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Unwanted pregnancies, unwanted births, consequences and unmet needs

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World Journal of Obstetrics and Gynecology 2014年第3期3卷 118-123页

作者： Shakuntala chhabra Naina Kumar Department of Obstetrics Gynaecology Mahatma Gandhi Institute of Medical Sciences Sevagram

Worldwide women have to cope up with heavy burden of unwanted pregnancies, mistimed, unplanned, with risk to their health. Their children and families also suf-fer. Such pregnancies are root cause of induced abortions （safe/unsafe） and grave consequences. Women, their partners can, for most part, prevent unwanted pregnancies by using contraceptives. However many women either do not use any contraceptive or use methods, with high failure rates. These women account for 82% of pregnancies that are not desired. Remaining unintended pregnancies occur among women who use modern contraceptive, either because they had diffculty using method consistently or because of failure. Helping women, their partner use modern contracep-tives effectively is essential in achieving Millennium Development Goals for improving women’s health, reducing poverty. If all women in developing countries use modern contraceptives, there would be 22 million less unplanned births, 25 million fewer induced, 15 million fewer unsafe abortions, 90000 less maternal deaths and 390000 less children losing their mothers. Also making abortion services broadly legal, by understand-ing size, type of unmet needs, most important by creating awareness in communities can surely help tackle this problem to a large extent.

关键词： Contraception Induced abortion Pregnan-cy Unmet need Unsafe abortion

HIPPO artificial intelligence:Correlating automated radiographic femoroacetabular measurements with patient-reported outcomes in developmental hip dysplasia

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World Journal of Experimental Medicine 2024年第4期14卷 136-146页

作者： Ahmed Alshaikhsalama Holden Archer Yin Xi Richard Ljuhar Joel E Wells Avneesh chhabra Department of Radiology University of Texas SouthwesternDallasTX 75390United States Department of Radiology University of Texas Southwestern Medical CenterDallasTX 75235United States Department of Radiology Image BiopsyVienna 1190Austria Department of Orthopedic Surgery Baylor Scott and WhiteDallasTX 75235United States

BACKGROUND Hip dysplasia(HD)is characterized by insufficient acetabular coverage of the femoral head,leading to a predisposition for *** radiographic measurements such as the lateral center edge angle(LCEA)and Tönnis angle are essential in evaluating HD severity,patient-reported outcome measures(PROMs)offer insights into the subjective health impact on *** To investigate the correlations between machine-learning automated and manual radiographic measurements of HD and PROMs with the hypothesis that artificial intelligence(AI)-generated HD measurements indicating less severe dysplasia correlate with better *** Retrospective study evaluating 256 hips from 130 HD patients from a hip preservation clinic *** and AI-derived radiographic measurements were collected and PROMs such as the Harris hip score(HHS),international hip outcome tool(iHOT-12),short form(SF)12(SF-12),and Visual Analogue Scale of the European Quality of Life Group survey were correlated using Spearman's rank-order *** The median patient age was 28.6 years(range 15.7-62.3 years)with 82.3%of patients being women and 17.7%being *** median interpretation time for manual readers and AI ranged between 4-12 minutes per patient and 31 seconds,*** measurements exhibited weak correlations with HHS,including LCEA(r=0.18)and Tönnis angle(r=-0.24).AI-derived metrics showed similar weak correlations,with the most significant being Caput-Collum-Diaphyseal(CCD)with iHOT-12 at r=-0.25(P=0.042)and CCD with SF-12 at r=0.25(P=0.048).Other measured correlations were not significant(P>0.05).CONCLUSION This study suggests AI can aid in HD assessment,but weak PROM correlations highlight their continued importance in predicting subjective health and outcomes,complementing AI-derived measurements in HD management.

关键词： Hip dysplasia Patient reported outcome measures Deep-learning Artificial intelligence Radiographs Lateral center edge angle

Eucleanal A and B:Two new napthalene derivatives from Euclea divinorum

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Chinese Chemical Letters 2012年第5期23卷 576-578页

作者： Margaret Mwihaki Ng'ang'a Hidayat Hussain Sumesh chhabra Caroline Langat-Thoruwa Ahmed AI-Harrasi Karsten Krohn Ivan Robert Green Department of Chemistry Kenyatta UniversityP.O.Box 43844-00100NairobiKenya Department Chemistry Universität PaderbornWarburger Straβe 10033098 PaderbornGermany Department of Biological Sciences and Chemistry College of Arts and SciencesUniversity of NizwaBirkat Al-MouzNizwa 616Oman Department of Chemistry University of the Western CapeP/Bag X17Bellville 7530South Africa

Two new naphthalene derivatives named eucleanal A and B（1 and 2） were isolated from Euclea *** structures of the new compounds were elucidated by detailed spectroscopic analysis such as ~1H,^（13）C NMR,COSY,HMQC,HM... 详细信息

