Mangalore Amith Shenoy
Maimonides Medical Center
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Publication
Featured researches published by Mangalore Amith Shenoy.
American Journal of Infection Control | 2017
Sushilkumar Satish Gupta; Pavan Irukulla; Mangalore Amith Shenoy; Vimbai Nyemba; Diana Yacoub; Yizhak Kupfer
HighlightsMultidisciplinary team approach reduces indwelling urinary catheter utilization ratio in a complex intensive care unit environment.Education of the health care providers and strict criteria to define appropriate indications for the use of indwelling urinary catheters in the intensive care unit are necessary to decrease the catheter‐associated urinary tract infection rate.Decreasing the indwelling urinary catheter utilization ratio is one of the most important determining factors to decrease the catheter‐associated urinary tract infection rate.Implementation of this kind of approach can decrease the incidence of catheter‐associated urinary tract infection. Background: Duration of indwelling urinary catheterization is an important risk factor for urinary tract infections. We devised a strategy to decrease the utilization of indwelling urinary catheters (IUCs). We also highlight the challenges of managing critically ill patients without IUCs and demonstrate some of the initiatives that we undertook to overcome these challenges. Methods: A retrospective observational outcomes review was performed in an adult medical intensive care unit (ICU) between January 2012 and December 2016. This period included a baseline and series of intervals, whereby different aspects of the strategies were implemented. IUC utilization ratio and catheter‐associated urinary tract infection (CAUTI) rates were calculated. Results: Our IUC utilization ratio had a statistically significant decrease from 0.92 (baseline) to 0.28 (after 3 interventions) (P < .0001). Similarly, CAUTI rates had a statistically significant decrease from 5.47 (baseline) to 1.08 (after 3 intervention) (P = .0134). These rates sustained a statistically significant difference over the 2‐year follow‐up period from the last intervention. Incontinence‐associated dermatitis (IAD) was identified as a potential complication of not using an IUC. There was no statistically significant change in the IAD rates during 2013‐2016. Conclusions: Our interventions demonstrated that aggressive and comprehensive IUC restriction protocol and provider training can lead to a successful decrease in IUC use, leading to a lower IUC utilization ratio and CAUTI rate in a large complex academic ICU setting.
Critical Care Medicine | 2016
Ishan Malhotra; Hatem Desoky; Mangalore Amith Shenoy; Shyam Shankar; Pavan Irukulla; Benhoor Shamian; Yizhak Kupfer; Richard Periut
Learning Objectives: Stress cardiomyopathy (SC) is a type of transient non-ischemic acute cardiomyopathy which is characterized by wall motion abnormalities of the heart in which intense physical or emotional stress can lead to sudden and severe heart muscle weakness. We present a rare case of sepsis/ respiratory distress induced stress cardiomyopathy with isolated right ventricle (RV) involvement, which was initially thought to be secondary to pulmonary embolism. Methods: A 84 year old woman with past medical history of chronic obstructive pulmonary disease (COPD) presented to the emergency room with shortness of breath and lethargy. The patient was started on anticoagulation for suspected pulmonary embolism (PE) and was admitted to the intensive care unit for hemodynamic instability requiring vasopressor support and respiratory failure. Echocardiogram (ECHO) showed severely decreased RV function, RV ballooning and normal left ventricular (LV) wall motion. Computed tomography angiography showed small chronic sub-segmental PE in the right upper lobe, which was not significant enough to cause the degree of hemodynamic instability in this patient. ECHO done two weeks prior to admission showed normal RV function. Electrocardiogram showed new V2-V4 “T” wave inversions with rising serum troponin levels. Coronary angiography showed clean coronary arteries. Cultures confirmed the diagnosis of urinary tract infection leading to sepsis and with appropriate treatment of sepsis and COPD exacerbation, patient showed clinical improvement and improved RV function on repeat ECHO. Results: SC most commonly involves the apical segment of the left ventricle. Isolated involvement of the RV has rarely been described in the literature, apart from few sporadic cases. To the best of our knowledge, this is the first case of isolated of RV stress cardiomyopathy masquerading as massive PE on initial presentation. This case makes it imperative to further study this new, emerging variant of SC in the future since it can be easily misdiagnosed as massive PE potentially leading to inappropriate thrombolytic therapy.
Chest | 2016
Shyam Shankar; Sushilkumar Satish Gupta; Ishan Malhotra; Mangalore Amith Shenoy; Hatem Desoky; Prarthna Chandar; William Pascal; Stephan Kamholz; Richard Periut; Chanaka Seneviratne; Yizhak Kupfer
Chest | 2014
Joy Victor; Mangalore Amith Shenoy; Sameer Chadha; Felix Yang; Gerald Hollander; Jacob Shani
Chest | 2018
Animesh Gour; Anisha Kamath; Mangalore Amith Shenoy
Chest | 2017
Shyam Shankar; Prarthna Chandar; Hatem Desoky; Ishan Malhotra; Anand Kumar Rai; Mangalore Amith Shenoy; Benhoor Shamian; Pavel Gozenput; Roman Bernstein; Pavan Irukulla; Yizhak Kupfer
Chest | 2017
Prarthna Chandar; Sakthidev Kulandaisamy; Mangalore Amith Shenoy; Shyam Shankar; Pavan Irukulla; Benhoor Shamian; Yizhak Kupfer; Kabu Chawla; Michael Bergman
Critical Care Medicine | 2016
Shyam Shankar; Ishan Malhotra; Pavel Gozenput; Mangalore Amith Shenoy; Pavan Irukulla; Roman Bernstein; Yizhak Kupfer
Critical Care Medicine | 2016
Prarthna Chandar; Selma Demir; Yizhak Kupfer; Chanaka Seneviratne; Sakthidev Kulandaisamy; Pavan Irukulla; Mangalore Amith Shenoy; William Pascal
Chest | 2016
Shyam Shankar; Karan Wats; Hitesh Raheja; Ishan Malhotra; Nupur Uppal; Mangalore Amith Shenoy; Stephan Kamholz