Medical Specialties Commons^™

Evaluation Of Noninvasive Methods For Diagnosis Of Cholestasis In Infancy, Ashraf M. Ayad, Hala Abdelal, Hasan Khalaf, Mohamed F. Alsoda

Journal of Medicine in Scientific Research

Background Cholestatic liver disease constitutes a large percentage of chronic liver diseases during infancy. Cholestasis is defined as interference with bile formation or flow owing to pathology anywhere between the hepatocyte and the ampulla of Vater. Aim To evaluate the different modalities used for diagnosing cholestasis in infants in Damanhour Medical National Institute (DMNI) to find out the sensitivity and the predictive values of each modality in defining the cause of cholestatic jaundice, whether surgical or medical. Patients and methods This study was a retrospective one which included 153 infants who were referred with cholestasis in first year of life …

Evaluation Of Vitamin D Status In Children With Cerebral Palsy, Mai M. Kamel, Mohamed F. Alsoda, Omnia S. Ali

Journal of Medicine in Scientific Research

Objective The current study was conducted to evaluate vitamin D status in children with cerebral palsy (CP) and its relations with associated risk factors. Patients and methods The present research included 50 children with CP of both sexes compared with a control group of 20 healthy children with matched age and sex. Serum 25-hydroxyvitamin D, serum calcium, and phosphorus were measured and compared in cases and controls. The Gross Motor Function Classification System (GMFCS) was recorded, and children with GMFCS level I–III were considered ambulatory, whereas children with level IV–V were considered nonambulatory. Results Median (interquartile range) serum vitamin D …

Comparison Between The Effect Of Single-Dose Radial Extracorporeal Shock Wave And Local Corticosteroid Injection In Treatment Of Patients With Carpal Tunnel Syndrome, Abeer H. Ismaiel, Lamis S. Ahmed, Nahed H. Taha

Journal of Medicine in Scientific Research

Objective To evaluate the efficacy of radial extracorporeal shock wave therapy (rESWT) compared with local corticosteroid injection (LCsI) in reducing pain and improving the function of patients with mild and moderate carpal tunnel syndrome (CTS) over 6 months. Patients and methods We studied 40 patients with mild and moderate CTS, where 20 patients received single-dose rESWT and the second group was treated with LCsI. Both groups had been assessed at baseline and at 1, 3, and 6 months after treatment using Boston self-assessment questionnaire (BQ) and visual analog scale (VAS) and at baseline and after 3 months using neurophysiological studies. …

Interrupted Course Of Antitumor Necrosis Factor Alpha Therapy Versus Combined Nonsteroidal Anti-Inflammatory Drug Therapy And Physiotherapy In Patients With Ankylosing Spondylitis: A Comparative Study, Sherry K. Abdelrahman, Taghreed F. M. Mostafa

Journal of Medicine in Scientific Research

Aim The aim was to evaluate the efficacy of interrupted course of antitumor necrosis factor alpha (TNF-α) blocking agents (etanercept and adalimumab) as 3-month-on-and-3-month-off regimen versus combined regimen of physiotherapy and NSAIDs in patients with ankylosing spondylitis (AS) within a 2-year period. Patients and methods A total of 60 patients who fulfilled the Modified New York Criteria for AS were enrolled in the current study and divided into two equal groups: one received interrupted course of anti-TNFα agents and one received NSAIDs plus physiotherapy. Both groups were subjected to follow-ups at 6, 12, 18, and 24 months. To assess the …

Waardenburg Syndrome As A Challenging Experience In Pediatric Cochlear Implantation, Ihab K. S. Abdelmalak, Iman Elrouby, Salwa Mahmoud

Journal of Medicine in Scientific Research

Background Waardenburg syndrome (WS) is a major cause of symptomatic sensorineural hearing loss, which accounts for 2–5% of patients with congenital hearing loss. Cochlear implantation (CI) has shown improvement in auditory perception and language skills of syndromic sensorineural hearing-impaired children and is now accepted as a gold standard treatment. Aim The aim of the present study was to evaluate the outcome of CI in cases with WS and to compare the results with nonsyndromic CI cases. Participants and methods A total of 268 children of less than 7 years of age underwent CI in the National Hearing and Speech Institute, …

