Medical Specialties Commons^™

Which Osteotomy For Osteonecrosis Of The Femoral Head And Which Patient For The Osteotomy?, Young-Kyun Lee, Beomseok Lee, Javad Parvizi, Yong-Chan Ha, Kyung-Hoi Koo

Rothman Institute Papers

Transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) are joint-preserving procedures for osteonecrosis of the femoral head. The purpose of this review is to provide up-to-date guidelines for the osteotomies. One retrospective comparison revealed that TCVO has shorter operation time, less bleeding, lower incidence of osteophyte formation, and lower rate of secondary collapse. To obtain successful results of the osteotomy, the patient should be younger than 40 years and should have a body mass index of less than 24 kg/m². The osteotomy should be performed in early stages of femoral head osteonecrosis before marked collapse of …

Special Considerations For Clinical Trials In Fibrodysplasia Ossificans Progressiva (Fop)., Edward C Hsiao, Maja Di Rocco, Amanda Cali, Michael Zasloff, Mona Al Mukaddam, Robert J Pignolo, Zvi Grunwald, Coen Netelenbos, Richard Keen, Genevieve Baujat, Matthew A Brown, Tae-Joon Cho, Carmen De Cunto, Patricia Delai, Nobuhiko Haga, Rolf Morhart, Christiaan Scott, Keqin Zhang, Robert J Diecidue, Clive S Friedman, Fredrick S Kaplan, Elisabeth M W Eekhoff

Department of Anesthesiology Faculty Papers

Clinical trials for orphan diseases are critical for developing effective therapies. One such condition, fibrodysplasia ossificans progressiva (FOP; MIM#135100), is characterized by progressive heterotopic ossification (HO) that leads to severe disability. Individuals with FOP are extremely sensitive to even minor traumatic events. There has been substantial recent interest in clinical trials for novel and urgently-needed treatments for FOP. The International Clinical Council on FOP (ICC) was established in 2016 to provide consolidated and coordinated advice on the best practices for clinical care and clinical research for individuals who suffer from FOP. The Clinical Trials Committee of the ICC developed a …

Urdu Translation And Validation Of The Urogenital Distress Inventory (Udi-6) In Women With Urinary Incontinence, Nuzhat Faruqui, Novera G. Chughtai, Jamil Ahmed

Section of Urology

Objective: To provide an Urdu translation of the six-item version of the Urogenital Distress Inventory (UDI-6) and its validation in patients with urinary incontinence (UI), as the UDI-6 is a recognised, useful disease-specific questionnaire for the evaluation of UI in women.
Patients and Methods: We used a multi-step linguistic translation of the UDI-6, which comprised backward and forward translations coordinated by clinical investigators, followed by a pre-test in 10 patients. The final version was completed by a larger sample of women (n = 200), of which 100 had UI for the last 3 months and 100 had no UI. …

Negative Appendectomy Rate And Associated Factors In Urban Referral Hospitals In Tanzania, Masawa Klint Nyamuryekung’E

Master of Medicine in General Surgery

Background: Acute appendicitis is a common surgical emergency. In atypical presentation, making a clinical diagnosis is difficult leading to delays with high perforation rate or misdiagnoses and high negative appendectomy rates. In the urban referral hospitals in Tanzania the baseline perforation rate, negative appendectomy rate, and factors that drive it are unknown. These could serve as measures of performance, and as evaluation parameters of future interventions aimed at improving acute appendicitis case management in Tanzania. Objectives: The aim of this study was to establish the negative appendectomy rate and associated factors among patients undergoing emergency appendectomy for suspected acute appendicitis …

How Providing Cervical Cancer Screening Results Via Cell Phone Affects Patient Follow-Up Rates In Western Kenya, Megan J. Huchko, Ibrahim Saduma, Cinthia Blat, Sandra Oketch, Elizabeth Bukusi

Obstetrics and Gynaecology, East Africa

Purpose: Human papillomavirus (HPV) testing is being more widely used in simplified cervical cancer screening protocols in low-resource settings. One challenge to successful implementation is the multiple visits necessary to provide results and follow-up. mHealth strategies may reduce visit burden by providing information through text message.

