Objective: To determine the effectiveness of a novel 10-day sequential therapy compared with the standard 10-day triple therapy for treatment of H. pylori infection in children.

Methods: A double-blinded, randomised, controlled trial was conducted. Children under the age of 16 years with recurrent abdominal pain associated …

Usefulness Of Plasmodium Falciparum-Specific Rapid Diagnostic Tests For Assessment Of Parasite Clearance And Detection Of Recurrent Infections After Artemisinin-Based Combination Therapy, B. Aydin-Schmidt, M. Mubi, U. Morris, M. Petzold, B.E. Ngasala, Zul Premji, A. Bjorkman, A. Martensson

Pathology, East Africa

Background: Rapid diagnostic test (RDT) is an important tool for parasite-based malaria diagnosis. High specificity of RDTs to distinguish an active Plasmodium falciparum infection from residual antigens from a previous infection is crucial in endemic areas where residents are repeatedly exposed to malaria. The efficiency of two RDTs based on histidine-rich protein 2 (HRP2) and lactate dehydrogenase (LDH) antigens were studied and compared with two microscopy techniques (Giemsa and acridine orange-stained blood smears) and real-time polymerase chain reaction (PCR) for assessment of initial clearance and detection of recurrent P. falciparum infections after artemisinin-based combination therapy (ACT) in a moderately high …

Uchunguzi (Journal Watch/Montre De Journal) December 2013, Benjamin Wachira

Family Medicine, East Africa

No abstract provided.

Uchunguzi (Journal Watch/Montre De Journal) September 2013, Benjamin Wachira

Family Medicine, East Africa

No abstract provided.

Ovarian Masses: Is Multi-Detector Computed Tomography A Reliable Imaging Modality?, Yasir Jamil, Saima Hafeez, Tariq Alam, Madiha Beg, Mohammad Awais, Imrana Masroor

Department of Radiology

Background: Ovarian cancer continues to pose a major challenge to physicians and radiologists. It is the third most common gynecologic malignancy and estimated to be fifth leading cancer cause of death in women, constituting 23% of all gynecological malignancies. Multi-detector computed tomography (MDCT) appears to offer an excellent modality in diagnosing ovarian cancer based on combination of its availability, meticulous technique, efficacy and familiarity of radiologists and physicians. The aim of this study was to compute sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of 64- slice MDCT in classifying ovarian masses; 95% confidence intervals were reported.MATERIALS AND …

Management Options For Patients With Chronic Back Pain Without An Etiology, Lenny D. Salzberg, Eron G. Manusov

School of Medicine Publications

The treatment and management of low back pain is complex when there is no specific etiology such as cancer, fracture, or herniated disc. An organized approach to management that follows evidence based guidelines will facilitate care in a problem that reflects a lifetime prevalence of over 70 percent. The purpose of this review is to present a guideline to care for a common disabling process with a very heterogeneous etiology.

An Exploratory Study Of User-Centered Indexing Of Published Biomedical Images, Sujin Kim

Pathology and Laboratory Medicine Faculty Publications

User-centered image indexing—often reported in research on collaborative tagging, social classification, folksonomy, or personal tagging—has received a considerable amount of attention [1-7]. The general themes in more recent studies on this topic include user-centered tagging behavior by types of images, pros and cons of user-created tags as compared to controlled index terms; assessment of the value added by user-generated tags, and comparison of automatic indexing versus human indexing in the context of web digital image collections such as Flickr. For instance, Golbeck's finding restates the importance of indexer experience, order, and type of images [8]. Rorissa has found a significant …

Peripheral T-Cell Lymphoma With Aberrant Expression Of Cd19, Cd20, And Cd79a: Case Report And Literature Review, Rahul G. Matnani, Rachel L. Stewart, Joseph Pulliam, Chester D. Jennings, Melissa Kesler

Pathology and Laboratory Medicine Faculty Publications

A case of lymphoma of T-cell derivation with aberrant expression of three B-cell lineage markers (CD19, CD20, and CD79a), which was diagnosed on a left axillary excision, is described. Immunohistochemical studies and flow cytometry analysis demonstrated neoplastic cells expressing CD3, CD19, CD20, and CD79a with absence of CD4, CD8, CD10, CD30, CD34, CD56, CD68, TDT, MPO, PAX-5, and surface immunoglobulin. Gene rearrangement studies performed on paraffin blocks demonstrated monoclonal T-cell receptor gamma chain rearrangement with no evidence of clonal heavy chain rearrangement. The neoplastic cells were negative for Epstein-Barr virus (EBV) or Human Herpes Virus 8 (HHV-8). At the time …

