Medical Specialties Commons^™

Stress Induced Hyperglycemia In Stroke Patients, Aziz U Rehman, Ajeet Kumar, Salma Razzaque, Ashok Kumar, M. Ishaq Ghauri

Pakistan Journal of Neurological Sciences (PJNS)

Background:
Stroke is the third most common cause of death in developed countries and second most common cause of death worldwide. High proportion of patients may develop hyperglycemia after an acute stress such as stroke or myocardial infarction even in the absence of preexisting diagnosis of diabetes mellitus. Prolonged stress hyperglycemia in ischemic stroke increases the risk of in-hospital 28- day mortality, especially in non-diabetic patients.

Aims and objectives:
To determine the frequency of stress-induced hyperglycemia in non-diabetic patients with ischemic or hemorrhagic stroke.

Subjects and methods:
A total of 255 patients admitted with acute stroke, fulfilling the inclusion …

Association Of Vitamin D With Statin Induced Myalgia, Ayla K. Zubair, Imran N Ahmad, Arsalan Ahmad Md

Pakistan Journal of Neurological Sciences (PJNS)

Objective:
To determine the association of serum 25-hydroxy vitamin D (25(OH) Vitamin D) deficiency with the occurrence of myalgia in patients on statin therapy.

Methods:
The pathology laboratory database was reviewed to identify patients tested for serum 25(OH) Vitamin D and creatine kinase. A retrospective chart review was then conducted to ascertain statin use and reporting of myalgia for patients tested concurrently for serum 25(OH) vitamin D and creatinekinase levels between January 1, 2013 and December 31, 2013.

Results:
Of the 825 patients tested for creatine kinase and 25 (OH) Vitamin D in 2013, 49 met the study criteria.The …

Frequency Of Cerebrovascular Accidents And Brain Abscess In Childrens With Tetralogy Of Fallot Dr., Sommayya Aftab, Amir Usman, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

OBJECTIVE:
To determine the frequency of cerebrovascular accidents and brain abscess in children of Tetralogy of Fallot presented with neurological manifestations.

PATIENTS AND METHODS:
It was a cross-sectional descriptive observational study done at the Pediatric Cardiology and Pediatric Neurology departments of The Children’s Hospital & Institute of Child Health, Lahore from Dec 2009 to Nov 2010. A total 75 patients of Tetralogy of Fallot (TOF) up to the age of 15 years with neurological manifestation meeting the inclusion criteria were enrolled in this study. CT brain with contrast was conducted in all patients to look for evidence of cerebrovascular accident …

Marburg Variant Of Multiple Sclerosis; A Diagnostic And Therapeutic Challenge, Sadia Imtiaz, Maimoona Siddiqui, Arsalan Ahmad Md

Pakistan Journal of Neurological Sciences (PJNS)

Marburg variant of multiple sclerosis (MS) is a highly aggressive, fulminant demyelinating disease with very high morbidity and mortality. Early diagnosis and aggressive management is vital to limit severe disability and improve the outcome. We present a case of 35 years old male who presented with rapidly progressive demyelinating illness, leading to bed bound status over the course of a month. He was treated aggressively with intravenous (IV) steroids, plasma exchange (PLEX) and Mitoxantrone (MTX), leading to a remarkable recovery.

A Rare Case Of Simple Hereditary Recessive Optic Atrophy, Fazal M. Arain, Prem Chand, Tanveer A. Choudary

Pakistan Journal of Neurological Sciences (PJNS)

Simple Autosomal Recessive Optic Atrophy (AROA) is a rare hereditary disorder that belongs to a group of disorders called Hereditary Optic Atrophy. Patients diagnosed with simple AROA have complete blindness since birth or from first few months of life. This blindness does not improve with age. However, no other organ or system is affected in this disorder. There is no known cause or gene mutation associated with it. Here we report a case of a two year old child diagnosed with simple AROA. Family history of the patient revealed that an older deceased relative also suffered from similar symptoms. Identification …

Encephalopathy With Behavioral And Psychiatric Features–Firstantibody Proven Case Of Anti-Nmda Receptor Encephalitis From Pakistan, Rabel Khalid Memon, Maimoona Siddiqui, Rizwanullah Khan

Pakistan Journal of Neurological Sciences (PJNS)

Background:
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is associated with psychiatric symptoms, memory disturbances, seizures, dyskinesia, and catatonia along with other constellation of symptoms. It is more common in females and usually associated with underlying ovarian teratoma. Treatment involves immunosuppression. This is the first antibody proven case from Pakistan.

