Medical Specialties Commons^™

A Review Of Brain Death Protocols Across The Globe And Need For Brain Death Guideline For Pakistan., Mohammad Wasay, Syeda Batool Mujtaba, Mughis Sheerani, Saleem Barech, Rashid Jooma

Pakistan Journal of Neurological Sciences (PJNS)

The concept of brain death was first formally presented in United States of America in 1968 (Ad Hoc Committee of the Harvard Medical School to examine the definition of Brain Death, 1968) in part to facilitate organ donation. It is a widely accepted term in most countries but some like Japan do not consider it as death. According toAAN, brain death is defined as death due to irreversible loss of function of the entire brain — comparable to circulatory death, which is defined as irreversible loss of function of the circulatory system. The purpose of our study is to review …

Factors Influencing Severity In Acute Ischemic Strokes, Inam E Khuda, Intisar Siddiqui, Saad Munzar, Rashid Nazir, Arsalan Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Background: Stroke severity is one of the factors that determines stroke related disability. We explored possible associations between stroke severity and commonly evaluated clinical parameters of stroke patients. Objective: To determine the relationships between clinical features including routine in- hospital investigations done in first 24 hours of admission and variations in the stroke severity. Patients and Methods: This was a retrospective, analytical study performed in the Department of Neurology at Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad, Pakistan. Adult patients admitted with ischemic stroke, over a period of 39 months, with Middle Cerebral Artery infarctions, were included. National Institute of …

Knowledge And Use Of The International Classification Of Functioning, Disability And Health (Icf) Among Health Professionals In A Developing Country, Sidra K. Jafri, Olaf Kraus De Camargo

Pakistan Journal of Neurological Sciences (PJNS)

The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) provides a biopsychosocial framework for understanding all the factors that should be considered while managing any health condition. The ICF has been employed for clinical, academic, research, and policymaking purposes in developed as well as developing countries. There is a great disparity in the representation in the literature regarding knowledge and potential application of the ICF in professional practice around the world especially from low middle-income countries like Pakistan. This study aims to evaluate the profile and knowledge of health professionals in Pakistan about the application of …

Concussion: A Review Of Epidemiology, Presentation And Treatment., Sidra Saleem, Arsalan Anwar, Fahham Asghar, Muhammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

A direct impact on the head can cause a Mild Traumatic Brain Injury or Concussion. It is a neuronal brain injury with or without loss of consciousness. Each year, approximately 69 million people are estimated to suffer from Concussion. Around 80-90% of these Concussion cases resolve within a week. The most commonly reported post-concussion symptoms include headache, cognitive changes, sleep disturbances, and depression. Essential in the approach to patients with concussion includes a detailed history taking and physical examination. Imaging modalities like Magnetic Resonance Images (MRI) of the brain may not show any significant changes; therefore more sensitive tests, like …

A Rare Presentation Of Pulmonary Sarcomatoid Carcinoma With Left Atrial Involvement And Spinal Metastasis Presenting With An Ischemic Infarct., Hina Imtiaz, Muhammad Dawood Amir Sheikh

Pakistan Journal of Neurological Sciences (PJNS)

Pulmonary Sarcomatoid Carcinoma is a rare, aggressive tumor comprising of both epithelial and mesenchymal cells. It is important to distinguish it from other lung tumors due to its poor prognosis and extensive metastasis. We present a case of a 36 year old female patient who initially presented with right sided weakness and slurred speech due to an ischemic infarct of the left basal ganglia. Further workup revealed a lung mass extending to the left atrium with spinal metastasis. Sarcomatoid Carcinoma remains a diagnostic challenge due to its early recurrence and atypical presentation.

