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Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

World Journal of Gastrointestinal Oncology 2024年第3期16卷 699-715页

作者： Ankit Agarwal Sagnik Biswas Shekhar Swaroop Arnav Aggarwal Ayush Agarwal Gautam Jain Anshuman Elhence Arun Vaidya Amit Gupte Ravi Mohanka Ramesh Kumar Ashwani Kumar Mishra Shivanand Gamanagatti Shashi Bala Paul Subrat Kumar Acharya akash shukla Shalimar Department of Gastroenterology and Human Nutrition All India Institute of Medical SciencesNew Delhi 110029DelhiIndia Department of Gastroenterology Seth Gordhandas Sunderdas Medical College and KEM HospitalMumbai 400012MaharashtraIndia Department of Gastroenterology Sir HN Reliance Foundation HospitalMumbai 400004India Department of Liver Transplant and HPB Sir HN Reliance Foundation HospitalMumbai 400004India Department of Gastroenterology All India Institute of Medical SciencesPatna 801507India Professor of Biostatistics National Drug Dependence Treatment Centre(NDDTC)All India Institute of Medical SciencesNew Delhi 110029India Department of Radiodiagnosis All India Institute of Medical SciencesNew Delhi 110029DelhiIndia

BACKGROUND There is scant literature on hepatocellular carcinoma(HCC)in patients with Budd-Chiari syndrome(BCS).AIM To assess the magnitude,clinical characteristics,feasibility,and outcomes of treatment in *** A total of 904 BCS patients from New Delhi,India and 1140 from Mumbai,India were *** prevalence and incidence of HCC were determined,and among patients with BCS-HCC,the viability and outcomes of interventional therapy were *** In the New Delhi cohort of 35 BCS-HCC patients,18 had HCC at index presentation(prevalence 1.99%),and 17 developed HCC over a follow-up of 4601 person-years,[incidence 0.36(0.22-0.57)per 100 person-years].BCS-HCC patients were older when compared to patients with BCS alone(P=0.001)and had a higher proportion of inferior vena cava block,cirrhosis,and long-segment vascular *** median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up(13029 ng/mL vs 500 ng/mL,P=0.01).Of the 35 BCS-HCC,26(74.3%)underwent radiological interventions for BCS,and 22(62.8%)patients underwent treatment for HCC[transarterial chemoembolization in 18(81.8%),oral tyrosine kinase inhibitor in 3(13.6%),and transarterial radioembolization in 1(4.5%)].The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo(P=0.0001).In contrast to the New Delhi cohort,the Mumbai cohort of BCS-HCC patients were predominantly males,presented with a more advanced HCC[Barcelona Clinic Liver Cancer C and D],and 2 patients underwent liver *** HCC is not uncommon in patients with *** interventions and liver transplantation are feasible in select primary BCS-HCC patients and may improve outcomes.

关键词： Budd chiari syndrome Cancer Cirrhosis Thrombosis Liver Varices Transarterial chemoembolization Hepatic venous outflow tract obstruction

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Boulder-induced form roughness and skin shear stresses in a gravel-bed stream

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Journal of Mountain Science 2024年第1期21卷 346-360页

作者： DAS Ratul DATTA akash Civil Engineering Department National Institute of Technology AgartalaAgartala-799046India

Boulder spacing in mountain rivers and near-wake flow zones within the boulder array is very useful for fish habitat and growth of aquatic *** present study aims to investigate how the boulder array and spacing influence the near-bed flow structures in a gravel-bed *** are staggered over a gravel-bed stream with three different inter-boulder spacing namely(a)large(b)medium and(c)small *** acoustic Doppler velocimeter was used for flow measurements in a rectangular channel and the results were compared with those acquired from numerical *** time-averaged velocity profiles at the near-wake flow zones of boulders experience maximum flow retardation which is an outcome of the boulder-induced form *** ratio of velocity differences associated to form and skin roughness and its positive magnitude reveals the dominance of form roughness closest to the *** roughness computed is 1.75 to 2 times higher than the skin roughness at the near-wake flow *** particular,the collective immobile boulders placed at different inter-boulder spacings developed high and low bed shear stresses closest to the *** low bed shear stresses characterised by a secondary peak developed at the trough location of the boulders is attributed to the skin shear ***,the spatial averaging of time-averaged flow quantities gives additional impetus to present an improved illustration of fluid shear *** formation of form-induced shear stress is estimated to be 17%to 23%of doubleaveraged Reynolds shear stress and partially compensates for the damping of time-averaged Reynolds shear stress in the interfacial *** quadrant analysis of spatial velocity fluctuations depicts that the form-induced shear stresses are dominant in the interfacial sub-layer and have no significance above the gravel-bed surface.

