Medical Specialties Commons^™

Pediatric Supracondylar Humeral Fractures: Epidemiology And Mechanisms Of Injury During The Covid-19 Pandemic, Dan Cohen, Jeffrey Kay, Mohammed Shehab, Darren De Sa, Devin C. Peterson, Waleed Kishta

Western Journal of Orthopaedics

Background: The purpose of this study was to evaluate the impact of the COVID-19 pandemic activity restrictions on pediatric supracondylar humerus fracture epidemiology in terms of both mechanism of injury and fracture patterns.

Methods: This was a retrospective chart review of all patients presenting with types II-IV supracondylar humerus fractures between March 15^th and June 30^th 2020 at the McMaster University Medical Centre. Data were collected from our secure electronic medical records for information on patient demographic data, mechanism of injury, operative reports and imaging. 5 treating surgeons independently analyzed each patient’s radiographs and classified them according …

Medical Autopsy For Sudden Unexplained Death In Saudi Arabia: A Call To Action, Wael Alqarawi, Abdulelah Alsaeed, Malak Alghamdi, Ahmed Hersi, Tarek Kashour, Khaldoon Aljerian

Journal of the Saudi Heart Association

Sudden unexplained death (SUD) is a sudden, unexpected, and unexplained death in an individual older than 1 year. It is one of the most devastating and tragic events to families and the community at large, particularly when it happens at a young age. Finding the cause of SUD is extremely important in order to prevent its recurrence in the family, and to help understand the epidemiology of SUD in the community. It has been well-established that the most effective way of finding the cause of SUD is by performing a medical autopsy. In many countries, medical autopsy is mandated in …

Screening And Assessment Of Cancer-Related Fatigue: An Executive Summary And Road Map For Clinical Implementation, Joy C. Cohn, Shana Harrington, Jeannette Lee, Daniel Malone, Mary I. Fisher

Physical Therapy Faculty Publications

Background: Cancer-related fatigue (CRF) prevalence is reported as high as 90%. Cancer-related fatigue is multidimensional and associated with lower health-related quality of life. Effective screening and assessment are dependent upon use of valid, reliable, and clinically feasible measures. This Executive Summary of the Screening and Assessment of Cancer-related Fatigue Clinical Practice Guideline provides recommendations for best measures to screen and assess for CRF based on the quality and level of evidence, psychometric strength of the tools, and clinical utility.

Methods: After a systematic review of the literature, studies evaluating CRF measurement tools were assessed for quality; data extraction included psychometrics …

Gunshot Wound To The Chest With Retained Epicardial Bullet., Toba Bolaji, Abuoma C Ekpendu, Frederick Giberson

Transitional Year Resident Research

Gunshot wounds remain the most common cause of penetrating injuries in children and adolescents and the second leading cause of death among youth in the United States. Penetrating cardiac injuries carry a significantly increased mortality rate. The extent of damage caused depends on the type of firearm, the bullet used, the velocityand the trajectory. Therefore, rapid diagnosis and treatment is of the utmost importance. We report a case of a 19-year-old boy who presented to ouremergency department (ED) after sustaining a gunshot wound (GSW) to the right chest. In the ED, the patient was stabilized and a large hematoma was …

Tetrahydrocurcumin Improves Lipopolysaccharide-Induced Myocardial Dysfunction By Inhibiting Oxidative Stress And Inflammation Via Jnk/Erk Signaling Pathway Regulation, Hanzhao Zhu, Liyun Zhang, Hao Jia, Lu Xu, Yu Cao, Mengen Zhai, Kaifeng Li, Lin Xia, Liqing Jiang, Xiang Li, Yenong Zhou, Jincheng Liu, Shiqiang Yu, Weixun Duan

Chemistry Undergraduate Publications

Background

Acute myocardial dysfunction in patients with sepsis is attributed to oxidative stress, inflammation, and cardiomyocyte loss; however, specific drugs for its prevention are still lacking. Tetrahydrocurcumin (THC) has been proven to contribute to the prevention of various cardiovascular diseases by decreasing oxidative stress and inflammation. This study was performed to investigate the functions and mechanism of action of THC in septic cardiomyopathy.

