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  1. Article ; Online: Drug-Induced Liver Injury Secondary to Turmeric Use.

    Ajitkumar, Ashika / Mohan, Gaurav / Ghose, Medha / Yarrarapu, Sivanaga / Afiniwala, Swara

    European journal of case reports in internal medicine

    2023  Volume 10, Issue 5, Page(s) 3845

    Abstract: Turmeric is a herbal medication and spice which has been used for thousands of years in traditional Eastern medicine for its flavour, colour, and purported anti-inflammatory, antioxidant, antineoplastic and antimicrobial properties. It has recently ... ...

    Abstract Turmeric is a herbal medication and spice which has been used for thousands of years in traditional Eastern medicine for its flavour, colour, and purported anti-inflammatory, antioxidant, antineoplastic and antimicrobial properties. It has recently garnered interest and popularity worldwide for these reasons. While turmeric supplements are generally safe, some reports of toxicity are emerging. Compounds like piperine are added to turmeric to enhance its bioavailability, potentially contributing to its toxicity. Here, we describe a 55-year-old woman with progressive jaundice and elevated bilirubin and liver enzymes but no evidence of acute liver failure. She was treated with N-acetyl cysteine (NAC) for 24 hours and liver function tests (LFTs) were closely monitored. As a downtrend in LFTs was noted and the patient remained asymptomatic, she was discharged with close outpatient follow-up. LFTs eventually normalized 2 months after the initial presentation. Clinicians must keep this differential in mind when evaluating acute liver injury. With our case report, we question the utility of NAC in non-acetaminophen-related liver injury and encourage further studies.
    Learning points: Eliciting information on recent drug or supplement use should be part of comprehensive history-taking to evaluate acute liver injury.Turmeric supplements which may contain piperine to enhance bioavailability are a potential source of acute liver injury.The role of N-acetyl cysteine in managing non-acetaminophen-related liver injury is unclear and further studies are required.
    Language English
    Publishing date 2023-04-21
    Publishing country Italy
    Document type Journal Article
    ISSN 2284-2594
    ISSN (online) 2284-2594
    DOI 10.12890/2023_003845
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Facing the Challenge of Post COVID-19 Pulmonary fibrosis

    Ghose, Medha / Islam, Tasbirul

    Bangladesh Critical Care Journal; Vol 8 No; 102-107 ; 2307-7654 ; 2304-0009

    What is so unique about it?

    2020  Volume 2

    Abstract: COVID-19 pandemic is the highlight of the 21st century that took drastic effects on humanity. Over 23 million confirm infected with the majority with mild infection. However, over 62,000 cases are in critical condition with varying degrees of ARDS. A ... ...

    Abstract COVID-19 pandemic is the highlight of the 21st century that took drastic effects on humanity. Over 23 million confirm infected with the majority with mild infection. However, over 62,000 cases are in critical condition with varying degrees of ARDS. A potential complication of severe ARDS could be Post COVID-19 Pulmonary fibrosis. Possible use of biomarkers to detect progression to fibrosis, along with prompt treatment of acute lung injury caused by COVID-19 and administration anti-fibrotic therapies, could be the next best method to treat this permanent and devastating sequela of COVID-19. Bangladesh Crit Care J September 2020; 8(2): 102-107
    Keywords covid19
    Language English
    Publishing date 2020-11-01
    Publisher Bangladesh Society of Critical Care Medicine
    Publishing country bd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Intestinal Perforation: A Rare Complication of Treatment With Bevacizumab.

    Adhikari, Ramesh / Ghose, Medha / Tekin, Aysun / Singh, Simranjit / Singh, Romil

    Cureus

    2021  Volume 13, Issue 3, Page(s) e14093

    Abstract: Bevacizumab, a monoclonal immunoglobulin-G1 antibody directed against vascular endothelial growth factor (VEGF), inhibits angiogenesis. Gastrointestinal perforation is a serious and often fatal adverse event related to bevacizumab use. Bevacizumab is ... ...

    Abstract Bevacizumab, a monoclonal immunoglobulin-G1 antibody directed against vascular endothelial growth factor (VEGF), inhibits angiogenesis. Gastrointestinal perforation is a serious and often fatal adverse event related to bevacizumab use. Bevacizumab is indicated in the treatment of colorectal malignancies, certain subtypes of non-small cell lung carcinoma, metastatic renal cell carcinomas, and cervical cancers. It is also indicated in the treatment of recurrent glioblastoma (GBM) in adult patients as the sole treatment agent or in combination with other antineoplastic medications. We present a case of a patient on bevacizumab currently with glioblastoma multiforme and seizures, who was previously treated with radiation treatment and temozolomide. The patient presented to the emergency room with abdominal pain, seizures and was diagnosed to have an intestinal perforation.
    Language English
    Publishing date 2021-03-24
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.14093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Impact of Obesity on In-Hospital Morbidity and Mortality Among Patients Admitted for Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD).

    Bhide, Poorva / Bapaye, Jay / Mohan, Gaurav / Ghose, Medha / Ravilla, Jayashree / Yarrarapu, Siva Naga S / Du, Doantrang

    Cureus

    2023  Volume 15, Issue 2, Page(s) e35138

    Abstract: Background Obesity has been considered to be a risk factor for increased morbidity and mortality among patients with cardiopulmonary diseases. The burden of chronic obstructive pulmonary disease (COPD) and obesity is very high in the United States. We ... ...

