Publications by authors named "Isha Puri"
We present an unusual case of complement-mediated thrombotic microangiopathy (formerly known as atypical hemolytic uremic syndrome) associated with inflammatory disease in a young patient. A 26-year-old male patient with no significant past medical history presented to our emergency department with a four-week history of diffuse, moderate, cramping, non-radiating abdominal pain with no known aggravating or relieving factors. Abdominal pain was associated with nausea, vomiting, and bloody stools.
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- Octreotide is a synthetic version of somatostatin that helps inhibit hormones like growth hormone and insulin, and is used in conditions such as acromegaly and carcinoid tumors.
- A 44-year-old man with type 2 diabetes and advanced kidney disease experienced severe hypoglycemia from sulfonylureas and was treated with octreotide, which unfortunately caused hyperkalemia as a side effect.
- This case underscores the risks of using octreotide in patients with renal impairment, highlighting the need for careful monitoring of potassium levels to prevent serious complications.
Context: Adjuvant radiation therapy plays an important role in the management of high-risk cervical cancer after radical hysterectomy or inadvertent hysterectomy. The prime concern with the use of dual modality is steep decline in sexual well-being in cervical cancer survivors. Intravaginal brachytherapy (IVBT) delivered by vaginal cylinder or ovoids is essential for local control but at the cost of impairment of sexual function.
View Article and Find Full Text PDFOgilvie's syndrome, also known as acute colonic pseudo-obstruction (ACPO), is a rare, nonobstructive dilation of the colon of unclear etiology. We present the case of a patient who presented with Ogilvie's syndrome and significant hypokalemia due to colonic loss despite repletion. This case report demonstrates the difficulty in diagnosis, treatment, and outcome.
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- The COVID-19 pandemic has strained healthcare systems worldwide, especially in low- and middle-income countries like Nepal, where resources are limited and most patients remain in home isolation.
- To address this, Himalaya Home Care (HHC) was established to provide monitoring and counseling for home-isolated COVID-19 patients using a team of healthcare professionals.
- Results from 5823 patients indicated high satisfaction rates, with 98.4% reporting that HHC helped avoid hospitalizations, 76.5% feeling capable of managing their symptoms at home, and 69.5% believing counseling reduced COVID-19 spread in their households.
Background: Low ionized calcium (I) is prevalent and prognostic in critical care, but poorly detected by either total calcium (T) or albumin-corrected T (cT). We recently derived models of I (Pred-I) and low I (Prob) in critical care that adjust T for binding to albumin and small anions-represented by the anion gap's components. On internal validation, they outperformed cT in diagnosing low I.
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- - Cancers in the head-and-neck region are increasingly common, especially in developing countries, with this study focusing on 48 cases over a year.
- - The research found a high male-to-female ratio of 4.33:1, with most patients in their 70s, and the majority of tumors were squamous cell carcinomas.
- - Effective treatment of metastatic neck disease involves targeting both visible and hidden cancerous areas, utilizing radiation and modified surgery to reduce recurrences and lower patient morbidity.
The widely used Modification of Diet in Renal Disease (MDRD) formula adapts a 1.212 multiplier for individuals who are identified as African Americans (AAs) or Blacks, which leads to a higher GFR estimation. As it stands, AAs have a lower prevalence of chronic kidney disease (CKD) but higher incidence of end-stage renal disease (ESRD) compared with Whites.
View Article and Find Full Text PDFBackground: Ionized hypocalcemia is common in critically ill patients with COVID-19 and is associated with adverse outcomes. We previously developed a linear model that estimates ionized calcium (I) by adjusting total calcium (T) for the three components of the anion gap and albumin. On internal validation, it outperformed the popular method that corrects T for albumin alone (cT) in diagnosing low I.
View Article and Find Full Text PDFTumor lysis syndrome (TLS) is an oncological emergency characterized by a classic tetrad of hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Risk assessment and prophylactic therapy is critical in preventing this oncological emergency. Treatment of established TLS involves aggressive hydration, electrolyte management, and the use of hypouricemic agents.
View Article and Find Full Text PDFPurpose Of Review: Renal replacement therapies, such as hemodialysis are invasive and impose significant financial burden as well as burden on quality of life. Conservative and 'gentler' forms of renal replacement therapy for the frail and palliative care patient is an unmet medical need.
Recent Findings: The treatment of uremia using the gut as a substitute for the kidney has been proposed but is not practiced widely because of proven lack of long-term mortality benefit coupled with complications like edema and hyperchloremia.
A System for Accurate Tracking and Video Recordings of Rodent Eye Movements using Convolutional Neural Networks for Biomedical Image Segmentation.
Annu Int Conf IEEE Eng Med Biol Soc
July 2018
Research in neuroscience and vision science relies heavily on careful measurements of animal subject's gaze direction. Rodents are the most widely studied animal subjects for such research because of their economic advantage and hardiness. Recently, video based eye trackers that use image processing techniques have become a popular option for gaze tracking because they are easy to use and are completely noninvasive.
View Article and Find Full Text PDFObjective: To determine the relative effect and quantify the impact of multiple prognostic variables on median overall survival time among cohorts of patients with advanced or recurrent endometrial cancer undergoing cytoreductive surgery.
Methods: Fourteen retrospective cohorts with advanced or recurrent endometrial cancer (672 patients) meeting study inclusion criteria were identified. Univariate analysis was used to assess the effect on median overall survival time of multiple variables.
Background: Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined.
Methods: The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001-2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990-2000.
Amniotic fluid embolism-risk factors, maternal and neonatal outcomes.
J Matern Fetal Neonatal Med
May 2009
Article Synopsis
- The study examined cases of amniotic fluid embolism in New Jersey between 1997-2005, focusing on demographics, risk factors, and outcomes for mothers and newborns.
- A total of 45 cases were found in over a million deliveries, indicating a prevalence of 1 in 22,313 pregnancies, with significant associations to factors like multifetal pregnancies and cesarean sections.
- The study reported higher rates of maternal complications and neonatal issues, but noted that mortality rates were lower than in past studies, likely due to improvements in healthcare.
Characteristics of obstetric intensive care unit admissions in New Jersey.
J Matern Fetal Neonatal Med
September 2009
Article Synopsis
- - The study analyzed ICU admissions among pregnant women in New Jersey from 1997 to 2005, noting that 1.54% of pregnancies resulted in ICU admissions and 0.15% led to maternal deaths.
- - Key demographic factors such as maternal age, race, and smoking significantly influenced the likelihood of ICU admission, with pregnancy complications like preeclampsia and diabetes identified as strong predictors.
- - Infants born to mothers who were admitted to the ICU faced worse outcomes, including higher rates of NICU admissions and lower Apgar scores, highlighting the impact of maternal health on neonatal care.
Objective: We sought to determine the value of conization margin status in predicting residual and recurrent adenocarcinoma in situ (ACIS) of the cervix.
Study Design: In all, 33 studies (1278 patients) were identified. Metaanalysis with pooled Mantel-Haenszel odds ratio (OR) was used to compare the risk of residual and recurrent disease according to margin status.
Article Synopsis
- The study aimed to evaluate how various factors affect survival time after recurrence in patients with recurrent ovarian cancer who have undergone cytoreductive surgery.
- The analysis included 1,999 patients from 40 cohorts, considering variables like age, disease-free interval, and the proportion of patients receiving complete cytoreductive surgery.
- Results indicated that the only significant factor improving survival was the proportion of patients who had complete surgery, where an increase of 10% in this group correlated to an approximate 3-month increase in median survival.