Handbook of Research on Unemployment and Labor Market Sustainability in the Era of Globalization, 2017
At a time when the Indian subcontinent is beset with a burgeoning population, rapid urbanization,... more At a time when the Indian subcontinent is beset with a burgeoning population, rapid urbanization, and high disposable incomes, the Indian economy is at a precarious stage of balancing demand uncertainties with pressures to minimize bottom line costs. As a consequence, there is great reliance on a dynamic workforce, which comprises of temporary, contract, and casual laborers referred to as the contingent workforce. A talent war is looming on the horizon and employers need to buckle up their workforce armory with an unparalleled employee value proposition, making the business landscape a tricky vehicle to maneuver. A robust strategic framework bolstered by prudent workforce management will aid an organization to fulfill its goals while isolating it from any legal liability. Technology can be used to leverage data analytically for job assessment and aid in seamless project execution. In sum, an approach sensitive to the legal, technological and psychological pillars of managing workers...
Annals of International medical and Dental Research, 2017
Introduction: Injuries to lacrimal apparatus in blunt trauma to face can present as epiphora cons... more Introduction: Injuries to lacrimal apparatus in blunt trauma to face can present as epiphora consequent upon acute or chronic obstruction of nasolacrimal pathway. Preoperative assessment of level, cause of obstruction is imperative in planning treatment. Case Report: 26 year male presented with epiphora, discharging sinus lateral to nasal ala following surgical repair of facial trauma. Multi detector computed tomography (MDCT) revealed injury to intraosseous part of nasolacrimal dcut with mucocele formation of lacrimal sac. Conclusion: MDCT is useful in assessment of level of injury / obstruction in nasolacrimal apparatus post trauma.
Cash, Demonetisation and the Informal Economy in India
The World Economy, 2018
India took a demonetisation step in November 2016 by banning 500 and 1000 rupee notes as legal te... more India took a demonetisation step in November 2016 by banning 500 and 1000 rupee notes as legal tender benefiting banks but hurting the poor and the under banked. The shadow economy was badly affected and even measured GDP growth rate slumped, but demonetisation proponents argued that the dip will reverse and the growth rate will reach 7.7% in 2019. A cashless economy would accelerate economic activities, curb corruption and protect consumers from fraud, frequent physical transactions and it has been estimated that it would save the Indian exchequer (and taxpayers) an amount equal to approximately 0.25% of GDP. The note withdrawal was a botched up job and demonetisation in India will only succeed if the Government can channelize it as a leverage point for a larger tax base, increased digitisation along with a more transparent, fluid and measurable Indian economy.
Obstructive sleep apnea (OSA) is a complex disorder characterized by collapse of the upper airway... more Obstructive sleep apnea (OSA) is a complex disorder characterized by collapse of the upper airway during sleep. Downstream effects involve the cardiovascular, pulmonary, and neurocognitive systems. OSA is more prevalent in men than women. Clinical symptoms suggest the diagnosis of OSA but none is pathognomonic of the condition. With rising awareness of OSA and the increasing prevalence of obesity, OSA is increasingly recognized as a major contributor to cardiovascular morbidity including systemic and pulmonary arterial hypertension, heart failure, acute coronary syndromes, atrial fibrillation, and other arrhythmias. Pulmonary manifestations include the development of chronic thromboembolic disease, which can then lead to chronic thromboembolic pulmonary hypertension (CTEPH). Neurocognitive morbidities include stroke and neurobehavioral disorders. Screening for OSA includes the use of symptom questionnaires and the diagnosis is confirmed by polysomnography. Management primarily inclu...
