Medical Specialties Commons^™

Perceptions Of Medical Students Regarding Dimensions Of Environmental Wellness, Shahjahan Katpar, Rakhshaan Khan, Rabia Siddiqu, Mehwish Hussain, Rehana Rehman

Department of Surgery Docs

Abstract

OBJECTIVE:

To explore the status of awareness on environmental wellness in medical students of Karachi.

METHODS:

The cross-sectional questionnaire-based survey was carried out at Bahria University Medical & Dental College, Karachi, from January 2009 to July 2013, and comprised randomly selected medical students. The response options were; never, sometimes, mostly and always (numbered 0-4) and these were analyzed in terms of frequency, proportion and percentages by Predictive analysis software version18.

RESULTS:

Out of 800 questionnaires distributed, 736(92%) were received fully completed. There were 210(28.5%) male and 526(71.5%) female respondents, with a male-to-female ratio of 1:2.5. Female medical students were …

Labrad : Vol 42, Issue 1 - April 2016, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Biochemical Bone Profiles Available at Clinical Laboratoryof Aga Khan University Hospital
• Ionized Calcium Determination in Clinical Labortory
• Parathyroid Hormone Disorders and Issues of Testing
• Tubular Maximum Reabsorption Rate of Phosphate to Glomerular Filtration Rate (TmP/GFR)
• Renal Osteodystrophy: A Disturbed Metabolic Aspect of Renal Failure
• Update on Microbiological Diagnosis of Bone and Joint Disorders
• Classification of Tumours of Bone : An Update Based on the 2013 World Health Organization Classification of Tumours of Soft Tissue and Bone
• Recent Developments in Benign Bone Tumours
• Role of Clinical and Radiological Correlation in Orthopaedic Pathology
• CME Seminar on ‘World Osteoporosis Day’

Reliability And Validity Of An Observational Measure Of Client Decision-Making: The Client Language Assessment - Proximal/Distal (Cla-Pd)., Molly Magill, Timothy R. Apodaca, Mitchell Karno, Jacques Gaume, Ayla Durst, Justin Walthers, Robert L. Stout, Carlo Diclemente

Manuscripts, Articles, Book Chapters and Other Papers

OVERVIEW: The Client Language Assessment - Proximal/Distal (CLA-PD) is a language rating system for measuring client decision-making in interventions that target a specified behavior change (e.g., alcohol or other drug use). In the CLA-PD, there are five dimensions of change language (Reason, Ability, Commitment, Taking Steps, Other) adapted from the client portion of the Motivational Interviewing Skill Code (MISC). For the CLA-PD, language codes are sub-divided to discriminate statements regarding the primary, or target behavior change (distal change) from the intermediate coping activities (proximal change) that are prescribed to facilitate that target behavior change. The goal of the CLA-PD is …

Rebound Growth Of Infantile Hemangiomas After Propranolol Therapy., Sonal D. Shah, Eulalia Baselga, Catherine Mccuaig, Elena Pope, Julien Coulie, Laurence M. Boon, Maria C. Garzon, Anita N. Haggstrom, Denise Adams, Beth A. Drolet, Brandon D. Newell, Julie Powell, Maria Teresa García-Romero, Carol Chute, Esther Roe, Dawn H. Siegel, Barbara Grimes, Ilona J. Frieden

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Propranolol is first-line therapy for problematic infantile hemangiomas (IHs). Rebound growth after propranolol discontinuation is noted in 19% to 25% of patients. Predictive factors for rebound are not completely understood and may alter the management approach. The goal of the study was to describe a cohort of patients with IHs treated with propranolol and to identify predictors for rebound growth.

