9 results on '"Niraj Gowda"'
Search Results
2. Dietary management of electrolytes in chronic kidney disease
- Author
-
Niraj Gowda, Sowmya Swamy, and Marijane Hynes
- Published
- 2021
3. Frequency and outcomes of gastrointestinal symptoms in patients with Corona Virus Disease-19
- Author
-
Brittney Gordon, Saadia Nawal, Marie L. Borum, David Yamane, WonSeok W. Choi, Hayley K. Rogers, Callie M. Rogers, Chinelo Onyilofor, and Niraj Gowda
- Subjects
Diarrhea ,medicine.medical_specialty ,Abdominal pain ,Gastrointestinal Diseases ,Nausea ,law.invention ,Betacoronavirus ,law ,Internal medicine ,medicine ,Humans ,Retrospective Studies ,Pandemic ,SARS-CoV-2 ,business.industry ,Gastroenterology ,Acute kidney injury ,COVID-19 ,Odds ratio ,Novel conrona virus ,medicine.disease ,Intensive care unit ,Hospitalized patients ,Confidence interval ,Vomiting ,Original Article ,medicine.symptom ,business - Abstract
Objectives To characterize the frequency and association of gastrointestinal (GI) symptoms with outcomes in patients with corona virus disease 2019 (COVID-19) admitted to the hospital. Methods Records were retrospectively collected from patients admitted to a tertiary care center in Washington, D.C., with confirmed COVID-19 from March 15, 2020 to July 15, 2020. After adjusting for clinical demographics and comorbidities, multivariate logistic regression analysis was performed. Results The most common presenting symptoms of COVID-19 in patients that were admitted to the hospital were cough (38.4%), shortness of breath (37.5%), and fever (34.3%), followed by GI symptoms in 25.9% of patients. The most common GI symptom was diarrhea (12.8%) followed by nausea or vomiting (10.5%), decreased appetite (9.3%), and abdominal pain (3.8%). Patients with diarrhea were more likely to die (odds ratio [OR] 2.750; p = 0.006; confidence interval [CI] 1.329–5.688), be admitted to the intensive care unit (ICU) (OR 2.242; p = 0.019; CI 1.139–4.413), and be intubated (OR 3.155; p = 0.002; CI 1.535–6.487). Additional outcomes analyzed were need for vasopressors, presence of shock, and acute kidney injury. Patients with diarrhea were 2.738 (p = 0.007; CI 1.325–5.658), 2.467 (p = 0.013; CI 1.209–5.035), and 2.694 (p = 0.007; CI 1.305–5.561) times more likely to experience these outcomes, respectively. Conclusions Screening questions should be expanded to include common GI symptoms in patients with COVID-19. Health care providers should note whether their patient is presenting with diarrhea due to the potential implications on disease severity and outcomes.
- Published
- 2021
4. Plant-based diets in chronic kidney disease: what does the evidence say?
- Author
-
Marijane Hynes, Ezra Lee, and Niraj Gowda
- Subjects
business.industry ,fungi ,food and beverages ,Medicine ,Physiology ,Plant based ,business ,medicine.disease ,Kidney disease ,End stage renal disease - Abstract
The prevention and treatment of chronic kidney disease can be managed not only with medical therapies, but also with dietary changes. Recent studies have shown that plant-based diets can slow disease progression and improve mortality
- Published
- 2021
5. Risk factors for Cesarean delivery in pregnancy with small‐for‐gestational‐age fetus undergoing induction of labor
- Author
-
Leah Bagiardi, Anthony Odibo, Rachel G. Sinkey, Chinedu Nwabuobi, Niraj Gowda, Michelle Kuznicki, Linda Odibo, Jourdan E. Schmitz, Hannah Camisasca-Lopina, Nicole Wood, and Anaisy Pargas
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Gestational Age ,Risk Assessment ,Sensitivity and Specificity ,Likelihood ratios in diagnostic testing ,03 medical and health sciences ,Fetal Heart ,0302 clinical medicine ,Predictive Value of Tests ,Pregnancy ,Risk Factors ,Clinical Decision Rules ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Labor, Induced ,030212 general & internal medicine ,reproductive and urinary physiology ,Retrospective Studies ,Fetus ,030219 obstetrics & reproductive medicine ,Radiological and Ultrasound Technology ,Cesarean Section ,business.industry ,Obstetrics ,Infant, Newborn ,Reproducibility of Results ,Obstetrics and Gynecology ,Gestational age ,Retrospective cohort study ,General Medicine ,medicine.disease ,Obstetric Labor Complications ,Fetal Diseases ,Fetal Weight ,Reproductive Medicine ,Area Under Curve ,Labor induction ,Infant, Small for Gestational Age ,Gestation ,Small for gestational age ,Female ,business ,Maternal Age - Abstract
Objectives To identify risk factors for Cesarean delivery and non-reassuring fetal heart tracing (NRFHT) in pregnancies with a small-for-gestational-age (SGA) fetus undergoing induction of labor and to design and validate a prediction model, combining antenatal and intrapartum variables known at the time of labor induction, to identify pregnancies at increased risk of Cesarean delivery. Methods This was a retrospective cohort study of non-anomalous, singleton gestations with a SGA fetus that underwent induction of labor, delivered in a single tertiary referral center between January 2011 and December 2016. SGA was defined as estimated fetal weight (EFW) Results A total of 594 pregnancies were included. Cesarean delivery was performed in 243 (40.9%) pregnancies. Significant risk factors associated with Cesarean delivery, and included in the final model, were maternal age, gestational age at delivery and initial method of labor induction. The bootstrap estimate of the AUC of the final prediction model for Cesarean delivery was 0.82 (95% CI, 0.78-0.86). The model had sensitivity of 64.2%, specificity of 86.9%, positive likelihood ratio (LR) of 4.9 and negative LR of 0.41. The model had good fit (P = 0.617). NRFHT complicated 117 (19.7%) pregnancies. Significant risk factors for NRFHT included EFW 95th percentile or absent/reversed end-diastolic flow) and gestational age at delivery. The final prediction model for NRFHT had an AUC of 0.69 (95% CI, 0.63-0.75) and specificity of 97.0%. Conclusion We identified several significant risk factors for Cesarean delivery and NRFHT among SGA pregnancies undergoing induction of labor. Clinicians may use these risk factors to guide patient counseling and to help anticipate the potential need for operative delivery. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
