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Psychogenic nonepileptic seizures in children [Meeting Abstract]

Grover, A
Psychogenic Nonepileptic Seizures (PNES) often resemble epileptic seizures and patients with PNES are often misdiagnosed or receive improper treatment. Children who exhibit PNES are also often improperly diagnosed and treated with anti-epileptic medications that alter can their neurological development. There is little data on these types of cases in the literature, but in our institution, we approximate roughly 5% of children admitted for seizures have exhibited PNES. Effective diagnosis and management requires the use of video EEG, which is the gold standard in identifying epileptic seizures from PNES. The best quality recording is invaluable to proper diagnosis, in addition to proper documentation of the patient's history. Both are vital parts of the EEG technologist's role since they the ones who spend the most time with the patient, hence their insight become very useful. The purpose of this poster is to bring awareness to the growing issue of PNES in pediatric patients and to utilize the unique perspectives of an EEG technologist. Input and recommendations from a Psychiatrist and Neurologist are included as supporting information. This poster aims to help EEG technologists differentiate between PNES and epileptic seizures in children
EMBASE:625955127
ISSN: 2375-8627
CID: 3615112

Understanding the problem of diabetes in India using geographical information system software

Kumar, Arun; Grover, Anjali
PMCID:3968725
PMID: 24701450
ISSN: 2230-9500
CID: 968152

Predictors of hyperglycemia after cardiac surgery in nondiabetic patients

Garg, Rajesh; Grover, Anjali; McGurk, Siobhan; Rawn, James D
OBJECTIVE: Postoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing cardiac surgery. However, some experts consider hyperglycemia to be an epiphenomenon related to acute stress. We investigated whether preoperative patient characteristics can predict hyperglycemia after cardiac surgery in nondiabetic patients. METHODS: This is a retrospective study of nondiabetic patients undergoing cardiac surgery at a single center during the years 2004 to 2009. Hyperglycemia was defined as 2 consecutive blood glucose readings of 150 mg/dL or greater during the 72 hours after cardiac surgery. RESULTS: This study included 1453 patients with hyperglycemia and 2205 patients without hyperglycemia. Hyperglycemic patients were older, were more likely to be men, had higher body mass index, were more likely to be hypertensive and hypercholesterolemic, and had lower left ventricular ejection fractions; in addition, a greater proportion had a history of cardiovascular disease and renal failure. Multivariate logistic regression analysis showed age, gender, body mass index, preoperative serum creatinine, left ventricular ejection fraction, previous cardiac surgery, and preoperative cardiogenic shock to be independently associated with hyperglycemia (P < .05 for all). Hyperglycemic patients had more intraoperative and postoperative complications. CONCLUSIONS: Preoperative patient characteristics are associated with hyperglycemia after cardiac surgery.
PMID: 22929221
ISSN: 0022-5223
CID: 854682

Metformin or thiazolidinedione therapy in PCOS?

Grover, Anjali; Yialamas, Maria A
PMID: 21283123
ISSN: 1759-5029
CID: 854692

Adjuvant treatment recommendations in older women with breast cancer: a survey of oncologists

Hurria, Arti; Naeim, Arash; Elkin, Elena; Limaye, Sewanti; Grover, Anjali; Hudis, Clifford; Pearce, Carol; Robson, Mark
OBJECTIVE: Previous studies demonstrate differing treatment patterns between older and younger patients with breast cancer. To explore the reasons for these disparities we conducted a survey of 28 oncologists specializing in breast cancer. DESIGN AND METHODS: Twenty-eight medical oncologists from Memorial Sloan-Kettering Cancer Center and the University of California Los Angeles who specialize in the treatment of breast cancer were asked to provide adjuvant treatment recommendations in hypothetical scenarios featuring older patients with high-risk breast cancer. For each of these hypothetical patients, the patient's age was varied over four possible values (70, 75, 80, or 85 years of age) and health and functional status varied across three possible states (perfect health, average health, or major health problems). Survey data were compiled and analyzed to determine the impact of theoretical patient age, baseline health, and functional status on their treatment recommendations. RESULTS: The proportion of oncologists who recommended adjuvant chemotherapy decreased as the patient's age increased or as the patient's functional status and health status decreased. For 96% of physicians (95% CI, 82-100%), patient age influenced chemotherapy recommendations, controlling for health/functional status; the same proportion of respondents were influenced by health/functional status, controlling for patient age. There was increased variability in treatment recommendations as the patient's age increased or functional status and health status decreased. CONCLUSION: Among these medical oncologists who primarily treat breast cancer adjuvant treatment recommendations vary based on patient age, health, and functional status. Future studies are needed to correlate age, health, and functional status with the risks and benefits of adjuvant therapy so that consensus guidelines can be formed. A more comprehensive baseline assessment of the older patient, such as can be derived from a comprehensive geriatric assessment may be useful in this regard.
PMID: 17098441
ISSN: 1040-8428
CID: 854702