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6 results on '"Prateek Ghatage"'

2. Improving Blood Transfusion Practices in a Community Hospital Setting: Our Experience with Real-Time Clinical Decision Support

Author

Muhammad Sardar, Muhammad Azharuddin, Ananta Subedi, Prateek Ghatage, Doantarang Du, and Arpad Szallasi

Subjects
blood utilization, real-time transfusion support, inappropriate transfusion alert, Medicine
Abstract

There is good evidence that 50% or more of red blood cell (RBC) transfusions are unnecessary. To curtail inappropriate RBC transfusions at our hospital, real-time clinical decision support was implemented in our electronic medical record (EMR) that alerts clinicians to the patient’s most recent pretransfusion hemoglobin value upon order entry and provides Best Practice Advisory. This is a soft pop-up alert which is activated when the hemoglobin exceeds 7 g/dL. The ordering clinician can either honor (by cancelling the order) or override the alert. We studied the impact of the alert on blood utilization during a 3-month period (November 2016 to January 2017). For patients who were transfused despite the alert, a retrospective review of the medical chart was performed to determine whether or not the transfusion was clinically indicated. During the study period, 178 of the 895 RBC transfusion orders (20%) triggered the alert. After excluding duplicates, 144 orders were included in our analysis. Most of these orders (124/144, 86%) were carried out despite the alert. According to our chart review, 48% of the alert transfusions could be considered inappropriate, with hemodynamically stable, asymptomatic anemia being the leading indication. Of clinical services, orthopedic surgery had the highest rate of overriding the alert with no clinical justification (70%). The number of RBC transfusions dropped from 313.5 units per month (preintervention period) to 293.2 units per month (postintervention period)—a 6.5% decrease. Real-time clinical decision support may reduce the number of inappropriate RBC transfusions in a community hospital setting, though in our study, the decrease in blood utilization (6.5%) did not reach statistical significance.

Published
2018
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3. A Veterinarian From Vermont Presenting With a Painful Right Index Finger Following a Needlestick Injury That Occurred While Caring for a Dog

Author

Kristen K. Pierce, Robert Nesbit, Christina Wojewoda, Nicole Mendelson, Christopher D. Huston, Timothy J Whitman, Jonathan Wilcock, and Prateek Ghatage

Subjects
Microbiology (medical), medicine.medical_specialty, Needlestick injury, business.industry, Index finger, Right index finger, medicine.disease, Veterinarians, Fingers, Dogs, Infectious Diseases, medicine.anatomical_structure, medicine, Physical therapy, Animals, Humans, Needlestick Injuries, business, Vermont
Published
2020
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4. Impact and costs of a hepatitis C virus screening programme for adults hospitalised at an academic medical centre

Author

Christopher D. Huston, Stephen G DeVoe, Timothy J Whitman, Louis B Polish, Kristen K. Pierce, Beth D. Kirkpatrick, Sean S M Bullis, Andrew J. Hale, Laura J Catoe, Cindy D Noyes, Lindsay M Smith, Prateek Ghatage, Devika Singh, W. Kemper Alston, Allen B Repp, Jean Dejace, and Timothy Lahey

Subjects
Adult, Medicine (General), Pediatrics, medicine.medical_specialty, Leadership and Management, Cost effectiveness, standards of care, Hepatitis C virus, Cost-Benefit Analysis, Population, Prevalence, Short Report, Hepacivirus, medicine.disease_cause, quality improvement, Screening programme, R5-920, Ambulatory care, Medicine, Endocarditis, Humans, Mass Screening, education, cost-effectiveness, education.field_of_study, Academic Medical Centers, business.industry, Health Policy, Public Health, Environmental and Occupational Health, medicine.disease, Cohort, business, clinical practice guidelines
Abstract

Approximately 1.7% of the US population has chronic hepatitis C virus (HCV) infection, but among adults born between 1945 and 1965 prevalence increases to 3.25%, and this birth cohort accounts for almost 75% of the total burden of HCV.1 2 The availability of effective direct-acting antiviral (DAA) therapy for HCV makes screening, linkage to care and treatment a national priority. The Centers for Disease Control and Prevention (CDC) and US Preventative Services Task Force (USPSTF) have recommended one-time HCV screening for persons born between 1945 and 1965,2 3 yet only 14%–17% of this cohort has been screened for HCV.4 5 To improve adherence to HCV screening recommendations for patients hospitalised at our medical centre, the Division of Infectious Diseases (ID) at the University of Vermont Medical Center (UVMMC) undertook a quality improvement (QI) initiative to screen patients born between 1945 and 1965 who were seen by the ID Consultation Service. UVMMC is a 562-bed academic medical centre affiliated with the Robert Larner MD College of Medicine at the University of Vermont (UVM) and serves over 1 million patients in Vermont and New York State. Recognising that the baseline prevalence rate of HCV is 1.45% of adults in Vermont and 1.49% in New York,1 we hypothesised that screening hospitalised patients seen by the ID Consultation Service would increase screening rates, identify undiagnosed HCV infections and link patients to care. We developed a protocol to identify patients born between 1945 and 1965 seen by the ID Consultation Service, perform HCV screening and link patients to outpatient care. All patients receiving a consult were being treated for conditions unrelated to HCV (eg, osteomyelitis, endocarditis, urinary tract infections). ID physicians …

Published
2021

6. Multiple fluid-filled liver cysts presenting as acute pancreatitis in a patient with known autosomal dominant polycystic kidney disease

Author

Braghadheeswar Thyagarajan, Shil Patel, Prateek Ghatage, and Sayee Sundar Alagusundaramoorthy

Subjects
0301 basic medicine, medicine.medical_specialty, Pathology, Autosomal dominant polycystic kidney disease, 030105 genetics & heredity, Gastroenterology, Epigastric pain, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Epigastric Region, Internal medicine, medicine, Humans, Blood urea nitrogen, Aged, Creatinine, Cysts, business.industry, Liver Diseases, General Medicine, Polycystic Kidney, Autosomal Dominant, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Liver, chemistry, Abdominal examination, Acute Disease, Abdomen, Acute pancreatitis, Female, Tomography, X-Ray Computed, business, 030217 neurology & neurosurgery
Abstract

A 70-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) presented with 3 days of progressive epigastric pain unrelated to food intake. Her history included hypertension and gastro-oesophageal reflux disease. Abdominal examination revealed a soft abdomen with normal bowel sounds, mild rebound tenderness in the epigastric region and an irregular palpable liver. Laboratory results include elevated amylase (368 IU/L, normal: 18–118 IU/L), lipase (813 IU/L, normal: 9–50 IU/L) and C reactive protein (182 mg/L, normal

Published
2016
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