METHODS: A multicenter retrospective cohort study was conducted in patients with IHs treated with propranolol. Patient demographic characteristics, IH characteristics, and specifics of propranolol therapy were obtained. Episodes of rebound growth were recorded. Patients' responses to propranolol …

Rates Of Icu Transfers After A Scheduled Night-Shift Interprofessional Huddle., Ross E. Newman, Michael A. Bingler, Paul N. Bauer, Brian R. Lee, Keith J. Mann

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To evaluate a scheduled interprofessional huddle among pediatric residents, nursing staff, and cardiologists on the number of high-risk transfers to the ICU.

METHODS: A daily, night-shift huddle intervention was initiated between the in-house pediatric residents and nursing staff covering the cardiology ward patients with the at-home attending cardiologist. Retrospective cohort chart review identified high-risk transfers from the inpatient floor to the ICU over a 24-month period (eg, inotropic support, intubation, and/or respiratory support within 1 hour of ICU transfer). Satisfaction with the intervention and the impact of the intervention on team-based communication and resident education was collected using a …

Kidney Disease Progression In Autosomal Recessive Polycystic Kidney Disease., Katherine M. Dell, Matthew Matheson, Erum A. Hartung, Bradley A. Warady, Susan L. Furth

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To define glomerular filtration rate (GFR) decline, hypertension (HTN), and proteinuria in subjects with autosomal recessive polycystic kidney disease (ARPKD) and compare with 2 congenital kidney disease control groups in the Chronic Kidney Disease in Children cohort.

STUDY DESIGN: GFR decline (iohexol clearance), rates of HTN (ambulatory/casual blood pressures), antihypertensive medication usage, left ventricular hypertrophy, and proteinuria were analyzed in subjects with ARPKD (n = 22) and 2 control groups: aplastic/hypoplastic/dysplastic disorders (n = 44) and obstructive uropathies (n = 44). Differences between study groups were examined with the Wilcoxon rank sum test.

RESULTS: Annualized GFR change in subjects …

Reinforcement Learning, Error-Related Negativity, And Genetic Risk For Alzheimer's Disease, Christina Marie Figueroa

Dissertations (1934 -)

Reinforcement learning (RL) has been widely used as a model of animal and human learning and decision-making. The neural networks underlying RL involve many of the same structures primarily affected by Alzheimer’s disease (AD) such as the hippocampus. Yet, RL and non-invasive evaluation of its neural underpinnings have been underutilized as a framework for understanding disease pathology and its pre-clinical states. This study aimed to provide a novel approach for assessing subtle changes in asymptomatic apolipoprotein-E (APOE) carriers and non-carriers. Electroencephalography was collected from forty APOE genotyped older adults (Male n = 11; Mage = 79.30; Meducation = 14.88 years) …

Colorectal Cancer In Nonagenarians: Treatment Decisions And Outcomes, Daniel Meikle Md, Martin Alvarez Md, Mark Wiseman Md, John S. Park Md

Department of Surgery

No abstract provided.

Advances In Allograft Monitoring After Intestinal Transplantation., Augusto Lauro, Md, Phd, Ignazio R. Marino, Md, Scd, Cal S. Matsumoto, Md

Department of Surgery Faculty Papers

PURPOSE OF REVIEW: The intestinal allograft, with an enormous lymphoid load, is a highly immunogenic organ which elicits a strong alloimmune response. In the early posttransplant period, a robust graft biopsy protocol via a temporary ileostomy is utilized for surveillance to detect rejection. In the later posttransplant period, after enteral continuity is reestablished, graft biopsies via a colonoscopy become more cumbersome. Alternative methods for intestinal allograft monitoring other than graft biopsy are of particular interest.