Movement Disorder Associated With Celiac Disease And Thyroid Dysfunction:Case Report, Ramla Nayaib Hashmi, Ummul Kiram, Rabbia Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Autoimmune movement disorders are uncommon yet likely treatable conditions. It is challenging to diagnose and manage these disorders, ultimately leading to a significant morbidity in terms of functional disability of patient. It is troublesome for practicing neurologists to identify whether the antibodies which are detected during the work up of these autoimmune movement disorders are merely incidental or have pathogenic role. This will help them to decide regarding whether to start immunotherapy or not. Here we have discussed two patients of movement disorder who were found to have positive work up for other autoimmune diseases. Available Literature on autoimmune movement …

Effects Of Intermittent Fasting On Taste Modulation And Perception, Sajid Hameed, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Postnatal Loss Of The Insulin Receptor In Osteoprogenitor Cells Does Not Impart A Metabolic Phenotype, John L. Fowlkes, R. Clay Bunn, Evangelia Kalaitzoglou, Phil Ray, Iuliana Popescu, Kathryn M. Thrailkill

Barnstable Brown Diabetes Center Faculty Publications

The relationship between osteoblast-specific insulin signaling, osteocalcin activation and gluco-metabolic homeostasis has proven to be complex and potentially inconsistent across animal-model systems and in humans. Moreover, the impact of postnatally acquired, osteoblast-specific insulin deficiency on the pancreas-to-skeleton-to-pancreas circuit has not been studied. To explore this relationship, we created a model of postnatal elimination of insulin signaling in osteoprogenitors. Osteoprogenitor-selective ablation of the insulin receptor was induced after ~10 weeks of age in IR^l°^x/lox/Osx-Cre^+/− genotypic male and female mice (designated postnatal-OIRKO). At ~21 weeks of age, mice were then phenotypically and metabolically characterized. Postnatal-OIRKO mice demonstrated …

Bacterial Contamination Of Mobile Phones Among Health Care Workers: A Meta-Analysis Study, Azza Omran, Mohamed S. Taha

Journal of Medicine in Scientific Research

Background Mobile phones (MPs) are becoming commonplace in both community and hospital settings. There are studies that show that phones can be considered fomites in potential, ones that give organisms an environment conducive to their development, such as constant heat and moisture. Aim The present study aimed to do a meta-analysis to investigate the bacterial contamination of MPs among health care workers (HCWs). Materials and methods Using MEDLINE database (http://www.pubmed.com), we conducted a systematic literature search to identify relevant studies published within the past 20 years (from 2000 up to 2020). Appropriate articles were accessed in full text …

Bileaflet Augmentation For Repair Of Rheumatic Mitral Valve Disease In Egyptian Patients, Maged M. A. Kisho

Journal of Medicine in Scientific Research

Objectives Mitral valve (MV) repair in rheumatic patients is a challenging procedure and carries high incidence of early and late failure. We aimed in this study to evaluate the mid-term results of MV bileaflet augmentation to increase the depth of coaptation and achieve satisfactory results of repair. Patients and methods Between January 2015 and December 2018 at the National Heart Institute of Egypt, 24 rheumatic patients had leaflet augmentation with glutaraldehydetreated autologous pericardium as part of their mitral repair procedure. Their clinical and echocardiographic data were prospectively analyzed. Results The mean age of the rheumatic patients was 34.2 ± 14.7 …

Hospital Outcome And Predictors Of Mortality Of Primary Isolated On-Pump Coronary Artery Bypass Grafting In Acute Coronary Syndrome, Ahmed M. E. Abdelgawad

Journal of Medicine in Scientific Research

Background The effect of surgical treatment on patients with acute coronary syndrome (ACS) is disputable. The objective of the present study was to analyze the outcome, in-hospital mortality, and its predictors as well as major adverse cardiac and cerebrovascular events in patients referred to coronary artery bypass grafting (CABG) with ACS presentation. Patients and methods Hospital medical records of ACS presentation were retrieved from Madinah Cardiac Center database between November 2011 and August 2017. A total number of 630 patients who underwent primary isolated CABG for ACS presentation were identified. Of these, unstable angina (UA) pectoris was present in 277 …

Comparison Of Drug-Eluting And Bare-Metal Stents In Patients With Saphenous Vein Graft Stenosis, Ahmed Zayed, Ahmed Algebaly, Tamer El Banna

Journal of Medicine in Scientific Research

Background The use of drug-eluting stents (DES) during the percutaneous coronary intervention of patients with degenerated saphenous vein graft (SVG) is uncertain. Although previous studies showed that DES might decrease the rate of re-intervention in patients with SVG stenosis, randomized controlled trials comparing bare-metal stents (BMS) and DES in SVG lesions have been inconclusive. Objective The purpose of this study was to compare the outcomes in patients undergoing SVG stent implantation treated with DES or BMS. Patients and methods This was a retrospective observational study that included 60 patients who underwent percutaneous coronary intervention for SVG lesions, comprising 30 patients …

