Medical Specialties Commons^™

Cisplatin Nephrotoxicity And Hydration Protocols, Ahmed Usman, Heeranand Keswani, Suresh Nagdev,, Ghulam H, Tehseen Khursheed,, Anis Malik,, Kasif Jafferi

Department of Medicine

Objective : Ahmed Usman, Heeranand Keswani, Suresh Nagdev, Ghulam Haider, Tehseen Khursheed, Anis Malik, Kasif Jafferi To evaluate the nephrotoxicity of cisplatiri in cancer patients, using different protocols of hydration.

Study Design : Randomized controlled trial.

Patients & Methods : This study was conducted between 1st June to 30th November 2004. Ninetynine patients with normal renal function were enrolled in the study and randomly assigned into the 3 study groups, each group having 33patients. In group 1 hydration was done with saline (2 liter) alone, in group 2 with saline (2 liter) and furosemide (40mg) and in group 3 with …

Neuroleptic Malignant Syndrome: Need For Early Diagnosis And Therapy, Humaira M. Khan, Nadir A. Syed, Mughis Sheerani, Bhojo Khealani, Ayeesha Kamal, Mohammad Wasay

Department of Medicine

Background: Neuroleptic Malignant Syndrome (NMS) is a medical entity that has received little attention in the clinical settings in Pakistan. The aim of our study was to review the predisposing factors, outcomes and characteristics of in-patients diagnosed with NMS.

Methods: We performed a retrospective chart review of all cases (age > 15 years) at a tertiary care center in Karachi between January 01, 1990 and November 30, 2001, diagnosed using ICD 10 coding. Data was collected using a standardized data entry form and statistical analysis was performed using Epi Info 6, Version 6.02.

Results: There were a total of 20 patients …

Minimally Symptomatic Severe Hypercalcaemia In A Patient With Parathyroid Carcinoma., Aisha Sheikh, Najmul Islam

Department of Medicine

The case of a 38 years old man with generalized pains fatigue, anorexia, constipation, polyuria serum calcium level of 20.6mg/dl in paired renal function parathyroid hormone is presented. Sestamibi scan showed a functioning left inferior parathyroid tumor, which was successfully removed. Before surgery he was managed with rehydration, diuretics and pamidronate infusion. Five months post surgery the serum calcium levels are normal and renal function has improved.

Potential Of Vibrational Spectroscopy In The Diagnosis Of Human Tumours., Eoghan O'Faolain

Doctoral

Just fewer than 20,000 people are annually diagnosed with some form of cancer in Ireland and one in three people are likely to contract some form of cancer by age 74. With the number of cases increasing at an annual rate of 2%, the early detection and treatment of cancer is becoming increasingly important. Both IR and Raman spectroscopy offer the potential for real time, quantitative detection of cancer and even precancer. This study investigates the potential of Raman and Fourier transform infrared, both benchtop and synchrotron spectroscopies for the detection of cervical cancer. The tissue was classified and its …

Analysis Of Indentation Loading Of Cortical Bone Using Acoustic Emission Techniques, Ashkan Safari, Ger Reilly, Brendan Mccormack

Conference Papers

In this study, we recorded the number of Acoustic emission (AE) hits and related AE energy during indentation fracture of cortical bone using a PAC PCI-2 card and pico sensor. A threshold value of 43dB was used to filter premature trigger due to background noise. Registered AE hits had more than one count (threshold crossing). Amplifier gain was set at 40dB with a (0.1-1) MHz band pass filter. 8mm cubes of cortical bones were indented in the longitudinal direction at constant crosshead speed of 1 mm min-1 using a large 2D, 50˚ wedge indenter. We hypothesised that signals occurring as …

Orally Delivered, Plant-Produced Tat Protein Primes Mice For A Challenge Dna Vaccine Expressing Tat, A V. Karasev, S Foulke, C Wellens, I Zwierzynski, R Baldwin, H Koprowski, M S. Reitz Jr

Department of Microbiology and Immunology Faculty Papers

Oral Presentation.

