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Mishra VN, Tripathi CB, Kumar A, Nandmer V, Ansari AZ, Kumar B, Chaurasia RN, Joshi D. Lathyrism: has the scenario changed in 2013? Neurol Res 2013; 36:38-40. [DOI: 10.1179/1743132813y.0000000258] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Neufeld KJ, Leoutsakos JS, Sieber FE, Joshi D, Wanamaker BL, Rios-Robles J, Needham DM. Evaluation of two delirium screening tools for detecting post-operative delirium in the elderly. Br J Anaesth 2013; 111:612-8. [PMID: 23657522 DOI: 10.1093/bja/aet167] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Postoperative delirium in the elderly is common and associated with poor outcomes, but often goes unrecognized. Delirium screening tools, validated in postoperative settings are lacking. This study compares two screening tools [Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Nursing Delirium Symptom Checklist (NuDESC)] with a DSM-IV-based diagnosis of delirium, conducted by neuropsychiatric examination in postoperative settings. METHODS Consecutive English-speaking patients, ≥70 yr, undergoing surgery with general anaesthesia and capable of providing informed consent, were recruited. Diagnostic test characteristics were compared for each screening tool vs neuropsychiatric examination, both in the Post-Anaesthesia Care Unit (PACU), and daily during inpatient hospitalization, adjusting for repeated measures. RESULTS Neuropsychiatric examination identified delirium in 45% of 91 patients evaluated in the PACU and in 32% of 166 subsequent delirium assessments on the ward in the 58 admitted patients. The sensitivity [95% confidence interval (CI)] of delirium detection of the CAM-ICU in the PACU, and in all repeated assessments was 28% (16-45%) and 28% (17-42%), respectively; for the NuDESC (scoring threshold ≥2), 32% (19-48%) and 29% (19-42%), respectively, and the NuDESC (threshold ≥1), 80% (65-91%) and 72% (60-82%), respectively. Specificity was >90% for both the CAM-ICU and the NuDESC (threshold ≥2); specificity for the NuDESC (threshold ≥1), in the PACU was 69% (54-80%) and 80% (73-85%) for all assessments. CONCLUSIONS While highly specific, neither CAM-ICU nor NuDESC (threshold ≥2) are adequately sensitive to identify delirium post-operatively; NuDESC (threshold ≥1) increases sensitivity, but reduces specificity.
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Joshi D, Carey I, Agarwal K. Review article: the treatment of genotype 1 chronic hepatitis C virus infection in liver transplant candidates and recipients. Aliment Pharmacol Ther 2013; 37:659-71. [PMID: 23432320 DOI: 10.1111/apt.12260] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 12/20/2012] [Accepted: 02/03/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Recently, the therapeutic landscape with regard to anti-HCV therapy has changed dramatically. The new directly acting anti-virals (DAAs) have demonstrated improved sustained virological response (SVR) compared with pegylated-interferon and ribavirin. AIM To examine and present the latest data with regard to anti-viral therapy in genotype 1 HCV-positive transplant candidates and recipients. METHODS An electronic search using Medline was performed. Search terms included 'HCV, DAA and protease inhibitor' in combination with 'treatment pre-transplantation' and 'treatment post-transplantation'. RESULTS Patients with advanced fibrosis and cirrhosis have inferior SVR rates compared with patients with minimal fibrosis. A low accelerating dose regimen (LADR) of pegylated interferon and ribavirin (PR) appears to be a safe therapeutic option. Side effects also appear to be more pronounced in patients with advanced disease. Data from the large registration studies with triple therapy (boceprevir or telaprevir plus PR) demonstrated improved SVR rates even in patients with advanced disease, although virological relapse rates were highest amongst these patients. In transplant recipients, initial data are being reported on the use of triple therapy, and although no SVR data are available, promising results are accruing. The drug-drug interactions appear to be manageable. Side effects in particular anaemia appear to be markedly increased in the posttransplant setting. CONCLUSIONS The use of the new DAAs in patients with advanced fibrosis/cirrhosis pretransplant and posttransplant appears possible, with manageable side effects and drug-drug interactions, and improved early virological response rates. We recommend that these patients are managed in centres with the appropriate expertise.