Effects Of Oral Sildenafil After Palliative Procedures To Increase Pulmonary Blood Flow In Cyanotic Heart Diseases, Ahmed Al-Gebaly, Ahmed Zayed, Amal Younan, Hanan Mohammed, Rania Aboushokka, Rasha Hossny, Yahia Mahmoud

Journal of Medicine in Scientific Research

Background Continuing efforts have been exerted to improve the outcome of palliative procedures for cyanotic congenital heart diseases. Sildenafil is known for the management of erectile dysfunction and pulmonary hypertension, but the cardiac benefits of this drug showed its impacts in the hemodynamic profile of cardiac patients. Aim To evaluate the effect of oral sildenafil on man-made shunts and vascular connection of cyanotic heart diseases. Patients and methods This comparative study was conducted from 2013 to 2017 on patients who had congenital cyanotic heart disease and who underwent acquired palliative procedure to increase the pulmonary blood flow. Procedures included: modified …

Evaluation Of Early Outcomes Of Modified Bentall Procedure As A Treatment Of Ascending Aortic Diseases, Ahmed S. Ali

Journal of Medicine in Scientific Research

Back ground Ascending aortic diseases are life-threatening conditions that have an increasing incidence. The modified Bentall procedure has become the technique of choice used to treat such diseases. Objectives This study evaluates early outcomes of patients who underwent modified Bentall procedure as a treatment of ascending aortic diseases. Patients and methods A total of 75 patients who underwent modified Bentall operation for ascending aortic diseases at the National Heart Institute during a 3-years period (July 2015 to August 2018) were studied prospectively. The included patients were divided according to the type of aortic disease into two groups: group A included …

Predictors Of Mortality In Valvular Infective Endocarditis: A Single-Center Study, Ahmed S. Ali

Journal of Medicine in Scientific Research

Background Valvular infective endocarditis (IE) may occur in association with either native or prosthetic valves, with great risk of mortality and morbidity. Surgical management is an essential part of the therapeutic process in these patients. Objectives This study aims at evaluation of early outcomes of surgically treated patients with native or prosthetic IE together with determining predictors of mortality. Patients and methods Outcomes of 60 patients who underwent surgery for native or prosthetic valve endocarditis at National Heart Institute during a 3-year period (April 2016 to March 2019) were studied prospectively. Preoperative, intraoperative, and postoperative data were tested as possible …

Rhinorrhea In Covid-19: Observation, Sora Yasri, Viroj Wiwanitkit

Journal of Medicine in Scientific Research

COVID‑19 is a new disease that started in China and spread to several countries[1]. After its first spread to Thailand, it has spread to more than 50 countries around the world [2]. In otolaryngology, otolarygeal presentation of this new infection is an interesting topic. As a respiratory infection, rhinorrhea is a possible clinical presentation in coronavirus infection. In previous new emerging coronavirus infection such as coronavirus 229E infection, rhinorrhea is observable [3]. Here, the authors share their observation on this specific issue.

From the data on 35 patients in our setting, Thailand, there is no patient with rhinorrhea. From summarizing …

Convalescent Plasma: Promise For Covid-19 Pandemic, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Covid-19 Pandemic: Public Trust And Guiding Ethics Where Ventilators Equal Lives, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Optimising Ventilator Use During The Covid-19 Pandemic, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

Hypoxemia is the most common cause for hospitalization in COVID-19 patients. Acute hypoxemic respiratory failure or acute respiratory distress syndrome (ARDS) is the most common complication in COVID-19 patients. Close monitoring of respiratory decompensation is essential. Supplemental oxygen, high flow nasal canula, non-invasive ventilation and endotracheal intubation are the most commonly suggested methods to improve oxygenation. Early intubation with pre-oxygenation, modified rapid sequence intubation and intubation using a video laryngoscope has been advised as a strategy including lung protective ventilation, prone position ventilation, adequate sedation and extracorporeal membrane oxygenation. Strict personal precautions and challenges related to airway management has been …

