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51.
Perception of nurse prescribing among nurses and psychiatrists in a developing country: A cross‐sectional survey 下载免费PDF全文
Ashish Badnapurkar RN MSc Daniel Bressington RN PhD Martin Jones RN DProf Deborah Nelson RN MSc Dona Thomas RN MSc Mohammed Mehndi RN MSc Richard Gray RN PhD 《International journal of mental health nursing》2018,27(2):866-876
Nurse prescribing has the potential to improve patients’ access to, and experiences of, treatment. The aim of the present study was to examine nurse and psychiatrist attitudes about this extended role in a developing country. We conducted a cross‐sectional survey using a previously‐used, 65‐item, seven subscale measure of attitudes to nurse prescribing in mental health. We achieved a 79% response rate. The majority of participants had trained in developing countries where nurse prescribing has yet to be implemented. Across five subscales (general beliefs, impact, uses, training, and supervision), both groups reported positive attitudes about nurse prescribing. Both groups scored the training subscale particularly highly. Compared with psychiatrists, nurses were more confident about the range of clinical settings where nurse prescribing could be applied (e.g. acute inpatient and substance use). Although both groups had less favourable attitudes on the two subscales relating to clinical and legal responsibility, compared to nurses, psychiatrists were more undesirable. Although, overall, clinician attitudes do not seem to represent a barrier towards the potential implementation of nurse prescribing in the study setting, clarity about clinical and legal responsibility needs to be addressed. 相似文献
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53.
Nair Aswin M. Mathew John Goel Ruchika Chebbi Pramod Mathew Ashish Jacob Arvind G. Yadav Bijesh Rebekah Grace Prakash John A. J. Danda Debashish 《Clinical rheumatology》2021,40(7):2805-2819
Clinical Rheumatology - Consensus on treatment of idiopathic inflammatory myositis (IIM), particularly with regard to flares and interstitial lung disease (ILD), does not exist. We studied the... 相似文献
54.
Ashish Kumar Jha Gaurav Kumar Vishwa Mohan Dayal Abhay Ranjan Arya Suchismita 《World journal of gastroenterology : WJG》2021,27(18):2090-2104
Hepatitis E virus (HEV) is an important cause of repeated waterborne outbreaks of acute hepatitis. Recently, several extrahepatic manifestations (EHMs) have been described in patients with HEV infection. Of these, neurological disorders are the most common EHM associated with HEV. The involvement of both the peripheral nervous system and central nervous system can occur together or in isolation. Patients can present with normal liver function tests, which can often be misleading for physicians. There is a paucity of data on HEV-related neurological manifestations; and these data are mostly described as case reports and case series. In this review, we analyzed data of 163 reported cases of HEV-related neurological disorders. The mechanisms of pathogenesis, clinico-demographic profile, and outcomes of the HEV-related neurological disorders are described in this article. Nerve root and plexus disorder were found to be the most commonly reported disease, followed by meningoencephalitis. 相似文献
55.
Ashish I. Vaska Saleh Abbas 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2019,21(2):148-156
Background
Bile leak following liver resection can be associated with significant morbidity. This systematic review and meta-analysis aims to evaluate the effect of intraoperative bile leak testing on postoperative bile leak rate and other complications after liver resection without biliary reconstruction for any cause.Methods
PubMed, MEDLINE, Embase, Cochrane Library and grey literature databases were searched for articles between 1960 and 2017 comparing bile leak rates with or without bile leak testing. Standard meta-analysis methods were used. The primary outcome was bile leak rate, and secondary outcomes were overall morbidity, reintervention rate and length of stay.Results
8 articles met inclusion criteria. Intraoperative bile leak testing after resection was associated with lower postoperative bile leak rate (4.1% vs 12.3%, OR 0.36, 95% CI 0.23–0.55, p < 0.001), overall morbidity (OR 0.67, 95% CI 0.47–0.96, p = 0.030), need for reintervention (OR 0.11, 95% CI 0.03–0.36, p < 0.001) and a shorter duration of hospital stay (2.21 days, 95% CI 0.69–3.73, p = 0.004).Conclusion
The routine use of intraoperative bile leak testing during liver resection results in a significant reduction in postoperative bile leak rate, overall morbidity, length of hospital stay and need for re-intervention. Bile leak testing should be performed after liver resection without biliary reconstruction. 相似文献56.