关键词： Array of boulders Near wake flow zones Velocity distributions Skin roughness Form induced shear stresses

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Study of plasma parameters of coaxial plasma source using triple Langmuir probe and Faraday cup diagnostics

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Plasma Science and Technology 2024年第4期26卷 94-100页

作者： Sunil KANCHI Rohit shukla Archana SHARMA Pulsed Power and Electromagnetics Division Bhabha Atomic Research CentreVisakhapatnam 531011India Homi Bhabha National Institute Mumbai 400085India Beam Technology Development Group Bhabha Atomic Research CentreMumbai 400085India

Coaxial plasma guns are a type of plasma source that produces plasma which propagates radially and axially controlled by the shape of the ground electrode, which has attracted much interest in several applications. In this work, a 120° opening angle of CPG nozzle is used as a plasma gun configuration that operates at the energy of 150 J. The ionization of polyethylene insulator between the electrodes of the gun produces a cloud of hydrogen and carbon *** triple Langmuir probe and Faraday cup are used to measure plasma density and plasma temperature. These methods are used to measure the on-axis and off-axis plasma divergence of the coaxial plasma gun. The peak values of ion densities measured at a distance of 25 mm on-axis from the plasma gun are(1.6±0.5)×10^(19)m^(-3)and(2.8±0.6)×10^(19)m^(-3)for hydrogen and carbon plasma respectively and the peak temperature is 3.02±0.5 eV. The mean propagation velocity of plasma is calculated using the transit times of plasma at different distances from the plasma gun and is found to be 4.54±0.25 cm/μs and 1.81±0.18 cm/μs for hydrogen and carbon plasma respectively. The Debye radius is obtained from the measured experimental data that satisfies the thin sheath approximation. The shot-to-shot stability of plasma parameters facilitates the use of plasma guns in laboratory experiments. These types of plasma sources can be used in many applications like plasma opening switches, plasma devices, and as plasma sources.

关键词： coaxial plasma source triple Langmuir probe Faraday cup plasma density plasma temperature

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Atrial fibrillation and prediabetes:A liaison that merits attention!

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World Journal of Diabetes 2024年第7期15卷 1645-1647页

作者： akash Batta Juniali Hatwal Department of Cardiology Dayanand Medical College and HospitalLudhiana 141001PunjabIndia Department of Internal Medicine Post Graduate Institute of Medical Education&ResearchChandigarh 160012India

Atrial fibrillation(AF)and prediabetes share common pathophysiological mechanisms with endothelial dysfunction and inflammation playing a key *** resultant vicious cycle which sets in culminates in a higher atherogenicity and thermogenicity of the vascular system resulting in increased major adverse cardiac or cerebrovascular event(MACCE)***,the same has not convincingly been verified in real-world *** the recent retrospective study by Desai et al amongst AF patients being admitted to hospitals following MACCE,prediabetes emerged as an independent risk factor for MACCE after adjusting for all confounding ***,certain questions like the role of metformin,quantifying the risk for MACCE amongst prediabetes compared to diabetes,the positive impact of reversion to normoglycemia remain *** provide our insights and give future directions for dedicated research in this area to clarify the exact relationship between the two.

关键词： Atrial fibrillation Major adverse cardiac or cerebrovascular event Prediabetes Diabetes Stroke Heart failure Dysglycemia Metformin

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Numerical Analysis of Phase Change and Container Materials for Thermal Energy Storage in the Storage Tank of Solar Water Heating System

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Journal of Thermal Science 2024年第2期33卷 408-421页

作者： SINGH Shailendra ANAND Abhishek shukla Amritanshu SHARMA Atul Non-Conventional Energy Laboratory Rajiv Gandhi Institute of Petroleum TechnologyJais Amethi229304India

