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Analysis of Cutaneous Adverse Drug Reactions at a Tertiary Care Hospital – a Prospective Study
SP Shah, MK Desai, RK Dikshit
Tropical Journal of Pharmaceutical Research , 2011,
Abstract: Purpose: To analyze the clinical, pharmacological and economical aspects of the cutaneous adverse drug reactions (ADRs) reported at Civil Hospital, Ahmedabad, India. Methods: A prospective observational study over a period of one and half years (November 2006 to April 2008) was undertaken. Semi-spontaneous reporting along with a review of case record forms were used. The reports were analyzed for clinical pattern, causal drug groups, causality (WHO-UMC criteria), severity (Hartwig and Siegel scale) and preventability (modified Schumock and Thornton criteria). The cost of ADRs was calculated on the basis of hospital expenditure per patient and the amount spent by patients themselves. Results: Out of 143 reports, chemotherapeutic agents (39 %) were the most commonly suspected drugs followed by unknown medicines (29 %). Most of the ADRs were designated as possible or probable (69 %) and moderately severe (96.5 %) in nature. However, 14 – 16 % were definitely preventable. Cost incurred by the hospital was Indian national rupees (INR) 374,255, i.e.,USD 8241. While average cost incurred by outpatients was INR 99 (USD 2.18) and that of hospitalized patients was INR 264 (USD 5.81). Conclusion: A large number of cutaneous ADRs are due to unknown medicines. This calls for strict drug control mechanisms, patient education regarding self-medication and maintenance of prescription records. The cost associated with ADRs is high. ADR monitoring is essential to reduce patient suffering as well as to achieve the substantial savings in health care cost.
Absence of musculocutaneous nerve in the left axilla
Virupaxi RD,Shirol VS,Desai SP,Ravishankar MV
International Journal of Anatomical Variations , 2009,
Abstract: Variations of the arrangement and distribution of the lateral cord and its branches in the infraclavicular part of the brachial plexus are common in one or both axillae. These variations are important to the surgeons, neurologists, anesthetists and anatomists during surgery and dissection in the region of axilla. The present case report describes the absence of musculocutaneous nerve in the infraclavicular part of left brachial plexus, observed during routine dissection of a 40-year-old male Indian cadaver. On the right side usual origin and course of musculocutaneous nerve was seen. The clinical importances of these variations are discussed.
A Method of Cognitive Training of Medical Students and Residents  [PDF]
Bobby Desai, Alpa Desai
Creative Education (CE) , 2018, DOI: 10.4236/ce.2018.99102
Abstract: Beginning learners in medicine face a daunting challenge of utilizing information gained in the first two years of medical school in a clinical setting in the latter half of their medical school and into residency. Constant interruptions and lack of knowledge are but two of the factors that may hamper the early clinician’s ability to safely and efficiently care for patients. Thus, a system that organizes thought into specific compartments—compartmentalization may benefit the learner by separating tasks into smaller, more specific objectives to complete prior to moving on in the diagnostic algorithm. Developing a system that utilizes compartmentalization may ease the transition into clinical practice using simple and effective tools that allow the beginning physician to mitigate the invariable distractions and interruptions that occur daily to allow for the safe practice of medicine.
A Blended Module for the Emergency Medicine Resident: An Introduction to Vital Signs and Emergency Stabilization  [PDF]
Bobby Desai
Creative Education (CE) , 2015, DOI: 10.4236/ce.2015.63035
Abstract: Beginning a residency in Emergency Medicine is a daunting task, and the new physician must be aware of what abnormal vital signs are and understand when to initiate emergency therapy. This module was created to teach the new physician about the vital sign of temperature. The module is blended to incorporate online learning via both direct and asynchronous methods, as well as face-to-face interactions using high fidelity simulation.
Geotechnical Parameters Impact on Artificial Ground Water Recharging Technique for Urban Centers  [PDF]
Pratima Patel, Mahesh Desai, Jatin Desai
Journal of Water Resource and Protection (JWARP) , 2011, DOI: 10.4236/jwarp.2011.35035
Abstract: Water scarcity is a serious problem throughout the world for both urban & rural community. Urban centers in India are facing an ironical situation of water scarcity today. This paper includes an Analytical solution, Numerical modeling, Empirical approaches, In-situ test results to predict recharge (rate) mound of the ground-water and capacity of recharge well which is essential for the proper management of suitable artificial ground-water recharge systems to maintain water balance and stop salt water intrusion. Authors have derived analytical equation for predicting growth as well as decline of the ground-water mound depending on the intensity of recharge rate qr with different value of permeability k, depth of pervious strata H and diameter of well d, also studying the effects of variation in the geotechnical parameters on water-table fluctuations. In this paper to study the impact of numerical modeling using quadratic equation for unconfined aquifer base on rainfall intensity P and a change in saturated thickness H with variation in piezometric level. Empirical approaches are for evaluation of correct value of k of an undercharged unconfined aquifer with drawdown s0, influence zone L, recharge rate qr. In-situ test results give actual correlation between value of recharging rate of well and permeability on field. Authors have verified recharging rate of installed well from all approaches. A result obtained from the various field case studies gives the validation of the derived equation. Scientific quality measures of aquifer water are also recorded.
Use of Solid-Supported Reagents towards Synthesis of 2-Arylbenzoxazole, 3, 5-Diarylisoxazole and 1, 3, 5-Triarylpyrazole  [PDF]
Sneha Naik, Vidya Desai
Green and Sustainable Chemistry (GSC) , 2013, DOI: 10.4236/gsc.2013.31001