Piyush Gupta Mehul Choksi Ashish Goel Uday Zachariah Kattiparambil Gangadharan Sajith Jeyamani Ramachandran George Chandy George Kurian Grace Rebekah Chundamannil Eapen Eapen 《Indian journal of gastroenterology》2018,37(1):31-38
Background
Experience with zinc in treating symptomatic hepatic Wilson’s disease (WD) is limited.Aim
To study the efficacy of Penicillamine followed by zinc in treating symptomatic hepatic Wilson’s disease.Methods
We retrospectively analyzed case records of 31 symptomatic hepatic WD patients for whom disease severity scores (Child’s, model for end-stage liver disease (MELD), Nazer’s, and New Wilson Index (NWI) score) and 24-h urinary copper were compared at 3-time points—baseline at presentation, at transition from penicillamine to zinc and at end of follow up.Results
Thirty-one patients (median age 11 [5–24] years) with symptomatic hepatic WD were studied; ten had associated neuropsychiatric manifestations of WD. Penicillamine was changed to zinc sulfate either due to financial constraints (28 patients) or due to adverse effects of penicillamine (3 patients). At presentation (baseline), six patients belonged to Child’s class A, five to Child’s B, and 17 to Child’s C. Duration of initial penicillamine chelation therapy was 134 (2–320) weeks, and of subsequent zinc therapy was 363 (35–728) weeks. There was a significant improvement in liver function tests and disease severity scores (Child’s, MELD, Nazer’s, and NWI score) at the transition from penicillamine to zinc compared to baseline. This improvement was maintained until the end of study period with 90% survival at 10 (2–20) years. Fifteen of the 17 Child’s C cirrhotic patients showed significant improvement in disease severity scores from baseline until end of follow up.Conclusions
Penicillamine followed by zinc may be a safe and effective treatment in resource-constrained setting for symptomatic hepatic WD patients in all grades of baseline disease severity. Some patients with decompensated cirrhosis due to WD may be managed with medical treatment, avoiding liver transplantation.57.
GOALS: To report the use of pH-impedance testing in evaluating patients with suspected gastroesophageal reflux disease (GERD) with atypical symptoms. BACKGROUND: Although the role of acid reflux in causing atypical GERD symptoms is generally accepted, the role, if any, of nonacid reflux is controversial, largely because until recently it has not been possible to detect nonacid reflux. The advent of intraluminal combined pH impedance testing (MII-pH), to detect nonacid reflux has heightened interest in its possible contribution to atypical symptoms. STUDY: Fifty consecutive patients referred for MII-pH testing to evaluate the cause of atypical symptoms presumed due to GERD were evaluated. The symptoms were either refractory to acid inhibition therapy or so atypical that further work up was desired by the referring physician. Patients underwent MII-pH testing to determine whether reflux was present, and, if so, if it was due to acid, nonacid, or gas. RESULTS: Only 16%, 22%, and 2% patients were found to have symptoms due to acid reflux, nonacid reflux, or both, respectively. Ten percent of these patients had gas reflux. MII-pH testing was useful in redirecting the management of patients who did not have reflux as the cause of their symptoms. CONCLUSIONS: MII-pH testing is useful in determining whether gastroesophageal reflux is present in patients with atypical symptoms that have not responded to proton pump inhibitor therapy. It also distinguishes between reflux due to acid, nonacid, and gas, with consequences for management. 相似文献
58.
Physicians' Attitudes and the Use of Oral Anticoagulants: Surveying the Present and Envisioning Future 总被引:5,自引:0,他引:5
Atrial fibrillation has the highest prevalence in the elderly. While the elderly are at the highest risk for stroke and would benefit the most from anticoagulation, they are also the least likely to receive anticoagulation. In a pooled analysis of the primary prevention trials, warfarin reduced stroke by 68% compared with placebo, and aspirin reduced stroke by 18%. Age, history of hypertension, diabetes, heart failure or reduced left ventricular function, and previous transient ischemic events and stroke are independent risk factors for stroke in patients with atrial fibrillation. Less than 50% of the elderly who have clear-cut indications and no contraindications for warfarin receive anticoagulant therapy. This low use of warfarin is driven by many factors, but physicians' fear of hemorrhage is among the most important. Better adherence to evidence-driven guidelines, better patient and physician education, point-of-care monitoring of INR and the future development of user friendly anticoagulant drugs are likely to result in higher rates of anticoagulation use. 相似文献
59.
Ashish Mahajan G Rao Gordon Lees Richard Owen 《Journal canadien de gastroenterologie》2008,22(1):69-70
A 79-year-old woman with a fistula between a subphrenic abscess and the fundus of the stomach was successfully treated with n-Butyl-2-Cyanoacrylate. Conservative management had failed. Clinical presentation, treatment progress and imaging findings by computed tomography scan, ultrasound, gastroscopy and fluoroscopy are presented, along with a brief review of the relevant literature. 相似文献
60.
Srivenu?Itha Ashish?Kumar Sadhna?Dhingra Gourdas?ChoudhuriEmail author 《BMC gastroenterology》2003,3(1):21