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1. Synthesis, characterization and spectroscopic studies of the dihydrobis(1,2,3-benzotriazolyl)borate anion and its complexes with MCl2·py2

Author

KHWAJA S. SIDDIQI, SADAF KHAN, SHAHAB A. A. NAMI, and AHMAD UMAR

Subjects
borate, transition metal complexes, spectroscopy, Chemistry, QD1-999
Abstract

The preparation of sodium dihydrobis(1,2,3-benzotriazolyl)borate was realised by refluxing one mole of sodium borohydride with two moles of 1,2,3-benzotriazole in toluene over a period of 12 h. Its complexes with MCl2·py2 [whereM=Mn(II), Fe(II), Co(II), Ni(II), Cu(II) and py=pyridine] were characterized by elemental analysis as well as magnetic, spectroscopic and conductivity measurements. On the basis of these studies, it is proposed that the geometry of all the complexes is octahedral. The ligand field parameters 10 Dq, B and b show extensive overlap between the M–L orbital. The molar conductance of 10-3 M solutions of the complexes in DMSO suggest them to be non-ionic in nature.

Published
2006

17. Isoniazid hair concentrations in children with tuberculosis: a proof of concept study

Author

Mave, V, Chandanwale, A, Kinikar, A, Khadse, S, Kagal, A, Gupte, N, Suryavanshi, N, Nimkar, S, Koli, H, Khwaja, S, Bharadwaj, R, Joshi, S, Horng, H, Benet, LZ, Ramachandran, G, Dooley, KE, Gupta, A, and Gandhi, M

Subjects
Pharmacology and Pharmaceutical Sciences, Biomedical and Clinical Sciences, Rare Diseases, Orphan Drug, Infectious Diseases, Pediatric, Tuberculosis, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Development of treatments and therapeutic interventions, 5.1 Pharmaceuticals, Good Health and Well Being, Antitubercular Agents, Child, Child, Preschool, Chromatography, Liquid, Drug Monitoring, Female, Hair, Humans, Isoniazid, Longitudinal Studies, Male, Patient Compliance, Proof of Concept Study, Prospective Studies, Tandem Mass Spectrometry, tuberculosis, paediatric TB, therapeutic drug monitoring, isoniazid drug concentrations, hair assays, Cardiorespiratory Medicine and Haematology, Microbiology, Cardiovascular medicine and haematology, Clinical sciences, Epidemiology
Abstract

Assessing treatment adherence and quantifying exposure to anti-tuberculosis drugs among children is challenging. We undertook a 'proof of concept' study to assess the drug concentrations of isoniazid (INH) in hair as a therapeutic drug monitoring tool. Children aged

Published
2016

19. S231 Rectal and Anal Ulceration: Analysis of Demographic Trends, Comorbidity Measures, and Outcomes from the National Inpatient Sample Database

Author

Haq, Khwaja S., primary, Solanki, Dhanshree, additional, Ugonabo, Onyinye, additional, Memon, Adil, additional, Iqbal, Unzela, additional, Rajwana, Yasir R., additional, Khan, Zarak H., additional, Ogude, Derick, additional, Varghese, Teresa, additional, Solanki, Shantanu, additional, Khan, Muhammad Ali, additional, Chandra Chakinala, Raja, additional, Jafri, Syed-Mohammed, additional, and Gbadehan, Emmanuel, additional

Published
2023
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20. The role of a mobile hearing application in secondary care ENT (HAppENT).

Author

Thompson, G, Abdelhamid, A, Khudan, A, Dobbs, S, Suleman, M T, Salem, O M, and Khwaja, S

Subjects
HEARING disorder diagnosis, AUDITORY perception testing, RESEARCH, EXPERIMENTAL design, MOBILE apps, SENSORINEURAL hearing loss, COMPARATIVE studies, AUDIOMETRY, DECISION making in clinical medicine, SECONDARY care (Medicine), LONGITUDINAL method
Abstract