This study evaluates the effectiveness of phase change materials(PCMs) inside a storage tank of warm water for solar water heating(SWH) system through the theoretical simulation based on the experimental model of *** et *** model is explained by five fundamental equations for the calculation of various parameters like the effectiveness of PCMs,the mass of hot water,total heat content,and duration of *** study simulated eleven PCMs to analyze their effectiveness like Sodium hydrogen phosphate dodecahydrate(SHPD),OM 37,N-Eicosane(NE),Lauric acid(LA),Paraffin wax(PW),OM 48,Paraffin wax C_(20-33)(PW-C20-33),Sodium acetate trihydrate(SAT),Palmitic acid(PA),Myristic acid(MA),and Stearic acid(SA).Among all PCMs,the SHPD has found the highest value of effectiveness factor of ***,it is the most recommended PCM for the storage tank of the SWH *** study also includes the melt fraction analysis of all enumerated PCMs corresponding to container materials of stainless steel,glass,aluminum mixed,tin,aluminum,and *** melt fraction analysis is performed by making a coding program in the FORTRAN programming *** the analysis,copper container material is found to have high melting rate for all PCMs so it is superior to other container materials.

关键词： theoretical model solar water heating system phase change material effectiveness factor melt fraction

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Development of pulmonary hypertension remains a major hurdle to corrective surgery in Down syndrome

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World Journal of Cardiology 2024年第1期16卷 1-4页

Down syndrome is the most common chromosomal abnormality encountered in clinical practice with 50%of them having associated congenital heart disease(CHD).Shunt lesions account for around 75%of all CHDs in Down *** syndrome patients,especially with large shunts are particularly predisposed to early development of severe pulmonary hypertension(PH)compared with shunt lesions in general *** necessitates timely surgical correction which remains the only viable option to prevent long term morbidity and ***,despite clear recommendations,there is wide gap between actual practice and fear of underlying PH which often leads to surgical refusals in Down syndrome even when the shunt is *** peculiarity is that Down syndrome patients can develop PH even after successful correction of *** is not uncommon to come across Down syndrome patients with uncorrected shunts in adulthood with irreversible PH at which stage intracardiac repair is contraindicated and the only option available is a combined heartlung ***,despite the guidelines laid by authorities,the rates of cardiac transplant in adult Down syndrome remain dismal largely attributable to the high prevalence of intellectual disability in *** index case presents a real-world scenario highlighting the impact of severe PH on treatment strategies and discrimination driven by the fear of worse outcomes in these patients.

关键词： Down syndrome Congenital heart disease Pulmonary hypertension Cardiac transplantation Pulmonary vascular resistance Surgical correction

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Transcatheter aortic valve replacement in low-risk young population:A double edge sword?

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World Journal of Cardiology 2024年第4期16卷 177-180页

作者： Sukhdeep Bhogal akash Batta Department of Cardiology Sovah HealthMartinsvilleVA 24112United States Department of Cardiology Dayanand Medical College and HospitalLudhiana 141001India

Since the advent of transcatheter aortic valve replacement(TAVR)in 2002,it has now become the default interventional strategy for symptomatic patients presenting with severe aortic stenosis,particularly in intermediate to highsurgical risk *** 2019,the United States Food and Drug Administration approved TAVR in low-risk patients based on two randomized ***,these breakthrough trials excluded patients with certain unfavorable anatomies and odd *** currently there is no randomized study of TAVR in young patients,it may be preferred by the young population given the benefits of early discharge,shorter hospital stay,and expedite ***,it is important to ruminate various factors including lifetime expectancy,risk of pacemaker implantation,and the need for future valve or coronary interventions in young cohorts before considering TAVR in these ***,the data on long-term durability(>10 years)of TAVR is still unknown given most of the procedures were initially performed in the high or prohibitive surgical risk ***,this editorial aims to highlight the importance of considering an individualized approach in young patients with consideration of various factors including lifetime expectancy while choosing TAVR against surgical aortic valve replacement.

关键词： Transcatheter aortic valve replacement Surgical aortic valve replacement Pacemaker implantation Coronary re-access Structural deterioration

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Risk of permanent pacemaker implantation following transcatheter aortic valve replacement:Which factors are most relevant?

