Medical Specialties Commons^™

Evaluation Of Solar Disinfection Of Water Intervention Delivered Through Lady Health Workers In Reduction Of Diarrheal Episodes In Under Five Children, Shabina Ariff, Ubaidullah Khan, Ali Turab, Imtiaz Hussain, Atif Habib, Tarab Mansoor, Dania Mallick, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Sajid Bashir Soofi, Zulfiqar A Bhutta

Department of Paediatrics and Child Health

Background: Solar Water Disinfection (SODIS) is a simple, inexpensive and sustainable means of daily household treatment for drinking and storage of water. Globally, over a billion people lack access to safe drinking water. As many as half million under five children die annually due to diarrheal illnesses. Most of these deaths are concentrated in Africa and South Asia. Unsafe water is one of the most critical risk factors for diarrhoea. Systematic reviews indicate that interventions to improve the microbial quality of drinking water in households are effective at reducing diarrhoea illnesses and thereby contribute significantly in reducing deaths due to …

Hyperlactetemia And Its Trends In Critically Ill Children Admitted In Pediatric Intensive Care Unit Of A Developing Country, Qalab Abbas, Muhammad Tariq Jamil, Leena Jafri, Anwar Ul Haque, Vivek Khetpal

Department of Paediatrics and Child Health

Background: There is increasing evidence that in setting of critical ailments clinical signs lag biomarkers like Lactate and hyperlactetemia can be the only marker for this disorder. This study was conducted to describe the incidence of hyperlactatemia in critically ill children and its association with outcome.Methods: Retrospective review of medical records of all children who had their lactic acid (LA) levels measured during their admission in PICU from January 2014 to December 2015 was done. Demographic and clinical variables were recorded along with PICU therapies, outcome (Survived or expired) and development of multi-organ dysfunction. Results are presented as frequency with …

Translating Knowledge For Action Against Stroke--Using 5-Minute Videos For Stroke Survivors And Caregivers To Improve Post-Stroke Outcomes: Study Protocol For A Randomized Controlled Trial (Movies4stroke)., Ayeesha Kamran Kamal, Adeel Khoja, Bushra Usmani, Nargis Asad, Asma Ahmed, Iqbal Azam, Sarah Saleem, Saleem Sayani

Department of Medicine

Background: Two thirds of the global mortality of stroke is borne by low and middle income countries (LMICs). Pakistan is the world’s sixth most populous country with a stroke-vulnerable population and is without a single dedicated chronic care center. In order to provide evidence for a viable solution responsive to this health care gap, and leveraging the existing >70 % mobile phone density, we thought it rational to test the effectiveness of a mobile phone-based video intervention of short 5-minute movies to educate and support stroke survivors and their primary caregivers.

Methods: Movies4Stroke will be a randomized control, outcome assessor …

Evaluation Of The Uptake And Impact Of Neonatal Vitamin A Supplementation Delivered Through The Lady Health Worker Programme On Neonatal And Infant Morbidity And Mortality In Rural Pakistan: An Effectiveness Trial, Sajid Soofi, Shabina Ariff, Kamran Sadiq, Atif Habib, Zaid Bhatti, Imran Ahmad, Masawar Hussain, Nabeela Ali, Simon Cousens, Zulfiqar A Bhutta

Department of Paediatrics and Child Health

Background: Despite evidence for the benefits of vitamin A supplementation (VAS) among children 6 to 59 months of age, the feasibility of introduction and potential benefit of VAS in the neonatal period in public health programmes is uncertain. Objective: The primary objective was to evaluate the feasibility and effectiveness of early neonatal VAS (single dose of 50 000 international units within 48–72 hours after birth) delivered through the public sector Lady Health Worker (LHW) programme in rural Pakistan and to document its association with a reduction in mortality at 6 months of age.
Methods: A community-based, cluster randomised, …

Application Of The Many Facet Rasch Model To Validate A Survey For The Selection Of Chief Residents, Kadriye O. Lewis, Haiqin Chen

Posters

The literature does not show any established guidelines, methods, or psychometric instruments for selecting Chief Residents in academic programs. This study validates a newly designed instrument based on the characteristics and leadership qualities from the residents' perspectives. Our newly developed survey can differentiate Chief Resident candidates' performance as well as identify why a specific candidate is selected or not through MFRM. This tool can be applied to other residency programs.

