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Sedation reversal trends at outpatient ambulatory endoscopic center vs in-hospital ambulatory procedure center using a triage protocol

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 413-423页

作者： Saqib Walayat Peter Stadmeyer Azfar Hameed minahil Sarfaraz Paul Estrada Mark Benson Anurag Soni Patrick Pfau Paul Hayes Brittney Kile Toni Cruz Deepak Gopal Department of Gastroenterology University of IllinoisPeoriaIL 61605United States Department of Gastroenterology University of WisconsinMadisonWI 53792United States Department of Internal Medicine Texas Health DentonDentonTX 76201United States Department of Internal Medicine Allama Iqbal Medical CollegeLahore 042Pakistan Department of Gastroenterology Texas Tech University Health Services CenterEl PasoTX 79911United States Department of Gastroenterology and Hepatology University of WisconsinMadisonWI 53705United States Finance Business Partners UW Health University of WisconsinMadisonWI 53792United States UW Health Digestive Health Center Endoscopy University of WisconsinMadisonWI 53792United States Division of Gastroenterology and Hepatology Department of MedicineUniversity of Wisconsin Hospitals and ClinicsMadisonWI 53705United States

BACKGROUND Routine outpatient endoscopy is performed across a variety of outpatient settings.A known risk of performing endoscopy under moderate sedation is the potential for over-sedation,requiring the use of reversal *** needs to be reported on rates of reversal across different outpatient *** academic tertiary care center utilizes a triage tool that directs higher-risk patients to the in-hospital ambulatory procedure center(APC)for their ***,we report data on outpatient sedation reversal rates for endoscopy performed at an inhospital APC vs at a free-standing ambulatory endoscopy digestive health center(AEC-DHC)following risk stratification with a triage *** To observe the effect of risk stratification using a triage tool on patient outcomes,primarily sedation reversal *** We observed all outpatient endoscopy procedures performed at AEC-DHC and APC from April 2013 to September *** were stratified to their respective sites using a triage *** evaluated each procedure for which sedation reversal with flumazenil and naloxone was *** and characteristics recorded include patient age,gender,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,procedure type,and reason for sedation *** There were 97366 endoscopic procedures performed at AEC-DHC and 22494 at the APC during the study *** these,17 patients at AEC-DHC and 9 at the APC underwent sedation reversals(0.017%vs 0.04%;P=0.06).Demographics recorded for those requiring reversal at AEC-DHC vs APC included mean age(53.5±21 vs 60.4±17.42 years;P=0.23),ASA class(1.66±0.48 vs 2.22±0.83;P=0.20),BMI(27.7±6.7 kg/m^(2) vs 23.7±4.03 kg/m^(2);P=0.06),and female gender(64.7%vs 22%;P=0.04).The mean doses of sedative agents and reversal drugs used at AEC-DHC vs APC were midazolam(5.9±1.7 mg vs 8.9±3.5 mg;P=0.01),fentanyl(147.1±49.9μg vs 188.9±74.1μg;P=0.10),flumazenil(0.3±0.18μg vs 0.17±0.17μg;P=0.13)and naloxo

关键词： Ambulatory care Conscious sedation Endoscopy Colonoscopy Risk assessment Risk factors

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Lightweight authentication protocol for e-health clouds in IoT-based applications through 5G technology

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Digital Communications and Networks 2021年第2期7卷 235-244页

作者： minahil Muhammad Faizan Ayub Khalid Mahmood Saru Kumari Arun Kumar Sangaiah Department of Computer Science COMSATS University Islamabad Sahiwal Campus57000Pakistan Department of Mathematics Ch.Charan Singh UniversityMeerutUtter Paradesh250001India School of Computing Science and Engineering VIT UniversityVelloreTamil NaduIndia

Modem information technology has been utilized progressively to store and distribute a large amount of healthcare data to reduce costs and improve medical *** this context,the emergence of e-Health clouds offers novel opportunities,like easy and remote accessibility of medical ***,this achievement produces plenty of new risks and challenges like how to provide integrity,security,and confidentiality to the highly susceptible e-Health *** these challenges,authentication is a major issue that ensures that the susceptible medical data in clouds is not available to illegal *** smart card,password and biometrics are three factors of authentication which fulfill the requirement of giving high *** three-factor ECC-based authentication protocols on e-Health clouds have been presented so ***,most of the protocols have serious security flaws and produce high computation and communication ***,we introduce a novel protocol for the e-Health cloud,which thwarts some major attacks,such as user anonymity,offline password guessing,impersonation,and stolen smart card ***,we evaluate our protocol through formal security analysis using the Random Oracle Model(ROM).The analysis shows that our proposed protocol is more efficient than many existing protocols in terms of computation and communication ***,our proposed protocol is proved to be more efficient,robust and secure.

关键词： Authentication Security protocol IoT 5G e-health cloud

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Vaccination Approach Toward Monkeypox: An Urgent Call

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Infectious Diseases & Immunity 2023年第1期3卷 1-2页

作者： minahil Binte Saleem Somina Shaikh Sadia Tahir Syeda Lamiya Mir Govinda Khatri Department of Internal Medicine Dow University of Health ScienceKarachiPakistan Karachi Medical and Dental College KarachiPakistan.

*** Following the global COVID-19 emergency,another public health emergency was declared by the World Health Organization on July 23,2022:“monkeypox.”Monkeypox virus(MPXV)belongs to the Poxviridae family and causes monkeypox,a disease clinically similar to smallpox.[1,2]Monkeypox was discovered in 1958 after two outbreaks of poxlike disease in research colonies of *** first known human infection was in 1970 in a newborn in the Democratic Republic of Congo.[3]Monkeypox began to reemerge in 2022,and the evolution of the outbreak is worrisome,as it does not seem that the pandemic,which has affected large numbers of people worldwide,is slowing down *** reported more than 57,000 cases and approximately 22 deaths on September 13.[4]Animal-to-human and human-to-human transmissions are two possible routes of transmission for *** to the clinicians,intimate sexual contact was the suspected route of transmission for the MPXV in 95% of *** or bisexual men,as well as other men who have sex with men,have been particularly hard hit by the current *** with smallpox,symptoms are similar but less severe and include pustular skin lesions,fever,headache,myalgia,and *** rash usually begins on the lips and spreads to the face and then to the limbs in a circular pattern.

关键词： belongs monkey circular

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