Placental Expression Of Angiopoietin-1, Angiopoietin-2 And Tie-2 During Placental Development In An Ovine Model Of Placental Insufficiency-Fetal Growth Restriction., Amy S Erickson Hagen, Ryan J Orbus, Randall B Wilkening, Timothy Regnault, Russell V Anthony

Paediatrics Publications

Fetal growth restriction (FGR) is associated with increased perinatal morbidity and mortality, and often results from functional placental insufficiency. Placentation requires extensive vasculogenesis and subsequent angiogenesis, in both maternal and fetal tissues. Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) are angiogenic growth factors expressed in the placenta, and compete for binding to a common receptor, Tunica interna endothelial cell kinase-2 (Tie-2). Our objective was to examine Ang-1, Ang-2 and Tie-2 expression in ovine placental tissue obtained from normal and FGR pregnancies throughout gestation. Fetal cotyledon and maternal caruncle tissue concentrations of Ang-1, Ang-2 and Tie-2 mRNA were assessed by real-time reverse transcriptase-polymerase …

Comparison Of Two Surveys Of Head Injured Patients Presenting During A Calendar Year To An Urban Medical Centre 32 Years Apart, Rashid Jooma, Shahid Ahmed, Abdul Malik Zarden

Section of Neurosurgery

Objective: To study the patients presenting with head injuries to a tertiary hospital in Karachi during the year 2003.
Methods: During the calendar year 2003, a cross-sectional study was conducted of all patients presenting to the casualty department of Jinnah Postgraduate Medical Centre (JPMC) with head injury. Personal information was collected from the patient's attendants at presentation or later if the patient had been brought in by the emergency services as an unknown person. The circumstances of the injury were similarly established and the clinical features documented.
Results: During the year 2003, a total of 3008 patients reported to the …

The Health Status Of Southern Children: A Neglected Regional Disparity, Jeffrey Goldhagen, Radley Remo, Thomas Bryant, Peter Wludyka, Amy B. Dailey, David Wood, Graham Watts, William Livingood

Health Sciences Faculty Publications

Purpose: Great variations exist in child health outcomes among states in the United States, with southern states consistently ranked among the lowest in the country. Investigation of the geographical distribution of children’s health status and the regional factors contributing to these outcomes has been neglected. We attempted to identify the degree to which region of residence may be linked to health outcomes for children with the specific aim of determining whether living in the southern region of the United States is adversely associated with children’s health status.

Methods: A child health index (CHI) that ranked each state in the United …

Inhibition Of Collagen Gene Expression In Systemic Sclerosis Dermal Fibroblasts By Mithramycin, Nora Sandorfi, Natalia Louneva, Elena Hitraya, Gyorgy Hajnoczky, Biagio Saitta, Sergio A. Jimenez

Selected Works of Sergio Jiménez, MD, MACR

ABSTRACT

Introduction. The antitumor antibiotic mithramycin has also been shown to be a potent and effective inhibitor of fibrosis following glaucoma surgery. This DNA interacting drug displays high affinity binding to GC rich sequences in DNA, including those present in the promoter of the gene encoding the Α1 chain of type I collagen (COL1A1).

Objective. To evaluate the effects of mithramycin on the production of type I collagen in fibroblast cultures from patients with systemic sclerosis. Methods. Confluent cultures of dermal fibroblasts from patients with recent onset of the diffuse form of systemic sclerosis were treated with varius concentrations of …

Oncolog, Volume 50, Number 12, December 2005, Sunni Hosemann, Diane Witter

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Moving New Drugs from "Bench to Bedside and Back"
• House Call: When the End Is Near: Ways to Cope When a Loved One Is Terminally Ill
• After Katrina: Caring for Cancer Patients in the Wake of the Storm

Validity Of Frozen Section In The Diagnosis Of Breast Lumps: 5 Years Experience At The Aga Khan University Hospital., Naila Kayani, Nuzhat Sultana

Department of Pathology and Laboratory Medicine

Abstract

Objective: To determine the accuracy of frozen section in the diagnosis of breast lump. Methods: Frozen section diagnosis given in consecutive breast biopsies performed in 5 years in our laboratory was evaluated against the final pathology report of permanent sections. Results: The Aga Khan University Hospital Lab receives more than 400 cases per year for frozen section. Three hundred and nineteen consecutive frozen sections of breast lumps examined from 1999-2003 were considered for analysis. Age of patients ranged between 22 and 90 years (mean age 49 years). In 316 cases (99%) there was no difference between the frozen section …

Outcome Of Endoscopic Therapeutic Interventions: Are They Different Among Various Non- Malignant Esophageal Diseases, Rustam Khan, Shahab Abid, Saeed Hamid, Z Abbas, Syed H Shah, Wasim Jafri

Section of Gastroenterology

Background: This study was carried out to evaluate and compare the outcome of various causes of non-malignant lesions of the esophagus after endoscopic therapeutic intervention.

