Medical Specialties Commons^™

Energy Drinks Consumption Practices Among Medical Students Of A Private Sector University Of Karachi, Pakistan, Asma Usman, Swaleha Tariq Bhombal, Ambreen Jawaid, Samar Zaki

Department of Family Medicine

Consumption of energy drinks has become popular among students and athletes over the past few years. To explore the phenomenon, a cross-sectional survey was conducted through a self-administered pilot-tested questionnaire. Frequency of energy drinks consumption was found to be 121(52%) in a sample of 233 medical students. Red bull was the most common brand consumed 101(43%). The major reasons reported for its usage were to gain/replenish energy by 36(15.4%), and studying for examination by 34(14.6%). Television was reported as the major source of information 153(66%) followed by friends 113(48%). There was a high frequency of energy drinks' consumption among medical …

Laser Treatment Of Laryngeal Papillomatosis In A Young Child: Anaesthetic And Surgical Management, Faisal Shamim, Durriya Raza, Mubasher Ikram

Department of Surgery Docs

Abstract

The authors report the case of a 4-year boy who required anaesthetic and surgical care during LASER excision of laryngeal papillomatosis. He presented with hoarseness and stridor and underwent emergency tracheostomy after confirmation of laryngeal papillomas on CT scan. He required LASER treatment under general anaesthesia with a requirement of paediatric LASER-safe endotracheal tube but unfortunately, this was not available in the country. Balanced anaesthesia technique using inhalational anaesthetic, muscle relaxant and narcotic is used with modifications. After three successful surgical sessions, the airway became patent and tracheostomy was de-cannulated. The perioperative issues surrounding this process are discussed including …

Lymphangioma Circumscriptum: Clinicopathological Spectrum Of 29 Cases, Saira Fatima, Nasir Uddin, Romana Idrees, Khurram Minhas, Zubair Ahmad, Rashida Ahmad, Naila Kayani, Muhammad Arif

Department of Pathology and Laboratory Medicine

Objective:
To describe the clinicopathological spectrum of Lymphangioma Circumscriptum (LC).
Study Design:
Observational case series.
Place and Duration of Study:
Department of Pathology and Microbiology, AKUH, Karachi, from 2002 to 2012.
Methodology:
All reported cases of LC were retrieved from medical record. Clinical and pathological features were noted. Frequency percentages were determined.
Results:
There were 29 cases of LC predominantly males (62%). The mean age was 27.17 ±15.5 years. The commonest sites was anal/perianal region (24%) followed by extremities (17%) and tongue, (14%). Vulval LC was seen in 3 patients. Two cases were described on scrotum. The lesions were most …

Pathogen-Specific Burdens Of Community Diarrhoea In Developing Countries: A Multisite Birth Cohort Study (Mal-Ed), Sadia Shakoor, Shahida Qureshi, Furqan Kabir, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Imran Ahmed, Didar Alam, Syed Asad Ali, Muneera Rasheed, Sajid Bashir Soofi, Ali Turab, Aisha Khizar Yousafzai

Department of Pathology and Laboratory Medicine

Background: Most studies of the causes of diarrhoea in low-income and middle-income countries have looked at severe disease in people presenting for care, and there are few estimates of pathogen-specific diarrhoea burdens in the community.
Methods: We undertook a birth cohort study with not only intensive community surveillance for diarrhoea but also routine collection of non-diarrhoeal stools from eight sites in South America, Africa, and Asia. We enrolled children within 17 days of birth, and diarrhoeal episodes (defined as maternal report of three or more loose stools in 24 h, or one loose stool with visible blood) were identified through …

Type Of Preoperative Aura May Predict Postsurgical Outcome In Patients With Temporal Lobe Epilepsy And Mesial Temporal Sclerosis., Ali Akbar Asadi-Pooya, Maromi Nei, Ashwini Sharan, Michael R. Sperling

Department of Neurology Faculty Papers

PURPOSE: As the initial symptoms of epileptic seizures, many types of auras have significant localizing or lateralizing value. In this study, we hypothesized that the type of aura may predict postsurgical outcome in patients with medically refractory temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS).