Methods: As part of a cluster-randomized trial to compare HPV testing in clinics and community health campaigns in western Kenya, we carried out a mixed-methods study to assess women's preferences and experiences with different strategies to receive their results. Women could opt to receive their HPV results via text message, cell phone call, home …

Limbic-Predominant Age-Related Tdp-43 Encephalopathy (Late): Consensus Working Group Report, Peter T. Nelson, Dennis W. Dickson, John Q. Trojanowski, Clifford R. Jack, Patricia A. Boyle, Konstantinos Arfanakis, Rosa Rademakers, Irina Alafuzoff, Johannes Attems, Carol Brayne, Ian T. S. Coyle-Gilchrist, Helena C. Chui, David W. Fardo, Margaret E. Flanagan, Glenda Halliday, Suvi R. K. Hokkanen, Sally Hunter, Gregory A. Jicha, Yuriko Katsumata, Claudia H. Kawas, C. Dirk Keene, Gabor G. Kovacs, Walter A. Kukull, Allan I. Levey, Nazanin Makkinejad, Thomas J. Montine, Shigeo Murayama, Melissa E. Murray, Sukriti Nag, Robert A. Rissman, William W. Seeley, Reisa A. Sperling, Charles L. White Iii, Lei Yu, Julie A. Schneider

Sanders-Brown Center on Aging Faculty Publications

We describe a recently recognized disease entity, limbic-predominant age-related TDP-43 encephalopathy (LATE). LATE neuropathological change (LATE-NC) is defined by a stereotypical TDP-43 proteinopathy in older adults, with or without coexisting hippocampal sclerosis pathology. LATE-NC is a common TDP-43 proteinopathy, associated with an amnestic dementia syndrome that mimicked Alzheimer’s-type dementia in retrospective autopsy studies. LATE is distinguished from frontotemporal lobar degeneration with TDP-43 pathology based on its epidemiology (LATE generally affects older subjects), and relatively restricted neuroanatomical distribution of TDP-43 proteinopathy. In community-based autopsy cohorts, ∼25% of brains had sufficient burden of LATE-NC to be associated with discernible cognitive impairment. Many …

Prevalence And Outcome Of Asymptomatic Cryptococcal Antigenemia In Art Naive And Art Experienced Hiv Patients In Dar Es Salaam, Tanzania, Charles Mandela Makakala

Master of Medicine in Internal Medicine

Introduction: Cryptococcal meningitis (CM) is a highly fatal disease and contributes to about 20% of all-cause mortality in HIV/AIDS. Sub-Saharan Africa is facing substantial challenges in the treatment of the disease; the focus has been shifted towards prevention of the condition in ART-naive patients with CD4 counts of less than 100 cells/μL. Most studies and interventions have been conducted on ART-naive HIV patients despite there being cases and deaths due to cryptococcal meningitis among ART-experienced patients. Recent studies have shown that although there is an increase in ART coverage among HIV patients, this has not affected the incidence of cryptococcal …

Carotid Dosimetry After Re-Irradiation With 131cs Permanent Implant Brachytherapy In Recurrent, Resected Head And Neck Cancer, Amanda Walsh, Emily Hubley, Laura Doyle M, David Cognetti, Joseph Curry, Voichita Bar-Ad, Adam Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Purpose: Permanent seed implant cesium-131 (¹³¹Cs) brachytherapy provides highly localized radiation for patients with recurrent head and neck cancer (HNC), who may be ineligible for external beam radiation therapy due to a high-risk of toxicity. As carotid blowout is a concern in the setting of re-irradiation, a dose to the carotid artery was examined for ¹³¹Cs brachytherapy implants.

Material and methods: Eleven patients were implanted with¹³¹Cs adjacent to carotid at the time of resection for recurrent HNC. Vascularized tissue flaps were used in some patients. The carotid artery was contoured on the post-implant brachytherapy treatment …

Chimeric Antigen T Cell Receptor Treatment In Hematological Malignancies, Natasha Ali

Department of Pathology and Laboratory Medicine

No abstract provided.

