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Shivanand Bomman,Sofya Malashanka,Adil Ghafoor,David J. Sanders,Shayan Irani,Richard A. Kozarek,Andrew Ross,Michal Hubka,Rajesh Krishnamoorthi 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.5
Background/Aims: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution’s programmatic allocation of resources during the safe implementation of TIF as a new procedure. Methods: A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was per- formed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and out- comes were evaluated during transition. Results: Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine esophagogram. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure dura- tion was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02). Conclusions: A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effec- tive transition to a fully outpatient procedure.
Shivanand Bomman,Munish Ashat,Navroop Nagra,Mahendran Jayaraj,Shruti Chandra,Richard A Kozarek,Andrew Ross,Rajesh Krishnamoorthi 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1
Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminatedduodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhancedsurveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethyleneoxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review andmeta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inceptionuntil January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates ofpost-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRTduodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]:2.3%–10.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%–2.7%,I2=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoingefforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design toimprove safety are warranted.
Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report
Shivanand B. Bagewadi,Ujjwala Rastogi Awasthi,Bharat M. Mody,Gundareddy N. Suma,Shruti Garg 대한영상치의학회 2015 Imaging Science in Dentistry Vol.45 No.3
Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.
Unusually large erupted complex odontoma: A rare case report
Shivanand B. Bagewadi,Rahul Kukreja,Gundareddy N. Suma,Bhawna Yadav,Havi Sharma 대한영상치의학회 2015 Imaging Science in Dentistry Vol.45 No.1
Odontomas are nonaggressive, hamartomatous developmental malformations composed of mature tooth substances and may be compound or complex depending on the extent of morphodifferentiation or on their resemblance to normal teeth. Among them, complex odontomas are relatively rare tumors. They are usually asymptomatic in nature. Occasionally, these tumors become large, causing bone expansion followed by facial asymmetry. Odontoma eruptions are uncommon, and thus far, very few cases of erupted complex odontomas have been reported in the literature. Here, we report the case of an unusually large, painless, complex odontoma located in the right posterior mandible.
Unusually large erupted complex odontoma: A rare case report
Bagewadi, Shivanand B.,Kukreja, Rahul,Suma, Gundareddy N.,Yadav, Bhawna,Sharma, Havi Korean Academy of Oral and Maxillofacial Radiology 2015 Imaging Science in Dentistry Vol.45 No.1
Odontomas are nonaggressive, hamartomatous developmental malformations composed of mature tooth substances and may be compound or complex depending on the extent of morphodifferentiation or on their resemblance to normal teeth. Among them, complex odontomas are relatively rare tumors. They are usually asymptomatic in nature. Occasionally, these tumors become large, causing bone expansion followed by facial asymmetry. Odontoma eruptions are uncommon, and thus far, very few cases of erupted complex odontomas have been reported in the literature. Here, we report the case of an unusually large, painless, complex odontoma located in the right posterior mandible.
Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report
Bagewadi, Shivanand B.,Awasthi, Ujjwala Rastogi,Mody, Bharat M.,Suma, Gundareddy N.,Garg, Shruti Korean Academy of Oral and Maxillofacial Radiology 2015 Imaging Science in Dentistry Vol.46 No.1
Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.
Devanand Degulmadi,Venkatramana Brahmajoshyula,Shivanand Mayi,Suman Teegala 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.4
This article presents a 56-year-old obese female who presented with back pain and progressive weakness in her lower limbs for three months. She was bed-ridden for one week before reporting to our hospital. Plain radiographs showed vertical striations in multiple vertebrae classical of haemangioma. Magnetic resonance imaging (MRI) spine revealed multiple thoracic and lumbar vertebral haemangiomas. Extra osseous extension of haemangioma at T12 was causing spinal cord compression. Two-stage surgery was performed with absolute alcohol (ethanol) injection followed by pedicle screw fixation and decompression with tricortical iliac crest bone graft into the vertebral body. Postoperatively rapid neurological improvement was seen. After three weeks, she could walk independently. One year later, computed tomography showed complete incorporation of bone graft and maintained vertebral body height. MRI showed complete resolution of the cord edema at T12. These findings indicated diminished vascularity of the tumor.
Nivedhitha Selvakumar,Vikas Menon,Shivanand Kattimani 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.2
Objective: Our objective was to determine patterns and predictors of medication adherence in bipolar disorder. Methods: Between August 2015 and December 2016, we recruited 160 patients with a diagnosis of bipolar disorder as per International Classification of Diseases-10: Clinical Descriptions and Diagnostic Guidelines. The diagnosis was further confirmed by using the MINI International Neuropsychiatric Inventory. All of them were currently in remission (confirmed by standard measures) and on stable dosing of medication for at least a year. Medication adherence was assessed using Tamil validated version of Morisky Medication Adherence Scale. Patients were dichotomized into low adherence (<6) and high adherence (≥6) groups and compared on various socio-demographic and clinical variables. Results: Majority of the sample (n=97, 60.6%) demonstrated low adherence to treatment regimen. Being employed and having spent greater number of days in hospital were predictive of higher medication adherence (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.019-7.585; and OR 1.02, 95% CI 1.003-1.037, respectively). Fewer number of lifetime depressive episodes and positive drug attitudes demonstrated trend level positive association with high medication adherence. Conclusion: Non-adherence to prescribed medications is a common problem in bipolar disorder. Interventions targeting vocation, medication focused psychoeducation and promotion of positive drug attitudes are likely to enhance medication adherence in this group.
Risk Factors and Surgical Treatment for Recurrent Lumbar Disc Prolapse: A Review of the Literature
Bharat R. Dave,Devanand Degulmadi,Ajay Krishnan,Shivanand Mayi 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.1
We aim to present the current evidence on various risk factors and surgical treatment modalities for recurrent lumbar disc herniation (rLDH). Using PubMed, a literature search was performed using the Mesh terms “recurrent disc prolapse,” “herniated lumbar disc,” “risk factors,” and “treatment.” Articles that were published between January 2010 and May 2017 were selected for further screening. A search conducted through PubMed identified 213 articles that met the initial screening criteria. Detailed analyses showed that 34 articles were eligible for inclusion in this review. Sixteen articles reported the risk factors associated with rLDH. Decompression alone as a treatment option was studied in seven articles, while 11 articles focused on different types of fusion surgery (anterior lumbar interbody fusion, posterior lumbar interbody fusion, open transforaminal lumbar interbody fusion [TLIF], and minimally invasive surgery-TLIF). Management of the rLDH requires consideration of the possible risk factors present in individual patients before primary and at the time of second surgery. Both, minimally invasive and conventional open procedures are comparably effective in relieving leg pain, and minimally invasive techniques offer advantage over the other technique in terms of tissue sparing. Non-fusion surgeries involve the risk of lumbar disc herniation re-recurrence, and the patient may require a third (fusion) surgery.