RECENT FINDINGS: Biomarkers and diagnostic tools, such as granzyme B, perforin, fecal calprotectin, citrulline, donor-specific antibody, and zoom video endoscopy have all been studied for …

Targeting Histone Deacetylases In Melanoma And T-Cells To Improve Cancer Immunotherapy, Andressa Sodre De Castro Laino

USF Tampa Graduate Theses and Dissertations

Histone deacetylases (HDACs) are key mediators of gene expression and, thus, major regulators of cell function. As such, HDACs play a role in orchestrating tumor biology, and the use of small inhibitors targeting theses proteins is attractive for the field of cancer therapy. Indeed, several HDAC inhibitors have received FDA-approval for the treatment of malignancies, while a myriad of these compounds continue to be evaluated in clinical trials. Besides their direct impact on tumor growth, HDAC inhibitors have been shown to increase immunogenicity of cancer cells, facilitating generation of a productive immune response against tumors. Immunotherapeutic approaches take advantage of …

Humoral Hypercalcemia Of Twin Pregnancy: Not A Laughing Matter, Areeb Zamir Md, Angela Manglitz Do, Gretchen A. Perilli Md

Department of Medicine

Background: Humoral hypercalcemia due to high serum levels of Parathyroid Hormone-Related Protein (PTHrP) is very rare in the setting of benign disease. PTHrP has a significant impact on developmental stages of life and is expressed in a variety of tissues including placental tissue and mammary glands. Therefore, PTHrP has a large role in the homeostasis of calcium between the mother and fetus.

Clinical case: A 25 year old female presented to the emergency department six days post-partum of spontaneous vaginal delivery of twins at 28 and 4/7 weeks. Her chief complaints included bilateral leg pain, weakness, and difficulty ambulating …

Predictors Of Coronary Artery Disease In Patients With Polycythemia Vera And Essential Thrombocytosis: Results From The National Inpatient Sample 2009-10., Parasuram Krishnamoorthy Md, Varun Mittal, Jalaj Garg Md, Neeraj Shah Md, Nainesh C. Patel Md

Department of Medicine

Background: Myelproliferative disorders (MPDs) including Polycythemia Vera (PCV) and Essential thrombocytosis (ET) are associated with increase in arterial and venous thromboembolic events. Chronic endothelial damage, hyperviscosity and platelet activation are possible mechanistic factors resulting in accelerated atherogenesis and coronary artery disease (CAD). However the differences in prevalence of CAD and traditional risk factors (TRFs) between PCV and ET are unknown. Hence, we aimed to determine the prevalence and predictors of CAD in PCV and ET patients using a national registry.

Methods: All patients ≥18 years diagnosed with PCV and ET were identified in the Nationwide Inpatient Sample (NIS) 2009-2010 …

A Milestone-Based System Of Pediatric Faculty Evaluation: They Aren’T Just For Residents Anymore, Richard J. Mazzaccaro Md, Kris Rooney Md, Elaine A. Donoghue Md

Department of Pediatrics

No abstract provided.

Procedure Documentation And Checklists In The Palm Of Your Hand, Kris Rooney Md, Richard J. Mazzaccaro Md, Liborio Larussa Md, Katherine Adams Pc

Department of Pediatrics

No abstract provided.

A Case Report Of Ruxolitinib Induced Hypocalcemia: A Stochastic Or Deterministic Effect?, Arsha Sreedhar Md, Ranjit R. Nair Md, Gretchen A. Perilli Md

Department of Medicine

Ruxolitinib is a novel selective JAK 1/2 inhibitor approved for the treatment of myelofibrosis (MF) and polycythemia vera (PCV). Hypocalcemia associated with ruxolitinib has not been reported in early trials or in literature.

A 65 year female with history of CKD stage 3, PCV since 1989, papillary thyroid carcinoma, total thyroidectomy and hypoparathyroidism since 1996 presented with complaints of severe myalgia, fatigue, paresthesia and critical hypocalcemia. Her corrected S. Ca 5.8 mg /dl (8.9-10.1 mg/dL) and Ionised Ca 2.9 mg/dl (4.5 - 5.4 mg/dL). Other labs showed stable creatinine 1.5 mg/dL, intact PTH 29 pg/ml(14-72pg/ml) and 25,OH vitamin D level …

Presenting Features, Treatment Patterns And Outcomes Of Patients With Breast Cancer In Pakistan: Experience At A University Hospital, Kumar S, Shaikh A. J, Rashid Ya, Masood N, Mohammed Atv, Malik Uz, Ghulam H

Department of Medicine

BACKGROUND:

Breast cancer is the most common cancer in Pakistani women. We report the presenting features, treatment patterns and survival of breast cancer from a University Hospital in Southern Pakistan and compare the data with international population based studies.