Association Between Fellowship Training, Surgical Volume, And Laparoscopic Suturing Techniques Among Members Of The American Association Of Gynecologic Laparoscopists, Emad Mikhail, Lauren Scott, Branko Miladinovic, Anthony N. Imudia, Stuart Hart

Obstetrics & Gynecology Faculty Publications

Study Objective. To compare surgical volume and techniques including laparoscopic suturing among members of the American Association of Gynecologic Laparoscopists (AAGL) according to fellowship training status. Design. A web-based survey was designed using Qualtrics and sent to AAGL members. Results. Minimally invasive gynecologic surgery (FMIGS) trained surgeons were more likely to perform more than 8 major conventional laparoscopic cases per month (63% versus 38%, , OR [95% CI] = 2.78 [1.54–5.06]) and were more likely to perform laparoscopic suturing during these cases (32% versus 16%, , OR [95% CI] = 2.44 [1.25–4.71]). The non-fellowship trained (NFT) surgeons …

Evidence-Based Cesarean Delivery For The Nonobstetrician, Joshua D. Dahlke, Hector Mendez-Figueroa, Jeffrey D. Sperling, Lindsay Maggio, Brendan D. Connealy, Suneet P. Chauhan

Obstetrics & Gynecology Faculty Publications

Cesarean delivery (CD) is one of the most common major surgeries performed in the United States and worldwide. Surgical techniques evaluated in well-designed randomized controlled trials (RCTs) that demonstrate maternal benefit should be incorporated into practice. The objective of this review is to provide a summary of surgical techniques of the procedure and review the evidence basis for them for the nonobstetrician. The following techniques with the strongest evidence should be commonly performed, when feasible: (1) prophylactic antibiotics with a single dose of ampicillin or first-generation cephalosporin prior to skin incision; (2) postpartum hemorrhage prevention with oxytocin infusion of 10 …

Pyoderma Gangrenosum Following Bilateral Deep Inferior Epigastric Perforator Flaps, Eric Clayman, Kristen Marcet, Lauren Kuykendall, Dunya M. Atisha

Surgery Faculty Publications

Pyoderma gangrenosum (PG) is an atypical ulcerative cutaneous condition, with an estimated six cases per million people per year in the United States.[1] One-half of patients have idiopathic disease, and it is most commonly associated with underlying systemic inflammatory conditions or hematologic malignancies.[1] [2] There have been several reported cases of PG following breast reduction procedures; however, postsurgical PG (PSPG) is rarely seen following autologous tissue breast reconstruction.[3]

In this article, the authors report the clinical course, treatment, and outcome of a patient diagnosed with PSPG following a delayed breast reconstruction with …

Bisphenol-A And Sleep Adequacy Among Adults In The National Health And Nutrition Examination Surveys, Hind A. Beydoun, May A. Beydoun, Hueiwang Anna Jeng, Alan B. Zonderman, Shaker M. Eid

