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Transcranial direct current stimulation as early augmentation in adolescent obsessive compulsive disorder:A pilot proof-of-concept randomized control trial

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World Journal of Clinical Pediatrics 2024年第2期13卷 161-170页

作者： Aditya Agrawal Vivek agarwal Sujita kumar Kar amit Arya Department of Psychiatry King George Medical UniversityUttar PradeshLucknow 226003India

BACKGROUND Transcranial direct current stimulation(tDCS)is proven to be safe in treating various neurological conditions in children and adolescents.It is also an effective method in the treatment of OCD in adults.AIM To assess the safety and efficacy of tDCS as an add-on therapy in drug-naive adolescents with OCD.METHODS We studied drug-naïve adolescents with OCD,using a Children’s Yale-Brown obsessive-compulsive scale(CY-BOCS)scale to assess their condition.Both active and sham groups were given fluoxetine,and we applied cathode and anode over the supplementary motor area and deltoid for 20 min in 10 sessions.Reassessment occurred at 2,6,and 12 wk using CY-BOCS.RESULTS Eighteen adolescents completed the study(10-active,8-sham group).CY-BOCS scores from baseline to 12 wk reduced significantly in both groups but change at baseline to 2 wk was significant in the active group only.The mean change at 2 wk was more in the active group(11.8±7.77 vs 5.25±2.22,P=0.056).Adverse effects between the groups were comparable.CONCLUSION tDCS is safe and well tolerated for the treatment of OCD in adolescents.However,there is a need for further studies with a larger sample population to confirm the effectiveness of tDCS as early augmentation in OCD in this population.

关键词： Adolescents Early augmentation Obsessive compulsive disorder Safety Transcranial direct current stimulation

An overview of pancreatic trauma

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Journal of Pancreatology 2020年第3期3卷 139-146页

作者： Harshit agarwal amit Gupta Subodh kumar Division of Trauma Surgery&Critical Care JPN Apex Trauma CenterAll India institute of Medical SciencesNew DelhiIndia

Pancreatic trauma remains a challenge to a trauma surgeon even with extensive advancement in medicine.The mortality and morbidity associated with this injury remain high.A high index of suspicion,mechanism of injury,and early identification hold key in the final outcome.The management of pancreatic injury should involve a multidisciplinary team comprising of trauma surgeons,radiologists,and gastroenterologists.This review highlights the burden of the pancreatic injury and its management.

关键词： Distal pancreatectomy ERCP Pancreatic trauma

Hirschsprung's disease:Is there a relationship between mast cells and nerve fibers?

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World Journal of Gastroenterology 2009年第12期15卷 1493-1498页

作者： amit kumar Yadav Kiran Mishra Anup Mohta Sarla agarwal Department of Pathology University College of Medical SciencesNew Delhi 110095India Department of Paediatric Surgery Chacha Nehru Baal ChikitsalyaNew Delhi 110095India

AIM:To define the topography of mast cells and their numbers in cases of Hirschsprung's disease(HD)and non-HD,assess neural hypertrophy using imaging software and to study the relationship between mast cells and nerve fibers.METHODS:HE stained sections of 32 cases of chronic constipation in the age group of 0-14 years were reviewed for ganglion cells.AChE staining was performed on frozen sections of colonic and rectal biopsies.Based on their findings cases were divided into HD and non-HD and mast cells stained by toluidine blue were evaluated.Image analysis by computerized software was applied to S-100 stained sections for assessment of neural hypertrophy.RESULTS:Difference between number of mast cells in HD group(mean=36.44)and in non-HD group(mean =14.79)was statistically significant.Image analysis morphometry on S-100 stained sections served as a useful adjunct.The difference between number,size,and perimeter of the nerve fibers between HD and non-HD group was statistically significant.CONCLUSION:Mast cells are significantly increased in HD and their base line values are much higher in Indian children than that reported in Western literature.Their role in HD needs further research.Morphometry of S-100 stained nerve fibers is a useful adjunct to conventional methods for diagnosis of HD.

关键词：先天性巨结肠症肥大细胞神经纤维乙酰胆碱酯酶染色计算机图像分析神经节细胞慢性便秘直肠活检

Development of port fuel injected methanol(M85)-fuelled two-wheeler for sustainable transport

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Journal of Traffic and Transportation Engineering(English Edition) 2020年第3期7卷 298-311页

作者： Tushar agarwal Akhilendra Pratap Singh Avinash kumar agarwal Engine R esearch Laboratory Department of Mechanical EngineeringIndian Institute of Technology KanpurKanpur 208016India

