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Search Results: 1 - 10 of 455 matches for " Neeraj Badjatia "
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Shivering: scores and protocols
Neeraj Badjatia
Critical Care , 2012, DOI: 10.1186/cc11267
Nutritional support and brain tissue glucose metabolism in poor-grade SAH: a retrospective observational study
J Michael Schmidt, Jan Claassen, Sang-Bae Ko, Hector Lantigua, Mary Presciutti, Kiwon Lee, E Sander Connolly, Stephan A Mayer, David S Seres, Neeraj Badjatia
Critical Care , 2012, DOI: 10.1186/cc11160
Abstract: We used a retrospective observational cohort study of 50 mechanically ventilated poor-grade (Hunt-Hess 4 or 5) aneurysmal SAH patients who underwent brain microdialysis monitoring for an average of 109 hours. Enteral nutrition was started within 72 hours of admission whenever feasible. Intensive insulin therapy was used to maintain serum glucose levels between 5.5 and 7.8 mmol/l. Serum glucose, insulin and caloric intake from enteral tube feeds, dextrose and propofol were recorded hourly. Cerebral metabolic distress was defined as a lactate to pyruvate ratio (LPR) > 40. Time-series data were analyzed using a general linear model extended by generalized estimation equations (GEE).Daily mean caloric intake received was 13.8 ± 6.9 cal/kg and mean serum glucose was 7.9 ± 1 mmol/l. A total of 32% of hourly recordings indicated a state of metabolic distress and < 1% indicated a state of critical brain hypoglycemia (< 0.2 mmol/l). Calories received from enteral tube feeds were associated with higher serum glucose concentrations (Wald = 6.07, P = 0.048), more insulin administered (Wald = 108, P < 0.001), higher body mass index (Wald = 213.47, P < 0.001), and lower body temperature (Wald = 4.1, P = 0.043). Enteral feeding (Wald = 1.743, P = 0.418) was not related to brain glucose concentrations after accounting for serum glucose concentrations (Wald = 67.41, P < 0.001). In the presence of metabolic distress, increased insulin administration was associated with a relative reduction of interstitial brain glucose concentrations (Wald = 8.26, P = 0.017), independent of serum glucose levels.In the presence of metabolic distress, insulin administration is associated with reductions in brain glucose concentration that are independent of serum glucose levels. Further study is needed to understand how nutritional support and insulin administration can be optimized to minimize secondary injury after subarachnoid hemorrhage.Hyperglycemia, defined as serum glucose > 11 mmol/l after suba
Effects of the neurological wake-up test on clinical examination, intracranial pressure, brain metabolism and brain tissue oxygenation in severely brain-injured patients
Raimund Helbok, Pedro Kurtz, Michael J Schmidt, Morgan R Stuart, Luis Fernandez, Sander E Connolly, Kiwon Lee, Erich Schmutzhard, Stephan A Mayer, Jan Claassen, Neeraj Badjatia
Critical Care , 2012, DOI: 10.1186/cc11880
Abstract: This prospective observational study was performed in a neuroscience intensive care unit in a tertiary-care academic center. Twenty consecutive severely brain-injured patients with multimodal neuromonitoring were analyzed for levels of brain lactate, pyruvate and glucose, intracranial pressure (ICP), cerebral perfusion pressure (CPP) and brain tissue oxygen tension (PbtO2) during IS trials.Of the 82 trial days, 54 IS-trials were performed as interruption of sedation and analgesics were not considered safe on 28 days (34%). An increase in the FOUR Score (Full Outline of UnResponsiveness score) was observed in 50% of IS-trials by a median of three (two to four) points. Detection of a new neurologic deficit occurred in one trial (2%), and in one-third of IS-trials the trial had to be stopped due to an ICP-crisis (> 20 mmHg), agitation or systemic desaturation. In IS-trials that had to be aborted, a significant increase in ICP and decrease in PbtO2 (P < 0.05), including 67% with critical values of PbtO2 < 20 mmHg, a tendency to brain metabolic distress (P < 0.07) was observed.Interruption of sedation revealed new relevant clinical information in only one trial and a large number of trials could not be performed or had to be stopped due to safety issues. Weighing pros and cons of IS-trials in patients with acute brain injury seems important as related side effects may overcome the clinical benefit.Titrating sedatives and analgesics to achieve the right balance between deep sedation and wakefulness and to ameliorate patients' comfort in the intensive care unit (ICU) is an integral part of critical care [1]. Over-sedation can lead to prolonged duration of mechanical ventilation and ICU stay and increase the incidence of secondary complications, including nosocomial infections and delirium.Daily interruption of sedation trials (IS-trials) have been implemented in many surgical and medical ICUs after randomized controlled trials demonstrated that IS decreased the duration of
Investigation of Crystallization Kinetics in Glassy Se and Binary Se98M2 (M=Ag, Cd, Zn) Alloys Using DSC Technique in Non-Isothermal Mode  [PDF]
Chandrabhan Dohare, Neeraj Mehta
Journal of Crystallization Process and Technology (JCPT) , 2012, DOI: 10.4236/jcpt.2012.24025
Abstract: The crystallization kinetics of glassy Se and binary Se98M2 (M=Ag, Cd, Zn) alloys have been studied at different heating rates (5, 10, 15, 20 Kmin-1) using Differential Scanning Calorimetric (DSC) technique. The crystallization temperature (Tc) is determined from exothermic peak obtained in DSC scans of present samples. The variation in peak crystallization temperature (Tc) with the heating rate (β) has been used to investigate the growth kinetics using Kissinger, Augis-Bennet and Matusita-Sakka models. The activation energy of crystallization (Ec) has been found to increase with Ag additive and to decrease with Zn and Cd additive. The value of various kinetic parameters such as rate constant (Kp), Avrami index (n), thermal stability (S) and Hruby number (Hr) have been calculated under non-isothermal mode. The maximum change in different kinetic parameters has been found after the incorporation of Ag additive.
Hypergammaglobulinemic purpura of waldenstorm associated with sjogren’s syndrome in a young female responding to rituximab treatment  [PDF]
Neeraj Jain, Lalit Duggal
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.22034