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Sheikh T, Patel B, Joshi D, Patel R, Jegoda M. Repeated dose oral toxicity of inorganic mercury in wistar rats: biochemical and morphological alterations. Vet World 2013. [DOI: 10.5455/vetworld.2013.563-567] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Joshi D, Spokes R. Case report: anaplastic large cell lymphoma associated with a breast implant capsule: importance of histological examination of breast capsule implant specimens. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32835-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Joshi D, Chatterjee P, Kumar B, Ansari A, Mishra V, Chaurasia R, Kumar B, Desai T. 1.032 NON-MOTOR SYMPTOMS AND QUALITY OF LIFE IN PATIENTS WITH PARKINSON'S DISEASE. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70146-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Joshi D, Spokes R. Case report: colonic tuberculosis mimicking crohn’s disease: importance of histological examination. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32834-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chatterjee P, Joshi D, Kumar B, Ansari A, Mishra V, Chaurasia R, Kumar B, Desai T. 1.067 NEUROPSYCHOLOGICAL PROFILE OF PATIENTS WITH IDIOPATHIC PARKINSON'S DISEASE. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70181-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Mittal D, Joshi D, Shukla S. Hepatoprotective effects of Polygonum bistorta (Linn.) and its active compound against acetaminophen-induced toxicity in rats. Toxicol Lett 2011. [DOI: 10.1016/j.toxlet.2011.05.809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Westbrook RH, Joshi D, Prachalias A. An 'illuminating' CT. Gut 2011; 60:1067, 1132. [PMID: 21636643 DOI: 10.1136/gut.2010.226902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Bhattacharya V, Purwar S, Joshi D, Kumar M, Mandal S, Chaudhuri G, Bhattacharya S. Electrophysiological and histological changes in extrinsic muscles proximal to post burn contractures of hand. Burns 2011; 37:692-7. [DOI: 10.1016/j.burns.2011.01.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 01/20/2011] [Accepted: 01/24/2011] [Indexed: 11/29/2022]
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Shrestha MR, Sherchan S, Shakya R, Joshi D. Monthly pattern of psychiatric morbidity and duration of stay among the patients admitted in Mental Hospital, a central level tertiary care hospital. NEPAL MEDICAL COLLEGE JOURNAL : NMCJ 2011; 13:133-136. [PMID: 22364100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Psychiatric morbidity is a major public health problem in the world across developed and developing countries. There is a paucity of Nepalese studies on psychiatric morbidity. All the patients who were admitted in mental hospital, Lagankhel from 17th July 2009 to 16th July 2010 were included in this study. Information on their Socio-demographic profiles and hospital diagnosis was extracted from their clinical notes. Eight hundred and fifty two patients were included in this study. Fifty eight percent were males. More than sixty percent of the patients were aged between 21 and 40 years. Sixty patients were married. In terms of ICD 10 diagnosis, the most common diagnoses were Schizophrenia in 427 (50.1%), mood disorders in 286 (33.5%) and substance use disorder in 80 (9.3%). In terms of length of stay, majority of them (56.4%) had stayed for 0-14 days. Thus, there is a need to increase the awareness in the general public regarding the impact of mental illness and the need for timely treatment.