MATERIALS AND METHODS:

Medical records of patients diagnosed to have breast cancer between January 1999 and November 2008 were reviewed retrospectively.

RESULTS:

A total of 845 patients were identified. Median age of diagnosis was 48 years (range 18-92). Clinical stage was as follows: Stage I 9.9%; Stage II 48.5%; Stage III 26.2%; Stage IV 13.8%; data not available 1.5%. Approximately, half …

Quality Of Life Of Stroke Survivors And Their Primary Caregivers In Pakistan., Wardah Khalid, Shafquat Rozi, Tazeen S. Ali, Iqbal Azam Syed, Michael T. Mullen

Department of Medicine

No abstract provided.

Transcatheter Aortic Valve Replacement (Tavr) Is Associated With A Higher Rate Of Permanent Pacemaker Implantation Compared To Surgical Aortic Valve Replacement (Savr): A Propensity Matched Analysis, Neeraj Shah Md, Achint Patel Mbbs, Nileshkumar Patel Md, Vratika Agarwal Md, Jalaj Garg Md, Nainesh C. Patel Md, David A. Cox Md

Department of Medicine

Background

Occurrence of conduction abnormalities requiring permanent pacemaker implantation (PPI) is a serious complication after both transcatheter (TAVR) & surgical (SAVR) aortic valve replacement.

Methods

Nationwide Inpatient Sample was queried from August 2011 to December 2012 using ICD-9 codes 35.05 & 35.06 for TAVR and 35.21 & 35.22 for SAVR. Patients undergoing other valve surgeries, bypass grafting & those with prior pacemakers or defibrillators were excluded. Propensity matching was performed (1:1) to match TAVR & SAVR cohorts on age, gender, right bundle branch block (RBBB), first degree AV block, bifascicular or trifascicular block, hospital region, teaching hospital status & hospital …

The Liberty Study: Design Of A Prospective, Observational, Multicenter Trial To Evaluate The Acute And Long-Term Clinical And Economic Outcomes Of Real-World Endovascular Device Interventions In Treating Peripheral Artery Disease., George L Adams, Jihad Mustapha, William Gray, Nick J Hargus, Brad J Martinsen, Gary Ansel, Michael R Jaff

Heart and Vascular Articles

Background: Most peripheral artery disease (PAD) clinical device trials are supported by commercial manufacturers and designed for regulatory device approval, with extensive inclusion/exclusion criteria to support homogeneous patient populations. High-risk patients with advanced disease, including critical limb ischemia (CLI), are often excluded leading to difficulty in translating trial results into real-world clinical practice. As a result, physicians have no direct guidance regarding the use of endovascular devices. There is a need for objectively assessed studies to evaluate clinical, functional, and economic outcomes in PAD patient populations.

Study design: LIBERTY is a prospective, observational, multicenter study sponsored by Cardiovascular Systems Inc …

Neuropathy Detection, Quality Of Life Tools & Treatment For Type 2 Diabetes, Jennifer J. Brown

Human Movement Studies & Special Education Theses & Dissertations

Type 2 diabetes (T2D) mellitus has become the epidemic of the new millennium, with an estimated 382 million people affected worldwide as of 2013, and statistics projected towards 592 million by the year 2035. With the development of diabetes, complications have risen, with diabetic neuropathy becoming one of the most prevalent, affecting between 10–90% of those with the disease. Diabetic peripheral neuropathy (DPN) is difficult to detect in early stages of pathology, yet devastating once significant damage has taken place. Cardiac autonomic neuropathy (CAN), which is often silent, is associated with autonomic nervous system (ANS) dysfunction and increased risk for …