The Role Of Optical Coherence Tomography Angiography In Diagnosis Of Central Serous Chorioretinopathy, Alaa Atia, Ghada Samir, Hussam E. O Elrashidy

Journal of Medicine in Scientific Research

Purpose To detect the findings of optical coherence tomography angiography (OCTA) in eyes with central serous chorioretinopathy (CSCR), in comparison with conventional multimodal imaging. Patients and methods In the current case series, 80 eyes of 80 patients were diagnosed to have CSCR, and they underwent spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and OCTA. OCTA images are performed at two main depth intervals: automatically segmented outer retina and automatically segmented choriocapillaris. Results In 40 of 80 eyes, OCTA images showed detached retina adjacent to the leakage point, compared with 40 of 80 eyes using FA, and 80 of …

Prospective Changes In The Retinal Nerve Fiber Layer And The Ganglion Cell Layer Prepan And Postpan Retinal Photocoagulation With Argon Laser In The Management Of Diabetic Retinopathy Patients, Mohammed S. Ahmed

Journal of Medicine in Scientific Research

Introduction Diabetic retinopathy (DR) is the primary retinal vascular complication of diabetes mellitus and is a leading cause of vision impairment and blindness. Argon laser is a common laser that is used for DR treatment. This study was carried out aiming to assess the effect of DR on the retinal nerve fiber layer (RNFL) thickness prepan and postpan retinal photocoagulation (PRP). Patients and methods This study was carried out on 100 eligible eyes in 62 consecutive patients. The authors performed a complete ophthalmologic examination, including best-corrected visual acuity using the early treatment diabetes retinopathy analysis charts, intraocular pressure measurement, slit-lamp …

Comparative Study Between The Visual Outcome Of Phacoemulsification And Small Incision Cataract Surgery, Mohammed S. Ahmed

Journal of Medicine in Scientific Research

Introduction Cataract is still one of the most common causes of visual impairment worldwide. Phacoemulsification is the primary method for cataract surgery in developed countries. However, it is associated with high cost and small incision cataract surgery (SICS), which has become an alternative surgery for phacoemulsification, mostly in developing countries. Patients and methods This study was carried out aiming to compare the effectiveness [postoperative visual acuity (VA)] of phacoemulsification versus SICS. Four hundred and fifty cataract patients, allocated into two groups with no statistically significant differences in their basic characteristics, were included in the current study. Patients in the first …

Is The Full Sternotomy In Cardiac Surgery Still The Preferred Approach?, Ahmed Zayed, Mohamed Makram, Tamer El Banna

Journal of Medicine in Scientific Research

Background There is increasing interest and patient demand for minimally invasive cardiac surgery. Aim We aimed to assess the safety and possibilities of such techniques and debated whether it would become the standard procedure. Patients and methods Since February 2013 till June 2019, 696 patients underwent variations of cardiac surgery procedures; of them, 456 patients underwent thoracoscopic minimally invasive mitral and tricuspid valve surgery; 65 patients underwent double valve replacement, and of them, 17 underwent concomitant tricuspid valve repair through upper mini-sternotomy; 88 patients underwent aortic valve replacement through upper mini-sternotomy; five cases underwent Bentall procedure through upper mini-sternotomy; five …

Upper Mini-Sternotomy Versus Right Mini-Thoracotomy Approach In Mitral Valve Surgery, Mohamed Zayed, Mohamed Makram, Mohamed Ramadan, Mohamed A. Metwally, Tamer El Banna

Journal of Medicine in Scientific Research

Background: Full median sternotomy has been a standard surgical approach for heart surgery for more than 50 years. Several advantages increasing the use of less invasive approaches to the mitral valve surgery including, cosmetic, blood product use, respiratory, and pain advantages over conventional surgery. Parasternal incision, right mini-thoracotomy and partial sternotomy are described approaches for less invasive cardiac surgery. Objective: Comparing the less invasive approaches via upper partial sternotomy vs right mini-thoracotomy in mitral valve surgery. Methods: Sixty patients, underwent mitral valve surgery in NHI, were enrolled in this study and divided into two equal groups, and randomly assigned into …