Objective: Sudden hearing loss is a common presentation to ENT. In the authors' practice, patients often wait many weeks for formal hearing testing. This study aimed to assess whether a tablet-based hearing test, hearTest, could aid clinical decision-making within secondary care ENT. Method: This was a multi-centre, prospective, non-randomised study to assess the feasibility, usability and accuracy of hearTest. Results: In the sample, hearTest was shown to be an acceptable method of testing for hearing loss by both patients and clinicians. The 0.5–4 kHz range had an average clinical agreement rate of 95.1 per cent when compared with formal pure tone audiometry, deeming it an accurate test to diagnose hearing loss. Conclusion: The authors propose that hearTest can be used within ENT as a clinical decision support tool when manual audiometry is not immediately available. Within the authors' practice, hearTest is used to aid diagnosis and management of sudden sensorineural hearing loss. [ABSTRACT FROM AUTHOR]

Published
2024
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21. A low-cost prosthetic orbital simulation model for endoscopic anterior ethmoid artery ligation.

Author

Yapp, J, Sebastian, R, and Khwaja, S

Subjects
PARANASAL sinus surgery, NOSEBLEED, ENDOSCOPIC surgery, PARANASAL sinuses, NATIONAL health services, ENDOSCOPY, LIGATURE (Surgery), OPHTHALMIC artery, ORBITAL diseases
Abstract

Objective: This study aimed to develop and evaluate a low-cost orbital prosthesis for simulation of endoscopically assisted intra-orbital anterior ethmoidal artery ligation. Methods: A low-cost orbital prosthesis was built and evaluated by ENT surgical trainees. Feedback was given following the assessment in the form of a face validity questionnaire. Results: Results were scored on a Likert scale of 1–7 (low to high). Trainees had limited exposure to the procedure (40 per cent) and predominantly low levels of confidence (mean, 3.67) that correlated with a lack of first-hand experience. The anatomy and likeness to human tissue of the prosthesis were both ranked highly, with mean scores of 5.0 and 4.93, respectively. Conclusion: The results of this study support the idea that a simple anatomical prosthesis for the simulation of endoscopic anterior ethmoidal artery ligation can be created with potential value to otolaryngology surgical training. To the authors' knowledge, this is the first documentation of simulated surgical epistaxis management using an artificial anatomical model. [ABSTRACT FROM AUTHOR]

Published
2023
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22. The burden of olfactory dysfunction during the COVID-19 pandemic in the United Kingdom

Author

Lechner, M., primary, Liu, J., additional, Counsell, N., additional, Gillespie, D., additional, Chandrasekharan, D., additional, Ta, N.H., additional, Jumani, K., additional, Gupta, R., additional, Rocke, J., additional, Williams, C., additional, Tetteh, A., additional, Amnolsingh, R., additional, Khwaja, S., additional, Batterham, R.L., additional, Yan, C.H., additional, Treibel, T.A., additional, Moon, J.C., additional, Woods, J., additional, Brunton, R., additional, Boardman, J., additional, Hatter, M., additional, Abdelwahab, M., additional, Holsinger, F.C., additional, Capasso, R., additional, Nayak, J.V., additional, Wang, P.H., additional, Paun, S., additional, Eynon-Lewis, N., additional, Kumar, B.N., additional, Jayaraj, S., additional, Hopkins, C., additional, Philpott, C., additional, and Lund, V.J., additional

Published
2022
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23. S688 Acute Gastrojejunal Ulcer With Hemorrhage: Nationwide Trends in Hospitalization, Demographic Disparity, Cost of Care, and Outcomes

Author

Solanki, Shantanu, primary, Haq, Khwaja S., additional, Solanki, Dhanshree, additional, Burney, Anam S., additional, Shah, Harshil, additional, Ghimire, Subash, additional, Kichloo, Asim, additional, Khan, Zarak, additional, Wani, Farah, additional, Yuridullah, Ruhin, additional, Dahiya, Dushyant S., additional, Memon, Adil I., additional, Khan, Hafiz M., additional, Haq, Khwaja F., additional, and Jafri, Syed-Mohammed, additional

Published
2022
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24. S103 Choleperitonitis: A Relatively Rare but Potentially Fatal Entity Encountered in the U.S. Hospitals