Community & Environmental Health Faculty Publications

Study Objectives: To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults.
Methods: A population-based cross-sectional study was conducted using 2005-2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles (< 0.9 ng/mL; 0.9 to < 1.9 ng/mL; 1.9 to < 3.7 ng/mL; 3.7+ ng/mL). Sleep adequacy was operationalized with three questions: "How much sleep do you usually get at night on weekdays or workdays?", "Have you ever told a doctor or other health professionals that you have trouble sleeping?" and "Have you ever been told by a doctor or other health professional that you have a sleep disorder?" Sleep duration was further categorized as (< 6 h, ≥ 6 h); (< 7 h, 7-8 h, > 8 h); (< 5 h, 5-6 h, 7-8 h, ≥ 9 h). Linear, binary, and ordinal logistic regression models were constructed.
Results: Loge-transformed BPA level was inversely related to sleep duration defined, in hours, as a continuous variable, a dichotomous variable (≥ 6, < 6), or an ordinal variable (≥ 9, 7-8, 5-6, < 5), after adjustment for confounders. Help-seeking behavior for sleep problems and diagnosis with sleep disorders were not significantly associated with loge-transformed BPA level in fully adjusted models.
Conclusions: Loge-transformed BPA level may be associated with fewer hours of …

Comparison Of Clinical Laboratory Standards Institute And European Committee On Antimicrobial Susceptibility Testing Guidelines For The Interpretation Of Antibiotic Susceptibility At A University Teaching Hospital In Nairobi, Kenya: A Cross-Sectional Study, Ali Kassim, Geoffrey Omuse, Zul Premji, Gunturu Revathi

Pathology, East Africa

Background: The Clinical Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines are the most popular breakpoint guidelines used in antimicrobial susceptibility testing worldwide. The EUCAST guidelines are freely available to users while CLSI is available for non-members as a package of three documents for US $500 annually. This is prohibitive for clinical microbiology laboratories in resource poor settings. We set out to compare antibiotic susceptibility determined by the two guidelines to determine whether adoption of EUCAST guidelines would significantly affect our susceptibility patterns.

Methods: We reviewed minimum inhibitory concentrations (MIC) of various antibiotics routinely …

Reference Intervals For Thyroid Stimulating Hormone And Free Thyroxine Derived From Neonates Undergoing Routine Screening For Congenital Hypothyroidism At A University Teaching Hospital In Nairobi, Kenya: A Cross Sectional Study, Geoffrey Omuse, Ali Kassim, Francis Kiigu, Syeda Hussain, Mary Limbe

Pathology, East Africa

Background: In order to accurately interpret neonatal thyroid function tests (TFTs), it is necessary to have population specific reference intervals (RIs) as there is significant variation across different populations possibly due to genetic, environmental or analytical issues. Despite the importance of RIs, globally there are very few publications on RIs for neonatal TFTs primarily due to ethical and technical issues surrounding recruitment of neonates for a prospective study. To the best of our knowledge, this is the first report from Africa on neonatal RIs for TFTs.

Methods: We used hospital based data largely derived from neonates attending the wellness clinic …

Isolated Gastric Tuberculosis Mimicking Malignancy, Wasim Memon, Saad Siddiqui

Department of Radiology

Isolated tuberculosis of upper gastrointestinal tract is a rare pathology, often mimicking malignancy in clinical presentation and radiological features. We present a case of middle aged gentleman with isolated tuberculosis of stomach, proven on histopathology and showing remarkable improvement on follow up.

Institutionalized Training Of Research Editors, Saba Sohail, Jamshed Akhtar

Department of Radiology

No abstract provided.

Effect Of Twisted Fiber Anisotropy In Cardiac Tissue On Ablation With Pulsed Electric Fields, Fei Xie, Christian W. Zemlin

Bioelectrics Publications

Background: Ablation of cardiac tissue with pulsed electric fields is a promising alternative to current thermal ablation methods, and it critically depends on the electric field distribution in the heart.

Methods: We developed a model that incorporates the twisted anisotropy of cardiac tissue and computed the electric field distribution in the tissue. We also performed experiments in rabbit ventricles to validate our model. We find that the model agrees well with the experimentally determined ablation volume if we assume that all tissue that is exposed to a field greater than 3 kV/cm is ablated. In our numerical analysis, we considered …

Hydrocortisone, Vitamin C And Thiamine For The Treatment Of Severe Sepsis And Septic Shock: A Retrospective Before-After Study, Paul E. Marik, Vikramjit Khangoora, Racquel Rivera, Michael H. Hooper, John Catravas

Bioelectrics Publications

BACKGROUND: The global burden of sepsis is estimated as 15 to 19 million cases annually with a mortality rate approaching 60% in low income countries.

