In A Model Of Batten Disease, Palmitoyl Protein Thioesterase-1 Deficiency Is Associated With Brown Adipose Tissue And Thermoregulation Abnormalities,
2012
Children's National Medical Center, Washington, DC
In A Model Of Batten Disease, Palmitoyl Protein Thioesterase-1 Deficiency Is Associated With Brown Adipose Tissue And Thermoregulation Abnormalities, Alfia Khaibullina, Nicholas Kenyon, Virginia Guptill, Martha M. Quezado, Li Wang, Deloris Koziol, Robert Wesley, Pablo R. Moya, Zhongjian Zhang, Arjun Saha, Anil B. Mukherjee, Zenaide M.N. Quezado
Anesthesiology and Critical Care Medicine Faculty Publications
Infantile neuronal ceroid lipofuscinosis (INCL) is a fatal neurodegenerative disorder caused by a deficiency of palmitoyl-protein thioesterase-1 (PPT1). We have previously shown that children with INCL have increased risk of hypothermia during anesthesia and that PPT1-deficiency in mice is associated with disruption of adaptive energy metabolism, downregulation of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), and mitochondrial dysfunction. Here we hypothesized that Ppt1-knockout mice, a well-studied model of INCL that shows many of the neurologic manifestations of the disease, would recapitulate the thermoregulation impairment observed in children with INCL. We also hypothesized that when exposed to cold, Ppt1-knockout …
Anaesthetic Management Of A Young Patient With Homocystinuria,
2012
Aga Khan University
Anaesthetic Management Of A Young Patient With Homocystinuria, Ali Asghar, Faiza Mazhar Ali
Department of Anaesthesia
Homocystinuria is a rare autosomal recessive genetic disease. It is caused by a deficiency in cystathionine-b-synthase leading to a defect in methionine metabolism. High levels of plasma homocysteine are associated with vascular injury via mechanisms of oxidative damage, vascular smooth muscle proliferation, promotion of platelet activation and aggregation,and disruption of normal procoagulant-anticoagulant balance favouring thrombosis. This is a case of 8 years old boy, a known case of homocystinuria, who was scheduled for bilateral lensectomy and intraocular lens placement. The major anaesthetic considerations include the development of thromboembolism, need to avoid nitrous oxide in balanced anaesthesia regimen and hypoglycaemia.
Anaesthetic Management Of Neonatal Primary Hyperparathyroidism,
2012
Aga Khan University
Anaesthetic Management Of Neonatal Primary Hyperparathyroidism, Anwar-Ul-Huda, Sanam Dost Mohammad, Tauseef Ahmed
Department of Anaesthesia
Neonatal primary hyperparathyroidism (NPHP) is a rare disease that presents in the first 6 months of life. It is almost invariably fatal unless a prompt diagnosis is made and urgent surgical intervention is instituted. Patients with hyperparathyroidism require special preoperative considerations. They require proper work-up from cardiac, renal and neurological point of view, correction of intravenous volume and electrolytes irregularities. We are presenting a case of an infant who started to have cyanosis and lethargy at 21st day of life. Initial diagnosis of pneumonia was made but later on diagnosed as hyperparathyroidism. He was planned for parathyroidectomy under general anaesthesia. …
Comparison Of Upper Lip Bite Test With Mallampati Test In The Prediction Of Difficult Intubation At A Tertiary Care Hospital Of Pakistan,
2012
Aga Khan University
Comparison Of Upper Lip Bite Test With Mallampati Test In The Prediction Of Difficult Intubation At A Tertiary Care Hospital Of Pakistan, Muhammad Asghar Ali, Muhammad Qamar-Ul-Hoda, Khalid Samad
Department of Anaesthesia
Objective: To determine the accuracy of the Upper lip bite test and Mallampati test in predicting difficult endotracheal intubation.Methods: The cross-sectional study was conducted at the Aga Khan University Hospital, a tertiary care facility in Karachi, Pakistan. Between June 1,2007 and May 31, 2008, 324 adult patients undergoing elective surgeries requiring general anaesthesia with endotracheal intubations were enrolled. Pre-operatively upper lip bite test and Mallampati test were performed for the assessment of airway by a specifically trained observer. Laryngoscopic view was rated by using Cormack and Lehane laryngoscopic grading once the patient was fully anaesthetised using standard anaesthesia technique. Completed …
The Crucial Role Of Bilateral Infraclavicular Nerve Blocks In The Anesthetic Management Of A Trauma Patient,
2012
George Washington University
The Crucial Role Of Bilateral Infraclavicular Nerve Blocks In The Anesthetic Management Of A Trauma Patient, Eric P. Chiang, Paul Dangerfield, Jaideep H. Mehta, Marian Sherman, Jeffrey S. Berger
Anesthesiology and Critical Care Medicine Faculty Publications
Bilateral brachial plexus blocks and regional anesthesia in trauma patients are rarely performed due to potential complications when using these techniques. We illustrate a case in which bilateral infraclavicular nerve blocks were placed as part of a multimodal approach to pain management in a trauma patient. We discuss potential hazards, important considerations, and rationale for attempting this procedure. Ultimately, performing bilateral brachial plexus nerve blocks in trauma patients is a viable option when choosing pain management techniques.
