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Search Results: 1 - 10 of 177 matches for " Kauntia Ritesh "
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Late postpartum preeclampsia with posterior reversible encephalopathy syndrome
Kauntia Ritesh,Valsalan Rohith,Seshadri Shubha,Pandit Vinay
Indian Journal of Medical Sciences , 2009,
Abstract: Posterior reversible encephalopathy syndrome is a reversible syndrome characterized by headache, seizures, altered mentation, and loss of vision associated with white matter changes on imaging. We report here a 27 year-old lady three weeks postpartum, presenting with posterior reversible encephalopathy syndrome. She was treated successfully with antihypertensives and showed dramatic improvement. This condition is important to recognize and needs to be treated promptly to prevent morbidity and mortality in pregnancy and postpartum.
Extravascular Lung Water and Acute Lung Injury
Ritesh Maharaj
Cardiology Research and Practice , 2012, DOI: 10.1155/2012/407035
Abstract: Acute lung injury carries a high burden of morbidity and mortality and is characterised by nonhydrostatic pulmonary oedema. The aim of this paper is to highlight the role of accurate quantification of extravascular lung water in diagnosis, management, and prognosis in “acute lung injury” and “acute respiratory distress syndrome”. Several studies have verified the accuracy of both the single and the double transpulmonary thermal indicator techniques. Both experimental and clinical studies were searched in PUBMED using the term “extravascular lung water” and “acute lung injury”. Extravascular lung water measurement offers information not otherwise available by other methods such as chest radiography, arterial blood gas, and chest auscultation at the bedside. Recent data have highlighted the role of extravascular lung water in response to treatment to guide fluid therapy and ventilator strategies. The quantification of extravascular lung water may predict mortality and multiorgan dysfunction. The limitations of the dilution method are also discussed. 1. Introduction In 1896, the physiologist Starling described the factors that influence fluid transport across semipermeable membranes like capillaries [1]. This description accounted for the net movement of fluids between compartments in relation to capillary and interstitial hydrostatic pressures, capillary and interstitial oncotic pressures, and coefficients of capillary permeability. Pulmonary oedema refers to the accumulation of fluid within the extravascular space of the lung and occurs when the Starling forces are unbalanced. This occurs most commonly from an increased pulmonary capillary hydrostatic pressure or an increased capillary permeability. The estimation of the severity of pulmonary oedema by chest auscultation, radiography, or arterial blood gas analysis is imprecise [2–4]. Chest auscultation may be altered by mechanical ventilation, and bedside chest radiographs in the critical care unit is subject to several technical limitations. There is poor correlation between the chest radiograph scores of pulmonary oedema and the actual amount of EVLW [5]. There is also high interobserver variability when applying the American-European Consensus Conference radiographic criteria for ARDS even amongst experts [6, 7]. Data from experimental studies suggest that EVLW on chest radiography may only be detectable when the lung water increases by more than 35% [8]. Experimental studies have also shown that arterial oxygenation decreased significantly only when the EVLW increases by more than 200% [4].
Do fluoroquinolones actually increase mortality in community-acquired pneumonia?
Ritesh Agarwal
Critical Care , 2005, DOI: 10.1186/cc3989
Abstract: First and foremost, almost 51% of the patients had a PORT (Pneumonia Patient Outcomes Research Team) score of 1–4 and did not meet the inclusion criteria as specified by the authors. Second, almost 9% of the patients received antibiotics after 8 hours, which alone is known to influence outcomes in patients with pneumonia. Two large studies showed that antibiotic administration within 4 hours [2] and 8 hours [3] of arrival in the hospital was associated with decreased mortality and length of stay. It is possible that this group of patients who received treatment after 8 hours was composed entirely of those who received fluoroquinolones, thus accounting for the adverse outcomes with this treatment. Another important point pertains to the choice of antibiotic; almost 25% of the patients in the study received piperacillin–tazobactam for CAP. This treatment should be reserved for serious hospital-acquired infections, and routinely is not necessary for management of CAP except in situations where Pseudomonas aeruginosa infection is suspected [4]. Using inappropriate antibiotics in such situations has increased the incidence of expanded-spectrum β-lactamases, which are resistant to multiple classes of antibiotics [5].Finally, the results of this retrospective study are discordant with the recently published MOXIRAPID study [6]. This multi-center trial, conducted among adult patients hospitalized with CAP, compared fluoroquinolone monotherapy (moxifloxacin) with standard therapy (cephalosporin with or without a macrolide). Although the clinical outcomes were similar in the groups, patients randomly assigned to receive moxifloxacin had rapid resolution of fever and relief of symptoms such as chest pain, as recorded in patient diary entries.EM Mortensen, MI Restrepo, A Anzueto and J PughWe appreciate Dr Agarwal's interest in our article. However, we should like to respond to the comments made.First, the statement that 51% of patients had pneumonia severity index scores of I–I
Burkitts lymphoma of the small intestine: A cytological diagnosis
Sachdev Ritesh
Journal of Cytology , 2010,
Treatment of Latent Tuberculous Infection in India: is it worth the salt?
