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101.
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Agnihotri N Dhingra MS Gautam V Gupta V Kaushal R Mehta D 《Japanese journal of infectious diseases》2005,58(1):29-30
A case of rarely encountered Salmonella Typhi septic arthritis of the hip in a child with no preexisting disease is reported. Salmonella etiology was not suspected in this case, and the diagnosis was made only after bacterial isolation. Arthrotomy was done as an initial mode of management, followed by intravenous ciprofloxacin therapy to which the child responded favorably. 相似文献
103.
Association of extent and infection of pancreatic necrosis with organ failure and death in acute necrotizing pancreatitis. 总被引:2,自引:0,他引:2
Pramod Kumar Garg Kaushal Madan Girish Kumar Pande Sudeep Khanna Garipati Sathyanarayan Narendra Prasad Bohidar Rakesh Kumar Tandon 《Clinical gastroenterology and hepatology》2005,3(2):159-166
BACKGROUND & AIMS: Organ failure is the usual cause of death in acute necrotizing pancreatitis. Our objective was to study whether the extent and infection of pancreatic necrosis correlate with organ failure and mortality. METHODS: All consecutive patients with acute pancreatitis were prospectively studied. They underwent a detailed clinical and investigative evaluation. Pancreatic necrosis, diagnosed on a computed tomography scan, was graded as <30%, 30%-50%, and >50% necrosis and characterized as either sterile or infected. Logistic regression analysis was done to find out the association of the extent and infection of pancreatic necrosis with organ failure and mortality. RESULTS: Of 276 patients (mean age, 41.25 years; 172 men), 104 had pancreatic necrosis: 30 had <30% necrosis, 37 had 30%-50% necrosis, and 37 had >50% necrosis; 74 had sterile necrosis, and 30 had infected necrosis. Of them, 37 (35%) patients developed organ failure. Two significant factors were associated with the development of organ failure, the extent of necrosis (<30% necrosis vs 30%-50% necrosis: P = .03; odds ratio [OR], 5.82; 95% confidence interval [CI], 1.15-29.45; <30% necrosis vs >50% necrosis: P = .0004; OR, 18.86; 95% CI, 3.75-94.92) and infected pancreatic necrosis (P = .02; OR, 3.29; 95% CI, 1.17-9.24). The overall mortality was 22%. Infected pancreatic necrosis (P = .006; OR, 4.99; 95% CI, 1.56-16.02) and Acute Physiology, Age, and Chronic Healthy Evaluation II score (P = .004; OR, 1.28; 95% CI, 1.08-1.52) were 2 independent predictors of mortality. CONCLUSIONS: Extent of necrosis and infected pancreatic necrosis were associated with the development of organ failure in patients with acute necrotizing pancreatitis. Infected pancreatic necrosis was the most significant predictor of mortality. 相似文献
104.
Jessica S Ancker Melissa C Miller Vaishali Patel Rainu Kaushal with the HITEC Investigators 《J Am Med Inform Assoc》2014,21(4):664-670
Background
Providing patients with access to their medical data is widely expected to help educate and empower them to manage their own health. Health information exchange (HIE) infrastructures could potentially help patients access records across multiple healthcare providers. We studied three HIE organizations as they developed portals to give consumers access to HIE data previously exchanged only among healthcare organizations.Objective
To follow the development of new consumer portal technologies, and to identify barriers and facilitators to patient access to HIE data.Methods
Semistructured interviews of 15 key informants over a 2-year period spanning the development and early implementation of three new projects, coded according to a sociotechnical framework.Results
As the organizations tried to develop functionality that fully served the needs of both providers and patients, plans were altered by technical barriers (primarily related to data standardization) and cultural and legal issues surrounding data access. Organizational changes also played an important role in altering project plans. In all three cases, patient access to data was significantly scaled back from initial plans.Conclusions
This prospective study revealed how sociotechnical factors previously identified as important in health information technology success and failure helped to shape the evolution of three novel consumer informatics projects. Barriers to providing patients with seamless access to their HIE data were multifactorial. Remedies will have to address technical, organizational, cultural, and other factors. 相似文献105.
Background:
Posterior endoscopic discectomy is an established method for treatment of lumbar disc herniation. Many studies have not been reported in literature for lumbar discectomy by Destandau Endospine System. We report a series of 300 patients operated for lumbar dissectomy by Destandau Endospine system.Materials and Methods:
A total of 300 patients suffering from lumbar disc herniations were operated between January 2002 and December 2008. All patients were operated as day care procedure. Technique comprised localization of symptomatic level followed by insertion of an endospine system devise through a 15 mm skin and fascial incision. Endoscopic discectomy is then carried out by conventional micro disc surgery instruments by minimal invasive route. The results were evaluated by Macnab''s criteria after a minimum followup of 12 months and maximum up to 24 months.Results:
Based on modified Macnab''s criteria, 90% patients had excellent to good, 8% had fair, and 2% had poor results. The complications observed were discitis and dural tear in five patients each and nerve root injury in two patients. 90% patients were able to return to light and sedentary work with an average delay of 3 weeks and normal physical activities after 2 months.Conclusion:
Edoscopic discectomy provides a safe and minimal access corridor for lumbar discectomy. The technique also allows early postoperative mobilization and faster return to work. 相似文献106.
Ganeswara Rao Melam Syamala Buragadda Adel Alhusaini Mohammed Abdulrahman Alghamdi Mansour Saleh Alghamdi Parmveer Kaushal 《Journal of Physical Therapy Science》2014,26(4):591-593
[Purpose] The purpose of our study was to investigate the effect of different positions
on pulmonary function test (PFT) values such as forced vital capacity (FVC) and forced
expiratory volume in one second (FEV1) of asthmatic patients .[Subjects and
Methods] Thirty subjects with severe asthma aged between 20–39 years were enrolled after
they had signed a written consent. Subjects were selected using the inclusion criteria,
and PFT were randomly administered. Spirometer measurements (FVC, FEV1) were
taken in the supine, side lying on right, side lying on left, sitting and standing
positions. Each measurement was taken three times, and the average values were analyzed.
[Results] One- way analysis of variance (ANOVA) and Tukey’s Test (post hoc) for pair- wise
comparison indicated that there was a significant difference in the FEV1 values
of the asthmatic patients however a significant difference was obtained between standing
and supine positions. There was also a significant difference in the FVC values between
the standing and supine lying position in the pair -wise comparison. [Conclusion] This
study showed standing is the best position for measuring FEV1 and FVC of
asthmatic subjects. The more upright the position, the higher the FEV1 and FVC
will be.Key words: Pulmonary function test, Standing position, Spirometry 相似文献
107.
Yadlapalli S. Kusuma Rita Kumari Sonia Kaushal 《Tropical medicine & international health : TM & IH》2013,18(10):1202-1210
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