METHODS: In this retrospective study, all patients with a clinical diagnosis of medically refractory TLE due to unilateral mesial temporal sclerosis who underwent epilepsy surgery at the Jefferson Comprehensive Epilepsy Center were recruited. Patients were prospectively registered in a database from 1986 through 2014. Postsurgical outcome was classified into two groups: seizure freedom or …

Near Complete Aortic Transection And Its Successful Repair Using A Novel Cardiopulmonary Bypass Technique, Dania Aijaz Shah, Adil Aijaz Shah, Syed Jawad Shah, Muhammad Naseer Khan, Saulat H. Fatimi

Department of Surgery Docs

Abstract

The case of a 38-year old female, victim of a road traffic accident who presented with a near complete aortic transection is presented. An emergent repair employing cardiopulmonary bypass was attempted in the operating room. Anticipating a high-risk of compromise to cerebral perfusion from air micro-emboli, the bypass was attempted with an innovative approach involving the successful cannulation of the pulmonary artery and descending aorta. The patient survived and was found to be doing well on subsequent post-operative visits.

Dual Antiplatelet Agents And Rivaroxaban For Massive Intracoronary Thrombus In Stemi, Nasiruddin Jamal, Mustaafa Bapumia

Internal Medicine, East Africa

Management of intracoronary thrombus in patients presenting more than 12 hours after the onset of ST elevation myocardial infarction is challenging. We present such a case which had massive thrombus in left anterior descending artery. It was managed successfully with dual antiplatelet agents and factor Xa inhibitor rivaroxaban administered orally

Track Extubation In Pediatric Congenital Heart Disease Open Heart Surgical Patients In Pakistan, Mohammad Irfan Akhtar

Department of Anaesthesia

No abstract provided.

Doctor! Will I Be Dry? Factors Determining Recurrence After Vesicovaginal Fistula Repair, Atif Ajaved

Department of Surgery Docs

Abstract

OBJECTIVE:

To evaluate various prognostic factors which determine outcome after surgical repair of vesicovaginal fistula.

METHODS:

The retrospective study was conducted at Koohi Goth Fistula Hospital, Karachi, and comprised data related to patients having undergone vesicovaginal fistula repair from January 2007 to June 2012. Multivariate analysis of the record was done using SPSS 19 software determining odds ratio with 95% confidence interval.

RESULTS:

Record of 640 patients were analysed with an overall success in 558(87.2%) cases. Multivariate analysis determined that the recurrence of vesicovaginal fistula was significantly related to multiplicity (9-fold recurrence risk), pre-operative size (10-fold recurrence risk for …

Speckle-Tracking Echocardiographic Measures Of Right Ventricular Function Correlate With Improvement In Exercise Function After Percutaneous Pulmonary Valve Implantation., Shahryar M. Chowdhury, Ziyad M. Hijazi, John T. Fahey, John F. Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Speckle-tracking echocardiographic (STE) measures of right ventricular (RV) function appear to improve after transcatheter pulmonary valve implantation (TPVI). Measures of exercise function, such as ventilatory efficiency (the minute ventilation [VE]/carbon dioxide production [VCO2] slope), have been shown to be prognostic of mortality in patients who may require TPVI. The aim of this study was to evaluate the correlation between STE measures of RV function and changes in VE/VCO2 after TPVI.

METHODS: Speckle-tracking echocardiography and cardiopulmonary exercise testing were performed at baseline and 6 months after TPVI in 24 patients from four centers. Conventional echocardiographic measures of RV function were …

Pregnancy And Pertussis: Why The Change In Tdap Administration?, Marietta Sperry

Books, Presentations, Posters, Etc.

Background and new guidelines vs. old guidelines. Systematic review of obstacles, recommendations, and conclusions.

Prevalence Of Mycoplasma Hominis And Ureaplasma Urealyticum Infection In Female Sex Workers And Its Association With Douching: A Study In East Jakarta, Indonesia Using Mycoplasma System Plus, Caroline Padang, Tjut Nurul Alam Jacoeb, Hanny Nilasari, Sjaiful Fahmi Daili

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Mycoplasma hominis and Ureaplasma urealyticum are commonly involved in pathogenesis of bacterial vaginosis and non-specific genital infection, while doing vaginal douching also already known as predisposing factor.

Methods: To evaluate the prevalence of Mycoplasma hominis and Ureaplasma urealyticum infection in female sex workers and its association with vaginal douching, we conducted a study through 180 female sex workers in East Jakarta, Indonesia. Vaginal fluid samples were collected from these women. It was revealed that most of the women used betel soap, baby soap, tooth paste, or herbal medicine as vaginal douching materials. The association of vaginal douching …

Systemic Contact Dermatitis Due To Nickel, Taruli Olivia, Windy Keumala Budianti, Fitria Agustina

Journal of General - Procedural Dermatology and Venereology Indonesia

Introduction: Systemic contact dermatitis (SCD) is a systemic reactivation of a previous allergic contact dermatitis. The initial exposure may usually be topical, followed by oral, intravenous or inhalation exposure leading to a systemic hypersensitivity reaction. A case of a 27 year-old male with SCD due to nickel is reported