Agarwal Ritesh
Lung India , 2005,
Allergic bronchopulmonary aspergillosis: Lessons for the busy radiologist
Ritesh Agarwal
World Journal of Radiology , 2011, DOI: 10.4329/wjr.v3.i7.178
Abstract: The probability of a radiologist interpreting a disease correctly is not only influenced by their training and experience but also on the knowledge of a particular entity. This editorial reviews certain myths and realities associated with radiological manifestations of allergic bronchopulmonary aspergillosis (ABPA). ABPA is a hypersensitivity disorder against the antigens of Aspergillus fumigatus. Although commonly manifesting with central bronchiectasis (CB), the disorder can present without any abnormalities on high-resolution computed tomography (HRCT) of the chest, so-called serologic ABPA (ABPA-S). HRCT of the chest should not be used in screening or in the initial diagnostic work up of asthmatics, as asthma without ABPA can manifest with findings of CB. High-attenuation mucus (HAM) is the pathognomonic sign of ABPA and is very helpful in the diagnosis of ABPA complicating asthma and cystic fibrosis. Instead of classifying ABPA based on the presence and absence of CB into ABPA-CB and ABPA-S respectively, ABPA should be classified as ABPA-S, ABPA-CB and ABPA-CB-HAM. The classification scheme based on HAM not only identifies an immunologically severe disease but also predicts a patient with increased risk of recurrent relapses.
High attenuation mucoid impaction in allergic bronchopulmonary aspergillosis
Ritesh Agarwal
World Journal of Radiology , 2010,
Abstract: Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity syndrome triggered against antigens of Aspergillus fumigatus, a fungus that most commonly colonizes the airways of patients with bronchial asthma and cystic fibrosis. It presents clinically with refractory asthma, hemoptysis and systemic manifestations including fever, malaise and weight loss. Radiologically, it presents with central bronchiectasis and recurrent episodes of mucus plugging. The mucus plugs in ABPA are generally hypodense but in up to 20% of patients the mucus can be hyperdense on computed tomography. This paper reviews the literature on the clinical significance of hyperattenuated mucus in patients with ABPA.
Scrub Typhus: Prevention and Control
Ritesh Sharma
JK Science : Journal of Medical Education & Research , 2010,
Abstract: Not applicable
Comparative Study of Leachate Characteristics of Pond Ash from Long-Term Leaching and Ash Pond Disposal Point Effluent from Chandrapura Thermal Power Station, India
Ritesh Kumar
Journal of Chemistry , 2010, DOI: 10.1155/2010/496806
Modeling an array of encapsulated germanium detectors
Ritesh Kshetri
Physics , 2012, DOI: 10.1088/1748-0221/7/04/P04008
Abstract: A probability model has been presented for understanding the operation of an array of encapsulated germanium detectors generally known as composite detector. The addback mode of operation of a composite detector has been described considering the absorption and scattering of gamma-rays. Considering up to triple detector hit events, we have obtained expressions for peak-to-total and peak-to-background ratios of the cluster detector, which consists of seven hexagonal closely packed encapsulated HPGe detectors. Results have been obtained for the miniball detectors comprising of three and four seven hexagonal closely packed encapsulated HPGe detectors. The formalism has been extended to the SPI spectrometer which is a telescope of the INTEGRAL satellite and consists of nineteen hexagonal closely packed encapsulated HPGe detectors. This spectrometer comprises of twelve detector modules surrounding the cluster detector. For comparison, we have considered a spectrometer comprising of nine detector modules surrounding the three detector configuration of miniball detector. In the present formalism, the operation of these sophisticated detectors could be described in terms of six probability amplitudes only. Using experimental data on relative efficiency and fold distribution of cluster detector as input, the fold distribution and the peak-to-total, peak-to-background ratios have been calculated for the SPI spectrometer and other composite detectors at 1332 keV. Remarkable agreement between experimental data and results from the present formalism has been observed for the SPI spectrometer.
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