METHODS: In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a 7-month period (treatment group) compared to a control group treated in our ICU during the preceding 7 months. The primary outcome was hospital survival. A propensity score was generated to adjust the primary outcome.

FINDINGS: There were 47 patients in both treatment and control groups with no …

Unusual Late Onset Of Parenchymal Neuro-Behçet Disease, Wai Wai Miller, Demetrios Konstas, Chetan Gandhy, Derrick Robertson

Neurology Faculty Publications

Neuro-Behçet disease (NBD) is a multisystem inflammatory disorder characterized by oral lesions, genital lesions, uveitis, and neurological deficits. If left untreated, it may lead to worsening neurological function and can be fatal. Here we present a case of a 52-year-old woman who was diagnosed with Behçet disease (BD) as a teenager and had a relatively mild disease course. Decades later after her initial DB diagnosis, she presented to our hospital with a chief complaint of headache. She did not have focal neurological deficits or any active mucosal lesions. Upon further investigation, the patient was found to have multiple inflammatory changes …

The Association Between Cognitive Function And Objective Adherence To Dietary Sodium Guidelines In Patients With Heart Failure., Mary A Dolansky, Julie T Schaefer, Misty Aw Hawkins, John Gunstad, Anup Basuray, Joseph D Redle, James C Fang, Richard A Josephson, Shirley M Moore, Joel W Hughes

Heart and Vascular Articles

BACKGROUND: Although cognitive impairment is common in heart failure (HF) patients, its effects on sodium adherence recommendations are unknown.

PURPOSE: Our aim is to examine if cognitive function is associated with patient sodium adherence.

METHODS: Sodium collection/excretion and cognitive function were assessed for 339 HF patients over a 5-8-week period. Neuropsychological testing was performed at baseline (Visit 1), whereas two 24-hour urine samples were collected within 7 weeks postbaseline. The ability to collect two 24-hour urine samples and the estimation of sodium excretion levels from these samples were used to estimate sodium adherence recommendations.

RESULTS: Nearly half (47%) of the …

Stand By You: An Interprofessional Compassionate Service, Rose Allen, Renato Santos, Arlenna Williams, Sarita Khanal

All Publications

No abstract provided.

Characterizing The Oncogenic Properties Of C-Terminal Binding Protein, Evan T. Sumner

Theses and Dissertations

The paralogous C-terminal binding proteins (CtBP) 1 and 2 are evolutionarily conserved transcriptional coregulators that target and disrupt the expression of several genes essential for multiple cellular processes critical to regulating tumor formation. CtBP’s ability to govern the transcription of genes necessary for apoptosis, tumor suppression, invasion/migration and EMT gives rise to its oncogenic activities. Both isoforms of CtBP are found to be overexpressed in cancers including colorectal, pancreatic, ovarian, and breast, with higher levels correlating to lower overall median survival. Although multiple lines of evidence suggest CtBP plays a role in tumorigenesis, it has never been formally characterized as …

Sciatic Peripheral Nerve Blockade For Pain Control Following Hamstring Autograft Harvest In Adolescents: A Comparison Of Two Techniques, James Furstein

Theses and Dissertations

Anterior cruciate ligament reconstruction utilizing a hamstring autograft is a surgical technique that has gained popularity among orthopedic surgeons caring for adolescent patients. While utilization of a hamstring autograft is a revered technique, harvest of the hamstring yields significant pain. Sciatic peripheral nerve blockade has proven to reliably provide analgesia at the hamstring donor site. Single-injection sciatic peripheral nerve blockade is considered a basic and effective technique, making its use following anterior cruciate ligament reconstruction standard practice in many institutions. The duration of action of a single-injection sciatic peripheral nerve blockade may fail to outlast the pain arising from the …

Tumor-Specific Cell Death Induction By Noxa Overexpression For Head And Neck Squamous Cell Carcinoma (Hnscc) Treatment, Nicolas T. Maxim Mr.