Methods: A cohort of patients with non-malignant dysphagia presenting at Aga Khan University hospital, a tertiary care setting who underwent endoscopic intervention was studied. Response to treatment was evaluated by improvement in dysphagia score on a scale of 0-4 and weight gain.

Results:99 subjects (53 males) were included. Mean age was 48.6 +/- 17.2 years. Dysphagia for solids was present in 48%, for liquids in 3% and for both in 49% patients. Significant weight …

Comparison Between Gram Stain And Culture For The Characterization Of Vaginal Microflora: Definition Of A Distinct Grade That Resembles Grade I Microflora And Revised Categorization Of Grade I Microflora, Rita Verhelst, Hans Verstraelen, Geert Claeys, Gerda Verschraegen, Leen Van Simaey, Catharine De Ganck, Ellen De Backer, Marleen Temmerman, Mario Vaneechoutte

Obstetrics and Gynaecology, East Africa

Background: The microbiological diagnosis of bacterial vaginosis is usually made using Nugent's criteria, a useful but rather laborious scoring system based on counting bacterial cell types on Gram stained slides of vaginal smears. Ison and Hay have simplified the score system to three categories and added a fourth category for microflora with a predominance of the Streptococcus cell type. Because in the Nugent system several cell types are not taken into account for a final score, we carried out a detailed assessment of the composition of the vaginal microflora in relation to standard Gram stain in order the improve the …

A Case Of Transient Diabetes Insipidus Following Cardiopulmonary Bypass, Omer Ashraf, Hasanat Sharif, Mansoor Shah

Section of Cardiothoracic Surgery

Cardiopulmonary bypass surgery has been linked with a number of postoperative complications. One of the frequently reported physiological alterations is the relative diuresis seen in the immediate post-op period. Rarely reported though is the development of full-blown diabetes insipidus in such patients. The etiology is unknown and has only been hypothesized in the past. We present the clinical course of a 54 year old male who developed transient diabetes insipidus post bypass surgery with subsequent recovery following exogenous vasopressin administration. The physiological alteration leading to the development of diabetes insipidus in a small fraction of bypass patients remains unknown. We …

Vital Pulp Therapy With Mineral Trioxide Aggregate: An Outcomes Study, Heather H. Lauer

Loma Linda University Electronic Theses, Dissertations & Projects

Mineral trioxide aggregate (MTA) is used in a variety of endodontic procedures. MTA is proven to provide good marginal adaption to dentin, to be biocompatible, and to stimulate dentin bridge formation through animal studies. These properties make MTA a potentially useful material to be used in vital pulp therapy. Clinical data on the use of MTA as a vital pulp medicament is sparse. The purpose of this study was to evaluate the clinical outcome of vital pulp therapy using MTA as the pulp medicament. Inclusion criteria for patient selection for recall was based on pulp treatment necessary from carious pulp …

Mechanisms Of Hbo-Induced Neuroprotection In A Neonatal Hypoxia-Ischemia Model, John Winter Calvert

Loma Linda University Electronic Theses, Dissertations & Projects

With an incidence approaching 1/4000 live births and as high as 60% in low birth weight infants, cerebral hypoxia-ischemia during the perinatal period is the single most important cause of acute mortality and chronic disability in newborns. Herein, we tested the hypothesis that following a hypoxic-ischemic insult hyperbaric oxygen (HBO) treatment can restore high energy metabolite levels in the affected regions of the brain and through this increase in energy levels ameliorate the spread of cell death following the insult. We also investigated if an additional mechanism by which HBO affords its neuroprotection is by altering the expression of the …

Accuracy Of The Newtom 3g™ In Measuring The Angle Of The Articular Eminence, Rehana Khan

