Bristol, TN, United States
Bristol, TN, United States

King University is a private university in Bristol, Tennessee. Graduate programs are offered in business administration, nursing, and education. Founded in 1867, King is independently governed with covenant affiliations to the Presbyterian Church and the Evangelical Presbyterian Church . Wikipedia.

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Abdulla Bin-Dohaish E.-J.,King College
Biological Research | Year: 2012

Alkylphenol polyethoxylates is a group of estrogenic compounds. Natural or synthetic types of these compounds react with the endocrine system by binding hormone receptors, resulting in interference with their action, which is why they are called endocrine disrupting chemicals. Among their hydrolytic products are nonylphenols (NP), which are considered pollutants of aquatic environments. The objective of this study was to evaluate the pathological alterations on liver tissue of fish exposed to these compounds for long durations, starting from beginning of life and during the period of sexual maturity. Tilapia fish were obtained from Abhur fish farms, reared in the laboratory in special basins, and divided into two groups. The first maternal group was untreated and their larvae were divided into three sub-groups: control; exposed to 15μg/L; and exposed to 30 μg/L. The second maternal group was divided into 2 sub-groups: with larvae exposed to 15μg/L; and with their larvae exposed to 30 μg/L. Larvae and mother exposed to different concentrations of NP (15 and 30 μg/L) showed an increased accumulation of NP in both livers and muscles compared to the control group due to bioaccumulation. Tissue section examinations of the treated group (15 μg NP /L) showed disruption of liver architecture, with lyses, loss of nuclei, necrosis, and fatty infiltration. The changes were more marked in tissues exposed to (30 μg NP /L). Although this pollution was not lethal, its effect may be reflected in vital activities and in the economy.

Brown P.J.P.,King College
American Journal of Physiology - Advances in Physiology Education | Year: 2010

Process-oriented guided-inquiry learning (POGIL), a pedagogical technique initially developed for college chemistry courses, has been implemented for 2 yr in a freshman-level anatomy and physiology course at a small private college. The course is populated with students with backgrounds ranging from no previous college-level science to junior and senior biology, biochemistry, and forensic science majors. Fifty percent of the lectures in the course were replaced with POGIL activities, performed in class by students working collaboratively in small groups. The introduction of POGIL pedagogy into the second half of a two-semester anatomy and physiology course significantly improved student performance on summative evaluations. Overall course scores increased from a mean score of 76% to 89% in the three semesters after POGIL was introduced. Performance on the same multiple-choice final exam rose from a mean of 68% to 88% over the same time period. Most significantly, the rate of students earning a D or F in the course was halved in the first two semesters after POGIL was introduced and was 0% in the third semester. Student satisfaction with the method was high, and most students perceived the value of this form of instruction. © 2010 The American Physiological Society.

Background: Multilevel ossified posterior longitudinal ligaments (OPLLs), particularly those that extend into the high cervical region, are formidable and challenging surgical problems. The aim of the presentation is to analyze the results of surgical treatment of seven consecutive patients having high cervical OPLL with atlantoaxial and subaxial facetal fixations. Objectives: We analyze the role of atlantoaxial instability in the management of OPLL that extended into the high cervical region, above the lower border of C3 vertebra. Materials and Methods: All patients in the series were males. The age of the patients ranged 48-65 years. Clinical evaluation was done by a 5-point clinical grading scale described by us, Japanese Orthopedic Association (JOA) score, and visual analog scale (VAS). All patients were identified to have relatively »subtle» but definite atlantoaxial facetal instability on sagittal imaging and the instability was confirmed by direct handling of the facets during surgery. All patients were treated by multilevel facetal fixation that included fixation of atlantoaxial facets. The aim of surgery was stabilization and arthrodesis of the involved spinal segments, as instability was considered to be the prime pathogenetic factor of OPLL. Spinal canal decompression, either by anterior corpectomy or discoidectomy or by posterior laminectomy or laminoplasty was not done and no attempts were made to remove the OPLL. At an average follow-up of 8 months, all patients showed progressive symptomatic recovery. Conclusion: Atlantoaxial facetal instability can be a cause or an association of high cervical OPLL. Stabilization of the atlantoaxial joint forms a remarkably effective method of treatment. © 2016 Journal of Craniovertebral Junction and Spine | Published by Wolters Kluwer - Medknow.

The double-barrel knot is a new arthroscopic sliding knot for soft tissue reconstruction and repair procedures in arthroscopic and open shoulder surgery. The double-barrel knot is a modified sliding hitch, and is formed using 2 sutures from a single double-loaded anchor (single-pulley technique) or 2 sutures from 2 adjacent anchors (double-pulley technique). This paper describes the method of double-barrel knot formation, and its variations; in addition, single-pulley and double-pulley techniques for anterior glenoid labral repair are presented. © 2013 by Lippincott Williams and Wilkins.

