Ritu Grewal - Academia.edu (original) (raw)

Papers by Ritu Grewal

Research paper thumbnail of Evaluation and Management of Insomnia in the Psychiatric Setting

FOCUS, 2009

... rhythms, resides in the suprachiasmatic nuclei (SCN) of the hypothalamus, which are bilateral... more ... rhythms, resides in the suprachiasmatic nuclei (SCN) of the hypothalamus, which are bilaterally paired and located slightly above the optic chiasm in the ... Another core symptom of PTSD is distressing dreams and nightmares, reflections of the reexperiencing of the traumatic event ...

Research paper thumbnail of Long term survival in non-encapsulated primary liposarcoma of the mediastinum

Thorax, 1993

An elderly woman presented with dyspnoea secondary to extensive mediastinal invasion by a primary... more An elderly woman presented with dyspnoea secondary to extensive mediastinal invasion by a primary well differentiated liposarcoma of the mediastinum. Five years after partial resection and postoperative radiotherapy (45 Gy) she is alive and well. To our knowledge, long term survival has not previously been reported for a non-encapsulated mediastinal liposarcoma treated by incomplete resection and subsequent radiation therapy.

Research paper thumbnail of Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

Journal of Clinical Sleep Medicine, 2000

Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevale... more Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing elective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely fashion. In this review article, we will discuss the epidemiology of sleep apnea in the surgical population. We will also discuss why these patients are at a higher risk of having postoperative complications, with the special emphasis on the role of anesthesia, opioids, sedation, and the phenomenon of REM sleep rebound. We will also review how to identify these patients preoperatively and the steps that can be taken for their perioperative management.

Research paper thumbnail of Obstructive Sleep Apnea Syndrome and Postoperative Complications

Archives of Otolaryngology–Head & Neck Surgery, 2010

To determine whether high risk scores on preoperative STOP-BANG (Snoring, Tiredness during daytim... more To determine whether high risk scores on preoperative STOP-BANG (Snoring, Tiredness during daytime, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, Gender) questionnaires during preoperative evaluation correlated with a higher rate of complications of obstructive sleep apnea syndrome (OSAS). Historical cohort study. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Adult patients undergoing elective surgery at a tertiary care center who were administered the STOP-BANG questionnaire for 3 consecutive days in May 2008. Number and types of complications. A total of 135 patients were included in the study, of whom 56 (41.5%) had high risk scores for OSAS. The mean (SD) age of patients was 57.9 (14.4) years; 60 (44.4%) were men. Patients at high risk of OSAS had a higher rate of postoperative complications compared with patients at low risk (19.6% vs 1.3%; P < .001). Age, American Society of Anesthesiologists class of 3 or higher, and obesity were associated with an increased risk of postoperative complications. On multivariate analysis, high risk of OSAS and American Society of Anesthesiologists class 3 or higher were associated with higher odds of complications. The STOP-BANG questionnaire is useful for preoperative identification of patients at higher than normal risk for surgical complications, probably because it identifies patients with occult OSAS.

Research paper thumbnail of Epidemiology of Insomnia

Clinical Handbook of Insomnia, 2010

... 2 Epidemiology of Insomnia Ritu Grewal and Karl Doghramji Page 2. ... Hajak and the SINE grou... more ... 2 Epidemiology of Insomnia Ritu Grewal and Karl Doghramji Page 2. ... Hajak and the SINE group (Study of Insomnia in Europe) in Germany and Leger and colleagues in France reported very similar results regarding quality of life and health care utilization [39, 61]. Zammit et al. ...

Research paper thumbnail of Evaluation and Management of Insomnia in the Psychiatric Setting

FOCUS, 2009

... rhythms, resides in the suprachiasmatic nuclei (SCN) of the hypothalamus, which are bilateral... more ... rhythms, resides in the suprachiasmatic nuclei (SCN) of the hypothalamus, which are bilaterally paired and located slightly above the optic chiasm in the ... Another core symptom of PTSD is distressing dreams and nightmares, reflections of the reexperiencing of the traumatic event ...

Research paper thumbnail of Long term survival in non-encapsulated primary liposarcoma of the mediastinum

Thorax, 1993

An elderly woman presented with dyspnoea secondary to extensive mediastinal invasion by a primary... more An elderly woman presented with dyspnoea secondary to extensive mediastinal invasion by a primary well differentiated liposarcoma of the mediastinum. Five years after partial resection and postoperative radiotherapy (45 Gy) she is alive and well. To our knowledge, long term survival has not previously been reported for a non-encapsulated mediastinal liposarcoma treated by incomplete resection and subsequent radiation therapy.

Research paper thumbnail of Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

Journal of Clinical Sleep Medicine, 2000

Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevale... more Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing elective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely fashion. In this review article, we will discuss the epidemiology of sleep apnea in the surgical population. We will also discuss why these patients are at a higher risk of having postoperative complications, with the special emphasis on the role of anesthesia, opioids, sedation, and the phenomenon of REM sleep rebound. We will also review how to identify these patients preoperatively and the steps that can be taken for their perioperative management.

Research paper thumbnail of Obstructive Sleep Apnea Syndrome and Postoperative Complications

Archives of Otolaryngology–Head & Neck Surgery, 2010

To determine whether high risk scores on preoperative STOP-BANG (Snoring, Tiredness during daytim... more To determine whether high risk scores on preoperative STOP-BANG (Snoring, Tiredness during daytime, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, Gender) questionnaires during preoperative evaluation correlated with a higher rate of complications of obstructive sleep apnea syndrome (OSAS). Historical cohort study. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Adult patients undergoing elective surgery at a tertiary care center who were administered the STOP-BANG questionnaire for 3 consecutive days in May 2008. Number and types of complications. A total of 135 patients were included in the study, of whom 56 (41.5%) had high risk scores for OSAS. The mean (SD) age of patients was 57.9 (14.4) years; 60 (44.4%) were men. Patients at high risk of OSAS had a higher rate of postoperative complications compared with patients at low risk (19.6% vs 1.3%; P < .001). Age, American Society of Anesthesiologists class of 3 or higher, and obesity were associated with an increased risk of postoperative complications. On multivariate analysis, high risk of OSAS and American Society of Anesthesiologists class 3 or higher were associated with higher odds of complications. The STOP-BANG questionnaire is useful for preoperative identification of patients at higher than normal risk for surgical complications, probably because it identifies patients with occult OSAS.

Research paper thumbnail of Epidemiology of Insomnia

Clinical Handbook of Insomnia, 2010

... 2 Epidemiology of Insomnia Ritu Grewal and Karl Doghramji Page 2. ... Hajak and the SINE grou... more ... 2 Epidemiology of Insomnia Ritu Grewal and Karl Doghramji Page 2. ... Hajak and the SINE group (Study of Insomnia in Europe) in Germany and Leger and colleagues in France reported very similar results regarding quality of life and health care utilization [39, 61]. Zammit et al. ...