Paurush Ambesh
Maimonides Medical Center
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Publication
Featured researches published by Paurush Ambesh.
Indian heart journal | 2016
Paurush Ambesh
Incidents of violence against doctors in the Indian subcontinent have increased in the last few years. Most doctors in India, China, Pakistan, Nepal and Sri Lanka are concerned about their safety at work. The problem is worse in government hospitals, which characteristically lack appropriate security protocols. In order to tackle the issue, doctors need to accept the problem, discuss the various causative factors, understand the public sentiment and collaborate with the government to find a solution. Formulation of legal provisions and standards to ensure the safety of health workers is the need of the hour.
Journal of Craniovertebral Junction and Spine | 2016
Guruprasad Bettaswamy; Paurush Ambesh; Kuntal Kanti Das; Rabi Narayan Sahu; Arun Kumar Srivastava; Anant Mehrotra; Awadhesh Kumar Jaiswal; Sushila Jaiswal; Sanjay Behari
Spinal meningiomas are mostly intradural in location although at times these are associated with some extradural extensions. Purely extradural spinal meningiomas (EDSMs) are however, extremely rare and when present, may cause diagnostic dilemma preoperatively. Only seven cases of pure EDSM have been reported till date. In this paper, we describe two cases of EDSM affecting the cervical spine and present their clinical profiles, radiological findings, operative management, and follow-up data, along with a review of the literature.
Indian heart journal | 2015
Neetu Soni; Paurush Ambesh; Kumar Sunil; Manas Jena
A 14-year-old male patient presented with worsening breathlessness since 1 week. He had a history of recurrent respiratory infections since the age of one year, and a recent bluish discoloration of both hands and feet since the last 5 years. A full body examination was unremarkable except for the peripheral cyanosis. Contrast Echocardiography showed enhancement in the left heart, with three beats after microbubbles. No obvious cardiac anomaly was evident, thus raising the possibility of extracardiac intra-pulmonary shunting. CT-guided Pulmonary Angiography (CTA) was performed, and it revealed early filling of the pulmonary veins, with dilated azygous and hemiazygous veins. However, no pulmonary arteriovenous malformation was detected (Fig. 1A, B). Interestingly, upper abdominal cuts showed a shunt between the Portal vein and Inferior Vena Cava (IVC), along with dilatation of the lumbar tributaries (Fig. 2).
Indian heart journal | 2017
Paurush Ambesh; Umberto Campia; Chukwudi Obiagwu; Rashika Bansal; Vijay Shetty; Gerald Hollander; Jacob Shani
Nanomedicine is one of the most promising therapeutic modalities researchers are working on. It involves development of drugs and devices that work at the nanoscale (10–9 m). Coronary artery disease (CAD) is responsible for more than a third of all deaths in age group >35 years. With such a huge burden of mortality, CAD is one of the diseases where nanomedicine is being employed for preventive and therapeutic interventions. Nanomedicine can effectively deliver focused drug payload at sites of local plaque formation. Non-invasive strategies include thwarting angiogenesis, intra-arterial thrombosis and local inflammation. Invasive strategies following percutaneous coronary intervention (PCI) include anti-restenosis and healing enhancement. However, before practical application becomes widespread, many challenges need to be dealt with. These include manufacturing at the nanoscale, direct nanomaterial cellular toxicity and visualization.
Journal of investigative medicine high impact case reports | 2018
Ankur Sinha; Ravikaran Patti; Paurush Ambesh; Chukwudi Obiagwu; Namrita Malhan; Kabu Chawla
A 29-year-old female with adult-onset Still’s disease (AOSD) presented with progressive shortness of breath both on rest and on exertion, increased abdominal girth, and swelling in both legs. She was on oral prednisone and was recently started on canakinumab (interleukin-1 antagonist) for joint pain and rash of AOSD. Echocardiogram showed severely dilated right ventricle, dilated pulmonary artery, moderately reduced right ventricular systolic function, but with normal left ventricular systolic function. Computed tomography with contrast ruled out pulmonary embolism. Blood tests ruled out other rheumatologic diseases. The patient was diagnosed with right-sided heart failure likely secondary to AOSD. Right heart catheterization was needed but could not be performed because of severely dilated pulmonary artery. The patient was transferred to a higher center for further management and possible cardiopulmonary transplant.