- Published
- 2020
6. Catheter-Directed Thrombolytic Therapy in the Management of Massive Pulmonary Embolism in Pregnancy
- Author
-
Judette Louis, Niraj Gowda, and Chinedu Nwabuobi
- Subjects
medicine.medical_specialty ,Percutaneous ,Computed Tomography Angiography ,medicine.medical_treatment ,Pregnancy Complications, Cardiovascular ,Embolectomy ,Fibrinolytic Agents ,Pregnancy ,medicine ,Humans ,Thrombolytic Therapy ,Thrombus ,Ultrasonography, Interventional ,Heparin ,business.industry ,Pregnancy Outcome ,Obstetrics and Gynecology ,Thrombolysis ,medicine.disease ,Pulmonary embolism ,Surgery ,Catheter ,Treatment Outcome ,Echocardiography ,Point-of-Care Testing ,Tissue Plasminogen Activator ,Female ,Pulmonary Embolism ,business ,medicine.drug - Abstract
Background Pulmonary embolism is one of the most common causes of maternal mortality and can be classified into low-risk, submassive, and massive. Three treatment options exist for massive pulmonary embolism in nonpregnant patients: thrombolysis, percutaneous catheter-based embolectomy, or surgical embolectomy; however, there is limited evidence to guide management of pulmonary embolism in pregnancy. Case We present a case of massive pulmonary embolism in pregnancy. Our patient presented with pulmonary embolism with biomarker and imaging evidence of right heart strain. She developed hypotension and an increased oxygen requirement and was subsequently treated with ultrasound-assisted catheter-directed thrombolysis. She was discharged on low-molecular-weight heparin and had a normal spontaneous vaginal delivery at 39 weeks of gestation. Conclusions Catheter-directed thrombolysis is preferred to systemic thrombolytic therapy in pregnant patients with massive pulmonary embolism requiring thrombus removal.
- Published
- 2019
7. Hair-Dye-Related Accidental Poisoning and Death
- Author
-
Joseph Delio, Amira Elshikh, Rahul Khosla, and Niraj Gowda
- Subjects
medicine.medical_specialty ,Systemic disease ,Angioedema ,business.industry ,angioedema ,General Engineering ,medicine.disease ,acute renal failure ,Para phenylenediamine ,Dermatology ,Allergy/Immunology ,Nephrology ,Hair dyes ,Internal Medicine ,rhabdomyolysis ,medicine ,Ingestion ,medicine.symptom ,Accidental poisoning ,para-phenylenediamine ,business ,Rhabdomyolysis - Abstract
Para phenylenediamine (PPD) is a common component of hair dye as well as temporary tattoos and is a well-known cause of type 4 hypersensitivity reactions from topical exposure. While there have been several cases reported in the literature describing toxicities following ingestion, there are a paucity of reports of severe systemic disease following topical exposure. Cases of PPD ingestion have been reported to present with angioedema-like reactions, often progressing to rhabdomyolysis and renal failure. To our knowledge, there have only been two reported cases of severe reactions following topical exposure to PPD. We present a case of a 59-year-old man with topical exposure to hair dye who presented with an angioedema-like reaction shortly after topical exposure to PPD containing hair dye that rapidly progressed to rhabdomyolysis, renal failure, and eventually death.
- Published
- 2021
8. EVALUATING APACHE AND SOFA SCORING SYSTEMS IN PATIENTS WITH COVID-19
- Author
-
Niraj Gowda, Ivy Benjenk, Gifty Dominah, David Yamane, Hayley K. Rogers, Amira Elshikh, and Suraj Gowda
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Critical Care ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Emergency medicine ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,business - Published
- 2021
9. Emphysematous osteomyelitis of the clavicle: a pleural process?
- Author
-
Robert B Maximos, Amira Elshikh, Lisa N Glass, and Niraj Gowda
- Subjects
medicine.medical_specialty ,medicine.drug_class ,business.industry ,Osteomyelitis ,Antibiotics ,Surgical debridement ,General Medicine ,Pleural cavity ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Rare Disease ,Clavicle ,medicine ,Fatal disease ,030212 general & internal medicine ,medicine.symptom ,Pectoralis Muscle ,business ,030217 neurology & neurosurgery ,Subcutaneous emphysema - Abstract
Emphysematous osteomyelitis (EO) is a rare infection associated with intraosseous gas. EO is an often fatal disease with an estimated 34% mortality. We present a case of a 63-year-old man with sternoclavicular EO with pleural involvement and significant subcutaneous emphysema diagnosed by CT. Extension of intraosseous gas into the pleural cavity is an extremely interesting presentation that has not been previously reported. The patient underwent a multidisciplinary treatment approach with surgical debridement and an extended antibiotic course. Intraoperative cultures of the pectoralis muscle and bone biopsy grew pan-sensitiveEscherichia coli. Prompt recognition and treatment are paramount to avoid a potentially fatal outcome. A review of the literature of the previous 46 cases of EO is presented for associated risk factors, the role of surgical management and antibiotic therapy.
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.