关键词： Euclea divinorum Hiern Ebenaceae NMR Structure elucidation

Comparison of abdominal ultrasound,endoscopic ultrasound andmagnetic resonance imaging in detection of necrotic debris in walled-off pancreatic necrosis

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Gastroenterology Report 2016年第1期4卷 50-53,I0002页

作者： Surinder S Rana Vinita Chaudhary Ravi Sharma Vishal Sharma Puneet chhabra Deepak K Bhasin Department of Gastroenterology Post Graduate Institute of Medical Education and Research(PGIMER)ChandigarhIndia

Background:Walled-off pancreatic necrosis(WOPN)is an important complication of acute pancreatitis that is diagnosed by imaging modalities such as endoscopic ultrasound(EUS)or magnetic resonance imaging(MRI),which can clearly visualize necrotic *** effectiveness of abdominal ultrasound(USG)in detecting solid debris in WOPN is not ***:A total of 52 patients(37 males,mean age 38.9612.6 years)with symptomatic WOPN were prospectively studied using EUS,MRI and *** investigations were done at a mean of 11.765.5 weeks of onset of acute pancreatitis and within two ***:WOPN was detected by EUS&MRI in all patients,whereas USG could not detect it in 4(7.6%)patients(3 had predominantly solid WOPN,whereas one had air foci in WOPN).USG,MRI and EUS could detect solid debris in all patients with detectable *** and USG detected40%debris in 8 patients(15%)compared to 5(11%)patients having>40%debris on *** detected collaterals around WOPN that were not detected on USG or ***:USG can characterize the majority of WOPN,with accuracy comparable to that of EUS/*** its limitations are the inability to detect collaterals around WOPN and characterize collections with high solid content or air.

关键词： endoscopic ultrasound abdominal ultrasound magnetic resonance imaging pancreatic necrosis acute pancreatitis

Spectrum of magnetic resonance imaging findings in congenital lumbar spinal stenosis

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World Journal of Clinical Cases 2014年第12期2卷 883-887页

作者： Theodoros Soldatos Majid Chalian Shrey Thawait Alan J Belzberg John Eng John A Carrino Avneesh chhabra Russell H Morgan Department of Radiology and Radiological Science the Johns Hopkins Hospital Baltimore MD 21287 United States Department of Neurosurgery the Johns Hopkins Hospital Baltimore MD 21287 United States Department of Radiology and Orthopaedic Surgery University of Texas Southwestern Medical Center Dallas TX 75390-9178 United States

AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects with CLSS and 48 control subjects were retrospectively evaluated. In each examination, the five lumbar levels were assessed for the presence or absence of circumferential or shallow annular bulges, annular tears, anterior or posterior disc herniations, epidural lipomatosis, Schmorl's nodes,spondylolisthesis, pars defects, and stress reactions of the posterior vertebral elements. RESULTS: Compared to control individuals, subjects with CLSS exhibited increased incidence of circumferential and shallow annular bulges, annular tears, discherniations and spondylolisthesis(P < 0.05). CONCLUSION: CLSS is associated with increased incidence of degenerative changes in specific osseous and soft-tissue elements of the lumbar spine.

关键词： Congenital lumbar spinal stenosis Magnetic resonance imaging Imaging findings Degenerative changes Low back pain

Electrocardiographic changes in Emphysema

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World Journal of Cardiology 2021年第10期13卷 533-545页

作者： Puneet Gupta Hitangee Jain Misbah Gill Gurpreet Bharaj Nauman Khalid Waseem Chaudhry Lovely chhabra Department of Interventional Cardiology Northeast Ohio Medical UniversityCantonOH 44272United States BA-MD Brooklyn CollegeBrooklynNY 11210United States Department of Family Medicine Memorial Hospital of CarbondaleCarbondaleIL 62901United States Psychiatry Loretto HospitalChicagoIL 60644United States Department of Interventional Cardiology St.Francis Medical CenterMonroeLA 71201United States Department of Cardiology Westchester Medical Center Network Advanced Physician ServicesPoughkeepsieNY 12601United States

Chronic obstructive lung disease(COPD),predominantly emphysema,causes several thoracic anatomical and hemodynamic changes which may cause changes in various electrocardiographic parameters.A 12-lead electrocardiogram(ECG),which is often a part of routine evaluation in most clinical settings,may serve as a useful screening modality for diagnosis of COPD or *** current article aims to provide a comprehensive review of the electrocardiographic changes encountered in COPD/emphysema utilizing published PubMed and Medline literature *** important ECG changes are present in COPD/emphysema and may serve as a good diagnostic *** of Pvector,changes in QRS duration,pattern recognition of precordial R-wave progression and axial shifts can be considered some of the most valuable markers among other *** conclusion,12-lead surface electrocardiogram can serve as a valuable tool for the diagnosis of COPD and/or *** appropriate knowledge of these ECG changes can not only help in the diagnosis but can also immensely help in an appropriate clinical management of these patients.