Participant Perspectives On A Phase I/Ii Ocular Gene Therapy Trial (Nct02077361), Stephanie P. Brooks, Shelly Benjaminy, Tania M. Bubela

Office of the Provost

Background: To learn from the experiences of potential clinical trial participants, participants in a Phase 1 ocular gene therapy trial, and their partners to improve communications and trial conduct.
Materials and methods: Primary and secondary qualitative analysis of semi-structured interviews of potential participants (n = 20), clinical trial participants (n = 2) and their partners (n = 2) in a gene therapy clinical trial for choroideremia (NCT02077361). Analysis included: 1) thematic analysis of transcribed entrance and exit semi-structured interviews with trial participants and their partners; and 2) secondary qualitative analysis of interviews with potential trial participants, …

A Prospective, Population-Based Study Of Trends In Operative Vaginal Delivery Compared To Cesarean Delivery Rates In Low- And Middle-Income Countries, 2010-2016., Margo S. Harrison, Sarah Saleem, Sumera Ali, Omrana Pasha, Elwyn Chomba, Waldemar A. Carlo, Ana L. Garces, Nancy F. Krebs, K. Michael Hambidge, Shivaprasad S. Goudar, S. M. Dhaded, Bhala Kodkany, Richard J. Derman, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Antoinette Tshefu, Adrien Lokangaka, Melissa Bauserman, Carl L. Bose, Fernando Althabe, Jose M. Belizan, Pierre Buekens, Janet L. Moore, Dennis D. Wallace, Menachem Miodovnik, Marion Koso-Thomas, Elizabeth M. Mcclure, Robert L. Goldenberg

Global Health Articles

OBJECTIVE: Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites.

STUDY DESIGN: A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected.

RESULTS: We analyzed 354,287 …

Vgkc Antibody (Anti Lg1) Associated Limbic Encephalitis In A Young Adult With Full Recovery., Farheen Niazi, Madeeha Iftikhar, Rizwan Ali, Tahir Aziz

Pakistan Journal of Neurological Sciences (PJNS)

A young boy with no premorbids was admitted with fever, fits and psychosis. His initial investigations including cerebrospinal fluid (CSF) routine examination, electroencephalogram(EEG) and MRI brain with contrast were normal. His autoimmune encephalitis panel revealed positive voltage gated potassium channel(VGKC) antibodies, anti -leucine rich glioma inactivated 1 antibody (LG1) group and was give five doses of methylprednisolone and five sessions of plasmapheresis. Psychiatric symptoms took one month to respond. He had a complete recovery. Autoimmune limbic encephalitis should be diagnosed promptly in young patient with fit, psychosis and a high index of suspicion should be kept as initial work up …

Polyneuropathy Associated With Iga Paraproteinemia: A Case Report And Literature Review., Waleed Shahzad, Sumaira Nabi, Hafiza Faiza Mushtaq, Tehmina Inayat, Muhammad Hassan, Haris Majid Rajput, Zakir Jan, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Paraproteinemia is precipitated by an accumulation of monoclonal plasma cells or B lymphocytes. Idiopathic neuropathies that are associated with paraproteinemia account for only 10% of the neuropathies. Paraprotein acts like an antibody and is targeted against myelin and axons present in the peripheral nerves. Despite being of interest for quite a long time, the caudal relationship between paraproteinemias and peripheral neuropathies still remains a sorcery. We report a case of a middle aged male who presented with pain and parasthesias in both arms and legs. His workup revealed him to be having a paraproteinemic neuropathy consistent with IgA Lambda chains …

Is It Really Transverse Myelitis? Acute Flaccid Myelitis A Rare Entity., Hina Yusuf, Arsalan Ahmad, Ejaz Ahmed Khan

Pakistan Journal of Neurological Sciences (PJNS)