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine the accuracy of the Newtom 3G™ in determining the angulation of the articular eminence. The benefits of conducting this study were to provide additional uses for the standard records that are taken for the purposes of orthodontic treatment, as well as evaluate the Newtom 3G™ for accuracy in measuring the anatomy of the glenoid fossa. This study required 20 participants that volunteered to allow their records to be used. Records evaluated were the Newtom 3G™, impressions, and wax check bite registrations. The wax record was taken using the 'forced bite' technique to …

Ricketts And Steiner Analysis Using Newtom 3g™ Scout Images, James I. Gibson Iii

Loma Linda University Electronic Theses, Dissertations & Projects

NewTom 3G™ scout images have the general appearance of traditional lateral cephalometric radiographs. The purpose of this research was to determine if Ricketts and Steiner analyses could be accomplished on NewTom 3G™ scout images.

This was a retrospective study comparing the use of NewTom 3G™ scans in DICOM (Digital Imaging and Communications in Medicine) format to scout images from 25 consecutive patients of the Loma Linda University School of Dentistry Department of Orthodontics, three of these patients did not meet the inclusion criteria. The DICOM images were used to create controls. The controls and scout images were digitized using QuickCeph™. …

Stability Of The Miniscrew-Bone Interface: Reverse Torque Values In Rabbits, Daniel John Drye

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Miniscrews are used in orthodontics as practical temporary anchorage devices (TAD's). The purpose of this animal study was to measure reverse torque values for Absoanchor 1.2 mm and Micerium 1.5mm miniscrews at 0, 2, and 12 weeks under loaded and unloaded conditions.

Methods: Ninety-six miniscrews were placed in the femora of twelve rabbits and allowed to heal for either two or twelve weeks. Half of the fixtures were loaded immediately with NiTi open coil springs producing a force of 150-200g and the other half served as unloaded controls. For each of the healing times, two and twelve weeks, …

Retrospective Review Of The Use Of Swan Ganz Catheters In Our Intensive Care Unit (Icu): A Short Report, Shahla Siddiqui

Department of Anaesthesia

The widespread and often 'misuse' of the Swan Ganz (SG) or Pulmonary artery catheter has often been seen in intensive care patients. The objective of this preliminary review was to observe the trends and possibly formulate an association with outcome of the use of SG catheters as well as to determine the frequency of use and possible complications. The chart review of ten patients was carried out for the months of January and February 2004 in a retrospective manner. The incidence of SG catheter insertion was 12% per month on average. Nine out of 10 patients received the SG catheters …

Fixation Of Bilateral Pelvic Osteotomies With External Fixator In Exstrophy Bladder Complex, Salman Riaz, Shahbaz Sarwar, Masood Umer

Department of Surgery Docs

Abstract

OBJECTIVE:

To present the early results of pelvic osteotomies performed for repair of exstrophy bladder.

METHODS:

Five cases of exstrophy bladder were treated with closure following bilateral iliac osteotomies. Three patients underwent closure of pubic symphysis diastasis by use of external fixator, one by screws and cerclage wires, and one by use of K-wires and suture. The patients were followed up by the pediatric urologist and orthopedic surgeon.

RESULTS:

All patients achieved a closure of diastasis and a tension free repair after the index surgery. The average follow-up was 3.6 years with range of 4 months to 6 years. …

Speech Results With Tracheoesophageal Voice Prosthesis After Total Laryngectomy, Mohammad Sohail Awan, Imtinan Ahmed, Yassar Iftikhar Ahmad, Daniyal Ahmad

Section of Otolaryngology, Head & Neck Surgery

Objective: To assess the success rate of tracheoesophageal voice prosthesis as the primary mode of voice rehabilitation in patients after total laryngectomy.Methods: Medical record files of 35 patients subjected to total laryngectomy were reviewed for determining success or failure of the voice prosthesis. The indicators used were quality of speech and utility of the device. Subsequent complications that developed were also assessed. In addition other factors taken into consideration were pharyngeal myotomy, use of radiation, and timing of replacement. All thirty five patients (n=35) had prosthesis placed at the time of laryngectomy.Results: The success rate at one month and four …

Resident Efficiency In A Pediatric Emergency Department., M Denise Dowd, Celeste Tarantino, Theodore M. Barnett, Laura Fitzmaurice, Jane F. Knapp

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To measure the hourly rate of patients evaluated and treated by resident physicians in an academic pediatric emergency department (PED) and examine differences in the rate by subspecialty and year of training.