Author

Solanki, Shantanu, primary, Solanki, Dhanshree, additional, Haq, Khwaja S., additional, Burney, Anam S., additional, Kichloo, Asim, additional, Dahiya, Dushyant S., additional, Wani, Farah, additional, Mansuri, Uvesh, additional, Patel, Achint, additional, Kapuria, Progga P., additional, Qureshi, Ammar, additional, Memon, Adil I., additional, Khan, Muhammad Ali, additional, Haq, Khwaja F., additional, and Jafri, Syed-Mohammed, additional

Published
2022
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25. S1641 Infection Due to Gastric Band Procedure: Descriptive Analysis of Trends in U.S. Hospitalizations

Author

Solanki, Shantanu, primary, Solanki, Dhanshree, additional, Haq, Khwaja S., additional, Burney, Anam S., additional, Kichloo, Asim, additional, Wani, Farah, additional, Mansuri, Uvesh, additional, Sharma, Purnima, additional, Patel, Anjali, additional, Memon, Adil I., additional, Qureshi, Ammar, additional, Khan, Zarak, additional, Khan, Hafiz M., additional, Haq, Khwaja F., additional, and Jafri, Syed-Mohammed, additional

Published
2022
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28. Assessment of heavy metals in cyprinid fishes: Rivers of district Khuzdar Balochistan Pakistan

Author

Gurganari, L., Dastageer, G., Mushtaq, R., Khwaja, S., Uddin, S., Baloch, M. I., and Hasni, S.

Subjects
fish, ciprinídeo, river, intestino, gut, rio, heavy metals, metais pesados, biodiversidade, biodiversity, cyprinid, peixe
Abstract

The present study was conducted to measured heavy metals in cyprinid fishes in rivers of District Khuzdar Balochistan, Pakistan. In the present study, 25 fish samples were collected that belonged to 8 order of 13 families, The Cyprinidae family had the largest number of eight fish species. Present study is focused on Heavy metals in cyprinid fishes. Heavy metals accumulation like Zinc, Manganese, Copper, and Nickel was evaluated in water and various organs of fishes. Atomic Absorption Spectroscopy was used for the identification of these heavy metals in fish species and water bodies. The average concentration (mg/L) of Zn 0.26-0.41, Mn 0.030- 0.073, Cu 0.017—0.080 and NI 0.14-0.79 were observed in water. The Concentration (mg/L), of Zn Conc 0.383-.028 Mn Conc .073- .030 Cu Conc 080-.017 NI Conc .79-.14. The concentration of heavy metals was found both similar and varied simultaneously across the whole research area. Zinc concentration was reported highest, whereas Copper was at the lowest concentration in all fish species .The concentration of heavy metals, in all the fish species under this study, was above the threshold of WHO limits. Resumo O presente estudo foi realizado para medir metais pesados em peixes ciprinídeos em rios do Distrito Khuzdar Balochistan, Paquistão. No presente estudo, foram coletadas 25 amostras de peixes pertencentes a 8 ordens de 13 famílias. A família Cyprinidae apresentou o maior número de oito espécies de peixes. O presente estudo está focado em metais pesados em peixes ciprinídeos. O acúmulo de metais pesados como zinco, manganês, cobre e níquel foi avaliado na água e em vários órgãos dos peixes. A Espectroscopia de Absorção Atômica foi utilizada para a identificação desses metais pesados em espécies de peixes e corpos d’água. A concentração em água ((mg/L),) Zn Conc. 0,383-.028 Mn Conc. .073- .030 Cu Conc. 080-.017 NI Conc. 0,79-.14. A concentração de metais pesados foi considerada semelhante e variou simultaneamente em toda a área de pesquisa. A concentração de zinco foi relatada mais alta, enquanto o cobre estava na concentração mais baixa em todas as espécies de peixes. A concentração de metais pesados, em todas as espécies de peixes neste estudo, estava acima do limite dos limites da Organização Mundial da Saúde (OMS).