Methods

After the oral administration of THC (120 mg/kg) for 5 consecutive days, a mouse model of sepsis was established via intraperitoneal lipopolysaccharide (LPS, 10 mg/kg) injection. Following this, cardiac function was assessed, pathological section staining was …

Screening Considerations For Patients With Sexually Transmitted Infections, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Impact Of Social Vulnerability On Comorbid Cancer And Cardiovascular Disease Mortality In The United States, Sarju Ganatra, Sourbha S. Dani, Ashish Kumar, Safi U. Khan, Rishi Wadhera, Tomas G. Neilan, Paaladinesh Thavendiranathan, Ana Barac, Joerg Hermann, Salim S. Virani

Office of the Provost

Background: Racial and social disparities exist in outcomes related to cancer and cardiovascular disease (CVD).
Objectives: The aim of this cross-sectional study was to study the impact of social vulnerability on mortality attributed to comorbid cancer and CVD.
Methods: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database (2015-2019) was used to obtain county-level mortality data attributed to cancer, CVD, and comorbid cancer and CVD. County-level social vulnerability index (SVI) data (2014-2018) were obtained from the CDC's Agency for Toxic Substances and Disease Registry. SVI percentiles were generated for each county and aggregated to form …

Breast Cancer In A Teenage Girl With Brca Mutation: A Case Report From A Low Middle-Income Country, Lubna Mushtaque Vohra, Danish Ali, Syeda Amrah Hashmi, Meher Angez

Section of General Surgery

Introduction: A staggering majority of pediatric breast masses are benign (mostly fibroadenoma) and so a biopsy is not readily performed as it can potentially lead to a future breast disfigurement. However, this should not be standard practice as this can lead to a delayed diagnosis, and hence, the treatment of pediatric breast cancer (BC); this was also seen in our patient's scenario.
Case history: Here, we report the case of the youngest known breast cancer patient in Pakistan, a 15-year-old girl. The right-sided breast lump which was diagnosed clinically as a fibroadenoma later turned out to be stage IIb pT3N0M0 …

Catatonia In The General Hospital: A Case Series Wading Through Diagnostic & Management Challenges, Shireen Najam, Marium Mansoor, Muhammad Yusuf Hafiz, Alviya Shafique, Ifrah Hambal, Banafsha Gul, Tania Nadeem

Pakistan Journal of Neurological Sciences (PJNS)

Catatonia is a cluster of affective, behavioral, and motor symptoms. Its causes are multifactorial ranging from severe and untreated psychiatric illnesses to neurological diseases and other general medical conditions. It is estimated that 20% of catatonia causes are due to medical conditions out of which two thirds are due to an underlying neurological condition which might include encephalitis, neural injury, developmental disorders, structural brain pathology, or seizures. Symptoms of catatonia can wax and wane, fluctuating between the retarded and the excited type within hours making it more difficult to identify and diagnose. If left untreated, catatonia can lead to multiple …

Mr Textural Features (Radiomics) For Predicting Response To Treatment In Patients With Intracranial Tuberculoma: A Retrospective Cross-Sectional Study, Muhammad Awais, Shahmeer Khan, Mohammad Wasay, Muhammad Azeemuddin, Ayesha Shoukat, Hafsa Khan

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: MR based radiomics can potentially response to treatment in intracranial tuberculoma, but very scarce literature is available in this regard. The purpose of this study was to determine whether MR based radiomic features can be used to predict response to antituberculosis (AT) treatment. Methods: Data of patients with intracranial tuberculomas who underwent MR imaging and AT treatment at our institution during the last 10 years was analyzed. In each case follow-up imaging performed at 6 months post initiation of treatment was reviewed to establish response to treatment. The textural analysis was performed by two consultant neuroradiologists, using …

Knowledge And Practice Of Pediatricians In Kenya Regarding Helicobacter Pylori Infection In Children., Aura Mwende Nzinga

