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  1. Article ; Online: Is post-endoscopic ultrasound pancreatic cancer analogous to post-colonoscopy colorectal cancer?

    Madhu, Deepak / Gardezi, Syed Anjum / Tehami, Nadeem

    Endoscopy

    2022  Volume 55, Issue 1, Page(s) 102

    MeSH term(s) Humans ; Colonoscopy ; Colorectal Neoplasms/diagnostic imaging ; Colorectal Neoplasms/etiology ; Endosonography ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms
    Language English
    Publishing date 2022-12-20
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 80120-3
    ISSN 1438-8812 ; 0013-726X
    ISSN (online) 1438-8812
    ISSN 0013-726X
    DOI 10.1055/a-1881-4533
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 669: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 162: Show issues

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  2. Article: Troponin: think before you request one.

    Gardezi, Syed Anjum

    BMJ quality improvement reports

    2015  Volume 4, Issue 1

    Abstract: Acute myocardial infarction (ACS) is one of the most common presentations in acute hospital settings. Troponin (cTn) has emerged as one of the most sensitive biochemical markers for the diagnosis of ACS. However, if used inappropriately and in the ... ...

    Abstract Acute myocardial infarction (ACS) is one of the most common presentations in acute hospital settings. Troponin (cTn) has emerged as one of the most sensitive biochemical markers for the diagnosis of ACS. However, if used inappropriately and in the absence of true clinical context then it can be elevated in a number of non cardiac conditions and lead to false clinical diagnosis, inappropriate workup, and increased patient stay in hospital. The cost of unnecessary clinical testing is another aspect of the problem. At Royal Gwent Hospital in Newport (one of the busiest district general hospitals in Wales) we retrospectively analysed the nature of troponin requests over a random period of one week, specifically looking for the indications and final diagnostic impact. In many cases it was found that requests were made without any clinical justification. One of the main and probably unavoidable reasons for this was that requests were made from triage before patient was assessed by a clinician. However, steps were taken to clarify common clinical indications for suspected cardiac diagnosis in which troponin was useful. Additionally, the "tick box" practice for inappropriate laboratory investigations was discouraged. A repeat audit was done on similar basic principles and a measurable improvement was identified, with a potential for significant impact in future.
    Language English
    Publishing date 2015-03-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2677829-4
    ISSN 2050-1315
    ISSN 2050-1315
    DOI 10.1136/bmjquality.u204560.w3221
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Improving bowel preparation for colonoscopy in a cost effective manner.

    Gardezi, Syed Anjum / Tibbatts, Clare

    BMJ quality improvement reports

    2017  Volume 6, Issue 1

    Abstract: Colonoscopy is a key investigation used to exclude large bowel pathologies including surveillance for CRC (Colorectal cancer) Poor bowel preparation (bowel prep) is one of the most important factors affecting its diagnostic yield. Different formulations ... ...

    Abstract Colonoscopy is a key investigation used to exclude large bowel pathologies including surveillance for CRC (Colorectal cancer) Poor bowel preparation (bowel prep) is one of the most important factors affecting its diagnostic yield. Different formulations of bowel prep are currently in use depending upon patient tolerance, indication & co-morbidities. In University Hospital Llandough we retrospectively reviewed the outcome of colonoscopies performed over period of 3 months, in relation to the type and outcome of bowel preparations used. We implemented a change of patient instruction and pre-assessment of bowel preparation prescribed. We repeated the same measurements over 3 different cycles on 3 different occasions and compared the outcome. We noticed that quality of bowel preparation noticeably improved from 80% to almost 93% if patients were given appropriate advice in a written format, prior to procedure. In addition to improvement in the quality of assessment & reducing the number of repeat procedures, by changing the bowel preparation product and postage methods we estimated savings of almost £150,000 for the trust in a year.
    Language English
    Publishing date 2017-05-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 2677829-4
    ISSN 2050-1315
    ISSN 2050-1315
    DOI 10.1136/bmjquality.u204560.w5376
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Improving patient care over weekends by reducing on-call work load and better time management.

