Medical Specialties Commons^™

Engaging Moms On Teen Indoor Tanning Through Social Media: Protocol Of A Randomized Controlled Trial, Sherry L. Pagoto, Katie Baker, Julia Griffith, Jessica L. Oleski, Ashley Palumbo, Barbara Walkosz, Joel J. Hillhouse, Kimberly L. Henry, David Buller

ETSU Faculty Works

Background: Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children.

Objective: This randomized controlled trial will test the efficacy …

Diagnostic Accuracy Of Ct Scan In Staging Resectable Esophageal Cancer, Rizwan Sultan, Zishan Haider, Tabish Chawla

Department of Surgery Docs

Abstract

INTRODUCTION:

CT scan is an important tool in staging of esophageal cancer. Survival can be improved by providing neoadjuvant treatment which depends on stage of esophageal cancer. So it is very important to stage the disease accurately.

METHODS:

The objective of this study is to determine diagnostic accuracy of CT scan to stage esophageal cancer. Ct scans of 62 patients included in the study were reviewed by a Consultant radiologist who was blinded to the final stage of tumour. Diagnosticaccuracy measured by comparing with histopathological staging.

RESULTS:

Accuracy, sensitivity and specificity of CT for T2 and T3 are 66%, …

Effect Of Prior Trauma Exposure On Alpha Amplitude, Heart Rate, And Self-Reported Negative Affect, Gina L. Denoble

All Master's Theses

This study was conducted to investigate whether the number of traumatic events an individual has previously experienced influences that individual’s physiological and psychological reactions when exposed to a negative affective stimulus followed by a mindfulness-based stress reduction (MBSR) intervention. Twenty-eight participants were placed into intact quasi-experimental groups based on their scores on the Traumatic Life Events Questionnaire (TLEQ). The negative affective stimulus consisted of a series of photos bearing negative affective valence. The photos were selected from the International Affective Picture System (IAPS), and paralleled the areas of trauma exposure evaluated by the TLEQ. All participants were exposed to the …

Success Of Bubble Cpap In Treatment Of Respiratory Distress Syndrome In Preterm Infants, Tufail Soomro, Shiyam Sunder Tikmani

Community Health Sciences

Background: To observe the survival of preterm infants with respiratory distress syndrome treated with bubble CPAP in a tertiary care hospital.
Methods: This prospective observational study was conducted in the NICU of Civil hospital Sukkur from 1st July 2013 to 18th August 2015. All consecutively born preterm neonates with gestational age between 27 weeks to 36 weeks of gestation, admitted to the neonatal intensive care unit with respiratory distress are included in the study.These neonates were managed by Bubble continuous positive airway pressure (bCPAP) in combination with surfactant (bovine derivative) via intubation, Surfactant replacement, extubation (INSURE) protocol Success was considered …

Critical Need Of Osteoporosis Risk Assessment Tool For Pakistan, Lena Jafri, Romaina Iqbal, Aysha Habib Khan

Community Health Sciences

No abstract provided.

Naegleria Fowleri Meningoencephalitis Associated With Public Water Supply, Pakistan, 2014, Najia Ghanchi, Erum Khan, Azam Khan, Wali Muhammad, Faisal Riaz Malik, Afia Zafar

Department of Pathology and Laboratory Medicine

No abstract provided.

Carotid Intima Media Thickness Evaluation By Ultrasound Comparison Amongst Healthy, Diabetic And Hypertensive Pakistani Patients, Waseem Mirza, Vaqar Bari, Mirza Kazim, Kainat Fatima, Zafar Sajjad, Aziz Jiwani, Nadeem Ahmad, Mubashir Arain, Arif Ali

Department of Pathology and Laboratory Medicine

Objective: To compare carotid Intima media thickness and atherosclerosis burden amongst healthy, diabetic and hypertensive Pakistani patients.
Methods: A cross-sectional study was carried out at the Department of radiology and family medicine, Aga Khan University Hospital Karachi from April 2014 to July 2015. Bilateral carotid ultrasound was done in 133 healthy adults, 65 hypertensive, 31 type-2 diabetic and 37 hypertensive with type-2 diabetes patients. Normal adults were matched for age and gender. Mean intimal media thickness was measured for common and internal carotid arteries. Presence or absence of atherosclerotic plaque was also identified. Height, weight, ethnicity, socioeconomic status and other …