关键词： Emphysema Chronic obstructive pulmonary disease Electrocardiogram Pwave axis Sensitivity Specific

Challenges faced for undertaking a stem cell based clinical trial in spinal cord injury in emerging countries

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Journal of Translational Neuroscience 2018年第3期3卷 1-8页

作者： Harvinder Singh chhabra Kanchan Sarda Spine Service Indian Spinal Injuries CenterSector-CVasant KunjNew Delhi 110070India

Repair and regeneration after spinal cord injury(SCI)is an unmet need and research into finding new avenues to achieve this are ongoing *** cells with their immense potential to proliferate and differentiate have been identified as prime candidates for spinal cord ***-clinical data on their efficacy has been very encouraging,especially in case of adult stem *** clinical translation of these findings has not been so successful,due to the ease of obtaining autologous adult bone marrow stem cells and their perceived therapeutic potential,these cells have been offered as a“therapy”in many countries without any scientific evidence generated though a valid clinical *** this review,we attempt to highlight the need for conducting clinical trials and the challenges faced in case of emerging *** current scenario of regulations governing the use of stem cells in emerging countries is also discussed.

关键词： stem cells emerging countries spinal cord injury(SCI) regulations clinical trial

A Novel Solution to Handle DDOS Attack in MANET

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Journal of Information Security 2013年第3期4卷 165-179页

作者： Meghna chhabra Brij Gupta Ammar Almomani Faculty of Computing and Information Technology North Jeddah Branch King Abdulaziz University Jeddah Saudi Arabia School of Computing Science & Engineering Galgotias Universiy Greater Noida India

Distributed Denial of Service (DDoS) attacks in the networks needs to be prevented or handled if it occurs, as early as possible and before reaching the victim. Dealing with DDoS attacks is difficult due to their properties such as dynamic attack rates, various kinds of targets, big scale of botnet, etc. Distributed Denial of Service (DDoS) attack is hard to deal with because it is difficult to distinguish legitimate traffic from malicious traffic, especially when the traffic is coming at a different rate from distributed sources. DDoS attack becomes more difficult to handle if it occurs in wireless network because of the properties of ad hoc network such as dynamic topologies, low battery life, multicast routing, frequency of updates or network overhead, scalability, mobile agent based routing, and power aware routing, etc. Therefore, it is better to prevent the distributed denial of service attack rather than allowing it to occur and then taking the necessary steps to handle it. This paper discusses various the attack mechanisms and problems due to DDoS attack, also how MANET can be affected by these attacks. In addition to this, a novel solution is proposed to handle DDoS attacks in mobile ad hoc networks (MANETs).

关键词： DDoS Attack MANET AODV DSR Flooding Attack Botnet

Arterial pH,bicarbonate levels and base deficit at presentation as markers of predicting mortality in acute pancreatitis:a single-centre prospective study

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Gastroenterology Report 2014年第3期2卷 226-231页

作者： Vishal Sharma Thingbaijam Shanti Devi Ravi Sharma Puneet chhabra Rajesh Gupta Surinder S.Rana Deepak K.Bhasin Department of Gastroenterology Post Graduate Institute of Medical Education and ResearchChandigarhIndia Department of Surgery Post Graduate Institute of Medical Education and ResearchChandigarhIndia

*** blood gas(ABG)parameters such as pH form part of multi-parameter scoring systems for predicting severe acute pancreatitis;however,literature on detailed evaluation of ABG alone in this context is *** with acute pancreatitis presenting to our unit between January 2012 and November 2013 were prospectively *** analysis was done at admission and development of organ failure,any need for intervention,and mortality were *** association between various parameters of ABG analysis and the development of organ failure or local complications,need for interventions(endoscopic/radiological/surgical)and mortality were *** hundred and five patients(mean age:39.33-13.85 years;61.0%males)were prospectively *** aetiology of acute pancreatitis was alcohol in 93 patients(45.4%)and gall stone disease in 73(35.6%).Organ failure developed in 71.2%patients and 83.9%had local *** 18%of patients,endoscopic/radiological/surgical interventions were needed and 14.6%*** patients(n=35)with metabolic acidosis(pH4 meq/L for prediction of mortality were 0.771(95%CI:0.664–0.878),0.707(95%CI:0.622–0.791)and 0.780(95%CI:0.693–0.867),*** pH,bicarbonate levels,and base deficit at presentation are useful early markers for predicting adverse outcome in acute pancreatitis.

关键词： acute pancreatitis base deficit MA organ failure