Published
2022

29. Multidisciplinary management of laryngeal pathology identified in patients with COVID-19 following trans-laryngeal intubation and tracheostomy.

Author

Boggiano, S, Williams, T, Gill, SE, Alexander, PD, Khwaja, S, Wallace, S, McGrath, BA, Boggiano, S, Williams, T, Gill, SE, Alexander, PD, Khwaja, S, Wallace, S, and McGrath, BA

Abstract

BACKGROUND: COVID-19 disease often requires invasive ventilatory support. Trans-laryngeal intubation of the trachea may cause laryngeal injury, possibly compounded by coronavirus infection. Fibreoptic Endoscopic Evaluation of Swallowing (FEES) provides anatomical and functional assessment of the larynx, guiding multidisciplinary management. Our aims were to observe the nature of laryngeal abnormalities in patients with COVID-19 following prolonged trans-laryngeal intubation and tracheostomy, and to describe their impact on functional laryngeal outcomes, such as tracheostomy weaning. METHODS: A retrospective observational cohort analysis was undertaken between March and December 2020, at a UK tertiary hospital. The Speech and Language Therapy team assessed patients recovering from COVID-19 with voice/swallowing problems identified following trans-laryngeal intubation or tracheostomy using FEES. Laryngeal pathology, treatments, and outcomes relating to tracheostomy and oral feeding were noted. RESULTS: Twenty-five FEES performed on 16 patients identified a median of 3 (IQR 2-4) laryngeal abnormalities, with 63% considered clinically significant. Most common pathologies were: oedema (n = 12, 75%); abnormal movement (n = 12, 75%); atypical lesions (n = 11, 69%); and erythema (n = 6, 38%). FEES influenced management: identifying silent aspiration (88% of patients who aspirated (n = 8)), airway patency issues impacting tracheostomy weaning (n = 8, 50%), targeted dysphagia therapy (n = 7, 44%); ENT referral (n = 6, 38%) and reflux management (n = 5, 31%). CONCLUSIONS: FEES is beneficial in identifying occult pathologies and guiding management for laryngeal recovery. In our cohort, the incidence of laryngeal pathology was higher than a non-COVID-19 cohort with similar characteristics. We recommend multidisciplinary investigation and management of patients recovering from COVID-19 who required prolonged trans-laryngeal intubation and/or tracheostomy to optimise laryngeal rec

Published
2022

31. The COVANOS trial – insight into post-COVID olfactory dysfunction and the role of smell training

Author

Lechner, M., primary, Liu, J., additional, Counsell, N., additional, Gillespie, D., additional, Chandrasekharan, D., additional, Ta, N.H., additional, Jumani, K., additional, Gupta, R., additional, Rao-Merugumala, S., additional, Rocke, J., additional, Williams, C., additional, Tetteh, A., additional, Amnolsingh, R., additional, Khwaja, S., additional, Batterham, R.L., additional, Yan, C.H., additional, Treibel, T.A., additional, Moon, J.C., additional, Woods, J., additional, Brunton, R., additional, Boardman, J., additional, Paun, S., additional, Eynon-Lewis, N., additional, Kumar, B.N., additional, Jayaraj, S., additional, Hopkins, C., additional, Philpott, C., additional, and Lund, V.J., additional

Published
2022
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32. Performance of Xpert® MTB/RIF and Xpert® Ultra for the diagnosis of tuberculous meningitis in children

Author

Pradhan, N. N., primary, Paradkar, M. S., additional, Kagal, A., additional, Valvi, C., additional, Kinikar, A., additional, Khwaja, S., additional, Dhage, R., additional, Chandane, J., additional, Ithape, M., additional, Bendre, M., additional, Madewar, R., additional, Nadgeri, V., additional, Nijampurkar, A., additional, Jain, D., additional, Gupte, N., additional, Gupta, A., additional, Mave, V., additional, Dooley, K. E., additional, and Thakur, K. T., additional

Published
2022
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34. S1355 Sepsis in Hospitalizations With Short Bowel Syndrome: A 10-Year Analysis From the National Inpatient Sample Database