Sustainable exploration of oil and natural gas on economic and ecological basis
International Journal on Environmental Sciences, 2014
The paper elucidates the adverse ecological impacts of oil exploration. Four case studies are bri... more The paper elucidates the adverse ecological impacts of oil exploration. Four case studies are briefly discussed, throwing light upon issues that are considered tangential to the oil sustainability debate. Oil wells have historically been vulnerable to both wartime and asymmetrical threats, thus posing a grave risk to both human safety and the environment. Oil spills mostly attributed to human error, have an equally deleterious impact on the flora and fauna, such as in the Mumbai oil spill. Indian market policies are known to be greatly influenced by communism with freebies on behalf of the exchequer being a classic example. The Indian economy besmirched by such consumer-end freebies has led to a debt ridden oil sector, discouraging further research in eco-friendly oil production. Lastly the contentious issue of why India should take a cautious approach in shale gas exploration with its dubious environmental credentials is analyzed. Drawing from the case studies, certain recommendati...
A Study on Fractional Replacement of Bitumen with Crumb Rubber
The main aim of this study was to determine an alternative for bitumen which will satisfy the phy... more The main aim of this study was to determine an alternative for bitumen which will satisfy the physical and binding properties of bitumen in terms of strength, endurance, and flexibility. The asphalt market is looking for alternative sustainable binders that can (fractionally) replace the bitumen in terms of environmental sustainability and which may also augment the availability of binders. In this research study, crumb rubber has been consumed in bituminous mixes and its optimum content percentage is found, the crumb rubber is used in powdered form and that amount has been replaced from the quantity of bitumen. Standard Marshal Mix design and Penetration test and Ductility test were performed. The various percentages of crumb rubber (from 2% to 10% by the weight of bitumen) were used to prepare the samples, with optimum value of bitumen content (5%). It was observed that crumb rubber at 6% (by weight of bitumen) and at 5% Optimum Bitumen Content came out to be optimum percentage of...
Basmati is long grain aromatic rice grown for many centuries in the specific geographical area at... more Basmati is long grain aromatic rice grown for many centuries in the specific geographical area at the Himalayan foot hills of Indian sub-continent. India being the world's largest producer, contributes more than 70 per cent of the total world basmati rice production. The present study was conducted in Bishnah and R.S. Pura blocks of Jammu district of Union Territory (UT) of J&K. The study revealed that on an average per farm marketed surplus comes to 17.48 quintals, whereas it was 44.71 quintals on medium farms followed by 23.27 quintals on small farm and 10.15 quintals on marginal farms respectively. The investigation revealed that the producer share in consumers rupee was highest that is 79.10 per cent in channel-I that is producer to consumer followed by channel-Il 43.14 per cent, channel-IV 40.57 per cent and channel-Ill 39.53 per cent respectively. The channel-I that is producer to consumer was the most efficient channel with having the marketing efficiency of 3.79 followed by channel Il (3.46), channel-Ill (2.36) and channel-IV (1.68) respectively.
1. Bo GP, Cocito L, Maffini M, et al. Arterial hypertension caused by carbamazepine. Riv Neurol. ... more 1. Bo GP, Cocito L, Maffini M, et al. Arterial hypertension caused by carbamazepine. Riv Neurol. 1987;57:333–335. 2. Downey P, Fajuri A, Vald es G. Refractory arterial hypertension and the use of anticonvulsant drugs: case report. Rev Med Chil. 2001;129:1325–1327. 3. Jette N, Veregin T, Guberman A. Carbamazepine-induced hypertension. Neurology 2002;59:275–276. 4. Marini AM, Choi JY, Labutta RJ. Transient neurologic deficits associated with carbamazepine-induced hypertension. Clin Neuropharmacol. 2003;26:174–176. 5. Frangos Lordos E, Trombert V, Kuzmanovic I, et al. Druginduced refractory arterial hypertension. Rev Med Suisse. 2005;1:2525–2526. 6. Furuta N, Fujita Y, Sekine A, et al. Reversible posterior leukoencephalopathy syndrome associated with carbamazepine-induced hypertension [in Japanese]. Rinsho Shinkeigaku. 2009;49:191–193. 7. Electronic Medicines Compendium (eMC). Summary of Product Characteristics: Tegretol (Carbamazepine), Novartis Limited. Available at: https://www.medicines.org.uk/ emc/printfriendlydocument.aspx?documentid51328. Accessed July 24, 2014.
