Hassan Tariq - Academia.edu (original) (raw)

Papers by Hassan Tariq

Research paper thumbnail of Bioanalyzer: An Efficient Tool for Sequence Retrieval, Analysis and Manipulation

Bioanalyzer provides combination of tools that are never assembled together. Software has list of... more Bioanalyzer provides combination of tools that are never assembled together. Software has list of tools that can be important for different researchers. The aim to develop this kind of software is to provide unique set of tools at one platform in a more efficient and better way than the software or web tools available. It is stand-alone application so it can save time and effort to locate individual tools on net. Flexible design has made it easy to expand it in future. We will make it available publicly soon.

Research paper thumbnail of Extrahepatic Biliary Obstruction: An Unusual Presentation of Hepatic Sarcoidosis

Clinical Medicine Insights: Gastroenterology, 2015

We report this case of a 63-year-old woman who presented with progressive illness characterized b... more We report this case of a 63-year-old woman who presented with progressive illness characterized by abdominal pain, weight loss, anorexia, generalized weakness, and fatigue. The patient was found to have obstructive jaundice with multiple mass lesions in the liver, spleen, and kidney on computed tomography scan of abdomen. She developed cholangitis, necessitating an emergent endoscopic retrograde cholangiopancreatography with biliary stenting and decompression. Later, she was found to have hepatic sarcoidosis on wedge biopsy of the liver. Extrinsic compression of biliary tree from mass effect of sarcoid granulomas with superimposed biliary sepsis is rare.

Research paper thumbnail of A fascinating presentation of hepatic hydrothorax

World journal of hepatology, Jan 27, 2013

We report this case of a 43-year-old woman with hepatitis-C cirrhosis who presented with a large ... more We report this case of a 43-year-old woman with hepatitis-C cirrhosis who presented with a large right sided pleural effusion complicated by hypoxic respiratory failure and altered mentation necessitating dependence on mechanical ventilation. The pleural effusion spontaneously resolved upon initiation of mechanical positive pressure ventilation and recurred almost immediately after weaning the patient off the ventilator. The pre-ventilation, ventilation and post-ventilation chest X-ray films in chronological order present a striking visual demonstration of fluid dynamics and pathophysiology of hepatic hydrothorax, thereby obviating the need for a dedicated diagnostic test. We also report this case to highlight the treatment strategies for this often intractable complication.

Research paper thumbnail of Abdominal aortitis associated with Crohn disease

Canadian journal of gastroenterology & hepatology, 2014

Research paper thumbnail of Sign of Leser-Trélat Associated with Esophageal Squamous Cell Cancer

The sign of Leser-Trélat is a rare paraneoplastic phenomenon marked by accelerated onset of multi... more The sign of Leser-Trélat is a rare paraneoplastic phenomenon marked by accelerated onset of multiple seborrheic keratoses. The occurrence of the sign often points towards underlying visceral malignancies which in a majority are adenocarcinomas of the gastrointestinal tract. We report this case of a 65-year-old man who presented with sign of Leser-Trélat and was diagnosed with poorly differentiated squamous cell cancer of the esophagus. To our knowledge this is only the second such reported association of Leser-Trélat sign with squamous cell cancer of esophagus.

Research paper thumbnail of Implementation of medical information bus (MIB) at LDS Hospital

Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 1988

Medical Information Bus (MIB) is a standard designed to allow different medical instrument manufa... more Medical Information Bus (MIB) is a standard designed to allow different medical instrument manufacturers to transmit data from their instruments to a host computer. The authors felt that such a system, if developed without any field experience and feedback from end users, might be impractical. Therefore, they developed and implemented an MIB system using IV pumps. The MIB standard at

Research paper thumbnail of Non-Alcoholic Fatty Pancreatic Disease: A Review of Literature

Gastroenterology research, 2016

There is an epidemic of obesity worldwide. The prevalence of obesity has doubled over the last th... more There is an epidemic of obesity worldwide. The prevalence of obesity has doubled over the last three decades. Obesity, especially abdominal obesity is associated with insulin resistance that can lead to pancreatic steatosis and non-alcoholic fatty pancreatic disease (NAFPD). NAFPD describes a phenotype entity ranging from deposition of fat in the pancreas to pancreatic inflammation, and resultant fibrosis, which is similar to that of non-alcoholic fatty liver disease (NAFLD). NAFPD may represent a meaningful manifestation of metabolic syndrome. Pancreatic steatosis can be diagnosed on ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI). In addition to a correlation between pancreatic steatosis and metabolic syndrome, pancreatic steatosis may lead to a worse outcome in pancreatitis and may be an etiological factor in pancreatic cancer, but we need further research to examine the associations, pathophysiology, and the impact of pancreatic steatosis and NAFPD ...