Case Report: A 27 year-old male presented with recurrent pruritic eruption consist of deep seated vesicles on both palmar and left plantar since 6 months before admission. This complaint began after patient consumed excessive amounts of chocolate, canned food, and beans. The patient worked as a technician in a …

Multiple Juvenile Xanthogranuloma: A Rare Case Of Having Clinical Appearance Mimicking Molluscum Contagiosum Or Syringoma, Heru Nugraha, Ridha Rosandi, Evelyn Nainggolan, Githa Rahmayunita, Triana Agustin, Rahadi Rihatmadja, Siti Aisah Boediardja

Journal of General - Procedural Dermatology and Venereology Indonesia

Introduction: Juvenile xanthogranuloma (JXG) is an uncommon benign cutaneous fibrohistiocytic, self-healing, class II non-Langerhan’s cell histiocytosis (NLCH). JXG accounts for 80-90% of cases of NLCH. It occurs most commonly on the head and neck of infants and young children and resolves spontaneously.

Case: A one year-old boy presented with asymptomatic, multiple yellowish, shiny, and firm nodules with telangiectasia on the surface, measuring around 1 centimeter in diameter, on the face, the trunk, the arms, and lower extremities. The first lesion appeared on the face 8 months prior to consultation then spread gradually to other areas. He was referred …

Developments In Neurovascular Diseases And Treatments., Robert M Starke, Stephen J Monteith, Andrew M Southerland, R Webster Crowley, Nohra Chalouhi, Dale Ding, David M Hasan, Aaron S Dumont

Department of Neurosurgery Faculty Papers

No abstract provided.

The Evidence-Based Topical Therapies For Management Of Minor Burns In Outpatient Clinic, Siphora Dien, Eliza Miranda, Erdina Hardiono D Pusponegoro, Aditya Wardhana

Journal of General - Procedural Dermatology and Venereology Indonesia

Burns are often seen in clinics or hospitals. Majority of burns are minor burns, which can be managed in outpatient setting with satisfactory result. The healing outcome depends on physician’s knowledge and competencies in burn pathogenesis and basic principles of burn care. Initial treatment of burns consists of emergency evaluation, assessment of depth and severity of burns and considerations for referral. The principles of minor wound therapy include cooling, cleansing, pain management, and topical therapy. Recently, many topical agents are available and indicated for first to second degree burn. Silver sulfadiazine (SSD) is the standard treatment; however, it has some …

A Rare Case Of Late Onset Reticulate Acropigmentation Of Kitamura Without Involvement Of The Palms And Soles, Conny Melly, Sri Adi Sularsito, Sondang Panjaitan Sirait, Rahadi Rihatmadja, Indah Widyasari, Vini Onmaya

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Reticulate acropigmentations of Kitamura (RAPK) is an autosomal dominant inherited disorder characterized by pigmented, angulated, irregular freckle-like lesion with atrophy on the surface, arranged in a reticulate pattern on the dorsa of the hands and feet. It was first described by Kitamura and Akamatsu in Japan in 1943. The usual age of onset is the first and second decades of life. Palms and soles reveal pits and breaks in the epidermal ridge pattern. The histopathological examination show epidermal atrophy, digitate and filiform elongated rete ridges with clumps of heavy melanin pigmentation at their tips.

Case: A 59-year-old …

Atypical Mycobacterial Infection Mimicking Carbuncle In An Elderly Patient: A Case Report, Terlinda Barros, Lili Legiawati, Shannaz Nadia Yusharyahya, Sri Adi Sularsito, Imelda Wihadi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Atypical mycobacterium infection occurs under certain skin conditions, namely the disruption of skin integrity and mucous membranes accompanied by the reduction of cellular immunity. However, atypical mycobacterial infection in elderly patients is rarely reported.

Case: A 64 years old male patient, complained of red lumps on the upper-backfor a month, accompanied by mild fever and minimal pain. Three months before, the patient had accupuncture on the neck and upper back. Physical examination showed multiple miliar to lenticular sized papules and pustules on an erythematous-violaceus base with hard and immobile palpable nodes and infiltrate. After clinical and laboratory …

Commentary On "Systemic Candidiasis And Cytomegalovirus Infection In The Setting Of Artificial Cardiac Device Deployment", Moises A. Huaman

The VAD Journal

No abstract provided.