Journal of Evolution of Medical and Dental Sciences, Feb 25, 2014
To report an atypical and misdiagnosed case of optic neuritis in a young female. METHOD: 26 year ... more To report an atypical and misdiagnosed case of optic neuritis in a young female. METHOD: 26 year healthy female was referred to the Regional Institute of Ophthalmology, Amritsar with the diagnosis of angle closure glaucoma both eyes. Patient was on 2% pilocarpine eye drops q.i.d and tablet acetazolamide 250 mg BD. On examination, visual acuity was 2/60 OD and 1/60 OS. Near vision was 6/36 OU. There was no circumcorneal congestion OU, no corneal edema OU, though anterior chamber was shallow OS >OD with pin pointed non-reacting pupil OU. IOP 14.6mm Hg OD and17.3mm Hg OS. Gonioscopically open angle grade 2. IOP and gonioscopy were repeated after pupil dilatation with tropicamide, findings were consistent with the previous ones. Fundoscopy showed bilateral disc edema with hyperemia and normal foveal reflex. Color vision was defective .Low vision prevented a conclusive perimetry. ONTT protocol was given, on the basis of decreased visual acuity, abnormal color vision, headache, disc changes, open angle and a normal MRI. Patient's vision improved to 6/6 OD 6/9 OS in thirteen days. CONCLUSIONS: Bilateral optic neuritis is rare and an atypical presentation can be misdiagnosed as angle closure glaucoma in presence of severe headache, OU visual loss and shallow anterior chamber.
Acute respiratory distress syndrome (ARDS) is a life-threatening inflammatory state of lung injur... more Acute respiratory distress syndrome (ARDS) is a life-threatening inflammatory state of lung injury that can require acute interventions including mechanical ventilation as well as emergent veno-venous extracorporeal membrane oxygenation (VV-ECMO) for management. Etiologies of ARDS are not clearly discernible in certain cases and can vary from sepsis, pneumonia, trauma and intoxication. Anti-nuclear cytoplasmic auto-antibody (ANCA)associated vasculitis (AAV) is a group of several conditions that can have pulmonary complications including ARDS. We present a case where the primary manifestation of myeloperoxidase (MPO)-ANCA positive vasculitis was ARDS, in order to highlight the importance of investigating rare vasculitides as the underlying cause of ARDS and the importance of ECMO as an early lifesaving intervention for the management of ARDS.
Sarcoidosis is a granulomatous disease of obscure etiology, with multisystem involvement. Myocard... more Sarcoidosis is a granulomatous disease of obscure etiology, with multisystem involvement. Myocardial involvement occurs in at least 25% of patients with Sarcoidosis in the US, and causes 13-25% of deaths from Sarcoidosis [1]. Clinical manifestations range from benign conduction abnormalities to fatal ventricular arrhythmias. The latter are unpredictable and can often be the first manifestation, as seen in our case. CASE PRESENTATION: 24-year-old male, with a remote history of asthma, was transferred from an outside hospital for ICD (implantable cardioverter-defibrillator) placement. He was in his usual state of health prior, with an active lifestyle, and denied sudden death in his family.As per family, he became acutely short of breath after smoking marijuana, was found unresponsive. He was noted to be in ventricular fibrillation by paramedics and defibrillated. In our hospital, review of telemetry strips revealed polymorphic ventricular tachycardia (VT). No prior history of syncopal episodes, chest pain, dyspnea with strenuous activity.
