Hospitalist physicians as educators in a community hospital: the trainee's view.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Rakesh Shrivastava.
Explore the source record for details and available documents.
Concurrent occurrence of carotid artery stenosis and intracerebral aneurysm is uncommon and poses a therapeutic dilemma. We report a patient with bilateral carotid artery stenosis and a 2.5 cm left middle cerebral artery aneurysm who simultaneously underwent a successful stent-assisted coiling for his intracerebral aneurysm and left carotid artery angioplasty with stenting during the same setting.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Heparin therapy is gaining more use in many clinical conditions. Considering the serious nature of the diseases managed with heparin, it is necessary to achieve the therapeutic goal within a short time to gain the best possible benefit. Adequate anticoagulation also is necessary during procedures such as cardiopulmonary bypass and hemodialysis. Heparin resistance, inability to achieve therapeutic anticoagulation, has been described in as many as 22% of patients undergoing open-heart surgeries. The results of undercoagulation can vary from subclinical coagulation to death. It also is necessary not to over anticoagulate a patient and to understand the existence of alternative methods for monitoring heparin therapy to prevent excess heparin therapy and its complications. Many common dinical situations can induce resistance to the action of heparin. Being aware of the existence of heparin resistance and taking timely appropriate action would prevent catastrophic consequences. The use of antithrombin III is one way of preventing heparin resistance.
Post-cardiac injury syndrome (PCIS) is an inflammatory process involving pleura and pericardium secondary to cardiac injury. Even though this clinical entity has been recognised for decades, diagnosis is difficult because of lack of a diagnostic test. Antimyocardial antibody titre in pleural fluid and serum has been proposed to have diagnostic value. However there are inherent difficulties in measuring and interpreting the role of antimyocardial antibody. A case of PCIS with low pleural fluid complement level is reported, which it is believed can be useful to support the diagnosis of PCIS.