Primary Healthcare Policy Implementation In South Asia, Chris Van Weel, Ryuki Kassai, Waris Qidwai, Raman Kumar, Kanu Bala, Pramendra Prasad Gupta, Ruvaiz Haniffa Haniffa, Neelamani Rajapaksa Hewageegana, Thusara Ranasinghe, Michael Kidd, Amanda Howe

Department of Family Medicine

Primary healthcare is considered an essential feature of health systems to secure population health and contain costs of healthcare while universal health coverage forms a key to secure access to care. This paper is based on a workshop at the 2016 World Organization of Family Doctors (WONCA) South Asia regional conference, where the health systems of Bangladesh, India, Nepal, Pakistan and Sri Lanka were presented in relation to their provision of primary healthcare. The five countries have in recent years improved the health of their populations, but currently face the challenges of non-communicable diseases and ageing populations. Primary healthcare should …

Present And Future Of Neurology In Pakistan, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Neurology started as a department in early nineteen sixties in Dow Medical College and King Edward Medical College and initially having a separate department of neurology was not mandated in medical colleges by Pakistan Medical and Dental Council¹. Some neurology training programs do not give exposure to subspecialties and training is focused on adult neurology². From 2015 to 2016, several conferences were held on neurology including an Annual Meeting in Quetta, movement disorder conference in Lahore.

Acute Childhood Ischemic Stroke: A Pakistani Tertiary Care Hospital Experience, Prem Chand, Shahnaz Ibrahim, Muhammad Matloob Alam, Fazal Arain, Bhojo Khealani

Pakistan Journal of Neurological Sciences (PJNS)

Stroke in pediatric population is increasingly recognized and has diverse clinical presentation and risk factor profile. Majority of patients survive acute stroke but remain disabled. The reported literature on the subject from our part of world is scarce.Methods:A retrospective chart review was carried out for stroke patients between 1 month and 14 years of age, admitted between January 2009 and January 2015. Their demographic, clinical and radiological data was collected and analyzed.Results:Twenty nine patients were admitted with stroke over 5 years. Their mean age was 5.7 ±11.7 and male to female ratio was 3:1. The most common clinical features reported …

Factors Influencing Antiepileptic Drug Non-Compliance In Epileptic Patients Of Pakistan, Safia Bano, Ahsan Numanb

Pakistan Journal of Neurological Sciences (PJNS)

Failure to comply with drug regimes is prevalent amongst patients with epilepsy and the consequence of this is often an increased risk of further seizures and other associated harms including increased health care costs. Contributing factors leading to non-compliance of anti-epileptic drugs has not been examined in Pakistan. We investigated the factors influencing non-compliance to prescribed antiepileptic drugs (AEDs). A cross-sectional study was employed for a total of 53 epileptic patients with non-compliance of anti-epileptic drugs. The data-collection tools were a questionnaire and structured interview for this study. Results showed that males were more liable to non-compliance of AEDs as …

Socio-Demographic Risk Factors For Hemorrhagic And Ischemic Stroke: A Study In Tertiary Care Hospital Of Hyderabad, Tariq Feroz Memon, Manzoor Ali Lakhair, Muzaffar Shaikh, Abeer Raque, Muhammad Saleem Rind

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is a common neurological disorder and major cause of death and disability worldwide. Stroke is a second leading cause of death after cancer and ischemic heart disease. Incidence of stroke has not been well studied in Pakistan but it is estimated that 350,000 cases of stroke occur per year. Objective: To determine the frequencies and Socio-demographic features of Hemorrhagic and Ischemic strokes among stroke patients in tertiary care hospital.Material & method:This cross-sectional study was carried out at department of medicine Liaquat university hospital Hyderabad from June to September 2010, Patients were included in study according to inclusion and exclusion …

Neurocutanoussarcoidosis: A Rare Entity, Muslim Ali Lakhiar, Manzoor Lakhiar, Abdul Hafeez Bughio

Pakistan Journal of Neurological Sciences (PJNS)

Neurosarcoidosis is a granulomatous disorder considered to be a great imitator. We report a case of young lady who presented with gradual onset flexed posturing of fingers of left hand for four years, followed by similar pattern of weakness involving the right hand for three years along with slipping of slippers for one year. Neurologic examination showed distal wasting & weakness in upper limbs with normal jerks and sensory impairment in gloves and stocking distribution. On skin examination there were hypopigmented macules over face, neck and back. Electro diagnostic studies showed sensory motor axonal polyneuropathy, while skin biopsy reported as …

Mental Health Is Not A Luxury In Pakistan, Salma Kerai

Pakistan Journal of Neurological Sciences (PJNS)

A day with a fever is taken serious enough to get off from work in contrast to a day with emotional distress. World health organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. However, mental health is not seen as an integral part of overall well-being in many cultures.