Hypergammaglobulinemic Purpura of Waldenstorm is one of the uncommon conditions with purpura and is often associated with collagen vascular disease. It is difficult to treat and sometimes needs anti CD 20 molecules for resistant cases.

Prevalence of Ringing Delusion among Mobile Phone Users  [PDF]
Neeraj Kumar, Raees A. Khan
E-Health Telecommunication Systems and Networks (ETSN) , 2012, DOI: 10.4236/etsn.2012.14006
Abstract: The exponential application of mobile technology has led to a concern about implications of electromagnetic radiation on human health. As we are aware that mobile phone radiates EMR when users communicate to others and that time subscribers of the device are regularly exposed nearby 40% - 50% of total mobile irradiation. We analyzed the risk of \"Ringing Delusion\" among normal users, moderate users and heavy users when compared to low users. Although the \"Ringing Delusion\" has not been added in medical terminology but we found frequently such kind of symptoms among mobile phone users. \"Ringing Delusion\" may be considered as an imagination of ringing voice from cellular phone. The risk was also compared between urban and rural, male and female and adult and children population. The information was gathered through well designed questionnaires for cellular user’s demographic and social characteristics, adopted safety measures and calling duration. Prevalence of “Ringing Delusion” among rural users was higher than the urban users. A trend for the risk was also observed in male users in comparison to female. Study may support innovators to re-examine health effects of mobile phones.
Commiphora wightii (Arnott) Bhandari—A Natural Source of Guggulsterone: Facing a High Risk of Extinction in Its Natural Habitat  [PDF]
Neeraj Jain, Rajani S. Nadgauda
American Journal of Plant Sciences (AJPS) , 2013, DOI: 10.4236/ajps.2013.46A009