Author

Anjali Patel, M C Segovia, Dhanshree Solanki, Syed-Mohammed Jafri, Mohammed Asad Chishti, Khwaja S. Haq, Ammar Qureshi, Yervant Ichkhanian, Shantanu Solanki, Khwaja F. Haq, Hafiz Khan, Zarak Khan, Thomas D. Schiano, and Asim Kichloo

Subjects
Sepsis, medicine.medical_specialty, Hepatology, business.industry, Emergency medicine, Gastroenterology, Medicine, Sample (statistics), business, medicine.disease, Short bowel syndrome
Published
2021
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39. S22 Endoscopic Retrograde Cholangiopancreatography in the Elderly: Trends, Demographic Variations, Complications, and Outcomes

Author

Ratna Joshi, Uvesh Mansuri, Asim Kichloo, Shantanu Solanki, Mohammed Asad Chishti, Khwaja F. Haq, Khwaja S. Haq, Zarak Khan, Amie Patel, Jagmeet P. Singh, Ammar Qureshi, Dhanshree Solanki, and Syed-Mohammed Jafri

Subjects
medicine.medical_specialty, Endoscopic retrograde cholangiopancreatography, Hepatology, medicine.diagnostic_test, business.industry, General surgery, Gastroenterology, Medicine, business
Published
2021
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40. S1057 Endoscopic Retrograde Cholangiopancreatography (ERCP) in Patients With Bariatric Surgery: A Propensity-Matched Analysis

Author

Achint Patel, Shantanu Solanki, Khwaja F. Haq, Farah Wani, Dhanshree Solanki, Shania Chishti, Hafiz Khan, Khwaja S. Haq, Jagmeet P. Singh, Darshan Gandhi, Dushyant Singh Dahiya, and Asim Kichloo

Subjects
medicine.medical_specialty, Endoscopic retrograde cholangiopancreatography, Hepatology, medicine.diagnostic_test, business.industry, Propensity score matching, Gastroenterology, medicine, In patient, business, Surgery
Published
2021
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42. S1285 Gallstone Ileus: How Common Is the Uncommon? A Nationwide Perspective With Overview of Hospitalization Trends, Cost of Care, and Outcomes

Author

Haq, Khwaja F., primary, Solanki, Shantanu, additional, Khan, Zarak, additional, Chandra Chakinala, Raja, additional, Iqbal, Umair, additional, Bhurwal, Abhishek, additional, Siddiqui, Mohammad, additional, Khan, Zubair, additional, Haq, Khwaja S., additional, Burney, Azam, additional, Waqar, Shanza, additional, Khan, Muhammad Ali, additional, Suresh, Suraj, additional, Simmer, Stephen, additional, and Bhatti, Faiza, additional

Published
2020
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43. S0256 Malignant Carcinoid Tumors of the Appendix, Large Intestine, and Rectum: A Nationwide Analysis of Hospitalization Trends, Comorbidity Measures, Cost of Care, and Outcomes

Author

Haq, Khwaja F., primary, Chandra Chakinala, Raja, additional, Solanki, Shantanu, additional, Iqbal, Umair, additional, Bhurwal, Abhishek, additional, Kamal, Faisal, additional, Khan, Zubair, additional, Siddiqui, Mohammad, additional, Simmer, Stephen, additional, Khan, Muhammad Ali, additional, Haq, Khwaja S., additional, Khan, Zarak, additional, Burney, Azam, additional, Syed, Tausif, additional, Waqar, Shanza, additional, and Bhatti, Faiza, additional

Published
2020
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44. Dieulafoy's Lesion: Decade-Long Trends in Hospitalizations, Demographic Disparity, and Outcomes

Author

Chakinala, Raja Chandra, primary, Solanki, Shantanu, additional, Haq, Khwaja F, additional, Singh, Jagmeet, additional, Shah, Harshil, additional, Solanki, Dhanshree, additional, Kichloo, Asim, additional, Haq, Khwaja S, additional, Burney, Azam H, additional, Waqar, Shanza, additional, Vyas, Manasee, additional, Chugh, Savneek, additional, and Nabors, Christopher, additional