METHODS: For all residents rotating in an academic, urban children's hospital PED, the rate of patients seen per hour over the course of their rotation was calculated using an electronic tracking system, EmSTAT, for calendar year 2000. Rates are reported as the mean number of patients seen per resident hour worked. Mean differences are reported for resident subspecialties (emergency medicine, pediatrics, and family practice) and postgraduate year …

Effect Of Cytokine Gene Polymorphism On Histological Activity Index, Viral Load And Response To Treatment In Patients With Chronic Hepatitis C Genotype 3, Zaigham Abbas, Tariq Moatter, Akber Hussainy, Wasim Jafri

Section of Gastroenterology

AIM: To investigate the association between cytokine gene polymorphism and disease status in chronic hepatitis C genotype 3 by liver biopsy, ALT, HCV RNA levels and response to treatment.Methods: Patients with chronic hepatitis C genotype 3 were analyzed for single nucleotide polymorphisms of interleukin (IL)-10, IL-1 beta, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta) by polymerase chain reaction using sequence-specific oligonucleotide primers. Liver biopsies were assessed by modified histological activity index (HAI) scoring system using a scale of 0-18 for grading the necro-inflammatory activity and 0-6 for staging the fibrosis. HCV RNA levels were determined by …

Continuous Asl Perfusion Fmri Investigation Of Higher Cognition: Quantification Of Tonic Cbf Changes During Sustained Attention And Working Memory Tasks, Junghoon Kim, John Whyte, Jiongjiong Wang, Hengyi Rao, Kathy Z. Tang, John A. Detre

Department of Rehabilitation Medicine Faculty Papers

Arterial spin labeling (ASL) perfusion fMRI is an emerging method in clinical neuroimaging. Its non-invasiveness, absence of low frequency noise, and ability to quantify the absolute level of cerebral blood flow (CBF) make the method ideal for longitudinal designs or low frequency paradigms. Despite the usefulness in the study of cognitive dysfunctions in clinical populations, perfusion activation studies to date have been conducted for simple sensorimotor paradigms or with single-slice acquisition, mainly due to technical challenges. Using our recently developed amplitude-modulated continuous ASL (CASL) perfusion fMRI protocol, we assessed the feasibility of a higher level cognitive activation study in twelve …

Posterior Longitudinal Ligament Status In Cervical Spine Bilateral Facet Dislocations, John A. Carrino, Geoffrey L. Manton, William B. Morrison, Alex R. Vaccaro, Mark E. Schweitzer, Adam E. Flanders

Department of Orthopaedic Surgery Faculty Papers

Objective: It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status.

Design: Retrospective case series.

Patients: A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between …

Medical Education Digest, Vol. 7 No. 6 (November/December 2005), Nova Southeastern University

Medical Education Digest

No abstract provided.

Antiviral Agents For Pregnant Women With Genital Herpes, Christopher Wenner Md

Articles

Clinical Question

Do antiviral medications prevent perinatal transmission of genital herpes to neonates?

Evidence-Based Answer

There is no evidence that the use of antiviral agents in women who are pregnant and have a history of genital herpes prevents perinatal transmission of herpes simplex virus (HSV) to neonates. [Strength of recommendation: A, based on multiple systematic reviews] However, treatment with antivirals during the last month of pregnancy does reduce the rate of HSV outbreaks in pregnant women and the resultant need for cesarean delivery. [Strength of recommendation: A, based on multiple systematic reviews]

Oncolog, Volume 50, Number 11, November 2005, Vickie J. Williams, Karen Stuyck, James D. Cox Md

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Cancer in Young Adults
• Do Mind/Body Techniques Work?
• House Call: Tapping into Local and Online Resources
• Phytoestrogen Consumption May Reduce Lung Cancer Risk
• DiaLog: Radiation Therapy and Lung Cancer, by James D. Cox, MD, Professor and Head of the Division of Radiation Oncology