Inferior Vena Cava Injuries - A Clinical Review, Zia Ur Rehman

Department of Surgery Docs

Inferior vena caval (IVC) injuries are uncommon and challenging to treat. Less than 5% of patients with penetrating abdominal trauma and less than 0.5% of patients with blunt abdominal trauma have this injury. Patient can present with intraperitoneal haemorrhage or with a contained retroperitoneal haematoma. Mostly it is associated with other abdominal structures injuries. Most commonly injured segment is infrarenal IVC. Operative strategy is different for each segment of injured vein. Infrahepatic injuries are exposed by medial visceral rotation. Retrohepatic and suprahepatic injuries need infrequent exposures. Mortality remains high and range between 31-51% for the patient brought alive to the …

First Rwanda National Trauma Symposium 2019: Challenges And Priorities., Ashley Rosenberg, Faustin Ntirenganya, Irene Bagahirwa, Gabin Mbanjumucyo, Lambert Rutayisire, Severien Muneza, Innocent Nzeyimana, Eric Benimana, Ernest Nahayo, Busisiwe Bhengu, Assuman Nuhu, Arsene Muhumuza, Costica Uwitonze, Ghislaine Umwali, Menelas Nkeshimana, Jeanne D'Arc Nyinawankusi, Elizabeth Krebs, Jean Marie Uwitonze, Igance Kabagema, Theophile Dushime, Jean Claude Byiringiro, Gilles Ndayisaba, Sudha Jayaraman

Department of Emergency Medicine Faculty Papers

No abstract provided.

Efficacy And Safety Of Intravenous 3% Hypertonic Saline Compared To Mannitol 20% For Lowering Intraocular Pressure In Patients With Glaucoma: A Prospective Randomized Double-Blind Study, Alaa A. Ibrham, Ashraf A. H. Mhmoud, Mohmed H. Mohamed, Wael A. E. Elhakeem

Journal of Medicine in Scientific Research

Objective The purpose of this study was to assess the efficacy and safety of intravenous 3% hypertonic saline (HTS) compared with mannitol 20% for lowering intraocular pressure (IOP) in patients with glaucoma. Patients and methods A total of 30 patients between age 35 and 60 years with American Society of Anesthesiologist status I–III with glaucoma (IOP=30 mmHg) were enrolled in a double-blind comparative study. Patients were randomized to one of two groups: group GH (n=15), where patients received HTS, and group GM (n=15), where patients received mannitol 20%. Results Regarding demographic data, no statistically significant difference was observed between the …

Reliability And Validity Of Watch: Warwick Assessment Instrument For Clinical Teaching, Sonia Ijaz Haider, Khalid Masood Gondol, Muhammed Tariq, Muhammad Furqan Bari, Iqbal Azam Syed

Department for Educational Development

Objective: To determine the reliability, validity, feasibility, acceptability and perceived educational impact of WATCH: Warwick Assessment insTrument for Clinical teacHing among doctors in Pakistan.
Study design: Cross-sectional research study.
Place and duration of study: The College of Physicians and Surgeons, Pakistan, from September 2018 to August 2019.
Methodology: Postgraduate trainees were asked to rate the clinical teaching sessions, using WATCH, which consists of 15 items. Percentage was used to calculate gender and participation from different specialties. Inter-item correlations of 15 items with individual mean scores, standard deviations and Cronbach's Alpha were reported, including Friedman test, in order to observe the …

Multicenter Clinical Evaluation Of The Revogene Strep A Molecular Assay For Detection Of Streptococcus Pyogenes From Throat Swab Specimens, Dithi Banerjee, Jeff Michael, B. Schmitt, H. Salimnia, N. Mhaissen, D. M. Goldfarb, P. Lachance, M. L. Faron, T. Aufderheide, N. Ledeboer, A. Weissfeld, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

Copyright © 2020 Banerjee et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license Group A streptococcus (GAS) species cause bacterial pharyngitis in both adults and children. Early and accurate diagnosis of GAS is important for appropriate antibiotic therapy to prevent GAS sequalae. The Revogene Strep A molecular assay (Meridian Bioscience Canada Inc, Quebec City, QC, Canada) is an automated real-time PCR assay for GAS detection from throat swab specimens within approximately 70 min. This multicenter prospective study evaluated the performance of the Revogene Strep A molecular assay compared to that …

Poorly Controlled Diabetes Mellitus Alters Placental Structure, Efficiency, And Plasticity., Jackson Nteeba, Kaela M. Varberg, Regan L. Scott, Mikaela E. Simon, Khursheed Iqbal, Michael J. Soares

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: The hemochorial placenta provides a critical barrier at the maternal-fetal interface to modulate maternal immune tolerance and enable gas and nutrient exchange between mother and conceptus. Pregnancy outcomes are adversely affected by diabetes mellitus; however, the effects of poorly controlled diabetes on placental formation, and subsequently fetal development, are not fully understood.