Interstitial lung disease (ILD) is the typical pulmonary manifestation of dermatomyositis/polymyo... more Interstitial lung disease (ILD) is the typical pulmonary manifestation of dermatomyositis/polymyositis (DM-PM), and can precede or follow the diagnosis of DM-PM. We describe a case of the acute form of ILD in DM, which rapidly progressed to respiratory failure and eventual mortality, over a span of few months. CASE PRESENTATION: A 58-year-old woman was recently diagnosed with dermatomyositis (DM) with systemic symptoms of fever, weight loss, myalgias, arthralgias, proximal lower extremity weakness with a positive electromyography, elevated aldolase and typical rashes. Myositis associated antibodies and anti Jo1 were all negative. Despite being on PO prednisone and azathioprine, she had worsening of her lung function and developed new vasculitic lesions on the hands. Over the past month, she became progressively dyspneic on minimal exertion associated with a nonproductive cough and pleuritic chest pain. She was sent to the ER by her rheumatologist for worsening respiratory status.
Aortic dissection is an entity that requires prompt diagnosis and management in order to optimize... more Aortic dissection is an entity that requires prompt diagnosis and management in order to optimize outcomes. Cases in which rapid recognition is missed can threatening a patient's outcome. We present the case of a patient who presented with chest pain where there was a delay in the diagnosis of aortic dissection.
The non-tubercular mycobacterium, Mycobacterium abscessus (M. abscessus), is a resistant, opportu... more The non-tubercular mycobacterium, Mycobacterium abscessus (M. abscessus), is a resistant, opportunistic pathogen that causes lung infections that are not curable, but which can be controlled with appropriate antibiotic regimens. A new broad-spectrum tetracycline analog called omadacycline was approved in 2018 in the United States for the treatment of bacterial, community-acquired pneumonia and acute skin infections. We discuss a case to assess the effect of this novel antibiotic in the management of a nefariously resistant M. abscessus infection. Our patient had underlying chronic bronchiectasis and a long-standing M.abscessus infection, along with numerous drug allergies and previously failed antibiotic regimens. All of these factors entailed a disease process that was difficult to manage and a worsening morbidity. The utilization of omadacycline in this case addressed a multitude of problems by improving ease of administration and circumventing the patient's allergic reaction to antibiotics; on follow-up, the patient demonstrated an improved clinical status including well-controlled symptoms and weight gain.
Handbook of Research on Unemployment and Labor Market Sustainability in the Era of Globalization, 2017
At a time when the Indian subcontinent is beset with a burgeoning population, rapid urbanization,... more At a time when the Indian subcontinent is beset with a burgeoning population, rapid urbanization, and high disposable incomes, the Indian economy is at a precarious stage of balancing demand uncertainties with pressures to minimize bottom line costs. As a consequence, there is great reliance on a dynamic workforce, which comprises of temporary, contract, and casual laborers referred to as the contingent workforce. A talent war is looming on the horizon and employers need to buckle up their workforce armory with an unparalleled employee value proposition, making the business landscape a tricky vehicle to maneuver. A robust strategic framework bolstered by prudent workforce management will aid an organization to fulfill its goals while isolating it from any legal liability. Technology can be used to leverage data analytically for job assessment and aid in seamless project execution. In sum, an approach sensitive to the legal, technological and psychological pillars of managing workers...
Annals of International medical and Dental Research, 2017
Introduction: Injuries to lacrimal apparatus in blunt trauma to face can present as epiphora cons... more Introduction: Injuries to lacrimal apparatus in blunt trauma to face can present as epiphora consequent upon acute or chronic obstruction of nasolacrimal pathway. Preoperative assessment of level, cause of obstruction is imperative in planning treatment. Case Report: 26 year male presented with epiphora, discharging sinus lateral to nasal ala following surgical repair of facial trauma. Multi detector computed tomography (MDCT) revealed injury to intraosseous part of nasolacrimal dcut with mucocele formation of lacrimal sac. Conclusion: MDCT is useful in assessment of level of injury / obstruction in nasolacrimal apparatus post trauma.