Research paper thumbnail of Computerized Tomography-Guided Paracentesis: An Effective Alternative to Bedside Paracentesis?

Journal of clinical medicine research, 2017

Ascites remains the most common cause of hospitalization among patients with decompensated cirrho... more Ascites remains the most common cause of hospitalization among patients with decompensated cirrhosis. Paracentesis is a relatively safe procedure with low complication rates. Computerized tomography (CT)-guided therapeutic paracentesis could be a safe and effective alternative to unaided or aided (ultrasonogram-guided) bedside paracentesis. In this retrospective study, we aimed to compare the efficacy, safety, and cost-effectiveness of CT-guided paracentesis with bedside paracentesis. The period of study was from 2002 to 2012. All patients with cirrhosis who underwent therapeutic paracentesis were included in the study. These patients were divided into two groups. Group I consisted of patients who underwent CT-guided pigtail catheter insertion with ascitic fluid drainage. Group II consisted of patients who underwent beside therapeutic paracentesis after localization of fluid either by physical examination or sonographic localization. We measured the efficacy of CT-guided paracentesi...

Research paper thumbnail of Symptomatic Gallstones in the Young: Changing Trends of the Gallstone Disease-Related Hospitalization in the State of New York: 1996 - 2010

Journal of clinical medicine research, 2017

The aim of the study was to evaluate if the gallstone-related hospitalizations in the young (<... more The aim of the study was to evaluate if the gallstone-related hospitalizations in the young (< 20 years of age) have increased over time in both the Bronx County and New York State as a whole. We retrospectively reviewed 15 years (1996 - 2010) of Statewide Planning and Research Cooperative System (SPARCS) data of New York State Department of Health. Patients with ICD-9 code diagnosis of 574 (cholelithiasis) among the first three discharge diagnoses were reviewed. Total number of all cause admissions to hospitals had increased from 2.44 million to 2.77 million (1996 - 2010). However, gallstone-related hospitalizations had decreased from 1.7% to 1.2%. It was noted that there was a 30% increment in the proportion of those below 20 years of age with gallstone disease requiring hospitalization over the same period. This young patient population contributed only 2.04% to all gallstone-related hospitalizations in 1996, whereas it had increased to 2.96% in 2010. This trend was more prono...

Research paper thumbnail of Fulminant Hepatic Failure Secondary to Herpes Hepatitis in a Patient With Myasthenia Crisis: An Elusive Diagnosis

Journal of clinical medicine research, 2016

Herpes hepatitis is a rare cause of fulminant hepatic failure contributing to less than 1% of all... more Herpes hepatitis is a rare cause of fulminant hepatic failure contributing to less than 1% of all cases. It is most often seen in persons who are immunosuppressed and in pregnant women. The presentation is usually non-specific and rapidly progressive, thus making antemortem diagnosis of this condition rare. We present a patient who was on chronic immunosuppressive therapy for systemic lupus erythematosus and subsequently developed multi-organ failure with anicteric transaminitis as a result of disseminated herpes infection. The diagnosis was only made post-mortem. A confounding factor in this case was the fact that the patient underwent plasmapheresis, which skewed the interpretation of liver function tests in the setting of acute liver failure.

Research paper thumbnail of Effect of Aloe Vera (Aloe barbadensis) and Clove (Syzigium aromaticum) Supplementation on Immune Status, Haematological and Serum Biochemical Parameters in Japanese Quails

Indian Journal of Animal Nutrition, 2014

Research paper thumbnail of Localization of CDK5 in the midbody and increased aneuploidy in CDK5-/- cells

Http Dx Doi Org 10 4161 Cc 9 17 12722, Sep 1, 2010

Letter to the Editor. Localization of CDK5 in the midbody and increased aneuploidy in CDK5 -/- ce... more Letter to the Editor. Localization of CDK5 in the midbody and increased aneuploidy in CDK5 -/- cells. Volume 9, Issue 17 September 1, 2010 Pages 3629 - 3630 DOI: 10.4161/cc.9.17.12722 Ki-Young Lee, Ashley Mummery, John Park, Hassan Tariq and Jesusa L. Rosales. ...