RESEARCH DESIGN AND METHODS: Streptozotocin was used to induce hyperglycemia in pregnant rats for the purpose of investigating the impact of poorly controlled diabetes on placental formation and fetal development. The experimental paradigm of hypoxia exposure in the pregnant rat was also used to assess properties of …

Fecal Lactoferrin As A Parameter In Determining Invasive Causes Of Acute Diarrhea, Abeer E. S. Hamed, Gehan F. Oreby, Mohamed F. Alsoda, Sahar H. Quashwa

Journal of Medicine in Scientific Research

Introduction Diarrhea may be acute, which subsides by 7–14 days and is related to infections (bacterial or viral) or reaction to medications, or chronic, which lasts more than 2 weeks and is mainly caused by inflammatory bowel disease, functional bowel disorder, food allergies, or parasitic infestations. The infective etiologies may be noninvasive or invasive pathogens that have the capacity to invade intestinal mucosa and stimulate local inflammatory response [by activated neutrophils that secrete lactoferrin (LF)] and sometimes cause ulceration, hemorrhage, and systemic inflammatory response. Stool culture is the standard method for the diagnosis of invasive diarrhea; however, it is laborious …

Patent Ductus Arteriosus Treatment In Preterm Neonates, Which Is The Drug Of Choice Paracetamol Vs Ibuprofen?, Reham S. Abd Al Hamid

Journal of Medicine in Scientific Research

Background Patent ductus arteriosus (PDA) is one of the most prevalent problems in preterm infants. Although ibuprofen represents one of the choices for the closure of PDA, this treatment can cause severe gastrointestinal and adverse renal effects and worsen platelet function. Effective therapy for PDA had been suggested as paracetamol. Aim Our study is aiming to compare the efficacy and safety of paracetamol and ibuprofen. Patients and methods A prospective observational, single-center study was performed from December 2016 until August 2017, at ElGalaa Teaching Hospital in Cairo. In this study we included neonates with a gestational age of 28–36 weeks, …

Interleukin 33 In Premenopausal Women With Rheumatoid Arthritis: Is It Related To Generalized Bone Loss?, Eman R. Amer, Hala A. E. Tabl, Sahar H. Quashwa, Taghreed F. M. Mostafa

Journal of Medicine in Scientific Research

Aim The aim was to study the role of interleukin (IL)-33 in rheumatoid arthritis (RA)-induced generalized bone loss in premenopausal women and its relation to general disease activity and various laboratory markers. Patients and methods A total of 60 premenopausal women with RA were enrolled in this work as a study group and 30 age-matched healthy women as a control group. The participants were subjected to full clinical, radiological, and laboratory assessments. The following were assessed in patients and controls by enzyme-linked immunosorbent assay technique: serum level of IL-33, 25-hydroxyvitamin D3 [25(OH) D3], and bone turnover markers, osteocalcin and C-terminal …

Covid-19 And Blood Type: People With Which Group Are More Vulnerable?, Falah H. O. Al-Khikani

Journal of Medicine in Scientific Research

No abstract provided.

Scope Of Attention Variation As A Function Of Anxiety And Depression, Kathleen Anne O'Donnell

Electronic Theses, Projects, and Dissertations

As a social species, correct emotional perception is so vital, that the human brain has evolved a mechanism to control attentional choices by exerting a narrowed field of perception during danger, called the scope of attention (SoA). The SoA determines what information will be focused on or ignored by blocking the perception of non-relevant items and increasing selective focus on danger; even if danger is merely a sad-face. The emotional items blocked from perception cannot be remembered because they were never perceived. But, attention-control to emotional stimuli also varies with mood, as seen in mood-disorders. A mood-disorder’s effect upon the …