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  1. Article: Intubation in a Case of Ectodermal Dysplasia During Surgery: A Case Report.

    Geetha, Sindhu / Verma, Neeta / Singam, Amol

    Cureus

    2024  Volume 16, Issue 1, Page(s) e51504

    Abstract: Ectodermal dysplasia, a heterogeneous group of rare genetic disorders, is characterized by the aberrant development of ectodermal structures, leading to various clinical anomalies. This case report presents a unique and challenging case of a 33-year-old ... ...

    Abstract Ectodermal dysplasia, a heterogeneous group of rare genetic disorders, is characterized by the aberrant development of ectodermal structures, leading to various clinical anomalies. This case report presents a unique and challenging case of a 33-year-old male with ectodermal dysplasia who underwent Le Fort III advancement and implant rehabilitation surgery to address severe craniofacial and dental deficiencies. This case, characterized by facial dysmorphism, craniofacial anomalies, and the absence of a nasal bone, highlights the complexity of surgical planning required to address these diverse clinical features. The crucial element of this report is the innovative approach to airway management through trans mylohyoid/submental intubation, which successfully navigated the patient's aberrant anatomy. Multidisciplinary collaboration played a pivotal role in achieving a holistic and patient-centered approach. By sharing this case, we aim to provide insights into the nuances of managing complex patients with ectodermal dysplasia, emphasizing the importance of individualized care, innovative techniques, and interdisciplinary teamwork to optimize patient outcomes and contribute to advancing medical knowledge.
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.51504
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Grand rounds in methodology: key considerations for implementing machine learning solutions in quality improvement initiatives.

    Verma, Amol A / Trbovich, Patricia / Mamdani, Muhammad / Shojania, Kaveh G

    BMJ quality & safety

    2024  Volume 33, Issue 2, Page(s) 121–131

    Abstract: Machine learning (ML) solutions are increasingly entering healthcare. They are complex, sociotechnical systems that include data inputs, ML models, technical infrastructure and human interactions. They have promise for improving care across a wide range ... ...

    Abstract Machine learning (ML) solutions are increasingly entering healthcare. They are complex, sociotechnical systems that include data inputs, ML models, technical infrastructure and human interactions. They have promise for improving care across a wide range of clinical applications but if poorly implemented, they may disrupt clinical workflows, exacerbate inequities in care and harm patients. Many aspects of ML solutions are similar to other digital technologies, which have well-established approaches to implementation. However, ML applications present distinct implementation challenges, given that their predictions are often complex and difficult to understand, they can be influenced by biases in the data sets used to develop them, and their impacts on human behaviour are poorly understood. This manuscript summarises the current state of knowledge about implementing ML solutions in clinical care and offers practical guidance for implementation. We propose three overarching questions for potential users to consider when deploying ML solutions in clinical care: (1) Is a clinical or operational problem likely to be addressed by an ML solution? (2) How can an ML solution be evaluated to determine its readiness for deployment? (3) How can an ML solution be deployed and maintained optimally? The Quality Improvement community has an essential role to play in ensuring that ML solutions are translated into clinical practice safely, effectively, and ethically.
    MeSH term(s) Humans ; Quality Improvement ; Teaching Rounds ; Delivery of Health Care ; Machine Learning
    Language English
    Publishing date 2024-01-19
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2592909-4
    ISSN 2044-5423 ; 2044-5415
    ISSN (online) 2044-5423
    ISSN 2044-5415
    DOI 10.1136/bmjqs-2022-015713
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  3. Article: Lessons for hospital care from the first wave of COVID-19 in Ontario, Canada.

    Verma, Amol A / Razak, Fahad

    Hospital practice (1995)

    2021  Volume 49, Issue 4, Page(s) 229–231

    MeSH term(s) COVID-19 ; COVID-19 Testing ; Communication ; Cross Infection/prevention & control ; Hospital Administration ; Hospital Bed Capacity ; Hospitalization ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Ontario ; Patient Care Team ; SARS-CoV-2 ; Workforce
    Language English
    Publishing date 2021-04-19
    Publishing country England
    Document type Editorial
    ZDB-ID 2570453-9
    ISSN 2377-1003 ; 2154-8331 ; 8750-2836
    ISSN (online) 2377-1003
    ISSN 2154-8331 ; 8750-2836
    DOI 10.1080/21548331.2021.1915657
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  4. Article ; Online: Anaerobic Antibiotic Coverage in Aspiration Pneumonia and the Associated Benefits and Harms: A Retrospective Cohort Study.

    Bai, Anthony D / Srivastava, Siddhartha / Digby, Geneviève C / Girard, Vincent / Razak, Fahad / Verma, Amol A

    Chest

    2024  

    Abstract: Background: Antibiotics with extended anaerobic coverage are used commonly to treat aspiration pneumonia, which is not recommended by current guidelines.: Research question: In patients admitted to hospital for community-acquired aspiration pneumonia, ...