Comparison Between Femoral Access Versus Radial Access In Primary Percutaneous Coronary Interventions, Ahmed K. A. G. Hassan

Journal of Medicine in Scientific Research

Introduction The femoral approach for coronary angiography and angioplasty is used by most interventional cardiologists in both elective and primary Percutaneous coronary intervention (PCI) procedures. The use of transradial access has been increasing worldwide as it has fewer access site complications. Aim In this study, the author compared femoral versus radial approaches in patients with acute myocardial infarction undergoing primary angioplasty. Patients and Methods The study population consisted of 100 patients who presented to the author's center with acute ST-segment elevation myocardial infarction. The author divided the study population into two groups: group A that consisted of 50 patients in …

Battling Against The Twin Pandemic Of Covid-19 And Hiv Infection: World Health Organization, Prateek Saurabh Shrivastava, Saurabh Rambiharilal Shrivastava

Journal of Medicine in Scientific Research

Human immunodeficiency virus (HIV) infection continues to remain one of the most significant public health concerns at the global level. The emergence of coronavirus disease-2019 (COVID-19) pandemic has significantly impacted the access to HIV testing, treatment and care facilities. There has been a gradual decline in the number of newly diagnosed people who are started on ART and some of them have also been forced to discontinue their ongoing treatment. It is the need of the hour to continue the delivery of the essential services and this calls for the need to strengthen primary health care and overall health care …

Risk Factors Associated With Length Of Hospital Stay In Children And Adolescents With Coronavirus Disease 2019 In Egypt, Abdelrhman K. Z. Darwish, Ahmed Arafa, Ahmed Heiba, Basem Eysa, Dalia Omran, Mahmoud Khalil, Mohamed Rabea, Mohamed Al Sodag, Mohamed Hassany, Muhammad A. Ghaffar, Shimaa Afify

Journal of Medicine in Scientific Research

Background With the growing incidence of children with coronavirus disease 2019 (COVID-19), the hospitalization rate in this age category has been increasing. This study aimed to assess the length of hospital stay (LOS) among children with COVID-19 and examine potential risk factors. Patients and methods We retrospectively collected data on 50 consecutive children and adolescents with mild to moderate COVID-19 who were discharged after treatment from one hospital in Egypt during July 2020. Betas (Bs) and their 95% confidence intervals (CIs) for the association of patients' sociodemographic and clinical characteristics with their LOS were computed using unadjusted and …

Assessing The Accuracy, Quality, And Readability Of Patient Accessible Online Resources Regarding Ocular Gene Therapy And Voretigene Neparvovec., Swetha Davuluri, Nicolas A. Yannuzzi, Amy Kloosterboer, Ajay E. Kuriyan, Jayanth Sridhar

Wills Eye Hospital Papers

Purpose: To evaluate the accuracy, quality, and readability of online information regarding the Food and Drug Administration (FDA) approved ocular gene therapy voretigene neparvovec (Luxturna, Spark Therapeutics, Philadelphia, PA, USA).

Methods: Ten online resources about voretigene neparvovec were assessed in this cross-sectional study. A novel 25-question assessment was created to evaluate the information most relevant to patients. Each article was assessed by independent graders using the assessment and the DISCERN instrument. An online readability tool, Readable, was used to assess readability. Accountability was evaluated using the Journal of the American Medical Association (JAMA) benchmarks.

Results: The average questionnaire score for …

Impact Of Pulse Oximetry On Hospital Referral Acceptance In Children Under 5 With Severe Pneumonia In Rural Pakistan (District Jamshoro): Protocol For A Cluster Randomised Trial, Fatima Mir, Apsara Ali, Suhail Chanar, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Zahid Memon, Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Pneumonia is a leading cause of death among children under 5 specifically in South Asia and sub-Saharan Africa. Hypoxaemia is a life-threatening complication among children under 5 with pneumonia. Hypoxaemia increases risk of mortality by 4.3 times in children with pneumonia than those without hypoxaemia. Prevalence of hypoxaemia varies with geography, altitude and severity (9%-39% Asia, 3%-10% African countries). In this protocol paper, we describe research methods for assessing impact of Lady Health Workers (LHWs) identifying hypoxaemia in children with signs of pneumonia during household visits on acceptance of hospital referral in district Jamshoro, Sindh.
Methods and analysis: A …