Can A Home-Based Cardiac Physical Activity Program Improve The Physical Function Quality Of Life In Children With Fontan Circulation?, Roni M. Jacobsen, Salil Ginde, Kathleen Mussatto, Jennifer Neubauer, Michael G. Earing, Michael E. Danduran

Exercise Science Faculty Research and Publications

Objective

Patients after Fontan operation for complex congenital heart disease (CHD) have decreased exercise capacity and report reduced health-related quality of life (HRQOL). Studies suggest hospital-based cardiac physical activity programs can improve HRQOL and exercise capacity in patients with CHD; however, these programs have variable adherence rates. The impact of a home-based cardiac physical activity program in Fontan survivors is unclear. This pilot study evaluated the safety, feasibility, and benefits of an innovative home-based physical activity program on HRQOL in Fontan patients.

Methods

A total of 14 children, 8–12 years, with Fontan circulation enrolled in a 12-week moderate/high intensity home-based …

Role Of Prophylactic Magnesium Supplementation In Prevention Of Postoperative Atrial Fibrillation In Patients Undergoing Coronary Artery Bypass Grafting: A Meta-Analysis Of 23 Randomized Controlled Trials, Jalaj Garg Md, Rahul Chaudhary Md, Parasuram Krishnamoorthy Md, Neeraj Shah Md, Babak Bozorgnia Md

Department of Medicine

Background

Several randomized clinical trials have evaluated the efficacy of prophylactic magnesium (Mg) supplementation in prevention of post-operative atrial fibrillation (POAF) in patients undergoing cardiac artery bypass grafting (CABG). We aim to determine the role of prophylactic Mg in 3 settings (intraoperative, postoperative, intraoperative + postoperative) in prevention of POAF.

Methods

A systemic literature search was performed (until October 20, 2015) using PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials to identify trials evaluating Mg supplementation post CABG. Primary outcome of our study was reduction in the POAF. For each study, the incidence of atrial fibrillation …

Sex Disparities In Access To Acute Stroke Care: Can Telemedicine Mitigate This Effect?, Catherine Wolff, Amelia K. Boehme, Karen Albright, Tzu-Ching Wu, Michael Mullen, Sean Savitz, Charles Branas, James Grotta, Brendan Carr

Journal of Health Disparities Research and Practice

Background: Women have more frequent and severe ischemic strokes than men, and are less likely to receive treatment for acute stroke. Primary stroke centers (PSCs) have been shown to utilize treatment more frequently. Further, as telemedicine (TM) has expanded access to acute stroke care we sought to investigate the association between PSC, TM and access to acute stroke care in the state of Texas.

Methods: Texas hospitals and resources were identified from the 2009 American Hospital Association Annual Survey. Hospitals were categorized as: (1) stand-alone PSCs not using telemedicine for acute stroke care, (2) PSCs using telemedicine for acute stroke …

Correlation Between Spiritual Aspect And Serum Interleukin-6level In Chronic Hemodialysis Patients, Wika Hanida, E Mudjaddid, Habibah Hanum Nasution, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Holistic approach in psychosomatic focus on spirituality factor and spiritual support is expected to improve services and psychological condition of the patients. Inflammatory response during hemodialisis procedure hence increased with the evidence of increasing level of serum interleukin-6 (IL-6). Further research is still needed to see the spiritual factors that can decrease the inflammatory factors. Methods. Cross sectional study on 51 chronic hemodialisis patients at RSUP. H. Adam Malik and RSU dr. Pirngadi Medan between July-August 2014. Serum IL-6 was measured using quantitative enzyme-linked immune sorbent assay (ELISA) methods. Blood samples and spiritual aspect assessment by handing out FACIT …

Pemeriksaan Kadar Laktat Pada Tata Laksana Sepsis:Apakah Benar Diperlukan?, Robert Sinto