Cash, Demonetisation and the Informal Economy in India
The World Economy, 2018
India took a demonetisation step in November 2016 by banning 500 and 1000 rupee notes as legal te... more India took a demonetisation step in November 2016 by banning 500 and 1000 rupee notes as legal tender benefiting banks but hurting the poor and the under banked. The shadow economy was badly affected and even measured GDP growth rate slumped, but demonetisation proponents argued that the dip will reverse and the growth rate will reach 7.7% in 2019. A cashless economy would accelerate economic activities, curb corruption and protect consumers from fraud, frequent physical transactions and it has been estimated that it would save the Indian exchequer (and taxpayers) an amount equal to approximately 0.25% of GDP. The note withdrawal was a botched up job and demonetisation in India will only succeed if the Government can channelize it as a leverage point for a larger tax base, increased digitisation along with a more transparent, fluid and measurable Indian economy.
Obstructive sleep apnea (OSA) is a complex disorder characterized by collapse of the upper airway... more Obstructive sleep apnea (OSA) is a complex disorder characterized by collapse of the upper airway during sleep. Downstream effects involve the cardiovascular, pulmonary, and neurocognitive systems. OSA is more prevalent in men than women. Clinical symptoms suggest the diagnosis of OSA but none is pathognomonic of the condition. With rising awareness of OSA and the increasing prevalence of obesity, OSA is increasingly recognized as a major contributor to cardiovascular morbidity including systemic and pulmonary arterial hypertension, heart failure, acute coronary syndromes, atrial fibrillation, and other arrhythmias. Pulmonary manifestations include the development of chronic thromboembolic disease, which can then lead to chronic thromboembolic pulmonary hypertension (CTEPH). Neurocognitive morbidities include stroke and neurobehavioral disorders. Screening for OSA includes the use of symptom questionnaires and the diagnosis is confirmed by polysomnography. Management primarily inclu...
Sustainable exploration of oil and natural gas on economic and ecological basis
International Journal on Environmental Sciences, 2014
The paper elucidates the adverse ecological impacts of oil exploration. Four case studies are bri... more The paper elucidates the adverse ecological impacts of oil exploration. Four case studies are briefly discussed, throwing light upon issues that are considered tangential to the oil sustainability debate. Oil wells have historically been vulnerable to both wartime and asymmetrical threats, thus posing a grave risk to both human safety and the environment. Oil spills mostly attributed to human error, have an equally deleterious impact on the flora and fauna, such as in the Mumbai oil spill. Indian market policies are known to be greatly influenced by communism with freebies on behalf of the exchequer being a classic example. The Indian economy besmirched by such consumer-end freebies has led to a debt ridden oil sector, discouraging further research in eco-friendly oil production. Lastly the contentious issue of why India should take a cautious approach in shale gas exploration with its dubious environmental credentials is analyzed. Drawing from the case studies, certain recommendati...
A Study on Fractional Replacement of Bitumen with Crumb Rubber
The main aim of this study was to determine an alternative for bitumen which will satisfy the phy... more The main aim of this study was to determine an alternative for bitumen which will satisfy the physical and binding properties of bitumen in terms of strength, endurance, and flexibility. The asphalt market is looking for alternative sustainable binders that can (fractionally) replace the bitumen in terms of environmental sustainability and which may also augment the availability of binders. In this research study, crumb rubber has been consumed in bituminous mixes and its optimum content percentage is found, the crumb rubber is used in powdered form and that amount has been replaced from the quantity of bitumen. Standard Marshal Mix design and Penetration test and Ductility test were performed. The various percentages of crumb rubber (from 2% to 10% by the weight of bitumen) were used to prepare the samples, with optimum value of bitumen content (5%). It was observed that crumb rubber at 6% (by weight of bitumen) and at 5% Optimum Bitumen Content came out to be optimum percentage of...