Master of Medicine in Paediatrics and Child Health

Background: Helicobacter pylori is one of the most common chronic bacterial infections. It affects more than half of the world’s population and is frequently associated with peptic ulcer disease, gastric carcinoma and other extra gastrointestinal manifestations. Globally, one third of the children are infected with the highest burdens observed in low and middle income countries. In Kenya the prevalence stands at 87% among school going children and 50% in children under three years. Justification: Studies in high income countries suggest poor knowledge and practice amongst physicians with limited data from Africa. There exists conflicting information regarding the pathogenic role and …

Education For Children And Adolescents Living With Disabilities In Sub–Saharan Africa—The Gaps And Opportunities, Pauline Samia, Katherine Oyieke, Barnabas Kigen, Susan Wamithi

Paediatrics and Child Health, East Africa

The World Health Organization (WHO) defines disability as an umbrella term that covers impairments, activity limitations, and restrictions in participation (1). Disability is not considered a health problem, but rather an interaction between a person’s body functions and features of the environments in which they live (1). WHO report a higher prevalence of severe and moderate disabilities in Africa compared to other regions (1). The United Nations Children’s Fund (2021) provides a global estimate of 230 million children, ages 0–17 years, living with a disability with 28.9 million children found in Eastern and Southern Africa (2). More than half of …

Heterogeneity In The Prevalence Of Premature Hypertension Among Asian American Populations Compared With White Individuals: A National Health Interview Survey Study, Sina Kianoush, Mahmoud Al Rifai, Anwar T. Merchant, Xiaoming Jia, Zainab Samad, Aneil Bhalla, Ayesha Khan, Dongshan Zhu, Salim S. Virani

Section of Cardiology

Background: Differences in prevalence of risk factors such as hypertension may explain heterogeneity in cardiovascular risk across Asian American populations.
Methods: We used National Health Interview Survey (NHIS) data from 2006 to 2018 among White, Chinese, Asian Indian, Filipino, and 'other Asians' (Japanese, Korean, and Vietnamese). Unadjusted and adjusted odds ratios (aOR) with 95% confidence intervals were reported using logistic regression models for the association between race and self-reported premature hypertension (age old). Models were adjusted for sex, education, body mass index, smoking status, diabetes, and coronary heart disease.
Results: We studied 99,864 participants with history of hypertension (mean age, …

Cancer-Specific Survival After Diagnosis In Men Versus Women: A Pan-Cancer Analysis., Yan He, Yonglin Su, Junsong Zeng, Weelic Chong, Xiaolin Hu, Yu Zhang, Xingchen Peng

Department of Medical Oncology Faculty Papers

Comprehensive understanding of cancer-specific survival differences in gender is critical for cancer prevention and treatment. Based on the Surveillance Epidemiology and End Results database, we included data from the most prevalent cancers (lung, esophageal, liver, pancreatic, stomach, colorectal, kidney, and bladder cancer). Cox proportional hazards regression models were constructed to estimate hazard ratios, simultaneously adjusting for demographic, clinical, and treatment factors. Overall, male patients had a worse cancer-specific survival than female patients. After adjustment for cancer prevalence with 1:1 matching, gender remained a significant factor in cancer-specific survival. Among the included cancer types, female patients showed survival benefit in lung, …

Arthroscopic Suprapectoral Biceps Tenodesis: The Best Of Both Worlds, Tyler Pratte, Tyler Smith, Alfonso Arevalo, Joseph Wazen, David Rubenstein

Orthopedic Surgery Resident Research

Biceps tendinopathy and superior labrum anterior posterior lesions are a common source of shoulder pain and disability and can be effectively treated with biceps tenodesis. There are a variety of open and arthroscopic tenodesis techniques, but no one technique has demonstrated superiority. Arthroscopic techniques often disregard the extra-articular portions of the biceps tendon as a potential source of pain. Open techniques address this concern; however, they can be associated with wound complications, increased blood loss, nerve injury, and disruptions to surgical workflow. Here, we describe an all arthroscopic tenodesis technique at the suprapectoral zone of the tendon. This method addresses …