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Right Ventricular Systolic And Diastolic Function Profile Inpatient With Stable Chronic Obstructive Pulmonary Disease, Dina Oktavia, Sally Aman Nasution, Anna Uyainah Zn, C Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Right ventricular dysfunction is one of the common complication of chronic obstructive pulmonary disease (COPD). Right ventricular assessment is importance, since it related with exercise intolerance and poor prognosis. Methods. Thirty stable COPD men (mean age: 65 ± 6 yr) underwent spirometry. In addition to conventional echocardiographic parameters, TAPSE, right heart chambers, and trans tricuspid inflow were determined. Results. The mean value of FEV1 was 28 ± 8% of the predicted value. There was no subject with mild airflow limitation, 57% subjects were with very severe airflow obstruction. All of pulmonary function test showed mixed restrictive-obstructive pattern. Mean of …

Association Of Glucose Variability In The First 72 Hours Of Icucare With Icu Mortality In Critically-Iii Patients, Elizabeth Yasmine, Arif Mansjoer, Dyah Purnamasari, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Hyperglycemia during hospitalization is a risk factor that can be managed in order to reduce mortality. Inspite of hyperglycemia, glucose variability also brings negative outcome to cells. Studies about glucose variability effect to mortality had been studied using many variables of glucose variability. Methods. Retrospective cohort study is done to 280 critical ill patient in ICU and HCU in Cipto Mangunkusumo Hospital who admitted to critical care between January 2012-August 2013. MAG change and glucose standard deviation are divided into 4 quartiles. Relationship between MAG change and glucose standard deviation are analyzed using Chi Square test. To control the …

Predictors Of Mortality In Hospitalized Hiv/Aids Patients, Estie Puspitasari, Evy Yunihastuti, Iris Rengganis, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is a big problem that threatening in Indonesia and many countries in the world. The knowledge on the characteristics and prediction of outcome were important for patients management. There are no studies on the predictors of mortality in Indonesia. Methods. We performed a retrospective cohort study among hospitalized patients with HIV/AIDS in Cipto Mangunkusumo Hospital between 2011-2013. Datas on clinical, laboratory measurement, outcome (mortality) and causes of death during hospitalization were gathered from medical records. Bivariate analysis using Chi- Square test were used to evaluate seven prognostic factors (male sex, not came …

The Difference In Prevalence Of Helicobacter Pylori Infectionbetween Chinese And Dayak Ethnics With Dyspepsia Syndrome, Willy Brodus Uwan, Ari Fahrial Syam, C. Rinaldi A. Lesmana, C Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Helicobacter pylori (H. pylori) infection risk is associated with many factors related to host-agent-environment. Ethnicity is one of the host factors which was the most studied factor overseas. The prevalence of H. pylori infection was found higher in certain ethnic such among Chinese. Based on migration and transmission theory, it was suspected that H. pylori infection was transmitted by people migrating from areas with a high prevalence of infection to the destination area. Chinese in West Borneo are originated from South China region where the prevalence of H. pylori infection is high. It is estimated that there are differences …

The Role Of Lactate Clearance In Severe Septic Patients Survival, Wirawan Hambali, Lie Khie Chen, Djoko Widodo, Esthika Dewiasty, Herdiman T. Pohan, Suhendro Suhendro

Jurnal Penyakit Dalam Indonesia

Introduction. Severe Sepsis is a major health problem that known to results high mortality rate, and still its incidents continue to rise. Lactate clearance represents kinetics alteration of anaerobic metabolism in severe septic patients that makes it to become a potential parameter to evaluate severity of one’s illness and intervention adequacy that received by the patient. However, the relationship between lactate clearance and occurrence of death in severe septic patients is still unknown. Methods. This is a prospective cohort study that conducted in Ciptomangunkusumo Hospital, from March to May 2011. Patients were categorized into high lactate clearance group if there …