The plants are the primary producers and an indispensible source of food and nutrition, medicine and fuel/biofuel. Unsustainable overharvesting and indiscriminate felling of plants due to ever increasing needs of population pressure are causes of great concern. The IUCN includes, the species facing a high risk of extinction in the wild as threatened, and “endangered” is one of the sub-categories under “threatened” category. Commiphora wightii (Arnott) Bhandari is an arid region plant, highly valued for its medicinally important guggul gum-resin as a source of guggulsterone. It is listed in IUCN’s Red Data List of threatened plants and now it is becoming endangered. Its population is fast depleting in its natural habitat, primarily due to over-exploitation, unsustainable and destructive methods of gum-extraction coupled with natural dry-arid habitat, slow growth and poor regeneration of the plant. Several other reasons have also been indicated for its declining population. Therefore, it demands severe measures for its conservation before we completely lose this important medicinal plant. A lot of research and study is underway but has vast scope for improvement, requiring efforts to supplement with such information that would aid transgenic development and breeding programmes for production and cultivation of improved varieties. The article presents the importance of this plant and its conservation in a nut-shell.

Green Communication: An Effective Approach to Minimize Risk of Forgetfulness from Mobile Phone Usage  [PDF]
Aditi Mishra, Neeraj Kumar Tiwari
E-Health Telecommunication Systems and Networks (ETSN) , 2014, DOI: 10.4236/etsn.2014.31001

The usage of mobile-phone among children increased significantly. Children are in their growing phase and cells of their body are rapidly dividing, therefore propagation of electro-magnetic (EM) radiation occurs quickly in children. The aim of the present study was to evaluate the extent of mobile-phone usage as well as its possible health effect. A total number of 455 (398 children and 57 adults, 396 urban and 59 rural) students of age group ranging from 10-29 years participated in this study. An “Information Gathering Chronological (IGC) model” was used for the collection and evaluation of information. The four major parameters, i.e. demographic and public uniqueness, mobile-phone consumption patterns, grievance of the “forgetfulness” symptom to the subjects and awareness about the safety measures were included to get the concise information from participants. We have observed that the prevalence of “forgetfulness” was 23.95% among mobile-phone users. The incidence of overall “forgetfulness” symptoms was 23.59%, 17.46%, 25.00% and 37.50% in low (LU), normal (NU), moderate (MU) and heavy (HU) mobile-phone users respectively. A trend for risk for “forgetfulness” was observed in HU as compared to LU in overall mobile-phone users. Three folds and nearly five folds increased risk for “forgetfulness” was found among HU as compared to LU in children (p ≤ 0.0210) and urban area mobile-phone users respectively. No significant difference for “forgetfulness” symptoms was found in other categories (i.e. adult and rural mobile-phone users). These results suggested that the incidences of “forgetfulness” among children from urban area mobile-phone users were significantly increased.

Primary Oral Malignant Melanoma: Two Case Reports and Review of Literature
Neeraj Sharma
Case Reports in Dentistry , 2012, DOI: 10.1155/2012/975358
Abstract: Primary malignant melanoma of the oral cavity is a rare neoplasm. The tumors tend to metastasize or locally invade tissue more readily than other malignant tumors in the oral region. The survival of patients with mucosal melanomas is less than for those with cutaneous melanomas. Tumor size and metastases are related to the prognosis of the disease. Early detection, therefore, is important.
Nutritional management of acute and chronic liver disease
Saraf Neeraj
Hepatitis B Annual , 2008,
Abstract: Malnutrition is prevalent in all forms of liver diseases. A number of factors contribute to malnutrition in patients with hepatic failure. Early diagnosis of malnutrition is essential to allow appropriate treatment, since malnutrition is an important predictor of complications of liver disease and mortality. Disease-specific nutritional therapy should be considered for acute liver failure, sepsis, transplantation, and encephalopathy. This article provides an overview of the nutritional management of acute and chronic liver disease and discusses the need for further intervention studies before appropriate rational treatment guidelines can be formulated.
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