    Abstract Background Obesity has been considered to be a risk factor for increased morbidity and mortality among patients with cardiopulmonary diseases. The burden of chronic obstructive pulmonary disease (COPD) and obesity is very high in the United States. We aimed to use the National Inpatient Sample (NIS) to evaluate the impact of obesity on the outcomes of patients hospitalized with COPD exacerbation. Materials & Methods This is a retrospective cohort study from the NIS database involving adult patients hospitalized for COPD exacerbation in the year 2019 obtained using the international classification of diseases, 10
    Language English
    Publishing date 2023-02-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.35138
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Pericardial Tamponade and Berger's Disease: An Unusual Association.

    Yarrarapu, Siva Naga S / Shah, Parth / Arty, Fnu / Ravilla, Jayasree / Ghose, Medha / Khan, Mahrukh A / Anwar, David

    Cureus

    2023  Volume 15, Issue 7, Page(s) e41281

    Abstract: Cardiac tamponade is considered a medical emergency because a patient can deteriorate easily and die of cardiac arrest if the fluid is not drained immediately. The most common etiologies are the same as pericarditis as fluid accumulates due to ... ...

    Abstract Cardiac tamponade is considered a medical emergency because a patient can deteriorate easily and die of cardiac arrest if the fluid is not drained immediately. The most common etiologies are the same as pericarditis as fluid accumulates due to pericardial inflammation, including infection, malignancy, trauma, iatrogenic, autoimmune, post-myocardial infarction, radiation, and renal failure. Although the treatment is pericardiocentesis or pericardial window, finding the etiology responsible for the development of pericardial effusion is important. Here, we describe the case of a 40-year-old female who presented to the emergency department with a chief complaint of severe epigastric pain of a two-day duration that was associated with multiple episodes of nausea, vomiting, dysphagia, and severe shortness of breath (New York Heart Association III). The patient was eventually diagnosed with cardiac tamponade as a cause of her dyspnea, as a two-dimensional cardiac echocardiogram detected a large pericardial effusion (>2 cm) with echocardiographic indications for cardiac tamponade with severe pulmonary hypertension. The patient underwent a therapeutic pericardial window with drainage of 250 mL of pericardial fluid. Ultrasound of the abdomen focusing on the kidneys showed an atrophic and echogenic right kidney with a bidirectional flow in the hepatic veins, suggestive of right heart failure. Subsequently, she underwent a kidney biopsy that showed diffuse mesangial proliferative glomerulonephritis with segmental sclerosing features consistent with IgA nephropathy, associated with tubular atrophy, interstitial fibrosis, interstitial inflammation, and moderate arteriosclerosis. The patient was diagnosed with stage V chronic kidney disease secondary to IgA nephropathy. IgA nephropathy is usually common in Caucasian or Asian males in their teens and late 30s, with hematuria as a usual presentation. This case is unique as cardiac tamponade with renal failure is rarely the presenting symptom of IgA nephropathy.
    Language English
    Publishing date 2023-07-02
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.41281
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Predictors of Escalation to Intensive Care Unit Level of Care Among Admissions for Alcohol Withdrawal.

    Mohan, Gaurav / Bhide, Poorva / Abu-Shanab, Amer / Ghose, Medha / Rajamohan, Adhithya / Muhammad, Tayyeb / Khan, Anosh A / Khan, Mahrukh / Khalid, Farhan / Padappayil, Rana P / Du, Doantrang

    Journal of community hospital internal medicine perspectives

    2023  Volume 13, Issue 5, Page(s) 8–14

    Abstract: According to the 2019 National Survey on Drug Use and Health, 14.5 million people ages 12 and older had alcohol abuse disorder. Alcohol withdrawal syndrome (AWS) can be defined as a collection of physical symptoms experienced due to abrupt cessation of ... ...

    Abstract According to the 2019 National Survey on Drug Use and Health, 14.5 million people ages 12 and older had alcohol abuse disorder. Alcohol withdrawal syndrome (AWS) can be defined as a collection of physical symptoms experienced due to abrupt cessation of alcohol after long-term dependence. In instances where regular inpatient management fails to control AWS symptoms, patients are shifted to intensive care units (ICUs) for closer monitoring and prevention of life-threatening complications like withdrawal seizures and delirium tremens (DTs), labeled as severe alcohol withdrawal syndrome (SAWS). Although this represents a significant healthcare burden, minimal studies have been conducted to determine objective predictors. In this study, we aim to determine the effect of patient demographics, socio-economic status, biochemical parameters, and clinical factors on the need for escalation to ICU level of care among admissions for AWS. Our study showed that factors such as a history of DTs or alcohol-related seizures, the initial protocol of management, degree of reported alcohol usage, activation of rapid response teams, mean corpuscular value, alcohol level on admission, highest Clinical Institute Withdrawal Assessment Alcohol Revised (CIWA-Ar) scored during the hospital stay, and the total amount of sedatives used were significantly associated with escalation to ICU level of care. Clinicians must use these objective parameters to identify high-risk patients and intervene early. We encourage further studies to establish a scoring algorithm incorporating biochemical parameters to tailor management algorithms that might better suit high-risk patients.
    Language English
    Publishing date 2023-09-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2616884-4
    ISSN 2000-9666
    ISSN 2000-9666
    DOI 10.55729/2000-9666.1241
    Database MEDical Literature Analysis and Retrieval System OnLINE

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