Theses and Dissertations

The primary focus of this research is the mechanisms of cell death in head and neck squamous cell carcinoma (HNSCC) treatment. These cancers typically originate in squamous cells that line the moist mucosal surfaces of head and neck. HNSCC is commonly treated with a platinum based agent, cisplatin. While the drug does offer strong antitumor effects, its prolonged use often results in tumor-acquired resistance, which limits treatment effectiveness. We have shown that cisplatin treatment induces the expression of a pro-apoptotic BCL-2 family member Noxa, which then initiates caspase- dependent apoptosis through its binding and sequestration of pro-survival protein MCL-1 for …

Pharmacological Inhibition Of Cyclophilin Ameliorates Experimental Allergic Encephalomyelitis, Zi L. Huang

Theses and Dissertations

A subset of cyclophilins have been implicated in mechanisms of neuroinflammation and neurodegeneration that contributes to the pathogenesis of Multiple Sclerosis. Mitochondrial dysfunction leading to mitochondrial permeability transition plays a pivotal role in axonal damage and disease progression in Multiple Sclerosis. Cyclophilin D (CypD) is a crucial regulatory component of the mitochondrial permeability transition pore and it was demonstrated that the cyclophilin D knockout animals showed reduced experimental allergic encephalomyelitis (EAE) clinical disease severity and axonal injury. We investigated the effect of N-methyl-4-isoleucine-cyclosporin (NIM811), a non-immunosuppressive and non-selective cyclophilin inhibitor, on the course and severity of EAE. EAE mice treated …

Age‐Related Changes In Cerebellar And Hypothalamic Function Accompany Non‐Microglial Immune Gene Expression, Altered Synapse Organization, And Excitatory Amino Acid Neurotransmission Deficits, Stephen J. Bonasera, Jyothi Arikkath, Michael D. Boska, Tammy R. Chaudoin, Nicholas W. Dekorver, Evan H. Goulding, Traci A. Hoke, Vahid Mojtahedzedah, Crystal D. Reyelts, Balasrinivasa R. Sajja, A. Katrin Schenk, Laurence H. Tecott, Tiffany A. Volden

Data: Geriatrics

No abstract provided.

Comparing Biocompatibility Of Ibad-Produced Nano-Films Of Titanium Oxide With Orthopaedic Grade Titanium, Raheleh Miralami

Posters and Presentations: Orthopaedic Surgery & Rehab

Titanium (Ti) is the material of choice for orthopaedic applications because it is biocompatible and encourages osteoblast growth. The present study was devised to compare the osteoblast functions on nano-crystalline titanium oxide films produced by an ion beam assisted deposition (IBAD) technique with the osteoblast functions on micro-crystalline orthopaedic-grade titanium. To characterize the biocompatibility of these surfaces, we have studied cell adhesion, growth, and differentiation on different samples. Cell responses to surfaces were examined using the human osteosarcoma cell line (SAOS-2) with osteoblastic properties. To compare cell adhesion and growth, DAPI-stained nuclei were counted using ImageJ and Metamorph software. Immunofluorescence …

Development Of A Novel In Vivo Corneal Fibrosis Model In The Dog, K. M. Gronkiewicz, Elizabeth A. Giuliano, K. Kuroki, F. Bunyak, Ajay Sharma, L. B. C. Teixeira, C. W. Hamm, R. R. Mohan