Case Report:
A 16 year old girl with a short history of sore throat and no other prior illness, presented with 12 day history of behavioral changes (can you please describe some behavioral changes?) and seizures, followed by decreased responsiveness, involuntary limb movements and facial grimacing. She also had intermittent high grade fever …

Challenges In Certification And Credentialing Of Pakistani Physicians In Middle East, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

9th Annual Neurology Research Day 2015 Abstracts Shifa International Hospital, Islamabad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Hospice Care In Malaysia: Knowledge, Attitude And Time Of Discussion, Shanthi Ellen Solomon

Loma Linda University Electronic Theses, Dissertations & Projects

Despite available and adequate hospice care resources, fewer terminally ill patients in Malaysia use hospice care services than one might reasonably expect. It is reported that only around 10% of patients who die of terminal illness in Malaysia, die in hospice care (Devaraj, 2003). The projected number of individuals that should receive palliative care in Malaysia is 17 to 27% (Connor & Sepulveda Bermedo, 2014). In order to study why hospice care is not accessed as expected, nurses and doctors in Penang and Sabah completed a survey measuring knowledge of current hospice practices, attitude toward caring for the dying, personal …

Accelerating The Dual Elimination Of Mother-To-Child Transmission Of Syphilis And Hiv: Why Now?, James Kiarie, Chandra K. Mishra, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Even though the elimination of congenital syphilis has been on the maternal and child health (MCH) agenda for over a decade, elimination has not yet been achieved; what, then, are the factors currently facilitating the elimination of mother-to-child transmission (MTCT) of syphilis?

Which Role Do Midwives And Gynecologists Have In Smoking Cessation In Pregnant Women?–A Study In Flanders, Belgium, Katrien De Wilde, Inge Tency, Sarah Steckel, Marleen Temmerman, Hedwig Boudrez, Lea Maes

Obstetrics and Gynaecology, East Africa

Objectives: The objectives of our study were (1) to explore knowledge, beliefs and practice among mid-wives and gynecologists concerning a smoking cessation policy for pregnant women and their partners and (2) to examine if midwives and gynecologists do have a role in smoking cessation in pregnant women.

Method: We performed a qualitative study using semi-structured interviews with nine midwives and eight gynecologists. Data were analyzed using deductive content analysis, based on the 5 A’s frame-work (Ask–Advise–Assess–Assist–Arrange).

Results: The national smoking cessation policy seemed to be insufficiently known. “Ask” and “Advise" were part of a standard prenatal consultation, the next three …

Oncolog, Volume 60, Number 06, June 2015, Bryan Tutt, Joe Munch, U. Arizor

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

• New Breast Imaging Modalities Show promise for Cancer Screening and Staging: New technology to supplement digital mammography may improve breast cancer screening and diagnosis. Although some of these new imaging modalities are still under development, others are already in clinical use as adjuncts to mammography for breast cancer screening and staging.
• Addressing Sexual Dysfunction in Cancer Survivors: Cancer treatments carry a host of side effects that can affect patients' ability to have and enjoy sex. The sexual dysfunction arising from these side effects, which include functional changes, can often be addressed, but uncovering sexual dysfunction can prove challenging.
• HOUSE CALL: …

Comparing Neonatal Respiratory Morbidity In Neonates Delivered At Term By Elective Caesarean Section With And Without Dexamethasone: Retrospective Cohort Study, Anita Dileep, Neelofur Babar Khan, Sana Sadiq Sheikh

Department of Obstetrics & Gynaecology

Objective: To assess the effect of dexamethasone on neonatal respiratory morbidity in babies delivered by early term elective lower segment Caesarean section. Method: The retrospective cohort study was conducted at a secondary level hospital in Karachi. It reviewed the medical record of pregnant women and their babies who were delivered by elective lower segment Caesarean section between January 1 and June 30, 2013, at 37-38+6 weeks of pregnancy. The women were divided into exposed group (Group A) who received prophylactic dexamethasone, and non-exposed group (Group B) who did not receive dexamethasone Neonatal respiratory morbidity was compared between the two groups. …

The Cognition-Enhancing Effects Of Psychostimulants Involve Direct Action In The Prefrontal Cortex, Robert C. Spencer, David M. Devilbiss, Craig Berridge