Research paper thumbnail of Colonic Interposition between the Liver and Diaphragm: “The Chilaiditi Sign”

Canadian Journal of Gastroenterology and Hepatology, 2016

A 90-year-old wheelchair bound male was brought to the emergency department with complaints of wo... more A 90-year-old wheelchair bound male was brought to the emergency department with complaints of worsening abdominal pain over the last 2-3 days. The patient also had difficulty in passing urine. Abdominal examination revealed tenderness in the umbilical and hypogastric area without rebound tenderness or guarding. Computed tomography (CT) of the abdomen showed a loop of colon interpositioned between the liver and the right hemidiaphragm (the Chilaiditi sign), mimicking free air. Foley&amp;amp;amp;amp;amp;amp;#39;s catheter was placed and the patient was managed conservatively. The patient clinically improved with improvement of the abdominal pain.

Research paper thumbnail of Gallstone ileus with multiple stones: Where Rigler triad meets Bouveret's syndrome

World journal of gastrointestinal surgery, Jan 27, 2015

A 53-year-old man with multiple medical conditions presented to the emergency department with com... more A 53-year-old man with multiple medical conditions presented to the emergency department with complaints of vomiting, anorexia and diffuse colicky abdominal pain for 3 d. A computed tomography scan of the abdomen and pelvis showed radiographic findings consistent with Rigler triad seen in small proportion of patients with small bowel obstruction secondary to gallstone impaction. In addition there was a gastric outlet obstruction, consistent with Bouveret's syndrome. The patient underwent an exploratory laparotomy and enterotomy with multiple stones extracted. The patient had an uneventful post-surgical clinical course and was discharged home.

Research paper thumbnail of Serum triglyceride level - a predictor of complications and outcomes in acute pancreatitis?

Canadian journal of gastroenterology & hepatology, Jan 14, 2015

Aim. To study serum triglyceride level as a predictor of complications and outcomes in acute panc... more Aim. To study serum triglyceride level as a predictor of complications and outcomes in acute pancreatitis. Methods. In this retrospective observational study, 582 patients admitted with acute pancreatitis, who had serum triglyceride levels measured within the first 24 hours, were divided into two groups. The study group consisted of patients with a triglyceride level ≥2.26 mmol/L (group 2) and the control group consisted of triglyceride level of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2.26 mmol/L (group 1). We collected data for baseline demographics, laboratory values, incidence of complications (local and systemic), admission to the intensive care unit (ICU), ICU length of stay, length of total hospital stay, and death in the two groups. Results. A triglyceride level of ≥2.26 mmol/L was found to be an independent predictor of developing altered mental status (p: 0.004), pancreatic necrosis (p: 0.001), acute respiratory distress syndrome (p: 0001), systemic Inflammatory response syndrome (p: 0.001), acute kidney injury (p: 0.001), hospital length of stay (LOS) (p: 0.002), admission to intensive care unit (ICU) (p: 0.002), and ICU LOS (p: 0.003). Conclusion. A triglyceride level of ≥2.26 mmol/L on admission in acute pancreatitis is an independent predictor of developing local and systemic complications, hospital LOS, admission to ICU, and ICU LOS.

Research paper thumbnail of Etanercept-induced myositis: do we have to stop it? A surprising outcome

BMJ case reports, Jan 11, 2016

We discuss a case of a 47-year-old man who presented with progressive proximal muscle weakness of... more We discuss a case of a 47-year-old man who presented with progressive proximal muscle weakness of the upper and lower extremities and unstable gait. He had been on etanercept for 6 months for severe psoriasis and psoriatic arthritis with good control of his disease. Serum creatine kinase (CK) level was found to be 5666 U/L and muscle biopsy showed a marked inflammatory myopathic process likely secondary to etanercept. He was started on high-dose steroids and advised to discontinue etanercept. Despite our recommendation, he never stopped using etanercept due to fear of a psoriasis flare. Three months later, he had significant improvement of clinical symptoms, normalised serum CK levels and discontinued prednisone.

Research paper thumbnail of Recurrent Thrombotic Vasculopathy in a Former Cocaine User

Case Reports in Dermatological Medicine, 2015

We report a case of a 35-year-old female who presented to the emergency room (ER) complaining of ... more We report a case of a 35-year-old female who presented to the emergency room (ER) complaining of a pruritic rash involving multiple areas of the body. She had a significant history of cocaine use in the past. She had first developed a similar rash in 2013 when she was diagnosed with cocaine-induced vasculitis. Her urine toxicology had been positive for cocaine in the past until July 2013. She was incarcerated and attended a drug rehabilitation program after which she quit cocaine use, which was consistent with negative urine toxicology on subsequent admissions. Further workup did not reveal any other, autoimmune or infectious, etiology of this clinical presentation. The patient underwent biopsy of the skin lesion that was consistent with thrombotic vasculopathy likely secondary to levamisole.

Research paper thumbnail of Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure

American Journal of Case Reports, 2015

Percutaneous endoscopic gastrostomy (PEG) is a procedure used most commonly for enteral access fo... more Percutaneous endoscopic gastrostomy (PEG) is a procedure used most commonly for enteral access for nutrition and continuation of treatment in patients when oral nutrition is not possible. It is a safe, cost-effective procedure; however, has its own complications and adverse effects that can be life threatening. Here, we present the case of a 76-year-old woman who was sent to a long-term skilled nursing facility after discharge from a hospital a month before, initially admitted for seizures after a fall and diabetic ketoacidosis. She underwent tracheostomy for prolonged respiratory support on mechanical ventilation and also underwent PEG tube placement. She presented in our Emergency Department (ED) with septic shock and multi-organ failure initially attributed to urinary tract infection and possible Clostridium difficile colitis. However, on further evaluation she was found to have a dislodged PEG tube, which led to development of gastro-hepatic fistula and multiple liver abscesses with liver necrosis. Comfort measures were implemented and she died due to her critical condition. To the best of our knowledge, this is the first case of a PEG tube, with no post-procedure complications, that dislodged and resulted in formation of a gastro-hepatic fistula and multiple liver abscesses. It is the first case that describes liver injury resulting from dislodgement rather than the liver being injured during the procedure of PEG tube placement itself.

Research paper thumbnail of Disseminated Histoplasmosis and Secondary Hemophagocytic Syndrome in a Non-HIV Patient

Case Reports in Critical Care, 2015

Histoplasma duboisii, a variant of Histoplasma capsulatum that causes &amp;amp;amp;amp;amp;am... more Histoplasma duboisii, a variant of Histoplasma capsulatum that causes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;African histoplasmosis,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; can be resistant to itraconazole, requiring intravenous amphotericin B treatment. Rarely, these patients do not respond to intravenous antifungal therapy, and in such cases, patients may progress to develop secondary hemophagocytic lymphohistiocytosis (HLH). We present a case of a 34-year-old male patient with sickle cell disease who presented with a 5-month history of an enlarging painless axillary mass, persistent low grade fevers, night sweats, weight loss, and anorexia. An excisional biopsy of the right axillary lymph node revealed yeast and granulomas consistent with histoplasma infection. He was started on oral itraconazole. After 4 weeks of therapy, laboratory evaluation revealed worsening anemia, thrombocytopenia, and transaminitis. Due to failure of oral therapy, he was admitted for intravenous amphotericin B treatment. During his hospital course anemia, thrombocytopenia, and transaminitis all worsened. A bone marrow biopsy was done that was consistent with HLH. His clinical status continued to deteriorate, developing multiorgan failure and disseminated intravascular coagulation. He unfortunately had a cardiorespiratory arrest after eight days of admission and passed away.

Research paper thumbnail of Affective AI Agents in a Game Scenario

In this paper we discuss several types of Affective Artificially Intelligent agents which employ ... more In this paper we discuss several types of Affective Artificially Intelligent agents which employ Artificial Intelligence technique and how they gather knowledge in a socially interactive environment. Later on, using the studies of these agents, it explains the methodology and algorithm for implementing an intelligent agent in the game scenario capable of playing the game. It also explains that how this agent can be used to study human emotions and referral expression.

Research paper thumbnail of Bioanalyzer: An Efficient Tool for Sequence Retrieval, Analysis and Manipulation

Bioanalyzer provides combination of tools that are never assembled together. Software has list of... more Bioanalyzer provides combination of tools that are never assembled together. Software has list of tools that can be important for different researchers. The aim to develop this kind of software is to provide unique set of tools at one platform in a more efficient and better way than the software or web tools available. It is stand-alone application so it can save time and effort to locate individual tools on net. Flexible design has made it easy to expand it in future. We will make it available publicly soon.

Research paper thumbnail of Extrahepatic Biliary Obstruction: An Unusual Presentation of Hepatic Sarcoidosis

Clinical Medicine Insights: Gastroenterology, 2015

We report this case of a 63-year-old woman who presented with progressive illness characterized b... more We report this case of a 63-year-old woman who presented with progressive illness characterized by abdominal pain, weight loss, anorexia, generalized weakness, and fatigue. The patient was found to have obstructive jaundice with multiple mass lesions in the liver, spleen, and kidney on computed tomography scan of abdomen. She developed cholangitis, necessitating an emergent endoscopic retrograde cholangiopancreatography with biliary stenting and decompression. Later, she was found to have hepatic sarcoidosis on wedge biopsy of the liver. Extrinsic compression of biliary tree from mass effect of sarcoid granulomas with superimposed biliary sepsis is rare.

Research paper thumbnail of A fascinating presentation of hepatic hydrothorax

World journal of hepatology, Jan 27, 2013

We report this case of a 43-year-old woman with hepatitis-C cirrhosis who presented with a large ... more We report this case of a 43-year-old woman with hepatitis-C cirrhosis who presented with a large right sided pleural effusion complicated by hypoxic respiratory failure and altered mentation necessitating dependence on mechanical ventilation. The pleural effusion spontaneously resolved upon initiation of mechanical positive pressure ventilation and recurred almost immediately after weaning the patient off the ventilator. The pre-ventilation, ventilation and post-ventilation chest X-ray films in chronological order present a striking visual demonstration of fluid dynamics and pathophysiology of hepatic hydrothorax, thereby obviating the need for a dedicated diagnostic test. We also report this case to highlight the treatment strategies for this often intractable complication.

Research paper thumbnail of Abdominal aortitis associated with Crohn disease

Canadian journal of gastroenterology & hepatology, 2014

Research paper thumbnail of Sign of Leser-Trélat Associated with Esophageal Squamous Cell Cancer

The sign of Leser-Trélat is a rare paraneoplastic phenomenon marked by accelerated onset of multi... more The sign of Leser-Trélat is a rare paraneoplastic phenomenon marked by accelerated onset of multiple seborrheic keratoses. The occurrence of the sign often points towards underlying visceral malignancies which in a majority are adenocarcinomas of the gastrointestinal tract. We report this case of a 65-year-old man who presented with sign of Leser-Trélat and was diagnosed with poorly differentiated squamous cell cancer of the esophagus. To our knowledge this is only the second such reported association of Leser-Trélat sign with squamous cell cancer of esophagus.

Research paper thumbnail of Implementation of medical information bus (MIB) at LDS Hospital

Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 1988

Medical Information Bus (MIB) is a standard designed to allow different medical instrument manufa... more Medical Information Bus (MIB) is a standard designed to allow different medical instrument manufacturers to transmit data from their instruments to a host computer. The authors felt that such a system, if developed without any field experience and feedback from end users, might be impractical. Therefore, they developed and implemented an MIB system using IV pumps. The MIB standard at

Research paper thumbnail of Non-Alcoholic Fatty Pancreatic Disease: A Review of Literature

Gastroenterology research, 2016

There is an epidemic of obesity worldwide. The prevalence of obesity has doubled over the last th... more There is an epidemic of obesity worldwide. The prevalence of obesity has doubled over the last three decades. Obesity, especially abdominal obesity is associated with insulin resistance that can lead to pancreatic steatosis and non-alcoholic fatty pancreatic disease (NAFPD). NAFPD describes a phenotype entity ranging from deposition of fat in the pancreas to pancreatic inflammation, and resultant fibrosis, which is similar to that of non-alcoholic fatty liver disease (NAFLD). NAFPD may represent a meaningful manifestation of metabolic syndrome. Pancreatic steatosis can be diagnosed on ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI). In addition to a correlation between pancreatic steatosis and metabolic syndrome, pancreatic steatosis may lead to a worse outcome in pancreatitis and may be an etiological factor in pancreatic cancer, but we need further research to examine the associations, pathophysiology, and the impact of pancreatic steatosis and NAFPD ...