Published
2020
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45. Sa1014 WHAT IF IT'S STILL THERE? ANALYSIS OF HOSPITALIZATIONS WITH FOREIGN BODY IN THE INTESTINES AND COLON

Author

Solanki, Shantanu, primary, Haq, Khwaja F., additional, Iqbal, Umair, additional, Chakinala, Raja Chandra, additional, Bhurwal, Abhishek, additional, Kamal, Faisal, additional, Khan, Muhammad Ali, additional, Haq, Khwaja S., additional, Khan, Zubair, additional, Shah, Harshil, additional, Al-Shammari, Mustafa, additional, and Bhatti, Faiza, additional

Published
2020
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47. Comparison of ibuprofen, cyclobenzaprine or both in patients with acute cervical strain: a randomized controlled trial

Author

Khwaja, S. Mustafah, Minnerop, Max, and Singer, Adam J.

Subjects
Ibuprofen, Cyclobenzaprine, Traffic accidents, Pain -- Care and treatment, Health, Health care industry, Science and technology
Abstract

Objective: We compared pain severity and time to resumption of activities in patients with cervical strains treated with a nonsteroidal anti-inflammatory drug (NSAID), a centrally acting muscle relaxant or both. Methods: We performed a double-blinded, randomized controlled trial of adults with cervical strains from motor vehicle collisions or from falls who presented to a suburban academic emergency department (ED). Patients were randomly assigned to receive ibuprofen 800 mg, cyclobenzaprine 5 mg or both, 3 times daily as needed for up to 7 days. Outcome measures included a pain score on a 100-mm visual analog scale, pain relief scores, the time to resumption of normal activities, the use of rescue medications, and adverse outcomes. We used repeated-measures analysis of variance to compare pain relief over time. Our sample size of 20 patients in each group had a power of 80% to detect a difference of 15 mm in pain relief scores between the highest and lowest groups. Results: We randomly assigned 61 patients to receive ibuprofen (n= 20), cyclobenzaprine (n= 21) or both (n= 20). Mean (standard deviation) age was 34 (11) years; 58% were women and 72% were white. Although pain scores improved over time in all groups, there were no significant differences between the groups in any of the outcome measures. The rate of adverse events was also similar between groups. Conclusion: Our study suggests that there is little benefit to routinely using or adding cyclobenzaprine to NSAIDs for ED patients with acute cervical strain. Keywords: cervical strain, ibuprofen, cyclobenzaprine Objectif : Nous avons compare la gravite de la douleur et le temps de reprise des activites chez les patients presentant une entorse du rachis cervical et ayant ete traites avec un anti-inflammatoire non steroidien (AINS) ou un relaxant musculaire a action centrale, ou les deux. Methodes : Nous avons realise un essai controle randomise a double insu aupres d'adultes qui ont consulte le service d'urgence d'un centre hospitalier universitaire de banlieue pour une entorse du rachis cervical liee a un accident de vehicule automobile ou a une chute. Les participants ont ete repartis de facon aleatoire pour recevoir 800 mg d'ibuprofene, 5 mg de cyclobenzaprine, ou les deux, 3 fois par jour, au besoin, pour un maximum de 7 jours. Les principales mesures des resultats comprenaient le score de douleur sur une echelle visuelle analogique de 100 mm, les scores de soulagement de la douleur, le delai de reprise des activites normales, l'utilisation de medicaments de secours et les evenements indesirables. Nous avons utilise une analyse de variance a mesures repetees pour comparer le soulagement de la douleur dans le temps. Chaque groupe de 20 patients etait capable a 80 % de detecter une difference de 15 mm quant au score de gravite de la douleur entre le groupe le plus eleve et le groupe le plus bas. Resultats : Soixante et un patients ont ete repartis de facon aleatoire pour recevoir de l'ibuprofene (n = 20), de la cyclobenzaprine (n = 21) ou les deux (n = 20). L'age moyen etait de 34 ans (ecart-type, 11); 58 % etaient des femmes et 72 % etaient Blancs. Bien que les scores de douleur se soient ameliores au fil du temps pour tous les groupes, il n'y avait pas de differences significatives entre les groupes pour aucune des mesures de resultats. Le taux d'evenements indesirables etait egalement similaire pour tous les groupes. Conclusion : Notre etude indique qu'il y a peu d'avantages a prescrire la cyclobenzaprine ou a l'ajouter de facon routiniere aux AINS chez les patients se presentant a l'urgence pour une entorse du rachis cervical., INTRODUCTION In each year there are 13 million motor vehicle collisions (MVCs) in the United States and an estimated 500 000 to 1 million result in cervical strains. (1) The [...]