Spontaneous Intracranial Hypotension; Three Case Reports With Similar Clinical Manifestations, Treated Successfully Using Different Management Techniques., Ali Ilyas, Wasim Tariq, Anam Abrar, Muhammad Amjad, Muhammad Azhar Saeed, Inayatullah Khan

Pakistan Journal of Neurological Sciences (PJNS)

Spontaneous Intracranial hypotension (SIH) is a rare neurological disorder, characterized by orthostatic headaches. Due to the complicity of its diagnosis and lack of awareness amongst physicians, SIH remains an under-diagnosed disease and its true prevalence remains unknown. It is a reversible condition, if diagnosed early. Delay in diagnosis can result in life threatening complications.Case Reports:We present a case series of three patients who presented with typical symptoms of SIH. But management course of each patient varied. The first patient responded well to the EBP (epidural blood patch) while the second improved with conventional symptomatic treatment. The third patient needed a …

An Unusual Presentation Of Gbs: Case Report And Literature Review, Sadaf Khattak, Sumaira Nabi, Irfan Khattak, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Guillain-Barre syndrome (GBS), also known as Landry paralysis is an acute idiopathic polyneuritis, believed to be immunologically mediated. It usually presents as a demyelinating neuropathy with ascending weakness, however, many clinical variants have been well documented in the medical literature, and variants involving the cranial nerves or pure motor involvement with axonal injury have also been described. We report a case of a 50 year old patient who initially presented to the ER with hemiparesis and cranial nerve palsies simulating a cerebrovascular event. Based on neurological examination, CSF analysis and needle EMG finding a diagnosis of GBS was made.

From Tip To Tpa, Shaista A Siddiqi, Syed Habibullah Kamran, Abubaker A Almadni

Pakistan Journal of Neurological Sciences (PJNS)

We present the case of a 50 year old lady who presented with sudden onset altered sensorium, anarthria, right hemianopia, ophthalmoplegia, quadriparesis and abnormal posturing of upper limbs for 4 hours. The NIHSS score was 31. The CT brain showed early ischemic changes in left posterior cerebral artery territory. The CT cerebral angiogram showed occlusion of the tip of basilar artery. Intravenous thrombolysis with rtPA resulted in remarkable recovery and NIHSS improved to 3 within 6 hours. In view of expected severe disability associated with tip of basilar artery syndrome, intravenous thrombolysis can be rewarding even in patients with high …

Sglt2 Inhibitor Therapy Improves Blood Glucose But Does Not Prevent Diabetic Bone Disease In Diabetic Dba/2j Male Mice, Kathryn M. Thrailkill, R. Clay Bunn, Jeffry S. Nyman, Mallikarjuna R. Rettiganti, Gael E. Cockrell, Elizabeth C. Wahl, Sasidhar Uppuganti, Charles K. Lumpkin, John L. Fowlkes

Barnstable Brown Diabetes Center Faculty Publications

Persons with type 1 and type 2 diabetes have increased fracture risk, attributed to deficits in the microarchitecture and strength of diabetic bone, thought to be mediated, in part, by the consequences of chronic hyperglycemia. Therefore, to examine the effects of a glucose-lowering SGLT2 inhibitor on blood glucose (BG) and bone homeostasis in a model of diabetic bone disease, male DBA/2J mice with or without streptozotocin (STZ)-induced hyperglycemia were fed chow containing the SGLT2 inhibitor, canagliflozin (CANA), or chow without drug, for 10 weeks of therapy. Thereafter, serum bone biomarkers were measured, fracture resistance of cortical bone was assessed by …

Synthesis Of Neoglycoproteins/Neoglycopeptides And Their Immunological Evaluation In The Context Of Chagas Disease, Nathaniel Scott Schocker