Basmati is long grain aromatic rice grown for many centuries in the specific geographical area at... more Basmati is long grain aromatic rice grown for many centuries in the specific geographical area at the Himalayan foot hills of Indian sub-continent. India being the world's largest producer, contributes more than 70 per cent of the total world basmati rice production. The present study was conducted in Bishnah and R.S. Pura blocks of Jammu district of Union Territory (UT) of J&K. The study revealed that on an average per farm marketed surplus comes to 17.48 quintals, whereas it was 44.71 quintals on medium farms followed by 23.27 quintals on small farm and 10.15 quintals on marginal farms respectively. The investigation revealed that the producer share in consumers rupee was highest that is 79.10 per cent in channel-I that is producer to consumer followed by channel-Il 43.14 per cent, channel-IV 40.57 per cent and channel-Ill 39.53 per cent respectively. The channel-I that is producer to consumer was the most efficient channel with having the marketing efficiency of 3.79 followed by channel Il (3.46), channel-Ill (2.36) and channel-IV (1.68) respectively.
1. Bo GP, Cocito L, Maffini M, et al. Arterial hypertension caused by carbamazepine. Riv Neurol. ... more 1. Bo GP, Cocito L, Maffini M, et al. Arterial hypertension caused by carbamazepine. Riv Neurol. 1987;57:333–335. 2. Downey P, Fajuri A, Vald es G. Refractory arterial hypertension and the use of anticonvulsant drugs: case report. Rev Med Chil. 2001;129:1325–1327. 3. Jette N, Veregin T, Guberman A. Carbamazepine-induced hypertension. Neurology 2002;59:275–276. 4. Marini AM, Choi JY, Labutta RJ. Transient neurologic deficits associated with carbamazepine-induced hypertension. Clin Neuropharmacol. 2003;26:174–176. 5. Frangos Lordos E, Trombert V, Kuzmanovic I, et al. Druginduced refractory arterial hypertension. Rev Med Suisse. 2005;1:2525–2526. 6. Furuta N, Fujita Y, Sekine A, et al. Reversible posterior leukoencephalopathy syndrome associated with carbamazepine-induced hypertension [in Japanese]. Rinsho Shinkeigaku. 2009;49:191–193. 7. Electronic Medicines Compendium (eMC). Summary of Product Characteristics: Tegretol (Carbamazepine), Novartis Limited. Available at: https://www.medicines.org.uk/ emc/printfriendlydocument.aspx?documentid51328. Accessed July 24, 2014.
Journal of Evolution of Medical and Dental Sciences, Feb 25, 2014
To report an atypical and misdiagnosed case of optic neuritis in a young female. METHOD: 26 year ... more To report an atypical and misdiagnosed case of optic neuritis in a young female. METHOD: 26 year healthy female was referred to the Regional Institute of Ophthalmology, Amritsar with the diagnosis of angle closure glaucoma both eyes. Patient was on 2% pilocarpine eye drops q.i.d and tablet acetazolamide 250 mg BD. On examination, visual acuity was 2/60 OD and 1/60 OS. Near vision was 6/36 OU. There was no circumcorneal congestion OU, no corneal edema OU, though anterior chamber was shallow OS >OD with pin pointed non-reacting pupil OU. IOP 14.6mm Hg OD and17.3mm Hg OS. Gonioscopically open angle grade 2. IOP and gonioscopy were repeated after pupil dilatation with tropicamide, findings were consistent with the previous ones. Fundoscopy showed bilateral disc edema with hyperemia and normal foveal reflex. Color vision was defective .Low vision prevented a conclusive perimetry. ONTT protocol was given, on the basis of decreased visual acuity, abnormal color vision, headache, disc changes, open angle and a normal MRI. Patient's vision improved to 6/6 OD 6/9 OS in thirteen days. CONCLUSIONS: Bilateral optic neuritis is rare and an atypical presentation can be misdiagnosed as angle closure glaucoma in presence of severe headache, OU visual loss and shallow anterior chamber.
