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Biomedical subjects

Ashish Agarwal

Publications and source records attributed to Ashish Agarwal.

3 recordsLinked to original sources

Atrial fibrillation: modern concepts and management.

Atrial fibrillation (AF) is a common cardiac arrhythmia responsible for significant morbidity and mortality. In recent years, progress has been made in determining the genetic abnormalities that may lead to AF. New trials have shown that rate control and anticoagulation are acceptable as a primary treatment strategy in many patients who have a high risk of recurrence. Newer and safer antiarrhythmics are now available. Pacemaker and implantable cardiac defibrillator technology is rapidly evolving and may play a significant role in future treatment and prevention of AF. Direct thrombin inhibitors are likely to add a user-friendly option to the current standard therapy for stroke prevention.

Anti-Arrhythmia Agents↗

Tuberculous appendicitis in India.

Tuberculous appendicitis (TBA) is a rare condition. The present study has been conducted to study its prevalence and presentation. This retrospective study was performed in the Department of Surgery, NSCB Government Medical College, Jabalpur, MP, India, in 870 consecutive appendectomies performed between January 1991 and December 2000. Of 870 consecutive appendicular specimens, 10 cases of primary (1.1%) and 16 of secondary TBA (1.8%) were encountered. Results of all pre-operative investigations were non-specific and the diagnosis was made only after histopathology. The prevalence of TBA in this study was 2.9%. Although it is a rare condition, its possibility should be kept in mind by clinicians as well as pathologists. All surgically removed appendix specimens should be histopathologically examined, whether or not the specimens are macroscopically normal. Given antitubercular treatment in addition to appendectomy, patients recover without complications.

Adolescent↗

Physicians' attitudes and the use of oral anticoagulants: surveying the present and envisioning future.

Atrial fibrillation has the highest prevalence in the elderly. While the elderly are at the highest risk for stroke and would benefit the most from anticoagulation, they are also the least likely to receive anticoagulation. In a pooled analysis of the primary prevention trials, warfarin reduced stroke by 68% compared with placebo, and aspirin reduced stroke by 18%. Age, history of hypertension, diabetes, heart failure or reduced left ventricular function, and previous transient ischemic events and stroke are independent risk factors for stroke in patients with atrial fibrillation. Less than 50% of the elderly who have clear-cut indications and no contraindications for warfarin receive anticoagulant therapy. This low use of warfarin is driven by many factors, but physicians' fear of hemorrhage is among the most important. Better adherence to evidence-driven guidelines, better patient and physician education, point-of-care monitoring of INR and the future development of user friendly anticoagulant drugs are likely to result in higher rates of anticoagulation use.

Administration, Oral↗