Tebipenem As An Oral Alternative For The Treatment Of Typhoid Caused By Xdr Salmonella Typhi, Elli Mylona, Phat Voong Vinh, Sonia Qureshi, Abhilasha Karkey, Sabina Dongol, Tuyen Ha Thanh, Judd Walson, Lluis Ballell, Elena Fernández Álvaro, Farah Naz Qamar, Stephen Baker

Department of Paediatrics and Child Health

Background: Antimicrobial therapy is essential for the treatment of enteric fever, the infection caused by Salmonella serovars Typhi and Paratyphi A. However, an increase in resistance to key antimicrobials and the emergence of MDR and XDR in Salmonella Typhi poses a major threat for efficacious outpatient treatments.
Objectives: We recently identified tebipenem, an oral carbapenem licensed for use for respiratory tract infections in Japan, as a potential alternative treatment for MDR/XDR Shigella spp. Here, we aimed to test the in vitro antibacterial efficacy of this drug against MDR and XDR typhoidal Salmonella.
Methods: We determined the in vitro activity of …

Determining Effective Drug Concentrations For Selection And Counterselection Genetics In Drosophila Melanogaster, Nick Matinyan, Yezabel Gonzalez, Herman A Dierick, Koen J T Venken

Faculty, Staff and Students Publications

We recently integrated into fly genetics a set of four selection and two counterselection markers and their corresponding drugs that can be used individually or in combination. These markers eliminate the need to visually screen progeny. Before using these markers in new genetic backgrounds, effective selection/counterselection concentrations should be established for each marker/drug combination. This protocol describes how to set up, perform, and analyze a drug titration curve to determine the effective selection/counterselection drug concentrations for their corresponding markers. For complete details on the use and execution of this protocol, please refer to Matinyan et al., 2021.

Facilitators And Barriers To Clinical Practice Guideline-Consistent Supportive Care At Pediatric Oncology Institutions: A Children's Oncology Group Study, Aaron J. Sugalski, Tammy Lo, Melissa Beauchemin, Allison C. Grimes, Paula D. Robinson, Alexandra M. Walsh, Nancy Santesso, Ha Dang, Brian T. Fisher, Andrea Rothfus Wrightson, Lolie C. Yu, Lillian Sung, L Lee Dupuis

School of Medicine Faculty Publications

Background Clinical practice guideline (CPG)-consistent care improves patient outcomes, but CPG implementation is poor. Little is known about CPG implementation in pediatric oncology. This study aimed to understand supportive care CPG implementation facilitators and barriers at pediatric oncology National Cancer Institute (NCI) Community Oncology Research Program (NCORP) institutions. Methods Healthcare professionals at 26 pediatric, Children's Oncology Group-member, NCORP institutions were invited to participate in face-to-face focus groups. Serial focus groups were held until saturation of ideas was reached. Supportive care CPG implementation facilitators and barriers were solicited using nominal group technique (NGT), and implementation of specific supportive care CPG recommendations …

Submental Paradoxical Adipose Hyperplasia Following Cryolipolysis: A Report And Management Recommendations, Demitri V. Franzoni, Miriam Al-Hamad Daubs, Mitchell E. Lyons, Jo-Lawrence Bigcas, Harry H. Ching, Joshua J. Goldman

School of Medicine Faculty Research

Cryolipolysis (CoolSculpting®) is a Food and Drug Administration-cleared noninvasive fat-reduction technique that has gained popularity in recent years given its reduced cost, risk of adverse effects, and recovery time relative to traditional invasive methods, such as liposuction. Despite this low incidence of adverse effects, there have been increasing reports of a rare aesthetically displeasing phenomenon termed paradoxical adipose hyperplasia (PAH). PAH presents several months after cryolipolysis as a painless and well-demarcated enlargement of the tissue limited to the treatment area.1 With a reported incidence ranging from 0.005% to 2%, all known cases of PAH have been localized to the treatment …