Acute respiratory distress syndrome (ARDS) is a life-threatening inflammatory state of lung injur... more Acute respiratory distress syndrome (ARDS) is a life-threatening inflammatory state of lung injury that can require acute interventions including mechanical ventilation as well as emergent veno-venous extracorporeal membrane oxygenation (VV-ECMO) for management. Etiologies of ARDS are not clearly discernible in certain cases and can vary from sepsis, pneumonia, trauma and intoxication. Anti-nuclear cytoplasmic auto-antibody (ANCA)associated vasculitis (AAV) is a group of several conditions that can have pulmonary complications including ARDS. We present a case where the primary manifestation of myeloperoxidase (MPO)-ANCA positive vasculitis was ARDS, in order to highlight the importance of investigating rare vasculitides as the underlying cause of ARDS and the importance of ECMO as an early lifesaving intervention for the management of ARDS.
Sarcoidosis is a granulomatous disease of obscure etiology, with multisystem involvement. Myocard... more Sarcoidosis is a granulomatous disease of obscure etiology, with multisystem involvement. Myocardial involvement occurs in at least 25% of patients with Sarcoidosis in the US, and causes 13-25% of deaths from Sarcoidosis [1]. Clinical manifestations range from benign conduction abnormalities to fatal ventricular arrhythmias. The latter are unpredictable and can often be the first manifestation, as seen in our case. CASE PRESENTATION: 24-year-old male, with a remote history of asthma, was transferred from an outside hospital for ICD (implantable cardioverter-defibrillator) placement. He was in his usual state of health prior, with an active lifestyle, and denied sudden death in his family.As per family, he became acutely short of breath after smoking marijuana, was found unresponsive. He was noted to be in ventricular fibrillation by paramedics and defibrillated. In our hospital, review of telemetry strips revealed polymorphic ventricular tachycardia (VT). No prior history of syncopal episodes, chest pain, dyspnea with strenuous activity.
Interstitial lung disease (ILD) is the typical pulmonary manifestation of dermatomyositis/polymyo... more Interstitial lung disease (ILD) is the typical pulmonary manifestation of dermatomyositis/polymyositis (DM-PM), and can precede or follow the diagnosis of DM-PM. We describe a case of the acute form of ILD in DM, which rapidly progressed to respiratory failure and eventual mortality, over a span of few months. CASE PRESENTATION: A 58-year-old woman was recently diagnosed with dermatomyositis (DM) with systemic symptoms of fever, weight loss, myalgias, arthralgias, proximal lower extremity weakness with a positive electromyography, elevated aldolase and typical rashes. Myositis associated antibodies and anti Jo1 were all negative. Despite being on PO prednisone and azathioprine, she had worsening of her lung function and developed new vasculitic lesions on the hands. Over the past month, she became progressively dyspneic on minimal exertion associated with a nonproductive cough and pleuritic chest pain. She was sent to the ER by her rheumatologist for worsening respiratory status.
Aortic dissection is an entity that requires prompt diagnosis and management in order to optimize... more Aortic dissection is an entity that requires prompt diagnosis and management in order to optimize outcomes. Cases in which rapid recognition is missed can threatening a patient's outcome. We present the case of a patient who presented with chest pain where there was a delay in the diagnosis of aortic dissection.
The non-tubercular mycobacterium, Mycobacterium abscessus (M. abscessus), is a resistant, opportu... more The non-tubercular mycobacterium, Mycobacterium abscessus (M. abscessus), is a resistant, opportunistic pathogen that causes lung infections that are not curable, but which can be controlled with appropriate antibiotic regimens. A new broad-spectrum tetracycline analog called omadacycline was approved in 2018 in the United States for the treatment of bacterial, community-acquired pneumonia and acute skin infections. We discuss a case to assess the effect of this novel antibiotic in the management of a nefariously resistant M. abscessus infection. Our patient had underlying chronic bronchiectasis and a long-standing M.abscessus infection, along with numerous drug allergies and previously failed antibiotic regimens. All of these factors entailed a disease process that was difficult to manage and a worsening morbidity. The utilization of omadacycline in this case addressed a multitude of problems by improving ease of administration and circumventing the patient's allergic reaction to antibiotics; on follow-up, the patient demonstrated an improved clinical status including well-controlled symptoms and weight gain.
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Papers by Shaurya Sharma