Published
2010

48. S1285 Gallstone Ileus: How Common Is the Uncommon? A Nationwide Perspective With Overview of Hospitalization Trends, Cost of Care, and Outcomes

Author

Shantanu Solanki, Zubair Khan, Khwaja S. Haq, Azam H. Burney, Suraj Suresh, Khwaja F. Haq, Muhammad Ali Khan, Zarak Khan, Umair Iqbal, Mohammad S. Siddiqui, Faiza Bhatti, Abhishek Bhurwal, Shanza Waqar, Raja Chandra Chakinala, and Stephen Simmer

Subjects
medicine.medical_specialty, Hepatology, business.industry, Gallstone ileus, Perspective (graphical), Gastroenterology, medicine, Intensive care medicine, business, Cost of care
Published
2020
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49. Gastrointestinal Hemorrhage in Acute Kidney Injury Patients on Hemodialysis

Author

Raja Chandra Chakinala, Darshan Gandhi, Shantanu Solanki, Khwaja S. Haq, Muhammad Ali Khan, Siddharth Mehta, Khwaja F. Haq, Uvesh Mansuri, Savneek Chugh, Jagmeet P. Singh, and Zubair Khan

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, medicine.medical_treatment, Population, acute kidney injury (aki), Disease, 030204 cardiovascular system & hematology, hemodialysis (hd), 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Epidemiology, gastrointestinal bleed (gib), medicine, Internal Medicine, education, education.field_of_study, business.industry, General Engineering, Acute kidney injury, Gastroenterology, Secondary diagnosis, medicine.disease, Nephrology, Hemodialysis, business, Cost of care, 030217 neurology & neurosurgery
Abstract

Background Gastrointestinal bleeding (GIB) has been reported to be more common in patients with chronic renal failure and end-stage renal disease requiring hemodialysis with higher mortality than in the general population. Limited epidemiological data exist on the annual number of hospitalizations, demographic variation, cost of care, and outcomes for GIB in patients with acute kidney injury (AKI) requiring and not requiring hemodialysis (HD). The main objective of this study was to analyze the trends of GIB in patients with AKI requiring HD and those not requiring HD during hospitalization. Methods and Results We analyzed the National (Nationwide) Inpatient Sample (NIS) database for all subjects with a discharge diagnosis of AKI as the primary or secondary diagnosis during the period from 2001 to 2011. Subjects with a discharge diagnosis of hemodialysis and GIB were then identified from the pool and trends were analyzed. A significant rise in the annual number of hospitalizations with AKI was found with a greater proportion being discharged without HD. From 2001 to 2011, there were 19,393,811 hospitalizations with a discharge diagnosis of AKI of which 1,424,692 (7.3%) received HD (HD group), whereas 17,969,119 (92.7%) did not receive HD (non-HD group) (p < 0.0001). The male gender was more commonly affected by GIB than the female gender in both groups (p < 0.0001). The cost of care per hospitalization for GIB patients in the HD group increased over the study period with average found to be $61,463 (adjusted for inflation, p < 0.0001), whereas for GIB patients in the non-HD group, it showed a slight decrease in trend with the average found to be $28,419 (p < 0.0001). All-cause mortality was higher for GIB patients in the HD group (38.1%) than in the non-HD group (25.1%) (p < 0.0001). Conclusions GIB is more common and associated with higher all-cause inpatient mortality in patients receiving HD in comparison to non-HD patients.

Published
2019

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