Systemic Candidiasis And Cytomegalovirus Infection In The Setting Of Artificial Cardiac Device Deployment., Manoj Thangam, Bindu Akkanti, Maan Malahafio, Sriram Nathan, Indranee Rajapreyar, Pranav Loyalka, Biswajit Kar, Igor Gregoric

The VAD Journal

Heart failure is a serious cause of morbidity and mortality worldwide. The advent of implantable cardiac assist devices has generated a new arsenal for treating severe heart failure. However, the potential ramifications of ventricular assist device (VAD) usage are not fully understood. Immune modulation resulting from VAD implantation is an area of growing research. Although we do not fully understand the mechanisms contributing to host immune alteration, changes in cytokine concentrations, deceased lymphocyte activity, and the local effects of device materials have been shown to down regulate immune function. ^7,8 Infection is a serious complication that affects prognosis in this …

Use Of Social Media As A Virtual Community And Support Group By Left Ventricular Assist Device (Lvad) Patients, Bryan Boling, Amanda Hart, Chizimuzo T.C. Okoli, Tamra Halcomb, Peggy El-Mallakh

The VAD Journal

Abstract

Background

Left ventricular assist device (LVAD) patients may benefit from participating in a social support group; however, several factors may limit the availability of these communities. Alternatively, online social support communities may be more accessible for LVAD patients. No studies have examined patterns and reasons for health-related social media use among people with LVADs

Methods

An online survey of patients actively participating in LVAD social media groups was conducted using both multiple choice and open-ended questions.

Results

Thirty-nine participants (65% male) completed the survey. Participants’ reasons for weekly engagement in online communities were to seek (69.2%) and offer (66.7%) …

Fifteen Years Of Irinotecan Therapy For Pediatric Sarcoma: Where To Next?, Lars M. Wagner

Pediatrics Faculty Publications

Over the past 15 years, irinotecan has emerged as an important agent for treating pediatric sarcoma patients. This review summarizes the activity noted in previous studies, and outlines current issues regarding scheduling, route of administration, and amelioration of side effects. Also discussed are new pegylated and nanoliposomal formulations of irinotecan and its active metabolite, SN-38, as well as future plans for how irinotecan may be used in combination with other conventional cytotoxic as well as targeted agents.

Optimizing Antibiotic Stewardship In Nursing Homes: A Narrative Review And Recommendations For Improvement, Robin Jump

Faculty Scholarship

The emerging crisis in antibiotic resistance and concern that we now sit on the precipice of a post-antibiotic era have given rise to advocacy at the highest levels for widespread adoption of programmes that promote judicious use of antibiotics. These antibiotic stewardship programmes, which seek to optimize antibiotic choice when clinically indicated and discourage antibiotic use when clinically unnecessary, are being implemented in an increasing number of acute care facilities, but their adoption has been slower in nursing homes. The antibiotic prescribing process in nursing homes is fundamentally different from that observed in hospital and clinic settings, with formidable challenges …

Insights Into Alzheimer’S Disease: The Levels Of Signaling Proteins In Brain Of Control Subjects Versus Brain From Subjects With Mild Cognitive Impairment, Georgianne F. Tiu

Kaleidoscope

The purpose of this study was to measure the expression levels of key signaling proteins in brain tissue from subjects with mild cognitive impairment (MCI) compared to control subjects. MCI is considered to be the beginning phase of Alzheimer’s disease (AD). Tumor necrosis factor alpha (TNF-α), nuclear factor kappa beta (NF-κβ), phospho Bad (pBad), and ubiquitin C-terminal hydrolase-L1 (UCH-L1) are four of the proteins that were investigated. Trends of either decreases or increases in protein expression levels in MCI vs. control brain were investigated. Western blot analysis was used in order to identify these trends. These signaling protein levels are …

Left Ventricular Mechanical Dysfunction In Diet-Induced Obese Mice Is Exacerbated During Inotropic Stress: A Cine Dense Cardiovascular Magnetic Resonance Study, Christopher M. Haggerty, Andrea C. Mattingly, Sage P. Kramer, Cassi M. Binkley, Linyuan Jing, Jonathan D. Suever, David K. Powell, Richard J. Charnigo, Frederick H. Epstein, Brandon K. Fornwalt

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Obesity is a risk factor for cardiovascular disease. There is evidence of impaired left ventricular (LV) function associated with obesity, which may relate to cardiovascular mortality, but some studies have reported no dysfunction. Ventricular function data are generally acquired under resting conditions, which could mask subtle differences and potentially contribute to these contradictory findings. Furthermore, abnormal ventricular mechanics (strains, strain rates, and torsion) may manifest prior to global changes in cardiac function (i.e., ejection fraction) and may therefore represent more sensitive markers of cardiovascular disease. This study evaluated LV mechanics under both resting and stress conditions with the hypothesis …

Treatment-Induced Changes In Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion In The Diabetes Prevention Program Cohort., Kieren J Mather, Qing Pan, William C Knowler, Tohru Funahashi, George A Bray, Richard Arakaki, Bonita Falkner, Kumar Sharma, Barry J. Goldstein

Department of Medicine Faculty Papers

BACKGROUND AND OBJECTIVES: Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity.