    Gardezi, Syed Anjum Ali

    BMJ quality improvement reports

    2014  Volume 3, Issue 1

    Abstract: The Royal College of Physicians states that "handover, particularly of temporary 'on-call' responsibility, has been identified as a point at which errors are likely to occur."[1] Working a weekend on-call covering medical wards is often busy and ... ...

    Abstract The Royal College of Physicians states that "handover, particularly of temporary 'on-call' responsibility, has been identified as a point at which errors are likely to occur."[1] Working a weekend on-call covering medical wards is often busy and stressful for all junior doctors. The high volume of routine and unplanned tasks make the situation even worse. In Nevill Hall hospital Abergavenny, we measured the workload on a junior doctor for medical ward cover on weekends by counting the number of times he/she was bleeped for routine tasks. Initial study demonstrated that on average 30-40% of time on a long day shift was spent on jobs which could have been done on the preceding Friday. The "FRIDAYS" checklist was introduced for clinical staff (particularly junior doctors) to identify these jobs. According to this model, all the junior doctors were encouraged to review: F: Phlebotomy R: Rewriting drug charts I: IV fluids D: discharge summaries A: Antibiotic review Y: Yellow book/Warfarin dose S: Status of resuscitation and escalation plans before leaving the wards on Friday afternoon. This implementation successfully showed reduction in weekend workload, allowing the ward cover to be focused on care and safety of comparatively sick patients while at the same time reducing the stress for the on-call team.
    Language English
    Publishing date 2014-06-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2677829-4
    ISSN 2050-1315
    ISSN 2050-1315
    DOI 10.1136/bmjquality.u204560.w2109
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Effect of azathioprine intolerance on outcomes of inflammatory bowel disease: a cross-sectional study.

    Lee, Lennard Y W / Gardezi, Anjum Syed / Santharam, Vidya / Boyd, Jason / Lanzon-Miller, Sandro

    Frontline gastroenterology

    2013  Volume 5, Issue 1, Page(s) 40–43

    Abstract: Background: Azathioprine is well established for the maintenance of remission in patients with inflammatory bowel disease (IBD). However, a significant proportion of patients are intolerant to azathioprine. It is not clear if intolerance of azathioprine ...

    Abstract Background: Azathioprine is well established for the maintenance of remission in patients with inflammatory bowel disease (IBD). However, a significant proportion of patients are intolerant to azathioprine. It is not clear if intolerance of azathioprine is a marker of poor prognosis for patients who will have a more aggressive disease or be more likely to require surgery.
    Objective: To determine if intolerance to azathioprine is a marker of poor prognosis, indicating patients who have a more aggressive disease course, and to analyse the risk factors and causes of intolerance.
    Methods: A cross-sectional study using the Milton Keynes Hospital IBD database was performed to compare azathioprine-intolerant and azathioprine-tolerant patients.
    Results: Two hundred and thirty-nine patients met the inclusion criteria comprising 141 patients with Crohn's disease (CD) and 98 patients with ulcerative colitis (UC). Overall, 28.0% of patients were intolerant to azathioprine. Risk factors for intolerance were female sex and age 50-70 years. Common reasons for intolerance were nausea and vomiting (34.3%), deranged liver function tests (28.4%) and headaches (11.9%). In patients with UC, there was no statistical difference in the disease activity scores between those who were azathioprine intolerant versus tolerant. In patients with CD, azathioprine intolerance was associated with significantly worse disease activity; 25% fewer patients were in clinical remission and 20% more had moderate/severe disease. Rates of surgery were similar between the groups for both UC/CD.
    Conclusions: We conclude that azathioprine intolerance acts as a surrogate marker for patients with CD who in future have poorer symptom control. Azathioprine intolerance marks out a group of patients with CD in whom increased vigilance of symptom control and early escalation of treatment is required.
    Language English
    Publishing date 2013-08-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2521857-8
    ISSN 2041-4137
    ISSN 2041-4137
    DOI 10.1136/flgastro-2013-100348
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6880: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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