Pharmacy Faculty Articles and Research

The aim of this study was to develop a novel in vivo corneal model of fibrosis in dogs utilizing alkali burn and determine the ability of suberanilohydroxamic acid (SAHA) to inhibit corneal fibrosis using this large animal model. To accomplish this, we used seven research Beagle dogs. An axial corneal alkali burn in dogs was created using 1 N NaOH topically. Six dogs were randomly and equally assigned into 2 groups: A) vehicle (DMSO, 2 μL/mL); B) anti-fibrotic treatment (50 μM SAHA). The degree of corneal opacity, ocular health, and anti-fibrotic effects of SAHA were determined utilizing the Fantes grading …

Molecular Mechanisms Of Suberoylanilide Hydroxamic Acid In The Inhibition Of Tgf-Β1-Mediated Canine Corneal Fibrosis, Kristina M. Gronkiewicz, Elizabeth A. Giuliano, Ajay Sharma, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

Objective—To investigate molecular mechanisms mediating anti-fibrotic effect of SAHA in the canine cornea using an in vitro model. We hypothesized that SAHA attenuates corneal fibrosis by modulating Smad-dependent and, to a lesser extent, Smad-independent signaling pathways activated by TGF-β1, as well as matrix metalloproteinase (MMP) activity.

Methods—Cultured canine corneal fibroblasts (CCF) were incubated in the presence/absence of TGF-β1 (5ng/ml) and SAHA (2.5μM) for 24hrs. Western blot analysis was used to quantify non-phosphorylated and phosphorylated isoforms of Smad2/3, p38 MAP kinase (MAPK), ERK1/2 and JNK1. Real-time PCR and zymography were utilized to quantify MMP1, MMP2, MMP8 and MMP9 mRNA expression and …

Recurrence Of Ganglion Cysts Following Re-Excision, Lindsay S. Mcalpine, Msiii, Juana Medina, Md, Nayoung Kim, Bs, Michael Rivlin, Md

CwiC Posters

Previous studies have examined the recurrence of ganglion cysts after surgical excision at a rate of 4 to 40%. However, recurrence after revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cysts in patients who underwent a 2nd excisional procedure.

Challenges Of Internet And Social Media Use In Adolescents, Mandakini Sadhir, Stephanie J. Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

There has been tremendous growth in use of technology in recent decades. The majority of teens now have access to a desktop/laptop computer as well as a gaming console and smartphone. With growing internet and social media use teens now face challenges including cyberbullying, sexting and problematic internet use that result in various health implications. Health care providers are in unique position to educate adolescents and families about current challenges and provide age appropriate guidance to promote healthy internet behaviors.

Art Therapy And Cancer Care: A Qualitative Analysis Of Visual Oncology Narratives, Jill Mcnutt

Expressive Therapies Dissertations

This document reviews the artworks created in the form of visual narratives of cancer survivors. The work sought to explore the subjective experience of cancer and explore potential functions of art therapy in oncology care. Previous research found stages of the cancer trajectory and psychosocial benefits of art therapy. Fifteen adult cancer survivors created visual narratives and participated in this qualitative inquiry. The research was action-based and used arts based and qualitative methodologies. Eight themes emerged and reflected stages of the cancer experience and corresponding functions of art therapy participation. The themes included: diagnosis and the onset of the cancer …

Longitudinal Examination Of Perceived Stress And Depression Symptomology In Division I Student-Athletes, Bobby Daigle

Electronic Theses and Dissertations

CONTEXT: Concussions are all too prevalent in amongst athletes. Concussions make up almost 5 percent of all collegiate athletic injuries. Concussions have been linked with many long lasting effects including depression and increased stress or anxiety.

OBJECTIVE: To longitudinally examine post-concussion depression and stress levels in National Collegiate Athletic Association Division 1 athletes.

DESIGN: Descriptive longitudinal study.

SETTING: National Collegiate Athletic Association Division I collegiate athletics.

PARTICIPANTS: Concussed and uninjured Division I collegiate athletes, ages 18-22, competing in football, women’s soccer, baseball, softball, and women’s track.

INTERVENTION(S): Participants completed the CES-D at baseline, 1 week, 1 month, and 3 months …