Management Of Recurrent Bacterial Vaginosis, Barbara Cymring, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Review the importance of appropriate management of recurrent BV (rBV)
• Review the appropriate diagnosis of rBV
• Review the causes and risk factors for BV and rBV
• Review the current literature on treatment for rBV
• Discuss some preventative measures for decreasing risk of BV infection

Epidemiology Of Type 2 Diabetes In The Middle East And North Africa: Challenges And Call For Action, Imad El-Kebbi, Nayda Bidikian, Layal Hneiny, Mona Nasrallah

Faculty Publications

Type 2 diabetes continues to be a serious and highly prevalent public health problem worldwide. In 2019, the highest prevalence of diabetes in the world at 12.2%, with its associated morbidity and mortality, was found in the Middle East and North Africa region. In addition to a genetic predisposition in its population, evidence suggests that obesity, physical inactivity, urbanization, and poor nutritional habits have contributed to the high prevalence of diabetes and prediabetes in the region. These risk factors have also led to an earlier onset of type 2 diabetes among children and adolescents, negatively affecting the productive years of …

Deviating From The Zero Balancing Protocol, John Hamwee

Journal of Transformative Touch

When is it appropriate to deviate from the Zero Balancing protocol? John Hamwee shares when there are exceptions to the rule and the times it makes more sense to deviate from the protocol than to observe it.

Analysis Of Genes (Tmem106b, Grn, Abcc9, Kcnmb2, And Apoe) Implicated In Risk For Late-Nc And Hippocampal Sclerosis Provides Pathogenetic Insights: A Retrospective Genetic Association Study, Adam J. Dugan, Peter T. Nelson, Yuriko Katsumata, Lincoln M. P. Shade, Kevin L. Boehme, Merilee A. Teylan, Matthew D. Cykowski, Shubhabrata Mukherjee, John S. K. Kauwe, Timothy J. Hohman, Julie A. Schneider, Alzheimer’S Disease Genetics Consortium, David W. Fardo

Biostatistics Faculty Publications

Limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is the most prevalent subtype of TDP-43 proteinopathy, affecting up to 1/3rd of aged persons. LATE-NC often co-occurs with hippocampal sclerosis (HS) pathology. It is currently unknown why some individuals with LATE-NC develop HS while others do not, but genetics may play a role. Previous studies found associations between LATE-NC phenotypes and specific genes: TMEM106B, GRN, ABCC9, KCNMB2, and APOE. Data from research participants with genomic and autopsy measures from the National Alzheimer’s Coordinating Center (NACC; n = 631 subjects included) and the Religious Orders Study and Memory …

Understanding Barriers And Facilitators To Implementation Of Psychosocial Care Within Orthopedic Trauma Centers: A Qualitative Study With Multidisciplinary Stakeholders From Geographically Diverse Settings, Ana-Maria Vranceanu, Jafar Bakhshaie, Mira Reichman, James Doorley, Ryan A. Mace, Cale A. Jacobs, Mitchel Harris, Kristin R. Archer, David Ring, A. Rani Elwy

Orthopaedic Surgery and Sports Medicine Faculty Publications

BACKGROUND: Psychosocial factors are pivotal in recovery after acute orthopedic traumatic injuries. Addressing psychosocial factors is an important opportunity for preventing persistent pain and disability. We aim to identify barriers and facilitators to the implementation of psychosocial care within outpatient orthopedic trauma settings using the Consolidated Framework for Implementation Research (CFIR) and Proctor's taxonomy of implementation outcomes, and to provide implementation strategies derived from qualitative data and supplemented by the Expert Recommendations for Implementing Change.

