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  1. Article: Supplements Are Not a Synonym for Safe: Suspected Liver Injury From Ashwagandha.

    Vazirani, Sondra / Kothari, Amit / Fujimoto, Jeffrey / Gomez, Mariana

    Federal practitioner : for the health care professionals of the VA, DoD, and PHS

    2023  Volume 40, Issue 9, Page(s) 315–319

    Abstract: Background: As patients look more to alternative herbal and dietary supplements to boost energy and mood, reports are increasing of unintended adverse effects, particularly to the liver.: Case presentation: We report a case of a 48-year-old man with ... ...

    Abstract Background: As patients look more to alternative herbal and dietary supplements to boost energy and mood, reports are increasing of unintended adverse effects, particularly to the liver.
    Case presentation: We report a case of a 48-year-old man with a history of severe alcohol use disorder who presented to the emergency department with a cholestatic pattern of liver injury in the setting of alcohol and use of a testosterone-boosting supplement containing ashwagandha.
    Conclusions: Drug-induced liver damage should be considered in patients with alcohol use disorder who present with a cholestatic pattern of liver injury. Although many natural substances are well tolerated, others can have unanticipated and harmful adverse effects and drug interactions. Future research should identify not only potentially harmful substances, but also which patients may be at greatest risk.
    Language English
    Publishing date 2023-09-12
    Publishing country United States
    Document type Journal Article
    ISSN 1078-4497
    ISSN 1078-4497
    DOI 10.12788/fp.0409
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Radiology Case of the Month: Idiopathic CD4 Lymphocytopenia.

    Malone, Chris / Gupta, Neel D / Kothari, Amit / Palacios, Enrique / Neitzschman, Harold

    The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society

    2017  Volume 169, Issue 3, Page(s) 85–87

    Abstract: A 39 year-old male with a history of diabetes, retinitis pigmentosa, and genital warts presented with intractable occipital headaches accompanied with nausea and vomiting. The patient had markedly depressed CD4 counts. Furthermore the patient tested ... ...

    Abstract A 39 year-old male with a history of diabetes, retinitis pigmentosa, and genital warts presented with intractable occipital headaches accompanied with nausea and vomiting. The patient had markedly depressed CD4 counts. Furthermore the patient tested negative for HIV and HTLV 1/2 and had normal immunoglobulin levels. During hospital course the patient underwent a lumbar puncture and multiple imaging exams, including both CT and MR. Except for occasional nausea and vomiting controlled by therapeutic lumbar punctures, phenergan, and dilaudid the patient's hospital course was uncomplicated.
    Language English
    Publishing date 2017-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 441025-7
    ISSN 0024-6921
    ISSN 0024-6921
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Improving Inpatient Tobacco Treatment Measures: Outcomes Through Standardized Treatment, Care Coordination, and Electronic Health Record Optimization.

    Iannello, Justin / Levitt, Mary P / Poetter, Daniel / Bromberg, David / James, Leann / Cruz, Melinda / Jean-Baptiste, Marie / Henry, Monique / Parissis, Eleni I / King, Elizabeth D / Antwi, Catherine / Johnson, Dawn / Skjerve, Patti / Kothari, Amit J / Schweighardt, Chris / Reynolds, Ericka / Wood, Kelley / Reiss, Alexander

    Journal for healthcare quality : official publication of the National Association for Healthcare Quality

    2021  Volume 43, Issue 1, Page(s) 48–58

    Abstract: Introduction: The Centers for Disease Control and Prevention states that tobacco use is the largest and most preventable cause of disease and mortality in the United States. The Joint Commission implemented inpatient tobacco treatment measures (TTMs) in ...

    Abstract Introduction: The Centers for Disease Control and Prevention states that tobacco use is the largest and most preventable cause of disease and mortality in the United States. The Joint Commission implemented inpatient tobacco treatment measures (TTMs) in 2012 to encourage healthcare systems to create processes that help patients quit tobacco use through evidence-based care.
    Methods: A tobacco cessation care delivery system was implemented at James A. Haley Veterans' Hospital and Clinics, which included: standardized pathways within the Veterans Health Administration (VHA) electronic health record system to improve nicotine replacement therapy ordering; evidence-based tobacco cessation counseling; and improved care coordination for tobacco cessation treatment through the use of technological innovation.
    Results: Outcomes were obtained from the VHA quality metric reporting system known as Strategic Analytics for Improvement and Learning (SAIL). TOB-2 and TOB-3 (two Joint Commission inpatient TTMs) equivalent to tob20 and tob40 within SAIL improved by greater than 300% after implementation at James A. Haley Veterans' Hospital and Clinics.
    Conclusion: Implementation of a tobacco cessation care system at James A. Haley Veterans' Hospital and Clinics enhanced interdisciplinary coordination of tobacco cessation care and resulted in improvements of The Joint Commission inpatient TTMs by greater than threefold.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Curriculum ; Delivery of Health Care/standards ; Education, Medical, Continuing ; Electronic Health Records/standards ; Evidence-Based Practice/standards ; Female ; Hospitalization ; Humans ; Male ; Middle Aged ; Organization and Administration/standards ; Practice Guidelines as Topic ; Quality Improvement/standards ; Smoking Cessation/methods ; United States ; United States Department of Veterans Affairs
    Language English
    Publishing date 2021-01-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1472097-8
    ISSN 1945-1474 ; 1062-2551
    ISSN (online) 1945-1474
    ISSN 1062-2551
    DOI 10.1097/JHQ.0000000000000251
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The Burden of Enteric Fever

    Atul Kothari, Amit Pruthi, Tulsi D. Chugh

    Journal of Infection in Developing Countries, Vol 2, Iss 4, Pp 253-

    2008  Volume 259

    Abstract: Enteric fever is a disease of developing countries associated with poor public health and low socio-economic indices. Cases of enteric fever occurring in travelers returning to the United States and the UK suggest that it is present across the developing ...

    Abstract Enteric fever is a disease of developing countries associated with poor public health and low socio-economic indices. Cases of enteric fever occurring in travelers returning to the United States and the UK suggest that it is present across the developing world but that the Indian subcontinent represents a hotspot of disease activity. The best figures available for the global burden of enteric fever support this and suggest that Africa (50/ 100,000) has a far lower burden of disease than Asia (274/100,000). However these figures are based mainly on data for typhoid fever in Asia and the data for returning travelers is biased by preferred travel destinations. Given that most socio-economic indices, including known risk factors for enteric fever, such as provision of safe drinking water and sanitation, are much lower in most parts of Africa than in South-East and South-Central Asia it seems remarkable that Africa has such a low burden of disease. In such a scenario, rather than comparing whole continents, it may be more relevant to estimate region-specific burden of disease. It is clear is that there is an urgent need for more population-based studies of typhoid fever incidence in different parts of Africa to clarify the typhoid fever situation for the continent and so guide public health intervention.
    Keywords Salmonella ; typhoid fever ; enteric fever ; incidence ; burden ; Internal medicine ; RC31-1245 ; Microbiology ; QR1-502
    Language English
    Publishing date 2008-08-01T00:00:00Z
    Publisher The Journal of Infection in Developing Countries
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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