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Singh R, Joshi D, Sharma SM, Singh P, Gangane N. Xanthogranulomatous salpingitis with enterobial appendicitis. J OBSTET GYNAECOL 2011; 31:95-6. [PMID: 21281012 DOI: 10.3109/01443615.2010.514622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Westbrook RH, Yeoman AD, Joshi D, Heaton ND, Quaglia A, O'Grady JG, Auzinger G, Bernal W, Heneghan MA, Wendon JA. Outcomes of severe pregnancy-related liver disease: refining the role of transplantation. Am J Transplant 2010; 10:2520-6. [PMID: 20977643 DOI: 10.1111/j.1600-6143.2010.03301.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Severe liver disease in pregnancy is generally considered to have a favorable prognosis. The limited data available have not yielded disease-specific prognostic criteria or guidance on who should undergo liver transplantation (LT). We retrospectively evaluated 54 admissions with pregnancy-related liver disease to (1) evaluate if any admission parameters were associated with death and/or transplantation and (2) identify maternal complications. Eighteen had acute fatty liver of pregnancy and 32 had hypertension/eclampsia related disease. Seven patients (13%) died and four (7%) underwent LT. Survival rates were 43/48 if not listed for LT and 4/6 if listed. Of the four transplanted, three survived. Patients who died and/or underwent LT were more likely to have encephalopathy (p = 0.04) and hyperlactaemia (p = 0.03). Serum lactate was the best discriminant (ROC AUC 0.84). An admission lactate greater than 2.8mg/dL had 73% sensitivity and 75% specificity for predicting death or LT. The addition of encephalopathy to this parameter increased sensitivity and specificity to 90% and 86%, respectively. The King's College criteria were not effective in predicting outcome. This study confirms the overall favorable prognosis in pregnancy-related liver failure but indicates that elevated lactate levels in the presence of encephalopathy best identify patients at greatest risk of death or LT.
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Mishra S, Joshi D, Ribeiro R, Anand S. Kinematics-coordinated walking pattern based on embedded controls. J Med Eng Technol 2010; 34:329-34. [PMID: 20482248 DOI: 10.3109/03091902.2010.481035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Electromechanical above-knee prosthetics are widely available, and are reliant on repetitive knee movements of fixed length/angle. This work explores the viability of developing adaptive movements on existing prototypes, through embedded controls from 8051-class 8-bit microcontroller units (MCUs). The system includes an integrated goniometer, intended for measuring the knee angle of the sound limb. The phase delay is subsequently processed to bring about kinematic coordination in the proposed echo-controlled prosthetic.
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Joshi D, Park MH, Saeung A, Choochote W, Min GS. Multiplex assay to identify Korean vectors of malaria. Mol Ecol Resour 2010; 10:748-50. [PMID: 21565085 DOI: 10.1111/j.1755-0998.2010.02835.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Following the recent emergence of malaria in South Korea, vector control has been an important task. For this, vector identification is very important. Earlier, two PCR-based assays have been described. But, poor species resolution and their ability to include only 4-5 species limit their use. Thus, it has now become important to revise the assay identifying these members. In this study, a new assay based on internal transcribed spacer 2 and 28S of ribosomal DNA has been described. The assay successfully identified all the Korean malaria vector mosquitoes. Therefore, it is an indispensable tool to study ecology, abundance and biology of these species.
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Joshi D, Saha S, Bernal W, Wendon J, Auzinger G. Advanced haemodynamic assessment of patients with liver disease and abdominal compartment syndrome. Crit Care 2010. [PMCID: PMC2933988 DOI: 10.1186/cc8769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Joshi D, Saha S, Bernal W, Wendon J, Auzinger G. Budd-Chiari syndrome complicated by abdominal compartment syndrome: evidence of central hypovolaemia? Crit Care 2010. [PMCID: PMC2934372 DOI: 10.1186/cc8325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Joshi D, Shiwalkar A, Cross MR, Sharma SK, Vachhani A, Dutt C. Continuous, non-invasive measurement of the haemodynamic response to submaximal exercise in patients with diabetes mellitus: evidence of impaired cardiac reserve and peripheral vascular response. Heart 2009; 96:36-41. [PMID: 19850585 PMCID: PMC3272706 DOI: 10.1136/hrt.2009.177113] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Reduced exercise capacity in diabetics has been attributed to limitations in cardiac function and microvascular dysfunction leading to impaired oxygen supply and nutritive perfusion to exercising muscles. OBJECTIVE To study changes in cardiac function and microvascular utilisation during exercise in diabetic individuals compared to age-matched controls. METHODS Diabetics with glycosylated haemoglobin (HbA(1c)) < 8 (n = 31), diabetics with HbA(1c) > or = 8 (n = 38) and age-matched non-diabetic controls (n = 32) performed exercise at 50 W for 10 minutes followed by recovery, with continuous monitoring of cardiac function by impedance cardiography and regional flow and oxygen saturation by laser Doppler and white light spectroscopy. RESULTS In the diabetics, cardiac reserve during exercise and cardiac overshoot during recovery are significantly reduced because of reduction in capacity to increase stroke volume. Regional flow to the exercising muscle is reduced and there is also disproportionately greater desaturation of the regional flow. Abnormalities in cardiac function and regional perfusion are related to the severity of diabetes. CONCLUSION Cardiac response to exercise is attenuated significantly in diabetic individuals. Simultaneously, there is impairment in the regional distribution. These changes could be the harbinger of reduced exercise capacity in diabetics.