Research paper thumbnail of Computerized Tomography-Guided Paracentesis: An Effective Alternative to Bedside Paracentesis?

Journal of clinical medicine research, 2017

Ascites remains the most common cause of hospitalization among patients with decompensated cirrho... more Ascites remains the most common cause of hospitalization among patients with decompensated cirrhosis. Paracentesis is a relatively safe procedure with low complication rates. Computerized tomography (CT)-guided therapeutic paracentesis could be a safe and effective alternative to unaided or aided (ultrasonogram-guided) bedside paracentesis. In this retrospective study, we aimed to compare the efficacy, safety, and cost-effectiveness of CT-guided paracentesis with bedside paracentesis. The period of study was from 2002 to 2012. All patients with cirrhosis who underwent therapeutic paracentesis were included in the study. These patients were divided into two groups. Group I consisted of patients who underwent CT-guided pigtail catheter insertion with ascitic fluid drainage. Group II consisted of patients who underwent beside therapeutic paracentesis after localization of fluid either by physical examination or sonographic localization. We measured the efficacy of CT-guided paracentesi...

Research paper thumbnail of Symptomatic Gallstones in the Young: Changing Trends of the Gallstone Disease-Related Hospitalization in the State of New York: 1996 - 2010

Journal of clinical medicine research, 2017

The aim of the study was to evaluate if the gallstone-related hospitalizations in the young (<... more The aim of the study was to evaluate if the gallstone-related hospitalizations in the young (< 20 years of age) have increased over time in both the Bronx County and New York State as a whole. We retrospectively reviewed 15 years (1996 - 2010) of Statewide Planning and Research Cooperative System (SPARCS) data of New York State Department of Health. Patients with ICD-9 code diagnosis of 574 (cholelithiasis) among the first three discharge diagnoses were reviewed. Total number of all cause admissions to hospitals had increased from 2.44 million to 2.77 million (1996 - 2010). However, gallstone-related hospitalizations had decreased from 1.7% to 1.2%. It was noted that there was a 30% increment in the proportion of those below 20 years of age with gallstone disease requiring hospitalization over the same period. This young patient population contributed only 2.04% to all gallstone-related hospitalizations in 1996, whereas it had increased to 2.96% in 2010. This trend was more prono...

Research paper thumbnail of Fulminant Hepatic Failure Secondary to Herpes Hepatitis in a Patient With Myasthenia Crisis: An Elusive Diagnosis

Journal of clinical medicine research, 2016

Herpes hepatitis is a rare cause of fulminant hepatic failure contributing to less than 1% of all... more Herpes hepatitis is a rare cause of fulminant hepatic failure contributing to less than 1% of all cases. It is most often seen in persons who are immunosuppressed and in pregnant women. The presentation is usually non-specific and rapidly progressive, thus making antemortem diagnosis of this condition rare. We present a patient who was on chronic immunosuppressive therapy for systemic lupus erythematosus and subsequently developed multi-organ failure with anicteric transaminitis as a result of disseminated herpes infection. The diagnosis was only made post-mortem. A confounding factor in this case was the fact that the patient underwent plasmapheresis, which skewed the interpretation of liver function tests in the setting of acute liver failure.

Research paper thumbnail of Effect of Aloe Vera (Aloe barbadensis) and Clove (Syzigium aromaticum) Supplementation on Immune Status, Haematological and Serum Biochemical Parameters in Japanese Quails

Indian Journal of Animal Nutrition, 2014

Research paper thumbnail of Localization of CDK5 in the midbody and increased aneuploidy in CDK5-/- cells

Http Dx Doi Org 10 4161 Cc 9 17 12722, Sep 1, 2010

Letter to the Editor. Localization of CDK5 in the midbody and increased aneuploidy in CDK5 -/- ce... more Letter to the Editor. Localization of CDK5 in the midbody and increased aneuploidy in CDK5 -/- cells. Volume 9, Issue 17 September 1, 2010 Pages 3629 - 3630 DOI: 10.4161/cc.9.17.12722 Ki-Young Lee, Ashley Mummery, John Park, Hassan Tariq and Jesusa L. Rosales. ...

