Browsing by Author "Munshi, Imtiaz A."

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    Analysis of Cases inWhich a Biopsy Specimen Is Positive and an Excised Lesion Is Negative for Nonmelanoma Skin Cancer
    (JAMA, 2016-05) Han, Jane; Nosrati, Naveed N.; Soleimani, Tahereh; Munshi, Imtiaz A.; Flores, Roberto L.; Tholpady, Sunil S.; Department of Surgery, IU School of Medicine
    Nonmelanoma skin cancers (NMSCs), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), are the most common types of cancer with the fastest-growing treatment costs in the United States.1 Standard treatment requires biopsy for histologic confirmation, followed by excision. Oftentimes, no residual carcinoma is detected, implying spontaneous clearance at rates reported to vary from 24% to 76%.2- 5 These types of lesions have been investigated by others2- 5 and are not fully understood. Our study aims to determine the lesion and patient characteristics that would most strongly predict a histologically negative result for an excised lesion after a biopsy specimen had positive margins.
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    Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital
    (Oxford, 2016-03) Konger, Raymond L.; Ndekwe, Paul; Jones, Genea; Schmidt, Ronald P.; Trey, Marty; Baty, Eric J.; Wilhite, Denise; Munshi, Imtiaz A.; Sutter, Bradley M.; Rao, Maddamsetti; Bashir, Chowdry M.; Department of Pathology and Laboratory Medicine, IU School of Medicine
    Objectives: To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. Methods: The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team.Results: Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged. Conclusions: Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care.
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    Ultrasonography-Guided Identification With Methylene Blue Tattooing of the Ilioinguinal Nerve for Neurectomy for Chronic Pain: A Case Series
    (AMA, 2015-02) Eppstein, Andrew Curtiss; Munshi, Imtiaz A.; Sakamato, Bryan; Gwirtz, Kenneth; Department of Surgery, IU School of Medicine
    Chronic ilioinguinal pain is a common but morbid complication of inguinal herniorrhaphy for 12% to 62% of patients.1 Although pharmacologic options exist (such as nerve blocks), long-term pain relief is inferior to surgical neurectomy.2,3 We present our experience in ilioinguinal neurectomy with preoperative ultrasonography-guided identification and perineural injection of methylene blue to tattoo the nerve.