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Joshi D, Kumar N, Patidar S. PO26-TH-29 Monomelic amyotrophy associated with Beckers Nevus: a case report. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)71170-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cross TJS, Quaglia A, Hughes S, Joshi D, Harrison PM. The impact of hepatic steatosis on the natural history of chronic hepatitis C infection. J Viral Hepat 2009; 16:492-9. [PMID: 19200134 DOI: 10.1111/j.1365-2893.2009.01098.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Since patients with hepatitis C virus (HCV) often have hepatic steatosis, this retrospective analysis aimed to assess whether steatosis influences fibrosis progression. We studied 112 HCV RNA positive subjects (median age 44, IQR 39-51 years), who had two liver biopsies performed (median biopsy interval 50, 34-74 months). Fibrosis was staged using the Ishak method and steatosis by the Kleiner system (<5% steatosis = S0, 5-33% = S1, 33-66% = S2, and >66% = S3). The subjects were untreated because they had mild fibrosis (n = 59), declined therapy (n = 48), or had co-existing disease precluding treatment (n = 5). On first liver biopsy, 60 (54%) had S0, 34 (30%) had S1, 12 (11%) had S2, and 6 (5%) had S3. Steatosis was associated with genotype 3, odds ratio 4.8 (95% CI 1.3-16.7, P = 0.02). Twenty-three patients (21%) had disease progression on the second biopsy, defined as an increase in Ishak score by > or =1 stage. On univariate analysis, fibrosis progression was associated with older age (P = 0.004), higher AST (P = 0.04), and steatosis (P = 0.005) but on multivariate analysis, only baseline steatosis was significant, odds ratio 14.3 (2.1-111.1, P = 0.006). Kaplan-Meier analysis demonstrated that steatosis impacted on time to progression to both significant fibrosis (Ishak > or =F3) and cirrhosis (Ishak F5-6) (P = 0.001 and P = 0.049, respectively). The finding that steatosis was significantly associated with fibrosis progression indicates that, independent of baseline fibrosis stage, patients should be considered for anti-viral treatment if steatosis is present. Furthermore, strategies to reduce steatosis may have a beneficial effect on fibrosis progression and, therefore, patient outcome.
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Frazer JK, Meeker ND, Rudner L, Bradley DF, Smith ACH, Demarest B, Joshi D, Locke EE, Hutchinson SA, Tripp S, Perkins SL, Trede NS. Heritable T-cell malignancy models established in a zebrafish phenotypic screen. Leukemia 2009; 23:1825-35. [PMID: 19516274 PMCID: PMC2761994 DOI: 10.1038/leu.2009.116] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
T cell neoplasias are common in pediatric oncology, and include acute lymphoblastic leukemia (T-ALL) and lymphoblastic lymphoma (T-LBL). These cancers have worse prognoses than their B cell counterparts, and their treatments carry significant morbidity. While many pediatric malignancies have characteristic translocations, most T lymphocyte-derived diseases lack cytogenetic hallmarks. Lacking these informative lesions, insight into their molecular pathogenesis is less complete. Although dysregulation of the NOTCH1 pathway occurs in a substantial fraction of cases, many other genetic lesions of T cell malignancy have not yet been determined. To address this deficiency, we pioneered a phenotype-driven forward-genetic screen in zebrafish (Danio rerio). Using transgenic fish with T lymphocyte-specific expression of enhanced green fluorescent protein (EGFP), we performed chemical mutagenesis, screened animals for GFP+ tumors, and identified multiple lines with a heritable predisposition to T cell malignancy. In each line, patterns of infiltration and morphologic appearance resembled human T-ALL and T-LBL. T cell receptor analyses confirmed their clonality. Malignancies were transplantable and contained leukemia-initiating cells (LIC), like their human correlates. In summary, we have identified multiple zebrafish mutants that recapitulate human T cell neoplasia and show heritable transmission. These vertebrate models provide new genetic platforms for the study of these important human cancers.