Habib H.S.,King College
Annals of Saudi Medicine | Year: 2012

BACKGROUND AND OBJECTIVES: The objective of this study was to assess the knowledge, perception, and professional experience of pediatricians in Saudi Arabia regarding child abuse and neglect. DESIGN AND SETTING: Descriptive study during a one day pediatric conference held on King King Abdulaziz University Hospital , a tertiary care teaching hospital in western Saudi Arabia. PATIENTS AND METHODS: The study targeted 198 attendees who were invited from different healthcare sectors in the country. RESULTS: The overall knowledge of participants about some important aspects of child abuse and negligence was adequate, ranging between 82% and 91%. However, their knowledge about reporting cases of child abuse and neglect was quite deficient, ranging between 66% and 79%. As for "professional experience about child abuse and negligence," it showed considerable variation between participants ranging between 43% and 82%, in which pediatricians who received their medical education in Saudi Arabia scored statistically significantly higher, while pediatricians who received their medical education in Western countries scored higher in all other aspects of the study. CONCLUSIONS: Currently, the knowledge and clinical experience on the subject of child abuse and neglect in Saudi Arabia is enough to adopt a comprehensive strategy for the prevention and interventions of child maltreatment at all levels. Pediatricians are expected to play a key role by leading and facilitating this process.

Bhatia D.N.,King College | DasGupta B.,King College
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013

Purpose: Combined occurrence of humeral avulsion of glenohumeral ligament (HAGL) lesion and a significant glenoid bone defect is an unusual and previously undescribed association in traumatic anterior shoulder instability. The purpose of this study was (1) to report a retrospective case series of seven anterior bony instability patients who were diagnosed with this unusual association and (2) to evaluate the results of a modified Latarjet procedure and simultaneous HAGL repair using a new subscapularis-sparing approach. Methods: A retrospective review of the records of 64 anterior shoulder instability patients who underwent bony stabilization surgery was performed, and patients who underwent a combined reconstruction for significant glenohumeral bone defects (glenoid loss >20 %) and an associated HAGL lesion were identified. Pre- and postoperative follow-up clinical parameters and functional scores were documented (Oxford shoulder instability score [OSIS], Western Ontario shoulder instability index [WOSI]), Rowe score). Radiological assessment included measurement of the glenoid bone defect (CT scan) and evaluation of soft tissue lesions (MR arthrogram). Results: Radiological and arthroscopic evaluation confirmed the combined lesion complex in 7 (11 %) patients. Follow-up evaluation (mean 20.6 months) suggested an excellent outcome (Rowe score: median 95, range 95-100); a statistically significant improvement was seen in the follow-up OSIS (median 12, range 12-14, p = 0.018) and WOSI score (median 28, range 17-102, p = 0.018) as compared to the preoperative score (median OSIS 50, range 32-53; median WOSI 1,084, range 919-1,195). Clinical tests for subscapularis function revealed a functional subscapularis muscle; no significant differences were detected in pre- versus postoperative internal rotation strength and in the operated versus normal contralateral shoulder (ns). The dual-window subscapularis-sparing approach provided adequate exposure for combined reconstruction of the humeral and glenoid lesions, and no complications were encountered. Conclusions: Significant glenoid defects are associated with HAGL lesions in approximately 1/10th of patients with bony instability. Combined reconstruction of these lesions via a subscapularis-sparing approach results in an excellent outcome and significant improvement in functional scores at a medium-term follow-up. Level of evidence: Therapeutic study, Level IV. © 2012 Springer-Verlag.

Goel A.,King College
Journal of Craniovertebral Junction and Spine | Year: 2015

Aim: The association of single or multiple level cervical spondylotic disease with atlantoaxial instability is assessed. The implications of identifying and treating atlantoaxial instability in such an association are highlighted. Materials and Methods: The analysis is based on an experience with 11 patients treated during the period June 2013-June 2014. All patients had single or multilevel cervical spondylotic disease. The spinal canal compromise and evidence of cord compression was evident on imaging in the cervical subaxial spine and was related to disc bulges and osteophytic bars. There was no or relatively insignificant compression of the cervicomedullary cord by the odontoid process. There was no evidence of odontoid process-related instability on dynamic imaging. Apart from presence of features of cervical spondylosis, investigations and surgical exploration and direct manual handling of the facets revealed evidence of Type B (posterior) atlantoaxial'facetal' instability in all patients. Our 5-point clinical grading system and Japanese Orthopaedic Association (JOA) scores were used to monitor the patients both before and after surgery and at follow-up. Surgery involved both at lantoaxial and subaxial cervical fixation. During the average period of follow-up of 9 months (5-17 months), all patients showed remarkable and gratifying neurological recovery. Conclusion: We conclude that atlantoaxial facetal instability can be 'frequently' associated with cervical spondylosis and needs surgical stabilization. Our surgical outcome analysis suggests that missing or ignoring the presence of atlantoaxial facetal instability can be an important cause of suboptimal result or failure of surgery for cervical spondylotic myelopathy.