Open Access Theses & Dissertations

The protozoan parasite, Trypanosoma cruzi, the etiologic agent of Chagas disease (ChD), has a cell surface covered by immunogenic glycoconjugates. A synthetic glycoarray containing non-reducing α-galactopyranosyl moieties related to mucin O-glycans of the parasite T. cruzi was evaluated by a chemiluminescent enzyme-linked immunosorbent assay (CL-ELISA) with sera from patients with chronic ChD, revealing the disaccharide Galα(1,3)Galβ as the immunodominant glycotope (Chapter 2). This disaccharide comprises the two terminal sugars of the known immunodominant glycotope Galα(1,3)Galβ(1,4)GlcNAcα, which is expressed on glycosylphosphatidylinositol-anchored mucins of the infective trypomastigote stage of T. cruzi and triggers high levels of protective anti-α-Gal antibodies (Abs) in infected …

Perceptions And Attitudes Of A Sample Of Primary Care Patients Receiving Psychological Care From Their Pcp, Nadine Henzes Gowarty

PCOM Psychology Dissertations

With millions of Americans suffering from a mental health disorder and slightly more than half receiving treatment, the demand for psychological services far outweighs the number of practitioners available to provide direct care. Therefore, the majority of all primary-care visits are based on psychosocial factors; one third of a PCP’s caseloads consist of patients with mental-health problems. Given the fact that PCPs provide comprehensive psychosocial care, it is important to determine the beliefs and perceptions of their patients. Results from this study identified numerous factors that influence the relationship between patients receiving mental health care from their PCP. Specifically, if …

A Combination Of Two Rare Coronary Anomalies Makes It Even Rarer: Right Sided Single Coronary Artery With Dual Left Anterior Descending Artery, Aram Barbaryan, Theodore Addai, Monahar Kola, Muhammad Wajih Raqeem, Sergey Barsamyan, Aibek E. Mirrakhimov

Internal Medicine Faculty Publications

An 82-year-old female with history of hyperlipidemia and hypertension presented to the clinic with chief complaint of nonradiating chest tightness accompanied by exertional dyspnea. Cardiac catheterization showed the absence of left coronary system; the entire coronary system originated from the right aortic sinus as a common trunk which then gave off the right coronary artery and the left main coronary artery. Cardiac catheterization demonstrated also another rare coronary anomaly: dual left anterior descending artery. Patient underwent percutaneous coronary intervention and subsequent multidetector computed tomography angiography confirmed the above angiography findings. Patient was subsequently discharged home on double antiplatelet therapy with …

Telomerase Inhibition By Everolimus Suppresses Smooth Muscle Cell Proliferation And Neointima Formation Through Epigenetic Gene Silencing, Jun Aono, Ernesto Ruiz-Rodriguez, Hua Qing, Hannes M. Findeisen, Karrie L. Jones, Elizabeth B. Heywood, Dennis Bruemmer

Internal Medicine Faculty Publications

Proliferation of smooth muscle cells (SMCs) during neointima formation is prevented by drug-eluting stents. The replicative capacity of mammalian cells is enhanced by telomerase expression; however, the contribution of telomerase to the proliferative response underlying neointima formation and its potential role as a pharmacological target are unknown. The present study investigated the mechanisms underlying the mitogenic function of telomerase, and tested the hypothesis that everolimus, which is commonly used on drug-eluting stents, suppresses SMC proliferation by targeting telomerase. Inhibition of neointima formation by everolimus was lost in mice overexpressing telomerase reverse transcriptase (TERT), indicating that repression of telomerase confers the …

Acute Liver And Renal Failure: A Rare Adverse Effect Exclusive To Intravenous Form Of Amiodarone, Robin Paudel, Prerna Dogra, Saurav Suman, Saurav Acharya, Jyoti Matta

Internal Medicine Faculty Publications

Amiodarone is an antiarrhythmic drug which is highly effective against a wide spectrum of ventricular tachyarrhythmias making it irreplaceable in certain group of patients. We report an unusual case of acute liver and renal failure within 24 hours of initiation of intravenous (IV) amiodarone which resolved after stopping the medication. The mechanism of acute liver and renal toxicity is not clearly known but is believed to be secondary to amiodarone induced (relative) hypotension, idiosyncratic reaction to the drug, and toxicity of the vector that carries the medication, polysorbate-80. In this case review, we discuss the hyperacute drug toxicity caused by …

Effect Of Vitamins C And E On Endothelial Function In Type 1 Diabetes Mellitus, Rachel-Marie Cazeau, Hong Huang, John A. Bauer, Robert P. Hoffman