Due to increasingly stringent environmental pollution norms,there is a need for alternate combustion techniques and alternate fuels to keep up with changing trends.One of the viable solutions for India is the adaptation of methanol as a fuel for automotive sector.Therefore,in this study a functional two-wheeler prototype was developed,which uses M85(85%v/v methanol and 15%v/v gasoline)in an electronic control unit(ECU)controlled port fuel injected(PFI)engine.This study included comparative investigations of simulated on-road two-wheeler performance on chassis dynamometer using a gasoline-fuelled motorcycle with stock ECU vis-a-vis M85-fuelled motorcycle using recalibrated ECU.ECU recalibration exhibited that M85-fuelled vehicle was operated at relatively more advanced spark timing compared to baseline gasoline-fuelled vehicle.Performance results showed that M85-fuelled motorcycle produced relatively higher engine power and higher maximum vehicle speed compared to gasoline-fuelled motorcycle.Relatively superior acceleration characteristics(especially at higher speeds)of M85-fuelled motorcycle was another important finding of this study,indicating that M85 provided superior throttle response compared to gasoline.Comparative analysis of raw tailpipe emissions showed that modified M85-fuelled motorcycle emitted relatively higher hydrocarbon(HC),carbon monoxide(CO)and oxides of nitrogen(NO_x)emissions compared to stock gasoline-fuelled motorcycle.However,these emissions can be controlled by using adaptation of suitable after-treatment systems.

关键词： Methanol Electronic control unit(ECU) Electronic fuel injection(EFI) ECU calibration Engine performance Emission

Randomized controlled trial of topical EMLA and vapocoolant spray for reducing pain during wDPT vaccination

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World Journal of Pediatrics 2017年第3期13卷 236-241页

作者： Navratan kumar Gupta amit Upadhyay Ajeet kumar Dwivedi Astha agarwal Vijay Jaiswal Abhishek Singh Department of Pediatrics LLRMMedical CollegeMeerut(UP)India

Background:Intramuscular vaccination is among the most common source of iatrogenic pain in infants.Vapocoolant sprays are rapid-acting alternative to topical anesthetics.They provide transient anesthesia via evaporation induced skin cooling,and reduce pain due to vaccine injection in children and adults.The objective was to compare the synergistic analgesic effect of eutectic mixture of local anesthetics (EMLA) with breastfeeding (EB group) and vapocoolant spay with breastfeeding (VB group) to that of only breastfeeding (BO group) during whole cell diptheria,pertussis and tetanus (wDPT) vaccination.Methods:A double blind randomized controlled trial was done to include infants up to 3 months of age who came for their first wDPT vaccination.The primary outcome variable was the duration of cry after vaccination.Secondary outcome variables were Modified Facial Coding Score,Neonatal Infant Pain Scale and latency of onset of cry.Results:Of the 201 eligible participants,111 babies were excluded and remaining 90 babies were randomized into three groups of thirty each.The groups did not differ significantly in baseline characteristics.Median (interquartile range,IQR) of duration of cry was lesser [35.86 (21.07-107.75) seconds] in babies receiving EMLA cream with breast feeding (EB group) and in babies receiving vapocoolant spray with breast feeding (VB group) [32.58 (21.25-106.21) seconds] as compared to babies receiving only breast feeding (BO group) [67.5 (27.6-180) seconds] (P=-0.147).Difference in median (IQR) of latency of cry was not statistically significant.Modified Facial Coding Score and Neonatal Infant Pain Scale at 1 minute and 3 minutes was significantly lower in the EB and VB group,as compared to the BO group (P<0.05).Conclusions:Addition of topical EMLA application or vapocoolant spray to breastfeeding during wDPT vaccination does not reduce duration of cry in infants up to 3 months of age.However,they are able to show reduction in pain score and further studies are warranted to assess their efficacy as pai

关键词： diptheria,pertussis and tetanus vaccine eutectic mixture of local anesthetics Modified Facial Coding Score Neonatal Infant Pain Scale

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

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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 BCS-HCC.METHODS A total of 904 BCS patients from New Delhi,India and 1140 from Mumbai,India were included.The prevalence and incidence of HCC were determined,and among patients with BCS-HCC,the viability and outcomes of interventional therapy were evaluated.RESULTS 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 obstruction.The 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 transplantation.CONCLUSION HCC is not uncommon in patients with BCS.Radiological 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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为减缓气候变化能源效率需经济可行

世界钢铁 2014年第2期14卷 58-63页

作者： Shibojyoti Dutta amit agarwal Dillip kumar Behera 何海良塔塔钢铁公司

印度的钢材消耗继续落后于世界上其他国家。为适应经济的发展,到2020年,印度的钢材需求量每年最少为1.5亿;亿t。当前,印度年钢产量约6 000万t,到2020年,年产量预计将达到2.75亿t。尽管采取有效的工艺可以减少CO2的排放强度,但预计其排... 详细信息

印度的钢材消耗继续落后于世界上其他国家。为适应经济的发展,到2020年,印度的钢材需求量每年最少为1.5亿;亿t。当前,印度年钢产量约6 000万t,到2020年,年产量预计将达到2.75亿t。尽管采取有效的工艺可以减少CO2的排放强度,但预计其排放量仍会升高。现有技术存在着经济性与适应性的挑战。例如,干熄焦技术有助于余热的利用,但新建焦炉的成本高是一个障碍,与此同时,现有焦炉也面临着大修的挑战。这些不利之处在大部分余热回收与能源效率项目中始终存在。为保证生产的连续性,关键需要额外的发电能力或配备强劲的电网,这些都与投资相关,因为其常常限制余热回收技术的实施。为紧急应对全球的气候变化,减少CO2排放,正在开发一些新项目。除了从熔渣中回收余热、低温余热资源、碳中性钢冶炼工艺之外,包括碳捕集与贮存也在考虑之列。与电厂锅炉排出的废气相比,高炉荒煤气中含有温度低、含量高的CO2,从中进行碳捕集相对来说更为经济。因此,加快开发与应用高炉的碳捕集与贮存技术具有财务上的激励作用,对印度钢铁业的增长而言,具有可以缓解气候变化的潜力。这些技术的应用在短中期内不利于公司的生存,但为了缓解气候变化和行业长期的可持续性,这些措施势在必行。因此,为保证能及时采用这些技术,总的工作计划需要确保其:①经济上能够承受;②能及时获取;③能够克服技术改造带来的挑战。