Gopal R.A.,King College
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists | Year: 2010

To investigate the effect of testosterone treatment on insulin resistance, glycemic control, and dyslipidemia in Asian Indian men with type 2 diabetes mellitus (T2DM) and hypogonadism. We conducted a double-blind, placebo-controlled, crossover study in 22 men, 25 to 50 years old, with T2DM and hypogonadism. Patients were treated with intramuscularly administered testosterone (200 mg every 15 days) or placebo for 3 months in random order, followed by a washout period of 1 month before the alternative treatment phase. The primary outcomes were changes in fasting insulin sensitivity (as measured by homeostasis model assessment [HOMA] in those patients not receiving insulin), fasting blood glucose, and hemoglobin A1c. The secondary outcomes were changes in fasting lipids, blood pressure, body mass index, waist circumference, waist-to-hip ratio, and androgen deficiency symptoms. Statistical analysis was performed on the delta values, with the treatment effect of placebo compared with the effect of testosterone. Treatment with testosterone did not significantly influence insulin resistance measured by the HOMA index (mean treatment effect, 1.67 +/- 4.29; confidence interval, -6.91 to 10.25; P>.05). Mean change in hemoglobin A1c (%) (-1.75 +/- 5.35; -12.46 to 8.95) and fasting blood glucose (mg/dL) (20.20 +/- 67.87; -115.54 to 155.94) also did not reach statistical significance. Testosterone treatment did not affect fasting lipids, blood pressure, and anthropometric determinations significantly. In this study, testosterone treatment showed a neutral effect on insulin resistance and glycemic control and failed to improve dyslipidemia, control blood pressure, or reduce visceral fat significantly in Asian Indian men with T2DM and hypogonadism.

Parekh D.,King College
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists | Year: 2010

To study the effect of improvement in vitamin D status on glucose tolerance in Asian Indian patients with moderately controlled type 2 diabetes mellitus (T2DM). This randomized, double-blind, placebo-controlled pilot study was conducted in 28 Asian Indian patients with T2DM. Study participants were randomly assigned to a vitamin D-treated group (group D) or a placebo group (group P). Serum 25-hydroxyvitamin D, hemoglobin A1c, and serum fructosamine levels were measured, and an oral glucose tolerance test (OGTT) was performed in all patients at baseline and 4 weeks after intervention. During the OGTT, plasma glucose and serum insulin levels were measured at 0, 30, 60, 90, and 120 minutes. The unpaired t test was used to compare the groups at baseline and to compare the differences in changes from baseline to 4 weeks between the 2 study groups. Group D and group P were similar with respect to their fasting plasma glucose and serum insulin concentrations, post-OGTT plasma glucose and serum insulin levels, and hemoglobin A1c and fructosamine values at baseline. Serum 25-hydroxyvitamin D levels increased significantly in group D at 4 weeks. No significant differences were found between the groups at baseline and 4 weeks with respect to serum fructosamine, fasting plasma glucose and serum insulin, post-OGTT plasma glucose and serum insulin levels, and homeostasis model assessment of insulin resistance. In this study, short-term improvement in vitamin D status was not associated with improvement in glucose tolerance, insulin secretion, or insulin sensitivity in Asian Indian patients with moderately controlled T2DM.

Combined bankart lesion and humeral avulsion of glenohumeral ligament lesion (HAGL) is a well-described pathologic complex in anterior shoulder instability; open surgical approaches with and without arthroscopic assistance have been suggested for simultaneous 1-stage repair of these lesions. Presence of a significant glenoid bone defect (inverted-pear glenoid) adds to the complexity of the problem and necessitates a bony reconstruction procedure. Open surgical approaches described for management of this combined lesion complex in anterior shoulder instability necessitate a subscapularis-cutting approach; suboptimal healing of the tenotomized subscapularis and subsequent delayed rehabilitation predisposes to late subscapularis dysfunction, and this compromises clinical outcomes. This study describes a new surgical technique that utilizes a dual-window approach through the subscapularis muscle; the dual window enables access to the glenoid and humeral lesions without the need for a subscapularis tenotomy. The approach can be used to perform a congruent-arc Latarjet procedure (for glenoid bone defects) or a Bankart repair (for capsulolabral lesions), in combination with a HAGL repair. Preliminary arthroscopy is essential to identify significant bone defects and HAGL lesions. The dual-window approach for reconstruction of the lesions involves (1) a lateral "subscapularis-sparing" window to identify and repair the HAGL lesion; (2) a medial "subscapularis muscle-splitting" window to perform either a glenoid capsulolabral reconstruction or a congruent-arc Latarjet procedure; and (3) a balanced inferior capsular shift and lateralization procedure of the glenohumeral capsule. Technical tips and guidelines to avoid complications are discussed, and a rehabilitation protocol is presented. Copyright © 2012 by Lippincott Williams & Wilkins.

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