Development Of A Standard And Functional Tactical Emergency Medical Curriculum -- Tems Medic, Benjamin Hannon

Honors Theses

Violent crime causes death and injury regularly in the United States. Some events such as the Newtown shootings, the Oklahoma City bombings, or the Washington, DC sniper case acutely focus the entire nation’s attention while other, less contemporary events fade away. The public safety apparatus – police, fire, and emergency medical services – always respond to save lives. On December 11, 2012 a man opened fire at a mall in Clackamas County, Oregon. The 9-1-1 dispatchers sent units to a shooting at the mall and then quickly reported that the shooter was still firing in the mall. One of the …

Therapies For Neovascular Age-Related Macular Degeneration: Current Approaches And Pharmacologic Agents In Development., Mostafa Hanout, Daniel Ferraz, Mehreen Ansari, Natasha Maqsood, Saleema Kherani, Yasir J. Sepah, Nithya Rajagopalan, Mohamed Ibrahim, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

As one of the leading causes of blindness, age-related macular degeneration (AMD) has remained at the epicenter of clinical research in ophthalmology. During the past decade, focus of researchers has ranged from understanding the role of vascular endothelial growth factor (VEGF) in the angiogenic cascades to developing new therapies for retinal vascular diseases. Anti-VEGF agents such as ranibizumab and aflibercept are becoming increasingly well-established therapies and have replaced earlier approaches such as laser photocoagulation or photodynamic therapy. Many other new therapeutic agents, which are in the early phase clinical trials, have shown promising results. The purpose of this paper is …

Vascular Disrupting Agent For Neovascular Age Related Macular Degeneration: A Pilot Study Of The Safety And Efficacy Of Intravenous Combretastatin A-4 Phosphate, Mohamed A. Ibrahim, Diana V. Do, Yasir J. Sepah, Syed M. Shah, Elizabeth Van Anden, Gulnar Hafiz, J. Kevin Donahue, Richard Rivers, Jai Balkissoon, James T. Handa, Peter A. Campochiaro, Quan Dong Nguyen

Journal Articles: Ophthalmology

BACKGROUND:

This study was designed to assess the safety, tolerability, and efficacy of intravenous infusion of CA4P in patients with neovascular age-related macular degeneration (AMD).

METHODS:

Prospective, interventional, dose-escalation clinical trial. Eight patients with neovascular AMD refractory to at least 2 sessions of photodynamic therapy received CA4P at a dose of 27 or 36 mg/m2 as weekly intravenous infusion for 4 consecutive weeks. Safety was monitored by vital signs, ocular and physical examinations, electrocardiogram, routine laboratory tests, and collection of adverse events. Efficacy was assessed using retinal fluorescein angiography, optical coherence tomography, and best corrected visual acuity (BCVA).

RESULTS:

The …

Comparing Biocompatibility Of Nanocrystalline Titanium And Titanium-Oxide With Microcrystalline Titanium, Raheleh Miralami, Laura Koepsell, Thyagaseely Sheela Premaraj, Bongok Kim, Geoffrey M. Thiele, J. Graham Sharp, Kevin L. Garvin, Fereydoon Namavar

Posters and Presentations: Orthopaedic Surgery & Rehab

No abstract provided.

A New Millennium: A New Age Of Behavioral Disorders?, Artemis Tsitsika, Mari Janikian, Donald E. Greydanus, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

The internet has become one of the most widely accessible media and is a significant part of everyday life in adolescence, offering opportunities for social networking and communication, education and entertainment. However, over the past decade a specific behavioral pattern has been researched in respect to Internet use, leading to isolation and neglect of everyday activities, social life –even personal health in general. The phenomenon has received increasing attention from the scientific community, describing it in various terms such as “excessive”, “problematic”, “pathological”, “addictive” use among others.

European research on Internet addictive behavior have been conducted in the past years …

Role Of Ultrasound In Characterization Of Ovarian Masses, Saima Hafeez, Saira Sufian, Quratulain Merchant, Yasir Jamil, Imrana Masroor

Department of Radiology

Background: Ovarian cancer is the second most common malignancy in Pakistani women, accounting for 4% of all cancers in the female population. The aim of this study was to determine sensitivity, specificity, positive and negative predictive values and 95% confidence intervals for ultrasound in characterization of ovarian masses in patients presenting at public and private tertiary care hospitals in Karachi, Pakistan.MATERIALS AND Methods: We adopted a cross-sectional analytical study design to retrospectively collect data from January 2009-11 from medical records of two tertiary care hospitals. Using a non-probability purposive sampling technique, we recruited a sample of 86 women aged between …

Implementation And Evaluation Of A Low Health Literacy And Culturally Sensitive Diabetes Education Program (Poster), Deborah Swavely Dnp, Rn, Allison Vorderstrasse Dnsc, Aprn, Edgardo Maldonado Md, Sherrine Eid Mph, Jeffrey Etchason Md

Department of Community Health and Health Studies

No abstract provided.

Foot Dimensions As A Tool For Gender Determination In Kenyan Adults, Maureen W. Waithaka

Master of Medicine in Anatomic Pathology

Introduction: Anthropometry has gained popularity over the years as a reliable method to determine gender. In forensic investigation, there are cases where gender cannot be readily determined using anatomy such as in mass casualty disasters with dismemberment and commingling of limbs. Kenyan descriptive data of foot dimensions is lacking as are formulae for estimating gender. Proven differences in foot dimensions across races prevent application of formula obtained using different populations necessitating generation of local data and formulae. Objectives: To describe the foot lengths, breaths and navicular heights of a representative adult Kenyan population, both male and female, and derive from …

A Randomised Controlled Trial Comparing The Effect Of Adjuvant Intrathecal 2mg Midazolam To 20-Micrograms Fentanyl On Post-Operative Pain For Patients Undergoing Lower Limb Orthopaedic Surgery Under Spinal Anaesthesia, Francis Otieno Codero

Master of Medicine in Anaesthesiology

Background: Intrathecal adjuvants are added to local anaesthetics to improve the quality of neuraxial blockade and prolong the duration of analgesia during spinal anaesthesia. As an intrathecal adjuvant, fentanyl improves the onset and quality of spinal blockade as compared to plain bupivacaine and confers a short duration of postoperative analgesia. However, its use is associated with several adverse effects that range from pruritus to life threatening respiratory depression. Intrathecal midazolam as an adjuvant has been used and shown to improve the quality of spinal anaesthesia and prolong the duration of postoperative analgesia. No studies have been done comparing intrathecal fentanyl …

Fmic Annual Report 2013 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Transatrial Access For Left Atrial Pressure (Lap) Monitoring Line Placement In Arterial Switch Operation (Aso) In Neonates, Mohammad Irfan Akhtar, Mohammad Hamid, Muneer Amanullah, Khalid Ahsan

Department of Anaesthesia

Left Atrial pressure monitoring is a useful and accurate method to guide Left ventricle filling in the patients who undergo Arterial switch operation for transposition of great arteries. We have used a different technique in three TGA patients for LA pressure monitoring line placement. After cleaning and draping,right internal jugular vein (rt IJV) located through 22G venous cannula, guide wire was put in followed by sliding the 22Gx8cm vygon arterial catheter over the guide wire into the right atrium that was directed transatrially into LA by the operating surgeon during atrial septum repair. The catheter was secured by silk on …

Nutritional Status Of Children Admitted For Diarrhoeal Diseases In A Referral Hospital In Western Kenya, I. Marete, J. Simba, Peter Gisore, C. Tenge, D. Bosire, A. Mwangi, F. Esamai

Paediatrics and Child Health, East Africa

Objectives: To determine the prevalence of malnutrition among children admitted with acute diarrhoea disease at Moi Teaching and Referral Hospital and to establish the effect of malnutrition on duration of hospital stay.

Design: Prospective observational study.

Setting: Paediatric wards of Moi Teaching and Referral Hospital, Eldoret, Kenya

Subjects: A total of 191 children aged 6 and 59 months admitted with acute diarrhoea disease, without chronic co-morbidities or visible severe malnutrition, were systematically enrolled into the study between November 2011 and March 2012.

Outcome Measures: Nutritional status based on WHO WHZ scores taken at admission and …

Commonly Cited Incentives In The Community Implementation Of The Emergency Maternal And Newborn Care Study In Western Kenya, Peter Gisore, B. Rono, J. Nekesa-Mangeni, C. Tenge, E. Shipala, H. Mabeya, D. Odhiambo, K. Otieno, S. Bucher, C. Makokha, E. Liechty, F. Esamai

Paediatrics and Child Health, East Africa

Background: Mortality of mothers and newborns is an important public health problem in low-income countries. In the rural setting, implementation of community based education and mobilization are strategies that have sought to reduce these mortalities. Frequently such approaches rely on volunteers within each community.

Objective: To assess the perceptions of the community volunteers in rural Kenya as they implemented the EmONC program and to identify the incentives that could result in their sustained engagement in the project.

Method: A community-based cross sectional survey was administered to all volunteers involved in the study. Data were collected using a self-administered supervision tool …