Spinal Anaesthesia For Caesarean Section: Plain Vs Hyperbaric Bupivacaine,
2012
Aga Khan University
Spinal Anaesthesia For Caesarean Section: Plain Vs Hyperbaric Bupivacaine, Gurmukh Das Punshi, Gauhar Afshan
Department of Anaesthesia
Objective: To compare the clinical characteristics of sensory and motor block as well as haemodynamic stability using plain and hyperbaric bupivacaine in spinal anaesthesia for caesarean section.Methods: Two equal groups were formed from a total of 60 patients who were enrolled in this prospective randomised double-blinded study that was done at tertiary care hospital in Karach, during 2005 to 2006. Equal volume of plain and hyperbaric bupivacaine 10 mg with 25 mcg of fentanyl was used for spinal anaesthesia in the two groups that were formed on the basis of random allocation. Characteristics of sensory and motor block, episodes of …
Trpv1 Antagonists May Exacerbate Sepsis In Aged Mice: Should We Be Nervous?,
2012
George Washington University
Trpv1 Antagonists May Exacerbate Sepsis In Aged Mice: Should We Be Nervous?, Zenaide M.N. Quezado, Arpad Szallasi
Anesthesiology and Critical Care Medicine Faculty Publications
No abstract provided.
Spontaneous Intracranial Hypotension In A Patient With Marfan's Syndrome Treated With Epidural Blood Patch--A Case Report,
2012
Aga Khan University
Spontaneous Intracranial Hypotension In A Patient With Marfan's Syndrome Treated With Epidural Blood Patch--A Case Report, Samad Khalid, Punshi Gurmukh Das, Hamid Mohammad, Ullah Hameed
Department of Anaesthesia
Spontaneous intracranial hypotension (SIH) is a well-defined clinical entity that is frequently misdiagnosed. We are reporting a case of 38 years old male who presented with severe headache and an episode of generalized tonic-clonic seizure. He was managed successfully with an epidural blood patch. Understanding of the characteristics, symptomatology, evaluation, treatment options, and prognosis is discussed.
Neurodevelopmental Consequences Of Sub-Clinical Carbon Monoxide Exposure In Newborn Mice,
2012
George Washington University
Neurodevelopmental Consequences Of Sub-Clinical Carbon Monoxide Exposure In Newborn Mice, Ying Cheng, Adia Thomas, Feras Mardini, Shannon L. Bianchi, Junxia X. Tang, Jun Peng, Huafeng Wei, Maryellen F. Eckenhoff, Roderic G. Eckenhoff, Richard J. Levy
Anesthesiology and Critical Care Medicine Faculty Publications
Carbon monoxide (CO) exposure at high concentrations results in overt neurotoxicity. Exposure to low CO concentrations occurs commonly yet is usually sub-clinical. Infants are uniquely vulnerable to a variety of toxins, however, the effects of postnatal sub-clinical CO exposure on the developing brain are unknown. Apoptosis occurs normally within the brain during development and is critical for synaptogenesis. Here we demonstrate that brief, postnatal sub-clinical CO exposure inhibits developmental neuroapoptosis resulting in impaired learning, memory, and social behavior. Three hour exposure to 5 ppm or 100 ppm CO impaired cytochrome c release, caspase-3 activation, and apoptosis in neocortex and hippocampus …
Sedation Safety Using Clinical Practice Guidelines,
2012
Lehigh Valley Health Network
Sedation Safety Using Clinical Practice Guidelines, Bonnie Wasilowsky Bspa-Hca, Rn, Cnrn
Patient Care Services / Nursing
No abstract provided.
Are We Anesthesiologists, Aware About The Incidence Of Muscle Stiffness Associated With Remifentanil?,
2012
Aga Khan University
Are We Anesthesiologists, Aware About The Incidence Of Muscle Stiffness Associated With Remifentanil?, Gauhar Afshan
Department of Anaesthesia
No abstract provided.
Examining Cancer-Related Pain And Quality Of Life In Lehigh Valley Home Care Patients,
2012
Lehigh Valley Health Network
Examining Cancer-Related Pain And Quality Of Life In Lehigh Valley Home Care Patients, Linda G. Alley Phd, Rn, Hannah D. Paxton Rn, Mph, Michelle D. Flores Bsn, Rn, Carol A. Foltz Phd, Jen Wike Mph, Mba, Vickie Cunningham Bsn, Rn, Jeffrey Etchason Md
Administration & Leadership
No abstract provided.
Anxiolytic Effect Of Midazolam Premedication Assessed By Clinical And Platelet Aggregation Profiles,
2010
Aga Khan University
Anxiolytic Effect Of Midazolam Premedication Assessed By Clinical And Platelet Aggregation Profiles, Ehtesham I Khan, Rehana S Kamal, Hameed Ullah
Department of Anaesthesia
BACKGROUND: It is well documented that surgery is associated with increased anxiety, which has an adverse impact on patient's outcome. This study was designed to assess the anxiolytic effect of midazolam in pre-anaesthetic medication by using clinical and platelet aggregation profiles.METHODS: Sixty ASA I and II female patients aged between 35 and 60 years undergoing elective abdominal hysterectomy were randomly divided into two equal groups. Group I received placebo as pre-medication while group II received 0.15 mg/kg midazolam as pre-medication 1 hour preoperatively. They were monitored for visual analogue scale (VAS) for anxiety, observer's anxiety criteria, sedation score, blood pressure, …