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World Journal of Cardiology 2024年第2期16卷 49-53页

Transcatheter aortic valve replacement(TAVR)has emerged as a formidable treatment option for severe symptomatic aortic stenosis ahead of surgical aortic valve *** encouraging results from large randomized controlled trials has resulted in an exponential rise in the use of TAVR even in the low-risk ***,this is not without *** for permanent pacemaker(PPM)post-TAVR remains the most frequent and clinically relevant ***,identifying risk factors which predispose an individual to develop high grade conduction block post-TAVR is *** demographic factors,electrocardiographic features,anatomic factors and procedural characteristics have all been linked to the development of advanced conduction block and need for PPM following *** these electrophysiological variables,most notably a prolonged QRS>120 ms regardless of the type of conduction block seems to be one of the strongest predictors on logistic regression *** index study by Nwaedozie et al highlights that patients requiring PPM post-TAVR had higher odds of having a baseline QRS>120 ms and were more likely to be having diabetes mellitus that those who did not require PPM.

关键词： Transcatheter aortic valve replacement Permanent pacemaker Diabetes mellitus QRS duration Electrophysiological variables

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Left bundle branch pacing set to outshine biventricular pacing for cardiac resynchronization therapy?

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World Journal of Cardiology 2024年第4期16卷 186-190页

作者： akash Batta Juniali Hatwal Department of Cardiology Dayanand Medical College and HospitalLudhiana 141001India Department of Internal Medicine Advanced Cardiac CentrePost Graduate Institute of Medical Education&ResearchChandigarh 160012India

The deleterious effects of long-term right ventricular pacing necessitated the search for alternative pacing sites which could prevent or alleviate pacinginduced *** recently,biventricular pacing(BiVP)was the only modality which could mitigate or prevent pacing induced ***,BiVP could resynchronize the baseline electromechanical dssynchrony in heart failure and improve ***,the high non-response rate of around 20%-30%remains a major *** non-response has been largely attributable to the direct non-physiological stimulation of the left ventricular myocardium bypassing the conduction *** overcome this limitation,the concept of conduction system pacing(CSP)came *** initial success of the first CSP via His bundle pacing(HBP),certain drawbacks including lead instability and dislodgements,steep learning curve and rapid battery depletion on many occasions prevented its widespread use for cardiac resynchronization therapy(CRT).Subsequently,CSP via left bundle branch-area pacing(LBBP)was developed in 2018,which over the last few years has shown efficacy comparable to BiVP-CRT in small observational ***,its safety has also been well established and is largely free of the pitfalls of the *** the recent metanalysis by Yasmin et al,comprising of 6 studies with 389 participants,LBBPCRT was superior to BiVP-CRT in terms of QRS duration,left ventricular ejection fraction,cardiac chamber dimensions,lead thresholds,and functional status amongst heart failure patients with left bundle branch ***,there are important limitations of the study including the small overall numbers,inclusion of only a single small randomized controlled trial(RCT)and a small follow-up ***,the entire study population analyzed was from China which makes generalizability a *** the concerns,the meta-analysis adds to the growing body of evidence demonstrating the efficacy of *** this st

关键词： Biventricular pacing Cardiac resynchronization therapy Conduction system pacing Left bundle branch-area pacing Left bundle branch block Electromechanical dssynchrony

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Excess cardiovascular mortality in men with non-alcoholic fatty liver disease:A cause for concern!

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World Journal of Cardiology 2024年第7期16卷 380-384页

Non-alcoholic fatty liver disease(NAFLD)has emerged as the commonest cause of chronic liver disease worldwide in recent *** time,our understanding of NAFLD has evolved from an isolated liver condition to a systemic disease with significant manifestations beyond the *** them,cardiovascular diseases(CVDs)are the most important and clinically *** research supports a strong independent link between NALFD and CVD beyond the shared risk factors and *** sex hormones are well known to not only protect against CVD in pre-menopausal females,but also contribute to improved adipose tissue function and preventing its systemic *** research highlights the increased risk of major adverse cardiovascular-cerebral events(MACCE)amongst male with NAFLD compared to ***,racial variation was observed in MACCE outcomes in NAFLD,with excess mortality in the Native Americans and Asian Pacific Islanders compared to the other races.

关键词： Non-alcoholic fatty liver disease Cardiovascular diseases Male sex Major adverse cardiovascular-cerebral events Inflammation Endothelial dysfunction

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