Journal of the Neurological Sciences | 2017
Paurush Ambesh; Vimal Kumar Paliwal; Vijay Shetty; Stephan Kamholz
The Babinski Sign is one of the most clinically relevant diagnostic signs in medicine. Though the plantar reflex is practiced thousands of times across the globe every day, few realize its historical importance. In this narrative review we trace the origins of the Plantar Reflex back in the 19th century, discuss its evolution over time and examine the body of evidence behind the current understanding. State of the art diagnostic modalities like video analysis and electromyography have helped us in dissecting the pathophysiology behind the simple yet beautiful Babinski Sign.
Journal of investigative medicine high impact case reports | 2017
Paurush Ambesh; Joseph Weissbrot; Sabina Ratner; Ankur Sinha; Ravikaran Patti; Jasminka Balderacchi; Michael Marcelin; Lawrence Wolf; Stephan Kamholz
Neoplastic lesions that demonstrate neuroendocrine features are rare. However, esophageal tumors containing both adenocarcinomatous and neuroendocrine components are exceedingly rare. Mixed adenoneuroendocrine carcinomas (MANECs) are gastrointestinal tumors with both adenocarcinomatous and neuroendocrine differentiation. They have a tendency for early metastases but clinically manifest relatively late. Imaging studies are often nonspecific with regard to tumor type, and a histopathologic study of biopsy material is required for definitive diagnosis. The overall prognosis is poor. The current report describes a rare case of gastroesophageal MANEC tumor, with approximately 60% neuroendocrine and 40% adenocarcinomatous components. Since there is a dearth of concrete management guidelines for MANECs, we present possible management options to add to the existing literature.
Neurology India | 2018
Ravi Uniyal; Vimal Kumar Paliwal; Sucharita Anand; Paurush Ambesh
New daily persistent headache (NDPH) is characterized by an abrupt onset of headache that becomes a daily entity, is unremitting and continuous from the onset, and lasts for more than 3 months. Dr Walter Vanast first described NDPH in the year 1986. Originally, it was proposed as a chronic daily headache but it was placed under “other primary headaches” in the International Classification of Headache Disorder Second Edition (ICHD 2nd edition). However, with evolving literature and better understanding of its clinical characteristics, it was classified as a “chronic daily headache” in the ICHD 3rd edition beta. There are still many knowledge-gaps regarding the underlying cause, pathophysiology, natural history and treatment of NDPH. This review tries to revisit the entity and discusses the current status of understanding regarding NDPH.
Current Cardiology Reports | 2018
Alec A. Schmaier; Paurush Ambesh; Umberto Campia
Purpose of ReviewThis review aims to summarize the epidemiology, current pathophysiologic understanding, and state-of-the-art treatment of venous thromboembolism (VTE) in cancer patients.Recent FindingsThe risk of VTE varies among cancer patients. Recently introduced prediction models better identify those at high risk of VTE. New mechanisms underlying hypercoagulability in cancer have been uncovered. Initial data on the efficacy of direct oral anticoagulants (DOACs) compared with low-molecular weight heparin to treat VTE in patients with cancer are promising. However, they may be associated with higher risk of gastrointestinal bleeding.SummaryVTE causes significant morbidity and mortality in cancer patients. Our understanding of the mechanisms of VTE, including those associated with cancer treatments, has significantly grown. The assessment of the benefit/risk balance of VTE treatment remains challenging in many patients with cancer. The introduction of DOACs has expanded treatment options, but knowledge on their efficacy and safety is incomplete.
Cureus | 2018
Arsalan Talib Hashmi; Muhammad Sohail Yousuf; Husnain Waseem; Paurush Ambesh; Daniel Rodriguez; Aleksander Adzic
We have presented a case of 41-year-old male who presented to the hospital with worsening shortness of breath, fatigue and flu-like symptoms. On admission to hospital, the patient was in severe cardiogenic shock secondary to acute perimyocarditis. He was admitted to the cardiac intensive care unit for close monitoring and aggressive hemodynamic support. Influenza B antigen was detected in nasopharyngeal aspirate and the patient was started on oseltamivir. The patient’s cardiac function improved significantly in few days and he was discharged home in stable condition with normal ejection fraction.
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Sanjay Gandhi Post Graduate Institute of Medical Sciences
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