Pediatrics Faculty Publications

Background/Objectives. Endothelial dysfunction due to hyperglycemia-induced oxidative damage is an important predictor of future cardiovascular risk in patients with type 1 diabetes mellitus (T1DM) and is present in adolescent T1DM. We hypothesized that combined treatment with the antioxidant vitamins C and E might improve endothelial function (EF) and other biochemical risk factors in adolescents with T1DM. Subjects/Methods. Open-label antioxidant supplementation was given for six weeks with endpoint measurements collected at baseline and study completion. Endpoints measured included EF and plasma measurements of biochemical endothelial risk. Results. Two males and 7 females were studied. Mean age was 12.9 ± 0.9 yrs; …

Effect Of Metformin On Body Mass Index In Adolescent Females With Polycystic Ovary Syndrome, Alissa Briggs, Mandakini Sadhir, Maya Todd, Hatim A. Omar

Pediatrics Faculty Publications

Polycystic ovary syndrome (PCOS) is often associated with obesity, insulin resistance, irregular menstrual periods and pelvic pain. Treatment involves hormonal methods for regulation of menstrual cycle, lifestyle changes and metformin for improving insulin resistance and weight. The aim of our study was to compare changes in body mass index (BMI) of adolescent female with PCOS treated with metformin as compared to lifestyle modification only. Participants: Adolescent and young adult females aged I0-25 years diagnosed with PCOS seen for at least two visits for at least one year on the same treatment. Based on treatment plan, participants were categorized as metformin …

Chinese Adolescent In Hong Kong, Mandakini Sadhir

Pediatrics Faculty Publications

No abstract provided.

The Effects Of A Trauma-Informed Care Training Program On Mental Health Professionals Knowledge, Skills, And Attitudes With The Smi, Angelina Pelletier

PCOM Psychology Dissertations

Trauma has been found to be highly prevalent among individuals diagnosed with SMIs. Mental health professionals have been reported to misdiagnose or avoid addressing trauma in this population. There is a need to provide information about trauma and to foster awareness among mental health professionals who are treating individuals diagnosed with SMIs. With a TIC approach, operating from a recovery-oriented philosophy, there have been interventions created to address trauma and SMIs with the aim of developing awareness about trauma and the impact it may have on someone’s life. With these factors in mind, mental health professionals should be competent in …

Overcoming Treatment Resistance In Heterogeneous Tumors, Nikhil Hebbar

Theses and Dissertations--Toxicology and Cancer Biology

Most primary tumors are heterogeneous and are often composed of therapy-sensitive and emerging therapy-resistant cancer cells. Rather unexpectedly, treatment of therapy-sensitive tumor cells in heterogeneous tumor microenvironments resulted in apoptosis of the therapy-resistant cancer cells. We identified a novel Par-4 amino-terminal fragment (PAF, which includes amino acids 1-131 of Par-4) that is produced and released by therapy-sensitive cancer cells following therapy-induced caspase-dependent cleavage of the tumor suppressor Par-4. PAF caused paracrine apoptosis in therapy-resistant cancer cells. Unlike Par-4-inducible apoptosis, which is dependent on the cell surface GRP78 receptor, PAF produced cancer-selective apoptosis independent of cell surface GRP78 function. Par-4 contains …

Emergency Department Frequent Utilization For Non-Emergent Presentments: Results From A Regional Urban Trauma Center Study, Joshua G. Behr, Rafael Diaz

VMASC Publications

Objectives
First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model.

Data Source
Primary data collection over an eight week period within a level-1 trauma urban hospital's emergency department.

Study Design
Representative randomized sample of 1,443 adult patients triaged ESI levels 4'5. Physicians …

Epidemiology Of Pediatric Prehospital Basic Life Support Care In The United States, Leigh Ann Diggs, Manasi Sheth-Chandra, Gianluca De Leo

Community & Environmental Health Faculty Publications

Children have unique medical needs compared to adults. Emergency medical services personnel need proper equipment and training to care for children. The purpose of this study is to characterize emergency medical services pediatric basic life support to help better understand the needs of children transported by ambulance. Pediatric basic life support patients were identified in this retrospective descriptive study. Descriptive statistics were used to examine incident location, possible injury, cardiac arrest, resuscitation attempted, chief complaint, primary symptom, provider's primary impression, cause of injury, and procedures performed during pediatric basic life support calls using the largest aggregate of emergency medical services …