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Shyangwa PM, Joshi D, Sherchan S, Thapa KB. Psychiatric morbidity among physically ill persons in eastern Nepal. NEPAL MEDICAL COLLEGE JOURNAL : NMCJ 2009; 11:118-122. [PMID: 19968153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This cross-sectional hospital-based study investigated the prevalence and pattern of psychiatric morbidity among 151 physically ill psychiatric-referred cases admitted various departments in BPKIHS. Consecutive referral cases were initially worked up by junior residents and diagnosis/differential diagnosis was made by consultant according to ICD-10 diagnostic guidelines. Of total 151; M: 77 (50.9%) and F: 74 (49.1); Majority 38 (25.1%) of subjects were young with age 15-24 yrs and 95 (62.9%) were from plains. About 21.8% referrals came from internal medicine followed by emergency department, 9 (5.9%). The highest number of cases 48 (31.7%) had neuropsychiatric illnesses and 17.0% had some medical complications resulted from suicide act. Among psychiatric co morbidity, dissociative/conversion disorders were the commonest 26 (17.2%) followed by alcohol use-related disorders 25 (16.5%) and depressive disorder 20 (13.2%). To conclude, the co-occurrence of medical and psychological/psychiatric conditions is common, which demands timely identification and early interventions in order to reduce morbidity and mortality.
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Meena M, Joshi D, Joshi R, Sridhar S, Waghdhare S, Gangane N, Kalantri SP. Accuracy of a multispecies rapid diagnostic test kit for detection of malarial parasite at the point of care in a low endemicity region. Trans R Soc Trop Med Hyg 2009; 103:1237-44. [PMID: 19477476 DOI: 10.1016/j.trstmh.2009.04.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Revised: 04/16/2009] [Accepted: 04/17/2009] [Indexed: 11/29/2022] Open
Abstract
Although highly accurate rapid diagnostic tests (RDT) for Plasmodium falciparum [based on identification of histidine-rich protein-2 (PfHRP2)] have been developed, the accuracy of non-falciparum tests is relatively poor. Recently, a Plasmodium vivax-specific RDT [based on identification of species-specific lactate dehydrogenase (PvLDH)] became available, which along with PfHRP2 may improve malaria diagnosis by identifying the species correctly. A cross-sectional hospital-based study was designed to evaluate the diagnostic accuracy of FalciVax, a commercially available PfHRP2- and PvLDH-based RDT (index test), using malaria microscopy as a reference standard. All consecutive inpatients who presented with fever underwent both the index test and the reference standard. The study sample included 657 patients and the overall sensitivity and specificity of the RDT for diagnosis of any malarial species were 92.9% and 98.4%, respectively. The diagnostic accuracy estimates for correct species identification were lower (sensitivity 91.8%, specificity 96.8%). The accuracy of the PvLDH test to detect P. vivax was low (sensitivity 76.6%, specificity 98.1%).
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Malla R, Sharma R, Rauniyar B, Kc MB, Maskey A, Joshi D, Hamal S. Left ventricular noncompaction. JNMA J Nepal Med Assoc 2009; 48:180-184. [PMID: 20387366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Left Ventricular Noncompaction (LVNC) is a genetic cardiac disease of emerging importance with a distinct clinical and pathophysiological presentation. The most common clinical manifestations include heart failure, arrhythmias and embolic events, and in children it may be associated with facial dysmorphisms and Wolff-Parkinson-White syndrome. The diagnosis of LVNC, however, is often missed, most often as a consequence of ignorance of the condition. Echocardiography is considered the reference standard for the diagnosis of LVNC. Prognosis remains poor for patients with impaired systolic left ventricular function, as treatment options are very limited. Because of the familial association of LVNC, first-degree relatives should be screened by Echocardiography.
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