356 Se 9Th Ave
Hillsboro OR 97123
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 002208
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Unfamiliar Manifestations of Anti-tubercular Therapy. - Journal of family medicine and primary care
Cutaneous drug reactions are frequent in hospitalized patients and vary from simple manifestations like rash and erythema to severe life threatening conditions like angio-oedema, erythroderma, Stevens-Johnson syndrome and toxic epidermal necrolysis. However drug eruptions with antitubercular drugs are largely unknown except few case reports. We highlight here one similar case which presented with pleomorphic cutaneous manifestations after taking anti tubercular therapy and closely mimicked vasculitis. But when the offending drugs were stopped the lesions disappeared and the patient improved.
Meningitis due to Neisseria meningitidis serogroup B in India. - Indian pediatrics
Invasive meningococcal disease has a fulminant course and high mortality. Neisseria meningitidis serogroup A is predominantly responsible for meningococcal disease in India and the developing countries. Group B meningococcus, which is prevalent in the developing world is uncommon in India. We herein report the second case of group B meningococcal infection from the country, two decades after the reporting of the first case. Ineffective vaccines against serogroup B warrant the need for close surveillance of this disease.
Giant liver abscess with bilateral pleural effusion: An unfamiliar association. - Tropical parasitology
Amoebic liver abscess is a common problem in tropical countries. However, its protean manifestations sometimes pose diagnostic dilemma leading to delay in starting appropriate therapy. We report here one interesting case of an amoebic liver abscess where the patient developed some uncommon features like bilateral pedal edema and bilateral pleural effusion. Although unilateral effusion is well known in such patients, the cause of bilateral involvement of pleura in this patient remained largely unknown. The cause of edema turned out to be compression of inferior vena cava by the large-sized abscess, rather than any cardiopulmonary abnormality. This case has global relevance because many of the migrant populations from tropical countries are settled all over the world, particularly in Europe and America. It would only be appropriate that the treating physicians are aware of this unfamiliar association.
Risk factors for the development of retroperitoneal hematoma after percutaneous coronary intervention in the era of glycoprotein IIb/IIIa inhibitors and vascular closure devices. - Journal of the American College of Cardiology
We sought to determine the incidence, clinical features, and risk factors for retroperitoneal hematoma (RPH) after percutaneous coronary intervention (PCI).Little is known about the clinical features, outcomes, and determinants of this serious complication in the contemporary era of PCI.A retrospective analysis yielded 26 cases of RPH out of 3,508 consecutive patients undergoing PCI between January 2000 and January 2004. Cases were compared with a randomly selected sample of 50 control subjects without RPH.The incidence of RPH was 0.74%. Features of RPH included abdominal pain (42%), groin pain (46%), back pain (23%), diaphoresis (58%), bradycardia (31%), and hypotension (92%). The mean systolic blood pressure nadir was 75 mm Hg. The hematocrit dropped by 11.5 +/- 5.1 points from baseline in RPH patients, as compared with 2.3 +/- 3.3 points in controls (p < 0.0001). The mean hospital stay was longer in RPH patients (2.9 +/- 3.8 days vs. 1.7 +/- 1.5 days, p = 0.06). The following variables were found to be independent predictors of RPH: female gender (odds ratio [OR] 5.4, p = 0.005), low body surface area (BSA <1.73 m(2); OR 7.1, p = 0.008), and higher femoral artery puncture (OR 5.3, p = 0.013). There was no association between RPH and arterial sheath size, use of glycoprotein IIb/IIIa inhibitors, or deployment of a vascular closure device.Female gender, low BSA, and higher femoral artery puncture are significant risk factors for RPH. Awareness of the determinants and clinical features of RPH may aid in prevention, early recognition, and prompt treatment.
Long-term effects of polymer-based, slow-release, sirolimus-eluting stents in a porcine coronary model. - Cardiovascular research
Stent-based delivery of sirolimus (SRL) has shown reduction in neointimal hyperplasia and restenosis. The purpose of this study was to evaluate the chronic vascular response and the expression of cell cycle regulators after SRL-eluting stent implantation in a porcine coronary model.Forty-nine pigs underwent placement of 109 oversized stents (control, n=54, SRL (140 microg/cm(2)), n=55) in the coronary arteries with histologic analysis and Western blot (PCNA, p27(kip1), CD45, MCP-1, IL-2, IL-6, TNF-beta) at 3, 30, 90 or 180 days.At 3 days, the mean thrombus area was similar for control (0.38+/-0.19 mm(2)) and SRL (0.29+/-0.09 mm(2)) stents. After 30 days, the mean neointimal area was significantly less for the SRL (1.40+/-0.35 mm(2)) versus the control stents (2.94+/-1.28 mm(2), p<0.001). At 90 and 180 days, the mean neointimal area was similar for the SRL (3.03+/-0.92 and 3.34+/-0.99 mm(2)) as compared with control stents (3.45+/-1.09 and 3.65+/-1.23 mm(2)). Western blot analysis demonstrated an increased expression of p27(kip1) in the vessel wall at 90 days for the SRL versus control stents (p=0.05) but with increased levels of PCNA in the SRL as compared with control stents (p=0.003).SRL-eluting stents favorably modulate neointimal formation for 30 days in the porcine coronary model. Long-term inhibition of neointimal hyperplasia is not sustained presumably due to delayed cellular proliferation despite increased levels of the cyclin-dependent kinase p27(kip1) in the vessel wall.
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356 Se 9Th Ave Hillsboro, OR 97123
364 8Th Ave., Suite 205 Tualigy Ob/Gyn
1001 Se Tualatin Valley Hwy Highway Suite A-16