    Abstract Background: Antibiotics with extended anaerobic coverage are used commonly to treat aspiration pneumonia, which is not recommended by current guidelines.
    Research question: In patients admitted to hospital for community-acquired aspiration pneumonia, does a difference exist between antibiotic therapy with limited anaerobic coverage (LAC) vs antibiotic therapy with extended anaerobic coverage (EAC) in terms of in-hospital mortality and risk of Clostridioides difficile colitis?
    Study design and methods: We conducted a multicenter retrospective cohort study across 18 hospitals in Ontario, Canada, from January 1, 2015, to January 1, 2022. Patients were included if the physician diagnosed aspiration pneumonia and prescribed guideline-concordant first-line community-acquired pneumonia parenteral antibiotic therapy to the patient within 48 h of admission. Patients then were categorized into the LAC group if they received ceftriaxone, cefotaxime, or levofloxacin. Patients were categorized into the EAC group if they received amoxicillin-clavulanate, moxifloxacin, or any of ceftriaxone, cefotaxime, or levofloxacin in combination with clindamycin or metronidazole. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included incident C difficile colitis occurring after admission. Overlap weighting of propensity scores was used to balance baseline prognostic factors.
    Results: The LAC and EAC groups included 2,683 and 1,316 patients, respectively. In hospital, 814 patients (30.3%) and 422 patients (32.1%) in the LAC and EAC groups died, respectively. C difficile colitis occurred in 5 or fewer patients (≤ 0.2%) and 11 to 15 patients (0.8%-1.1%) in the LAC and EAC groups, respectively. After overlap weighting of propensity scores, the adjusted risk difference of EAC minus LAC was 1.6% (95% CI, -1.7% to 4.9%) for in-hospital mortality and 1.0% (95% CI, 0.3%-1.7%) for C difficile colitis.
    Interpretation: Extended anaerobic coverage likely is unnecessary in aspiration pneumonia because it is associated with no additional mortality benefit, only an increased risk of C difficile colitis.
    Language English
    Publishing date 2024-02-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2024.02.025
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  5. Article: Continuous Spinal Anesthesia Technique After Accidental Dural Puncture.

    Matturu, Soumya / Singam, Amol / Madavi, Sheetal / Verma, Neeta

    Cureus

    2022  Volume 14, Issue 9, Page(s) e29046

    Abstract: Continuous spinal anesthesia (CSA) is a mode of anesthesia and analgesia that has various therapeutic advantages. CSA allows the anesthesiologist to titrate tiny doses of a local anesthetic to achieve the desired degree of spinal anesthesia. The duration ...

    Abstract Continuous spinal anesthesia (CSA) is a mode of anesthesia and analgesia that has various therapeutic advantages. CSA allows the anesthesiologist to titrate tiny doses of a local anesthetic to achieve the desired degree of spinal anesthesia. The duration can be extended to accommodate the demands of the protracted operation. Due to a lack of equipment and financial restraints, particularly in resource-constrained areas, and worries of neurologic consequences such as cauda equina syndrome, CSA is yet to acquire general acceptability among anesthesiologists. In terms of postoperative pain management, CSA can be comparable to epidural analgesia and is considered far superior to abdominal wall blocks when correctly applied. Here we discuss a case wherein a standard epidural catheter in subarachnoid space was used to successfully perform an emergency exploratory laparotomy.
    Language English
    Publishing date 2022-09-11
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.29046
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  6. Article ; Online: Awake prone positioning and covid-19.

    Verma, Amol A / Razak, Fahad / Munshi, Laveena / Fralick, Michael

    BMJ (Clinical research ed.)

    2022  Volume 379, Page(s) o2888

    MeSH term(s) Humans ; COVID-19 ; Wakefulness ; Prone Position ; SARS-CoV-2 ; Patient Positioning ; Respiratory Insufficiency
    Language English
    Publishing date 2022-12-07
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.o2888
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  7. Article ; Online: An Update to the Kaiser Permanente Inpatient Risk Adjustment Methodology Accurately Predicts In-Hospital Mortality: a Retrospective Cohort Study.

    Roberts, Surain B / Colacci, Michael / Razak, Fahad / Verma, Amol A

    Journal of general internal medicine

    2023  Volume 38, Issue 15, Page(s) 3303–3312

    Abstract: Background: Methods to accurately predict the risk of in-hospital mortality are important for applications including quality assessment of healthcare institutions and research.: Objective: To update and validate the Kaiser Permanente inpatient risk ... ...