Herein we report a convenient and efficient synthesis of 2-Arylbenzoxazole from the Schiff’s bases of 2-Aminophenol, 3, 5-Diarylisoxazole from α, β-unsaturated ketoxime and 1,3,5-Triarylpyrazole from 2-pyrazoline and N-Arylhydrazone by using milder, less toxic and less expensive-NBS-SiO2, KMnO4-Al2O3, PCC-SiO2 and ACC-Al2O3 as solid-supported oxidizing agents at room temperature. Within the framework of Green Chemistry, the use of solid supported reagents has many advantages such as 1) they are easy to remove from reactions by filtration 2) excess reagents can be used to drive the reaction without introducing any difficulties in purification 3) such solid-supported reagents react differently, mostly more selectively, than their unbound counterparts and 4) toxic, noxious and explosive chemicals are handled more safely when contained on solid support.

On Expressing the Probabilities of Categorical Responses as Linear Functions of Covariates  [PDF]
Tejas A. Desai
Applied Mathematics (AM) , 2013, DOI: 10.4236/am.2013.411200

Logistic regression is usually used to model probabilities of categorical responses as functions of covariates. However, the link connecting the probabilities to the covariates is non-linear. We show in this paper that when the cross-classification of all the covariates and the dependent variable have no empty cells, then the probabilities of responses can be expressed as linear functions of the covariates. We demonstrate this for both the dichotmous and polytomous dependent variables.

The Utility of Routine Electrolytes in Patients with Sickle Cell Anemia Presenting with an Acute Pain Crisis  [PDF]
Bobby K. Desai
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.41005
Abstract: Background: The evaluation of sickle cell vaso-occlusive crisis may include the measurement of the patient’s CBC and reticulocyte count. Twelve clinical criteria have been previously published for patients at risk for electrolyte abnormalities, but a chemistry panel is often ordered as well occasionally without a true indication. Objectives: Our objective was to determine whether routine measurement of electrolytes can be safely avoided in patients with SCA who present to the ED with an acute painful crisis. Methods: This was a retrospective study of patients with SCA who presented with a painful crisis. All visits were considered separately. All medical records were reviewed for any electrolyte abnormalities and any treatment(s). Patients with an electrolyte abnormality had their medical record screened for the presence of specific criteria, and if any interventions or consultations were performed due to the results. Results: One hundred twenty-two unique patients were found to have one or more abnormal laboratory value over a total of 337 distinct patient visits, with a total of 686 abnormal values. Of these, only 2 laboratory values caused a change in treatment or disposition, both of which were replacement of potassium for hypokalemia. There were no consultations from the ED to any service other than the admitting team in any of the 337 distinct patient visits. Conclusions: For SCA patients presenting to the ED with a painful vaso-occlusive crisis, measuring electrolytes in the absence of another more specific and established clinical reason, is very likely unnecessary and can be safely avoided.
Design and Optimization of the Geometric Properties of a Crane Hook  [PDF]
Niranjan Desai, Nuri Zeytinoglu
World Journal of Engineering and Technology (WJET) , 2016, DOI: 10.4236/wjet.2016.43038
Abstract: Cranes are used in many industries to transport heavy loads from one position to another. These loads are fastened to a crane hook which makes it a critical aspect of the crane itself. The purpose of this study is to optimize the performance of the crane hook based on stress, geometry, and weight. A single load is considered and multiple cross sections—including square, circular, and trapezoidal—are analyzed. The analysis takes the form of theoretical calculations and finite element analysis through the use of SOLIDWORKS Simulation. The trapezoidal cross section is determined to be the most efficient and the weight and stress of this cross section are optimized by varying the cross sectional parameters.
Bilateral Luxatio Erecta: A Case Report  [PDF]
Jason Lippert, Bobby Desai
Case Reports in Clinical Medicine (CRCM) , 2018, DOI: 10.4236/crcm.2018.712056
Abstract: Luxatio erecta is a highly uncommon type of shoulder dislocation, representing approximately 0.5% of all shoulder dislocations fitting into this category. In this paper, we present the case of a patient who presented post trauma with bilateral inferior glenohumeral joint dislocations (also called Luxatio Erecta). Considering that Luxatio Erecta only has a 0.5% chance of being present with a unilateral dislocation, the probability of a patient presenting 2 of these dislocations at the same time is approximately 0.25% (0.5% × 0.5% = 0.25%). In addition to this, Luxatio Erecta frequently presents with injuries to the brachial plexus and/or a humeral fracture. Despite this, neither of our patient’s dislocations were associated with any fractures or neurovascular injury and both were successfully reduced the Emergency Department. Both the patient’s presentation and outcome are quite uncommon, which makes this case an invaluable opportunity to go over the unique characteristics to Luxatio Erecta.
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