Research paper thumbnail of Colonic Interposition between the Liver and Diaphragm: “The Chilaiditi Sign”

Canadian Journal of Gastroenterology and Hepatology, 2016

A 90-year-old wheelchair bound male was brought to the emergency department with complaints of wo... more A 90-year-old wheelchair bound male was brought to the emergency department with complaints of worsening abdominal pain over the last 2-3 days. The patient also had difficulty in passing urine. Abdominal examination revealed tenderness in the umbilical and hypogastric area without rebound tenderness or guarding. Computed tomography (CT) of the abdomen showed a loop of colon interpositioned between the liver and the right hemidiaphragm (the Chilaiditi sign), mimicking free air. Foley&amp;amp;amp;amp;amp;amp;#39;s catheter was placed and the patient was managed conservatively. The patient clinically improved with improvement of the abdominal pain.

Research paper thumbnail of Gallstone ileus with multiple stones: Where Rigler triad meets Bouveret's syndrome

World journal of gastrointestinal surgery, Jan 27, 2015

A 53-year-old man with multiple medical conditions presented to the emergency department with com... more A 53-year-old man with multiple medical conditions presented to the emergency department with complaints of vomiting, anorexia and diffuse colicky abdominal pain for 3 d. A computed tomography scan of the abdomen and pelvis showed radiographic findings consistent with Rigler triad seen in small proportion of patients with small bowel obstruction secondary to gallstone impaction. In addition there was a gastric outlet obstruction, consistent with Bouveret's syndrome. The patient underwent an exploratory laparotomy and enterotomy with multiple stones extracted. The patient had an uneventful post-surgical clinical course and was discharged home.

Research paper thumbnail of Serum triglyceride level - a predictor of complications and outcomes in acute pancreatitis?

Canadian journal of gastroenterology & hepatology, Jan 14, 2015

Aim. To study serum triglyceride level as a predictor of complications and outcomes in acute panc... more Aim. To study serum triglyceride level as a predictor of complications and outcomes in acute pancreatitis. Methods. In this retrospective observational study, 582 patients admitted with acute pancreatitis, who had serum triglyceride levels measured within the first 24 hours, were divided into two groups. The study group consisted of patients with a triglyceride level ≥2.26 mmol/L (group 2) and the control group consisted of triglyceride level of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2.26 mmol/L (group 1). We collected data for baseline demographics, laboratory values, incidence of complications (local and systemic), admission to the intensive care unit (ICU), ICU length of stay, length of total hospital stay, and death in the two groups. Results. A triglyceride level of ≥2.26 mmol/L was found to be an independent predictor of developing altered mental status (p: 0.004), pancreatic necrosis (p: 0.001), acute respiratory distress syndrome (p: 0001), systemic Inflammatory response syndrome (p: 0.001), acute kidney injury (p: 0.001), hospital length of stay (LOS) (p: 0.002), admission to intensive care unit (ICU) (p: 0.002), and ICU LOS (p: 0.003). Conclusion. A triglyceride level of ≥2.26 mmol/L on admission in acute pancreatitis is an independent predictor of developing local and systemic complications, hospital LOS, admission to ICU, and ICU LOS.

Research paper thumbnail of Etanercept-induced myositis: do we have to stop it? A surprising outcome

BMJ case reports, Jan 11, 2016

We discuss a case of a 47-year-old man who presented with progressive proximal muscle weakness of... more We discuss a case of a 47-year-old man who presented with progressive proximal muscle weakness of the upper and lower extremities and unstable gait. He had been on etanercept for 6 months for severe psoriasis and psoriatic arthritis with good control of his disease. Serum creatine kinase (CK) level was found to be 5666 U/L and muscle biopsy showed a marked inflammatory myopathic process likely secondary to etanercept. He was started on high-dose steroids and advised to discontinue etanercept. Despite our recommendation, he never stopped using etanercept due to fear of a psoriasis flare. Three months later, he had significant improvement of clinical symptoms, normalised serum CK levels and discontinued prednisone.