关键词：气候变化铁钢效率余热回收碳贸易

Constructing a biofunctionalized 3D-printed gelatin/sodium alginate/chitosan tri-polymer complex scaffold with improvised biological andmechanical properties for bone-tissue engineering

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Bio-Design and Manufacturing 2024年第1期7卷 57-73页

作者： amit kumar Singh Krishna Pramanik amit Biswas Centre of Excellence in Tissue Engineering Department of Biotechnology and Medical EngineeringNational Institute of TechnologyRourkela 769008India

Sodium alginate(SA)/chitosan(CH)polyelectrolyte scaffold is a suitable substrate for tissue-engineering application.The present study deals with further improvement in the tensile strength and biological properties of this type of scaffold to make it a potential template for bone-tissue regeneration.We experimented with adding 0%–15%(volume fraction)gelatin(GE),a protein-based biopolymer known to promote cell adhesion,proliferation,and differentiation.The resulting tri-polymer complex was used as bioink to fabricate SA/CH/GEmatrices by three-dimensional(3D)printing.Morphological studies using scanning electron microscopy revealed the microfibrous porous architecture of all the structures,which had a pore size range of 383–419μm.X-ray diffraction and Fourier-transform infrared spectroscopy analyses revealed the amorphous nature of the scaffold and the strong electrostatic interactions among the functional groups of the polymers,thereby forming polyelectrolyte complexes which were found to improve mechanical properties and structural stability.The scaffolds exhibited a desirable degradation rate,controlled swelling,and hydrophilic characteristics which are favorable for bone-tissue engineering.The tensile strength improved from(386±15)to(693±15)kPa due to the increased stiffness of SA/CH scaffolds upon addition of gelatin.The enhanced protein adsorption and in vitro bioactivity(forming an apatite layer)confirmed the ability of the SA/CH/GE scaffold to offer higher cellular adhesion and a bone-like environment to cells during the process of tissue regeneration.In vitro biological evaluation including the MTT assay,confocal microscopy analysis,and alizarin red S assay showed a significant increase in cell attachment,cell viability,and cell proliferation,which further improved biomineralization over the scaffold surface.In addition,SA/CH containing 15%gelatin designated as SA/CH/GE15 showed superior performance to the other fabricated 3D structures,demonstrating its potential for use in bone-tissue engineering.

关键词： Scaffold Biomaterial Sodium alginate Chitosan Gelatin 3D printing Tissue engineering

Abundant closed-form wave solutions and dynamical structures of soliton solutions to the (3+1)-dimensional BLMP equation in mathematical physics

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Journal of Ocean Engineering and Science 2022年第2期7卷 178-187页

作者： Sachin kumar amit kumar Department of Mathematics Faculty of Mathematical SciencesUniversity of DelhiDelhi 110007India Department of Mathematics Sri Vankateswara CollegeUniversity of DelhiDelhi 110021India

The physical principles of natural occurrences are frequently examined using nonlinear evolution equa-tions(NLEEs).Nonlinear equations are intensively investigated in mathematical physics,ocean physics,scientific applications,and marine engineering.This paper investigates the Boiti-Leon-Manna-Pempinelli(BLMP)equation in(3+1)-dimensions,which describes fluid propagation and can be considered as a non-linear complex physical model for incompressible fluids in plasma physics.This four-dimensional BLMP equation is certainly a dynamical nonlinear evolution equation in real-world applications.Here,we im-plement the generalized exponential rational function(GERF)method and the generalized Kudryashov method to obtain the exact closed-form solutions of the considered BLMP equation and construct novel solitary wave solutions,including hyperbolic and trigonometric functions,and exponential rational func-tions with arbitrary constant parameters.These two efficient methods are applied to extracting solitary wave solutions,dark-bright solitons,singular solitons,combo singular solitons,periodic wave solutions,singular bell-shaped solitons,kink-shaped solitons,and rational form solutions.Some three-dimensional graphics of obtained exact analytic solutions are presented by considering the suitable choice of involved free parameters.Eventually,the established results verify the capability,efficiency,and trustworthiness of the implemented methods.The techniques are effective,authentic,and straightforward mathematical tools for obtaining closed-form solutions to nonlinear partial differential equations(NLPDEs)arising in nonlinear sciences,plasma physics,and fluid dynamics.

关键词： Closed-form solutions Generalized exponential rational function method Solitons Generalized Kudryashov method Solitary waves