DESIGN, SETTING, PARTICIPANTS AND METHODS: We evaluated cross-sectional correlations between plasma adiponectin and urinary albumin excretion at baseline, and the relationship of treatment-related changes in adiponectin and albuminuria. Baseline and follow-up urine albumin to creatinine ratios (ACR (albumin to creatinine ratio)) …

Identifying The Critical Domain Of Ll-37 Involved In Mediating Neutrophil Activation In The Presence Of Influenza Virus: Functional And Structural Analysis., Shweta Tripathi, Guangshun Wang, Mitchell White, Michael Rynkiewicz, Barbara Seaton, Kevan Hartshorn

Journal Articles: Pathology and Microbiology

The human cathelicidin LL-37 has been shown to play a role in host defense against influenza A viruses (IAV) through direct antiviral effects and through modulating inflammatory responses to infection. We recently showed that LL-37 increases neutrophil respiratory burst and neutrophil extracellular trap (NET) responses to IAV through engaging formyl peptide receptor 2 (FPR-2). In this paper we show that a fragment of LL-37, GI-20, which is composed of the central helical segment of the peptide, has similar effects as LL-37 on neutrophil activation. In addition to increasing respiratory burst and NET responses of the cells to IAV through an …

Staphylococcus Aureus Biofilms Induce Macrophage Dysfunction Through Leukocidin Ab And Alpha-Toxin., Tyler D. Scherr, Mark L. Hanke, Ouwen Huang, David B.A. James, Alexander R. Horswill, Kenneth W. Bayles, Paul D. Fey, Victor J. Torres, Tammy Kielian

Journal Articles: Pathology and Microbiology

UNLABELLED: The macrophage response to planktonic Staphylococcus aureus involves the induction of proinflammatory microbicidal activity. However, S. aureus biofilms can interfere with these responses in part by polarizing macrophages toward an anti-inflammatory profibrotic phenotype. Here we demonstrate that conditioned medium from mature S. aureus biofilms inhibited macrophage phagocytosis and induced cytotoxicity, suggesting the involvement of a secreted factor(s). Iterative testing found the active factor(s) to be proteinaceous and partially agr-dependent. Quantitative mass spectrometry identified alpha-toxin (Hla) and leukocidin AB (LukAB) as critical molecules secreted by S. aureus biofilms that inhibit murine macrophage phagocytosis and promote cytotoxicity. A role for Hla …

Proton Pump Inhibitors And Corticosteroids As Synergistic Risk Factors For Candida Esophagitis, Nihar Shah Md, Yana Cavanagh, Oleg Shulik, Pooja Patel, Vincent A. Debari, Walid Baddoura

Gastroenterology

Abstract:

Introduction: Inhaled & systemic steroids are one of the well-documented risks factors for Candida esophagitis. However, the role of gastric acid suppression remains controversial.

Methods:

We conducted a retrospective case-control study of 420 patients consisting of 84 cases of Candida esophagitis and 336 matched controls. Our cohort was gathered from subjects evaluated from 2001 to 2012. The diagnosis of Candida esophagitis was based on endoscopic and/or histological criteria.

Results:

On univariate analysis, proton pump inhibitors were associated with higher risk (OR = 2.14; 95 % CI: 1.30 to 3.54); steroid use also increased the risk (OR = 3.55; 95% …

Early Mortality And Functional Outcome After Acute Stroke In Uganda: Prospective Study With 30 Day Follow-Up, Martha Sajatovic

Faculty Scholarship

Identification of early outcomes post stroke and their predictors is important in stroke management strategies. We prospectively analysed 30-day outcomes (mortality and functional ability) after stroke and their predictors among patients admitted within 7 days post event to a national referral hospital in Uganda. This was a prospective study of acute stroke patients consecutively enrolled between February and July 2014. Social demographics, clinical, laboratory, imaging characteristics, outcomes (all through 30 days), time of death were assessed using standardised questionnaires. Multiple regression was used to analyse the independent influence of factors on outcomes. Of 127 patients, 88 (69.3 %) had ischemic …