METHODS: We conducted live video qualitative focus groups, exit interviews and individual interviews with stakeholders within 3 geographically diverse level 1 trauma settings (N …

Post-Concussion And Post-Traumatic Stress Symptoms After Pediatric Traumatic Brain Injury: Shared Vulnerability Factors?, Emily R Fisher, Janelle J Montroy, Gerardo Duque, Charles S Cox, Linda Ewing-Cobbs

Faculty, Staff and Student Publications

Following pediatric traumatic brain injury (TBI), post-concussion symptoms (PCS) and post-traumatic stress symptoms (PTSS) occur commonly; however, it is unknown to what degree they overlap. The study examined PCS and PTSS persisting 7 weeks after injury in children and adolescents ages 8-15 years with TBI (n = 89) or extracranial injury (EI; n = 40) after vehicle collisions. TBI was divided into mild, complicated-mild/moderate, and severe groups. Parents retrospectively rated children's pre-injury symptoms and behavior problems, and children completed self-report measures after injury. PCS and PTSS total scores were significantly correlated in TBI and EI groups, respectively, for child …

Emergency Medicine And Covid-19: Now And Next Year, Theodore A. Christopher, Adrienne N. Christopher

Department of Emergency Medicine Faculty Papers

The COVID-19 pandemic is responsible for infecting to date more than 93 million people worldwide and causing more than 2 million deaths. That the vast majority of deaths have occurred in the United States (U.S.) can be attributed to nonadherence by Americans to basic public health mitigation strategies that are known to curtail coronavirus spread. Emergency Departments (ED’s) throughout the U.S. experienced a dramatic decrease in patient visits during the first surge of COVID-19, followed by an ED patient visit rebound to approximately 80% of pre-COVID-19 numbers, which have remained relatively stable through the current second COVID-19 surge. The pandemic …

Covid-19 Newsletter (Vol. 88), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Barriers And Benefits Experienced In Qualitative Geriatric Emergency Care Research During The Covid-19 Era, James D. Van Oppen, Emma Regen, Kay Phelps, Timothy J. Coats, Jose M. Valderas, Simon P. Conroy, Nicola Mackintosh

Journal of Geriatric Emergency Medicine

No abstract provided.

Multiplexed Drug-Based Selection And Counterselection Genetic Manipulations In Drosophila, Nick Matinyan, Mansi S Karkhanis, Yezabel Gonzalez, Antrix Jain, Alexander Saltzman, Anna Malovannaya, Alejandro Sarrion-Perdigones, Herman A Dierick, Koen J T Venken

Faculty, Staff and Students Publications

The power of Drosophila melanogaster as a model system relies on tractable germline genetic manipulations. Despite Drosophila's expansive genetics toolbox, such manipulations are still accomplished one change at a time and depend predominantly on phenotypic screening. We describe a drug-based genetic platform consisting of four selection and two counterselection markers, eliminating the need to screen for modified progeny. These markers work reliably individually or in combination to produce specific genetic outcomes. We demonstrate three example applications of multiplexed drug-based genetics by generating (1) transgenic animals, expressing both components of binary overexpression systems in a single transgenesis step; (2) dual selectable …

Exercise Intolerance In Older Adults With Heart Failure With Preserved Ejection Fraction: Jacc State-Of-The-Art Review, Ambarish Pandey, Sanjiv J Shah, Javed Butler, Dean L Kellogg, Gregory D Lewis, Daniel E Forman, Robert J Mentz, Barry A Borlaug, Marc A Simon, Julio A Chirinos, Roger A Fielding, Elena Volpi, Anthony J A Molina, Mark J Haykowsky, Flora Sam, Bret H Goodpaster, Alain G Bertoni, Jamie N Justice, James P White, Jingzhone Ding, Scott L Hummel, Nathan K Lebrasseur, George E Taffet, Iraklis I Pipinos, Dalane Kitzman

Faculty, Staff and Students Publications

Exercise intolerance (EI) is the primary manifestation of chronic heart failure with preserved ejection fraction (HFpEF), the most common form of heart failure among older individuals. The recent recognition that HFpEF is likely a systemic, multiorgan disorder that shares characteristics with other common, difficult-to-treat, aging-related disorders suggests that novel insights may be gained from combining knowledge and concepts from aging and cardiovascular disease disciplines. This state-of-the-art review is based on the outcomes of a National Institute of Aging-sponsored working group meeting on aging and EI in HFpEF. We discuss aging-related and extracardiac contributors to EI in HFpEF and provide the …