Suicide Numbers During The First 9-15 Months Of The Covid-19 Pandemic Compared With Pre-Existing Trends: An Interrupted Time Series Analysis In 33 Countries, Jane Pirkis, David Gunnell, Sangsoo Shin, Marcos Del Pozo-Banos, Vikas Arya, Pablo Analuisa Aguilar, Louis Appleby, S. M. Yasir Arafat, Ella Arensman, Murad Khan

Department of Psychiatry

Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally.
Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the …

Impact Of Remote Monitoring During The Interstage Period On Outcomes In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal, Lori Erickson, Janelle R. Noel-Macdonnell, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Natalie Jayaram

Posters

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation. We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period. Methods: Using the CHAMP database, we identified 607infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with a Windows-based …

Periprosthetic Knee Infection After Benign Tumor Excision Complicated By Carbapenem Resistant Enterobacteriaceae: A Case Report, Jennifer Adams, Daniel Habenicht, Duncan C. Ramsey

MEDI 9331 Scholarly Activities Clinical Years

Introduction

Periprosthetic joint infection (PJI) is a major complication after total knee arthroscopy. Enterobacter is a rare cause of PJI.

Case presentation

We present a 65 year old Caucasian man who presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem.

Discussion

CRE is an uncommon cause of PJI, but when it does occur, it commonly infects patients who are immunosuppressed or have specific risk factors. For an immunocompetent patient with CRE …

Menstrual Irregularities Following Covid-19 Vaccination: A Global Cross-Sectional Survey, Azza Sarfraz, Zouina Sarfraz, Muzna Sarfraz, Zainab Nadeem, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Introduction: The coronavirus disease 2019 (COVID-19) vaccination generates protective immunity against SARS-CoV-2 infection. There is no clear evidence of COVID-19 vaccine-induced menstrual irregularities.
Objective: To identify potential menstrual irregularities following COVID-19 vaccine among females.
Methods: A worldwide cross-sectional survey study was conducted from June 10, 2021, to July 10, 2021 using online mediums. The survey consisted of 15 questions divided into baseline characteristics, vaccination status and dosage, menstruation and relate factors, and thoughts and knowledge about menstrual irregularities. Non-probability convenience sampling method was used including 510 responses. The results were tabulated, with bivariate analysis and chi-square test results. The sensitivity …

The Impact Of The Covid-19 Pandemic On The Career Choice Of Medicine: A Cross-Sectional Study Amongst Pre-Medical Students In Pakistan, Raisa Saleh, Russell Seth Martins, Muhammad Saad, Asad Saulat Fatimi, Manzar Abbas, Inaara Akbar, Hamzah Jehanzeb, Shamila Ladak, Shamama Kaleem, Sarah Nadeem

Medical College Documents

Background: The COVID-19 pandemic has significantly affected the lives of healthcare workers due to the frontline nature of their work. Their hard work and sacrifice have forged new perceptions of healthcare workers. These changes may potentially influence students' interest in medicine. This study explores how the COVID-19 pandemic has affected premedical students' decisions to pursue medicine as a career.
Methods: A cross-sectional study using a self-designed online questionnaire was carried out amongst pre-medical students across Pakistan.
Results: A total of 1695 students from 93 public and private schools filled in the survey. After the onset of the COVID-19 pandemic, significantly …

B-Cell Lymphoblastic Lymphoma Of The Paranasal Sinus: A Rare Clinical Entity, Brian Anderson, Christopher M. Metz

Conference Presentation Abstracts

No abstract provided.

Perceptions Of The Virtual Interview Process: A National Survey Of Rhinology Fellowship Directors, Jared A. Johnson, Benjamin S. Johnson, Michael T. Chung, Adam Folbe

Conference Presentation Abstracts

No abstract provided.