    Abstract Background: Methods to accurately predict the risk of in-hospital mortality are important for applications including quality assessment of healthcare institutions and research.
    Objective: To update and validate the Kaiser Permanente inpatient risk adjustment methodology (KP method) to predict in-hospital mortality, using open-source tools to measure comorbidity and diagnosis groups, and removing troponin which is difficult to standardize across modern clinical assays.
    Design: Retrospective cohort study using electronic health record data from GEMINI. GEMINI is a research collaborative that collects administrative and clinical data from hospital information systems.
    Participants: Adult general medicine inpatients at 28 hospitals in Ontario, Canada, between April 2010 and December 2022.
    Main measures: The outcome was in-hospital mortality, modeled by diagnosis group using 56 logistic regressions. We compared models with and without troponin as an input to the laboratory-based acute physiology score. We fit and validated the updated method using internal-external cross-validation at 28 hospitals from April 2015 to December 2022.
    Key results: In 938,103 hospitalizations with 7.2% in-hospital mortality, the updated KP method accurately predicted the risk of mortality. The c-statistic at the median hospital was 0.866 (see Fig. 3) (25th-75th 0.848-0.876, range 0.816-0.927) and calibration was strong for nearly all patients at all hospitals. The 95th percentile absolute difference between predicted and observed probabilities was 0.038 at the median hospital (25th-75th 0.024-0.057, range 0.006-0.118). Model performance was very similar with and without troponin in a subset of 7 hospitals, and performance was similar with and without troponin for patients hospitalized for heart failure and acute myocardial infarction.
    Conclusions: An update to the KP method accurately predicted in-hospital mortality for general medicine inpatients in 28 hospitals in Ontario, Canada. This updated method can be implemented in a wider range of settings using common open-source tools.
    MeSH term(s) Adult ; Humans ; Risk Adjustment/methods ; Hospital Mortality ; Inpatients ; Retrospective Studies ; Ontario/epidemiology ; Troponin
    Chemical Substances Troponin
    Language English
    Publishing date 2023-06-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639008-0
    ISSN 1525-1497 ; 0884-8734
    ISSN (online) 1525-1497
    ISSN 0884-8734
    DOI 10.1007/s11606-023-08245-w
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  8. Article ; Online: Editorial: liver disease in secondary care-'money or your life'. Authors' reply.

    Roberts, Surain B / Verma, Amol A / Hirschfield, Gideon M

    Alimentary pharmacology & therapeutics

    2021  Volume 54, Issue 6, Page(s) 856–857

    MeSH term(s) Digestive System Diseases ; Humans ; Liver Cirrhosis ; Liver Diseases/etiology ; Secondary Care
    Language English
    Publishing date 2021-08-23
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.16562
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  9. Article ; Online: Solanum nigrum

    Yadav, Karan Singh / Bisen, Amol Chhatrapati / Ishteyaque, Sharmeen / Sharma, Isha / Verma, Smriti / Sanap, Sachin Nashik / Verma, Shobhit / Washimkar, Kaveri R / Kumar, Akhilesh / Tripathi, Vineeta / Bhatta, Rabi Sankar / Mugale, Madhav Nilakanth

    Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics

    2024  

    Abstract: Purpose: ...

    Abstract Purpose:
    Language English
    Publishing date 2024-04-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1237021-6
    ISSN 1557-7732 ; 1080-7683
    ISSN (online) 1557-7732
    ISSN 1080-7683
    DOI 10.1089/jop.2023.0089
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  10. Article: Failing to protect humanitarian workers: lessons from Britain and Voluntary Aid Detachments in the Second World War.

    Verma, Amol A

    Medicine, conflict, and survival

    2017  Volume 33, Issue 3, Page(s) 216–228

    Abstract: This paper draws on official records of international and British organizations, newspaper reports, and volunteer memoirs to study the failure to protect humanitarian workers in the Second World War. The Second World War saw a significant expansion in ... ...

    Abstract This paper draws on official records of international and British organizations, newspaper reports, and volunteer memoirs to study the failure to protect humanitarian workers in the Second World War. The Second World War saw a significant expansion in the use of air warfare and flying missiles and these technological advances posed a grave threat to civilians and humanitarian workers. In this context, the International Committee of the Red Cross advocated unsuccessfully to restrict air warfare and create safe hospital zones. The British Government grappled with the tension between military and humanitarian objectives in setting its bombardment policy. Ultimately, humanitarian principles were neglected in pursuit of strategic aims, which endangered civilians and left humanitarian workers particularly vulnerable. British Voluntary Aid Detachment nurses experienced more than six-fold greater fatality rates than civil defence workers and the general population. The lessons from failures to protect humanitarian workers in the face of evolutions in warfare remain profoundly relevant.
    MeSH term(s) Aviation/history ; Bombs ; Government ; History, 20th Century ; Hospitals ; Humans ; International Cooperation ; Military Personnel ; Red Cross ; Relief Work/history ; Relief Work/legislation & jurisprudence ; Security Measures/history ; United Kingdom ; Volunteers/history ; World War II
    Language English
    Publishing date 2017-09
    Publishing country England
    Document type Historical Article ; Journal Article
    ZDB-ID 1314196-x
    ISSN 1362-3699
    ISSN 1362-3699
    DOI 10.1080/13623699.2017.1303240
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