Acute Flaccid Myelitis is a relatively new and rare disease entity which was recognized for the first time in United States in 20121. Usually children below 18 years of age present with sudden onset rapidly progressive flaccid paralysis sometimes following upper respiratory tract infection. To date no cases have been reported from Afghanistan and Pakistan. We are reporting case of a young girl who presented with sudden onset flaccid paralysis and respiratory distress. Her MRI Cervical spine showed longitudinally extensive transverse myelitis. One year after the onset of disease flaccid paraparesis continued despite various treatments. It is important to report …

Spectrum Of Electroencephalogram Finding In Children With Newly Diagnosed Epilepsy –An Experience At A Tertiary Care Hospital., Sanam B. Rajper, Khairunnisa Mukhtiar, Fozia Baloch, Shahnaz H. Ibrahim, Abdul Rashid Memon

Pakistan Journal of Neurological Sciences (PJNS)

Epilepsy is the most common neurological disorders that affect all age groups. It is characterized by at least two unprovoked seizures more than 24 hours apart. The most common investigation used for both diagnosis and management is an Electroencephalogram (EEG), which is relatively cheap and easy to perform. However, EEG requires technical expertise and is prone to misinterpretation. Objective: To determine the frequency of abnormal EEG findings in children with newly diagnosed epilepsy at tertiary care hospital.

Humanism And Mental Health Of Married Female Patients With Systemic Lupus Erythematosus., Hafiza Muzammal Shafiq, Dr. Muhammad Rafiq, Dr. Zahid Mahmood

Pakistan Journal of Neurological Sciences (PJNS)

Autoimmune diseases exert adverse impact on the psychological, social and physical well-being of the individuals who suffer from such diseases. Systemic lupus erythematosus is one of chronic illnesses that disturb the all areas of life especially psychosocial perspective of life. In such conditions, belief and view of patients about their own self is necessary to prognosis of their health. Studies suggest that humanism is one of those protective factors that can lead risky health towards better life.

The Mhgap; Will It Bridge The Mental Health Treatment Gap In Pakistan?, Shireen Najam, Aisha Sanober Chachar, Ayesha Mian

Pakistan Journal of Neurological Sciences (PJNS)

In Pakistan, the treatment gap for mental disorders is significantly high. Pakistan faces a unique problem of sustainable delivery. In 2009, WHO launched a mental health gap action program (mhGap) to provide evidence-based services at the primary and secondary level for the prevention and management of psychiatric and neurological disorders. This article highlights the discrepancies of the systems and issues related to mental health services provision in Pakistan. By discussing two initiatives of mhGap implementation for the Pakistani health system, authors have surveyed core areas where the sustainability of such a model can be compromised. The structural challenges marked by …

Alterations In Human Reaction Time Upon Consumption Of Taurine-Caffeine Based Energy Drink. A Gender Based Study., Asif Abbasi, Amaila Fazal, Faizan Mirza, Sadaf Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Energy drinks contains several potentially psychoactive ingredients including taurine, glucoronolactone, and caffeine that increases the human performances, reaction time and mood with relative differences to visual and auditory stimuli between both the genders.

Vagal Nerve Stimulation; Current And Future Interventions, Sidra Saleem, Muhammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Vagus Nerve is the 10th and the largest cranial nerve of the parasympathetic system, consist of approximately 20% efferent and 80% afferent. It is a big nerve, providing autonomous, cardiovascular, respiratory, gastrointestinal, immune and endocrine systems.

Perception Of Shisha Smoking & Drug Abuse Among University Students Of Karachi, Farwah Rizvi, Lubna Naz, Nazneen Zehra

Pakistan Journal of Neurological Sciences (PJNS)

Tobacco smoking in the form of cigarettes and shisha hasbecome a sign of modernization and trend among youth for pleasant and relaxing experience. Drug addiction is the most common problem in young ones nowadays causing craving practices and long-term consequences includesdisturbances in physical and mental health.

Prevalence Of Risk Factors Promoting Diabetic Neuropathy ., Aisha Qadir, Sumera Sohail1, Lubna Naz, Ghazala Yasmeen, Nazish Iqbal

Pakistan Journal of Neurological Sciences (PJNS)

Diabetic neuropathy is the worst consequence of diabetes mellitus leading to nerve dysfunction that is the cause of several complications such as pain, loss of sensitivity, damage to body systems, foot ulcers, morbidity and amputations etc. The aim of the present work was to study the prevalence of risk factors and occurrence of diabetic neuropathy in patients with diabetes, and how much diabetic neuropathy complications affect the life of diabetic patients.

Factors Associated With Geriatric Morbidity And Impairment In A Megacity Of Pakistan, Saniya Sabzwari, Romaina Iqbal, Zafar Fatmi, Iqbal Azam Syed

Department of Family Medicine

Background: The elderly population is increasing globally. In Pakistan, the elderly comprise 6% of the population that is predicted to triple by 2050. Non-communicable diseases are common health problems of the elderly in Pakistan, however, resulting geriatric impairments and disability are unknown. This study was conducted to determine geriatric impairments and identify associated socio-demographic factors and comorbidities among community dwelling elderly in Karachi, Pakistan.
Methods: A cross-sectional study was conducted during 2013-2014. Community clusters were selected from all sub-districts of Karachi, the largest city of Pakistan. Data was collected from systematically selected households within these clusters from individuals, aged ≥60 …

Serum Level Of Matrix Metalloproteinase 3 (Stromelysin 1) In Patients With Systemic Lupus Erythematosus: Relation To Clinical Nephritis And Neuropsychiatric Manifestations, Eman R. Amer, Fatema A. Elshabacy, Hala A. Elhameed Tabl, Lobna Y. Ebrahim, Taghreed F. M. Mostafa

Journal of Medicine in Scientific Research

Aim The aim of this study was to assess serum matrix metalloproteinase 3 (MMP-3) level in patients of systemic lupus erythematosus (SLE) and its relation to various clinical and laboratory findings. Patients and methods The study involved 40 female patients with SLE as a study group and 20 sex-matched and age-matched healthy individuals as a control group. All patients were subjected to thorough clinical examinations and laboratory investigations. Disease activity was assessed using SLE Disease Activity Index, as well as Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Serum level of MMP-3 was assessed using enzyme-linked immunosorbent assay …

Endovascular Management Of Medically Refractory Intracranial Arterial Stenosis, Ahmed El-Bassiouny, Ayman Nassef, Eman Awad, Hossam Eldin Afify, Mohamed A. Shafik, Romany A. Yousef

Journal of Medicine in Scientific Research

Background Despite aggressive medical therapy, the risk of recurrent stroke in patients with symptomatic intracranial arterial (ICA) disease is as high as 15% per year. In patients with severe stenosis (>70%) and in certain high-risk groups, the risk of recurrent stroke has been reported to be as high as 25% per year. Objective Our study aimed to follow-up the patients after ICA stenting by using transcranial duplex (TCD). Patients and methods This is a retrospective single-center study carried out on data of patients recruited to Neurovascular Unit of El Mataria Teaching Hospital during the period from June 2015 to …

Once-Daily Versus Twice-Daily Enoxaparin For The Initial Treatment Of Acute Deep Venous Thrombosis: A Case–Control Study, Ahmed Samir, Asim M. Herz-Allah, Mohamad T. Yusuf, Mohamed M. Gouda, Mourad I. Alkhouly

Journal of Medicine in Scientific Research

Background In the initial treatment of deep venous thrombosis (DVT), enoxaparin is administered twice daily. A once-daily treatment regimen is more convenient for the patients and may optimize home treatment. However, it is not clear whether a once-daily treatment regimen is as safe and effective as a twice-daily treatment regimen. Purpose Our objective is to assess and compare the efficacy (in terms of recurrent venous thromboembolism) and safety (i.e. major hemorrhagic events) of once-daily versus twice-daily administration of enoxaparin for the initial treatment of DVT. Patients and methods A case–control study was conducted. We studied the efficacy and safety of …

Whole Genome Metagenomic Analysis Of The Gut Microbiome Of Differently Fed Infants Identifies Differences In Microbial Composition And Functional Genes, Including An Absent Crispr/Cas9 Gene In The Formula-Fed Cohort, Matthew D. Di Guglielmo, Karl Franke, Courtney Cox, Erin L. Crowgey

Department of Pediatrics Faculty Papers

Background: Advancements in sequencing capabilities have enhanced the study of the human microbiome. There are limited studies focused on the gastro-intestinal (gut) microbiome of infants, particularly the impact of diet between breast-fed (BF) versus formula-fed (FF). It is unclear what effect, if any, early feeding has on short- term or long-term composition and function of the gut microbiome.

Results: Using a shotgun metagenomics approach, differences in the gut microbiome between BF (n = 10) and FF (n = 5) infants were detected. A Jaccard distance principle coordinate analysis was able to cluster BF versus FF infants based on the presence …

Assessment Of Sensitivity And Specificity Of Ultrasonographic Features Of Gout In Intercritical And Chronic Phases, Abeer H. Ismaiel, Mohamed A. Safy, Nisreen H. Mohmoud, Tamer A. Aboul-Sood El-Kassas

Journal of Medicine in Scientific Research

Aim To study the usefulness of ultrasonography (US) in the diagnosis of gouty arthritis and to assess its sensitivity and specificity in intercritical and chronic stages and also its use in comparing patients with high serum uric acid (HSUA) and low serum uric acid (LSUA). Patients and methods We studied 60 patients known to be gouty in either chronic phase or intercritical phase, diagnosed clinically and through laboratory assessments, and 30 controls. Demographic, clinical, and serological data were evaluated. Knee and first metatarsophalangeal joints were assessed by musculoskeletal US by a blinded radiologist. Results A total of 53 (88.3%) patients …

Prevalence Of Anemia In Patients With Type 2 Diabetes, El-Saied Shaheen

Journal of Medicine in Scientific Research

Background Diabetes mellitus (DM) has a high prevalence worldwide. It leads to various complications, including microvascular and macrovascular complications. The nephropathy may undermine the renal production of erythropoietin, positively contributing to an increased anemia framework. The inflammatory situation created by kidney disease also interferes with intestinal iron absorption. Therefore, diabetic patients with kidney disease have higher risk for developing anemia. Aim The aim of this work was to determine the prevalence and various types of anemia in patients with type 2 DM. Patients and methods After obtaining informed written consent, all diabetics as well as control individuals were subjected to …

Effect Of Sildenafil On Stable Chronic Heart Failure: A Prospective Randomized-Controlled Clinical Trial, Hatem Khairy, Wael Abdelatief Elhakeem

Journal of Medicine in Scientific Research

Background Patients with systolic heart failure (HF) who develop secondary pulmonary hypertension have reduced exercise capacity and increased mortality compared with HF patients without pulmonary hypertension. A defective nitric oxide signaling is involved in left ventricular (LV) diastolic abnormalities and remodeling. Phosphodiesterase type 5 inhibition, by blocking degradation of nitric oxide second-messenger cyclic guanosine monophosphate, might be beneficial. Aim of the study In our study, we tested the effects of phosphodiesterase type 5 inhibition (sildenafil) on LV ejection fraction, diastolic function, pulmonary artery pressure, and clinical status. Patients, methods, and results One hundred HF patients (New York Heart Association classes …

Efficacy Of On-Pump Versus Off-Pump Coronary Artery Bypass Grafting In Early-Stage Renal Impairment Without Dialysis Therapy, Ashraf Zahra

Journal of Medicine in Scientific Research

Background Coronary artery disease is the most common of the cardiovascular diseases that can be treated with coronary artery bypass grafting (CABG) surgery, with either on-pump or off-pump technique. In this study, we aimed to compare the early results of isolated CABG, using on-pump and off-pump techniques, in patients with preoperative mild-to-moderate elevation of serum creatinine (1.6–2.5 mg/dl) level who did not require maintenance dialysis to support renal function. Patients and methods This prospective nonrandomized study included 60 patients who complained of symptoms of coronary artery disease and subsequently underwent myocardial revascularization at Cardiothoracic Surgery Department, Shebin El-Kom Teaching Hospital, …