Research paper thumbnail of Recurrent Thrombotic Vasculopathy in a Former Cocaine User

Case Reports in Dermatological Medicine, 2015

We report a case of a 35-year-old female who presented to the emergency room (ER) complaining of ... more We report a case of a 35-year-old female who presented to the emergency room (ER) complaining of a pruritic rash involving multiple areas of the body. She had a significant history of cocaine use in the past. She had first developed a similar rash in 2013 when she was diagnosed with cocaine-induced vasculitis. Her urine toxicology had been positive for cocaine in the past until July 2013. She was incarcerated and attended a drug rehabilitation program after which she quit cocaine use, which was consistent with negative urine toxicology on subsequent admissions. Further workup did not reveal any other, autoimmune or infectious, etiology of this clinical presentation. The patient underwent biopsy of the skin lesion that was consistent with thrombotic vasculopathy likely secondary to levamisole.

Research paper thumbnail of Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure

American Journal of Case Reports, 2015

Percutaneous endoscopic gastrostomy (PEG) is a procedure used most commonly for enteral access fo... more Percutaneous endoscopic gastrostomy (PEG) is a procedure used most commonly for enteral access for nutrition and continuation of treatment in patients when oral nutrition is not possible. It is a safe, cost-effective procedure; however, has its own complications and adverse effects that can be life threatening. Here, we present the case of a 76-year-old woman who was sent to a long-term skilled nursing facility after discharge from a hospital a month before, initially admitted for seizures after a fall and diabetic ketoacidosis. She underwent tracheostomy for prolonged respiratory support on mechanical ventilation and also underwent PEG tube placement. She presented in our Emergency Department (ED) with septic shock and multi-organ failure initially attributed to urinary tract infection and possible Clostridium difficile colitis. However, on further evaluation she was found to have a dislodged PEG tube, which led to development of gastro-hepatic fistula and multiple liver abscesses with liver necrosis. Comfort measures were implemented and she died due to her critical condition. To the best of our knowledge, this is the first case of a PEG tube, with no post-procedure complications, that dislodged and resulted in formation of a gastro-hepatic fistula and multiple liver abscesses. It is the first case that describes liver injury resulting from dislodgement rather than the liver being injured during the procedure of PEG tube placement itself.

Research paper thumbnail of Disseminated Histoplasmosis and Secondary Hemophagocytic Syndrome in a Non-HIV Patient

Case Reports in Critical Care, 2015

Histoplasma duboisii, a variant of Histoplasma capsulatum that causes &amp;amp;amp;amp;amp;am... more Histoplasma duboisii, a variant of Histoplasma capsulatum that causes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;African histoplasmosis,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; can be resistant to itraconazole, requiring intravenous amphotericin B treatment. Rarely, these patients do not respond to intravenous antifungal therapy, and in such cases, patients may progress to develop secondary hemophagocytic lymphohistiocytosis (HLH). We present a case of a 34-year-old male patient with sickle cell disease who presented with a 5-month history of an enlarging painless axillary mass, persistent low grade fevers, night sweats, weight loss, and anorexia. An excisional biopsy of the right axillary lymph node revealed yeast and granulomas consistent with histoplasma infection. He was started on oral itraconazole. After 4 weeks of therapy, laboratory evaluation revealed worsening anemia, thrombocytopenia, and transaminitis. Due to failure of oral therapy, he was admitted for intravenous amphotericin B treatment. During his hospital course anemia, thrombocytopenia, and transaminitis all worsened. A bone marrow biopsy was done that was consistent with HLH. His clinical status continued to deteriorate, developing multiorgan failure and disseminated intravascular coagulation. He unfortunately had a cardiorespiratory arrest after eight days of admission and passed away.

Research paper thumbnail of Affective AI Agents in a Game Scenario

In this paper we discuss several types of Affective Artificially Intelligent agents which employ ... more In this paper we discuss several types of Affective Artificially Intelligent agents which employ Artificial Intelligence technique and how they gather knowledge in a socially interactive environment. Later on, using the studies of these agents, it explains the methodology and algorithm for implementing an intelligent agent in the game scenario capable of playing the game. It also explains that how this agent can be used to study human emotions and referral expression.