Closing The Gap: Stapes Surgery Outcome And Operative Time Analysis By Body Mass Index, Jonathan S. Choi, Christian G Fritz, Dennis I. Bojrab Ii, Christopher P. Lenkeit

Conference Presentation Abstracts

No abstract provided.

Endolymphatic Sac Decompression Effect On Secondary Symptoms Of Ménière Diseas, Robert L. Conway, Seilesh C Babu, Patrick Mallany, Alexandria Weymon, Brent Wilkerson

Conference Presentation Abstracts

No abstract provided.

Novel Mathematical Model For Diagnosis Of Superior Semicircular Canal Dehiscence, Garrett G. Casale, Christian G. Fritz, Lulia Kana, Robert S. Hong

Conference Presentation Abstracts

No abstract provided.

Utility Of Radiofrequency Treatment Of The Internal Nasal Valve Status Post Rhinoplasty: A Salvage Technique, Jake Sims, Andrew M. Compton

Conference Presentation Abstracts

No abstract provided.

Conversion Of Dissertations To Publications At The Aga Khan University Kenya: An Exploratory Study Of Residents Perceptions And Experiences, Brigette Macharia

Master of Medicine in Anaesthesiology

Background: The successful completion and submission of a dissertation is a fundamental milestone for many residency programs worldwide. Publication of a dissertation in a peer-reviewed journal makes it more accessible and is impactful within the scientific context. It contributes to the global outlook of total burden of disease, for which significant geographical variation exists. Publication of residents’ research is a convenient surrogate marker for research training and experience. However, the preparation of a manuscript, successful submission and acceptance in a peerreviewed journal is challenging for both residents and their supervisors. Justification: Aga Khan University (AKU) invests heavily in infrastructure to …

Informing Healthcare Operations With Integrated Pathology, Clinical, And Epidemiology Data: Lessons From A Single Institution In Kenya During Covid-19 Waves, Allan Njau, Jemimah Kimeu, Jaimini Gohil, David Nganga

Pathology, East Africa

Pathology, clinical care teams, and public health experts often operate in silos. We hypothesized that large data sets from laboratories when integrated with other healthcare data can provide evidence that can be used to optimize planning for healthcare needs, often driven by health-seeking or delivery behavior. From the hospital information system, we extracted raw data from tests performed from 2019 to 2021, prescription drug usage, and admission patterns from pharmacy and nursing departments during the COVID-19 pandemic in Kenya (March 2020 to December 2021). Proportions and rates were calculated. Regression models were created, and a t-test for differences between …

“Do Not Detach The Placenta From My Baby's Cord” - Lotus Birth Case Series From Tanzania Tertiary Hospital, Willbroad Kyejo, Davis Rubagumya, Christian Mwalo, Lynn Moshi, Munawar Kaguta, Miriam Mgonja, Shweta Jaiswal

Family Medicine, East Africa

Introduction: Lotus birth is seldom practiced, with its prevalence being not well documented. There is no clear existing guideline or pathway for this practice. Safety in delivery as well as caring for newborn and her mother is of paramount importance. Hence, clarity for Lotus delivery in any set up is indispensable.

Cases findings: We have described on case series approach to women who opted to delivery without detachment of placenta. We have described delivery characteristics, neonatal clinical course, cord, and placenta manage- ment. In year 2022 at our center, we have received two cases of lotus delivery.

Conclusion and …

Communication Skills Of General Practitioners In Nairobi, Kenya: A Descriptive Observational Study, Gulnaz Mohamoud, Robert Mash

Family Medicine, East Africa

Background High-quality primary care needs to be person-centred, and GPs must communicate effectively to ensure continuity and coordination of care. In Kenya, there is little knowledge about the quality of communication in consultations by GPs.

Aim To evaluate the quality of communication in consultations by GPs.

Design & setting Descriptive, observational study of 23 GP consultations in 13 private sector primary care facilities in Nairobi, Kenya.

Method One consultation with a randomly selected adult patient was recorded per GP, and 16 communication skills evaluated with the Stellenbosch University Observation Tool (SUOT). A total percentage score was calculated per consultation, and …