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Psychostimulants are highly effective in the treatment of attention-deficit/hyperactivity disorder. The clinical efficacy of these drugs is strongly linked to their ability to improve cognition dependent on the prefrontal cortex (PFC) and extended frontostriatal circuit. The procognitive actions of psychostimulants are only associated with low doses. Surprisingly, despite nearly 80 years of clinical use, the neurobiology of the procognitive actions of psychostimulants has only recently been systematically investigated. Findings from this research unambiguously demonstrate that the cognition-enhancing effects of psychostimulants involve the preferential elevation of catecholamines in the PFC and the subsequent activation of norepinephrine α2 and dopamine D1 receptors. …

Intensive Transition Team - Analysis Of Program Impacts, Bill J. Wright, Keri B Vartanian, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

Hepatic Encephalopathy In Chronic Liver Disease: Predisposing Factors In A Developing Country, Fakhar Qazi, Shameem Behram Khan, Anam Umar

Section of Gastroenterology

Objective: To fi nd out the risk factors for developing Hepatic Encephalopathy in patients suffering from Chronic liver disease.

Background: Hepatic encephalopathy (HE) is a neuropsychiatric disorder that is caused by liver damage. In its pathology, alterations in normal brain function are associated with an increase in blood ammonia, benzodiazepine like substances, products of neurotoxic fatty acids, and other gut derived toxins, which gain access to the brain as a result of liver dysfunction.

Study Design: Hospital based descriptive, cross sectional study.

Settings: Medical Unit 1, Ward- 5, Jinnah Post Graduate Medical Centre, Karachi.

Duration: July 2013 to December 2013. …

Quantifying Unnecessary Normal Tissue Complication Risks Due To Suboptimal Planning: A Secondary Study Of Rtog 0126., Kevin L. Moore, Rachel Schmidt, Vitali Moiseenko, Lindsey A. Olsen, Jun Tan, Ying Xiao, James Galvin, Stephanie Pugh, Michael J Seider, Adam P. Dicker, Walter Bosch, Jeff Michalski, Sasa Mutic

Department of Radiation Oncology Faculty Papers

PURPOSE: The purpose of this study was to quantify the frequency and clinical severity of quality deficiencies in intensity modulated radiation therapy (IMRT) planning in the Radiation Therapy Oncology Group 0126 protocol.

METHODS AND MATERIALS: A total of 219 IMRT patients from the high-dose arm (79.2 Gy) of RTOG 0126 were analyzed. To quantify plan quality, we used established knowledge-based methods for patient-specific dose-volume histogram (DVH) prediction of organs at risk and a Lyman-Kutcher-Burman (LKB) model for grade ≥2 rectal complications to convert DVHs into normal tissue complication probabilities (NTCPs). The LKB model was validated by fitting dose-response parameters relative …

Funding And Other Resources For Beginning Researchers, Jane Z. Dumsha, David Yens, Grace Brannan

PCOM Scholarly Papers

Despite the fact that osteopathic research is essential for the continued advancement of our profession, such research is lacking. One barrier is the attainment of funding resources to launch and continue quality research studies. In the present article, the authors outline resources for the early stages of research and provide guidance for grant proposal preparation, if it is determined that external funding is needed. Free and low-cost resources for obtaining preliminary data and sources of external funds are described. An overview of grant writing and information on where to obtain training is presented. Information on proposal writing basics, tips to …

The Effect Of Osteopathic Manipulative Treatment On Length Of Stay In Posterolateral Postthoracotomy Patients: A Retrospective Case Note Study, Regina K. Fleming, Karen T. Snyder, Kent J. Blanke, Jane C. Johnson

PCOM Scholarly Papers

Objective

This study retrospectively evaluated the effect of OMT on length of stay (LOS) in hospitalized posterolateral postthoracotomy patients.

Methods

Inpatient medical records of patients who received posterolateral thoracotomies with lung resection between 1998 and 2011 were reviewed for demographic data, LOS, thoracotomy surgery data, consultation data excluding osteopathic manipulative medicine, discharge data, and osteopathic manipulative medicine consultation data.

Results

Thirty-eight patients received posterolateral thoracotomies with lung resection; 23 patients received OMT and 15 did not. The mean (standard deviation) LOS was 11.0 (6.8) days (range, 5–29 days) for those who received OMT and 10.4 (5.5) days (range, 3–22 days) …

Validation Study Of The Mini-Mental State Examination In Urdu Language For Pakistani Population, Safia Awan, Naila Shahbaz,, Syed Wasim Akhtar, Arsalan Ahmad, Sadaf Iqba, Sellal Ahmed, Haider Naqvi, Mohammad Wasay

Section of Neurology

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. Objective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population. Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu …