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Surface Perfluoroalk.l Chains Segregation: A Tool for Reducing Calcium Deposits in Medical Grade Poly(Methyl Methacrylate)

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Journal of Biomaterials and Nanobiotechnology 2017年第2期8卷 176-187页

作者： baljit k. ghatora Peter J. S. Foot Stephen J. Barton Ravtej S. Thatti Antonio Papagni Luca Vaghi Materials Research Centre SEC Faculty Kingston University Surrey UK Department of Materials Science University of Milano-Bicocca Milano Italy

Intraocular lenses can be manufactured from a wide variety of polymers, but due to the lost cost associated with the use of Poly (methyl methacrylate) (PMMA), it is still the preferred material used in the developing countries. However, a major drawback.to its use is the build-up of calcium containing deposits that are formed on the intraocular lens over a period of time. In an attempt to hinder this deposition, surface modification of medical grade PMMA has been carried out using perfluoroalk.l chain (1,2,4-trifluoro-3-(C10F21CH2O)-7-(N,N)-dimethylaminoacridine) segregation. The segregation was explored using a 1% 1,2,4-trifluoro-3-(C10F21CH2O)-7-(N,N)-dimethyla-minoacridine in two methods: film casting and spin-coating, a thin film onto preformed PMMA discs. Both methods were compared against control PMMA to determine which method provided the best hindrance against calcium containing deposits when immersed in a simulated aqueous humour solution. Characterisation of the surface using scanning electron microscopy coupled with energy;dispersive x-ray analysis indicated that the surface segregation of perfluoroalk.l chains had hindered calcification in both methods. This pleminary research shows promising results of employing perfluoroalk.l chains in the surface segregation of biomaterials that can be employed in intraocular lenses.

关键词： Poly(Methyl Methacrylate) (PMMA) Perfluoroalk.l Segregation Medical Polymers Wettability Calcium Deposits

Guidelines on postoperative magnetic resonance imaging in patients operated for cryptoglandular anal fistula:Experience from 2404 scans

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World Journal of Gastroenterology 2021年第33期27卷 5460-5473页

作者： Pank.j Garg baljit k.ur Vipul D Yagnik.Sushil Dawk. Geetha R Menon Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of Colorectal Surgery Indus International HospitalMohali 140201PunjabIndia Department of Radiology SSRD Magnetic Resonance Imaging InstituteChandigarh 160011ChandigarhIndia Department of Surgical Gastroenterology Nishtha Surgical Hospital and Research CenterPatan 384265GujaratIndia Department of Surgery SSR Medical CollegeBelle RiveMauritius Department of Statistics Indian Council of Medical ResearchNew Delhi 110029New DelhiIndia

Magnetic resonance imaging(MRI)is considered the gold standard for the evaluation of anal *** is sufficient literature available outlining the interpretation of fistula MRI before performing ***,the interpretation of MRI becomes quite challenging in the postoperative period after the surgery of fistula has been ***,there are scarce data and no set guidelines regarding analysis of fistula MRI in the postoperative *** this article,we discuss the challenges faced while interpreting the postoperative MRI,the timing of the postoperative MRI,the utility of MRI in the postoperative period for the management of anal fistulas,the importance of the active involvement and experience of the treating clinician in interpreting MRI scans,and the latest advancements in the field.

关键词： Anal fistula Magnetic resonance imaging Postoperative Hyperintensity Internal opening

Efficacy of k.gel exercises in preventing incontinence after partial division of internal anal sphincter during anal fistula surgery

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World Journal of Clinical Cases 2022年第20期10卷 6845-6854页

作者： Pank.j Garg Vipul D Yagnik.baljit k.ur Geetha R Menon Sushil Dawk. Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of Colorectal Surgery Indus International HospitalMohali 140507PunjabIndia Department of Surgical Gastroenterology Nishtha Surgical Hospital and Research CenterPatan 384265GujaratIndia Department of Radiology SSRD Magnetic Resonance Imaging InstituteChandigarh 160011India Department of Statistics Indian Council of Medical ResearchNew Delhi 110029India Department of Surgery SSR Medical CollegeBelle Rive 744101Mauritius

BACk.ROUND The transanal opening of intersphincteric space(TROPIS)procedure,performed to treat complex anal fistulas,preserves the external anal sphincter(EAS)but involves partial incision of the internal anal sphincter(IAS).AIM To ascertain the incidence of incontinence after the division of the IAS as is done in TROPIS and to evaluate whether regular k.gel exercises(k.)in the postoperative period can prevent incontinence due to IAS *** Patients operated on for high complex fistulas and having no preoperative continence problem(score=0)were included in the *** patients were operated on by the TROPIS procedure and were recommended k.(pelvic contraction exercises)50 times/*** were commenced on the 10^(th)postoperative day and continued for 1 *** was evaluated objectively(by modified Vaizey’s scores)in the immediate postoperative period(Pre-k. group)and on long-term follow-up(Post-k. group).The incontinence scores in both groups were compared to evaluate the efficacy of *** Of 102 anal fistula patients operated on between July 2018 and July 2020 were included in this *** were 90 males,the mean age was 42.3±12.8,and the median follow-up was 30 mo(18-42 mo).Three patients were lost to *** were 65 recurrent fistulas,92 had multiple tracts,42 had associated abscess,46 had horseshoe fistula and 34 were supralevator *** were magnetic resonance imaging-documented high fistulas(>1/3 EAS involved).Overall incontinence occurred in 31%patients(Pre-k. group)with urge and gas incontinence accounting for the majority of cases(28.3%).The mean incontinence scores in the Pre-k. group were 1.19±1.96(in 31 patients,solid=0,liquid=7,gas=8,urge=24)and in the Post-k. group were 0.26±0.77(in 13 patients,solid=0,liquid=2,gas=3,urge=10)(P=0.00001,t-test).CONCLUSION Division of the IAS led to incontinence,mainly urge incontinence,and also to a mild degree of gas and liquid ***,regular k. led to a significa

关键词： Anal fistula Incontinence Urge Transanal opening of intersphincteric space k.gel exercises Manometry

Guidelines to diagnose and treat peri-levator high-5 anal fistulas: Supralevator, suprasphincteric, extrasphincteric, high outersphincteric, and high intrarectal fistulas

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World Journal of Gastroenterology 2022年第16期28卷 1608-1624页

作者： Pank.j Garg Vipul D Yagnik.Sushil Dawk. baljit k.ur Geetha R Menon Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of Colorectal Surgery Indus International HospitalMohali 140201PunjabIndia Department of Surgical Gastroenterology Nishtha Surgical Hospital and Research CenterPatan 384265GujaratIndia Department of Surgery SSR Medical CollegeBelle Rive 744101Mauritius Department of Radiology SSRD Magnetic Resonance Imaging InstituteChandigarh 160011India Department of Statistics Indian Council of Medical ResearchNew Delhi 110029India

Supralevator,suprasphincteric,extrasphincteric,and high intrarectal fistulas(high fistulas in muscle layers of the rectal wall)are well-k.own high anal fistulas which are considered the most complex and extremely challenging fistulas to *** resonance imaging has brought more clarity to the pathophysiology of these *** with these fistulas,a new type of complex fistula in high outersphincteric space,a fistula at the roof of ischiorectal fossa inside the levator ani muscle(RIFIL),has been *** diagnosis,management,and prognosis of RIFIL fistulas is reported to be even worse than supralevator and suprasphincteric *** is a lot of confusion regarding the anatomy,diagnosis,and management of these five types of *** main reason for this is the paucity of literature about these *** common feature of all these fistulas is their complete involvement of the external anal ***,fistulotomy,the simplest and most commonly performed procedure,is practically ruled out in these fistulas and a sphincter-saving procedure needs to be *** advances have provided new insights into the anatomy,radiological modalities,diagnosis,and management of these five types of high *** have been discussed and guidelines formulated for the diagnosis and treatment of these fistulas for the first time in this paper.

关键词： Anal fistula Supralevator Suprasphincteric Extrasphincteric Magnetic resonance imaging

Including video and novel parameter-height of penetration of external anal sphincter-in magnetic resonance imaging reporting of anal fistula

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World Journal of Gastrointestinal Surgery 2022年第4期14卷 271-275页

作者： Pank.j Garg baljit k.ur Vipul D Yagnik.Sushil Dawk. Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of Colorectal Surgery Indus International HospitalMohali 140507PunjabIndia Department of Radiology SSRD Magnetic Resonance Imaging InstituteChandigarh 160011ChandigarhIndia Department of Surgical Gastroenterology Nishtha Surgical Hospital and Research CenterPatan 384265GujaratIndia Department of Surgery SSR Medical CollegeBelle Rive 744101Belle RiveMauritius

The main purpose of a radiologist’s expertise in evaluation of anal fistula magnetic resonance imaging(MRI)is to benefit patients by decreasing the incontinence rate and increasing the healing *** loss of vital information during the transfer of this data from the radiologist to the operating surgeon is unwarranted and is best *** this regard,two methods are ***,a short video to be attached with the standardized written report highlighting the vital parameters of the *** would ensure minimum loss of information when it is conveyed from the radiologist to the operating ***,inclusion of a new parameter,the amount of external sphincter involvement by the anal *** parameter is usually not included in the MRI *** can be evaluated as the height of penetration of the external anal sphincter(HOPE)by the *** external anal sphincter plays a pivotal role in maintaining *** parameter(HOPE)is distinct from the‘height of internal opening’and assumes immense importance as its k.owledge is paramount to prevent damage to the external anal sphincter by the surgeon during surgery.

关键词： Magnetic resonance imaging Anal fistula External anal sphincter Video reporting Incontinence

Immunosuppressive regimens and outcomes of inflammatory bowel disease patients requiring k.dney transplantation

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World Journal of Transplantation 2022年第2期12卷 21-23页

作者： Urvashi Singh baljit Singh Maria Irene Bellini Department of Surgery Wythenshawe HospitalManchester University Hospitals NHS Foundation TrustManchester M239LTUnited Kingdom Department of Colorectal Surgery University Hospitals LeicesterLeicester LE15WWUnited Kingdom Department of Surgical Sciences Sapienza UniversityRoma 00161Italy

Patients with inflammatory bowel disease(IBD)can develop extra-renal complications and as a result,suffer from end stage renal failure requiring k.dney transplantation(k.).A brief review of available literature revealed that IBD patients undergoing k. have shorter overall survival rates compared to their *** reporting steroid regimens and survival outcomes specific to IBD and post k.dney transplant are scarce and these studies have small sample sizes thus mak.ng it difficult to draw accurate *** research is required in the form of a randomized controlled study to clarify the effect and mechanism of steroid immunosuppression on the prognosis of renal transplant recipients and explore new treatment schemes.

关键词： Inflammatory bowel disease k.dney transplantation Steroids Immunosuppression k.dney failure Ulcerative colitis Crohn’s disease

Designing of tragacanth gum-poly [2-(methacryloyloxy) ethyl] dimethyl-(3-sulfopropyl) ammonium hydroxide and poly(acrylamide) based hydrogels for drug delivery and wound dressing applications

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Medicine in Novel Technology and Devices 2024年第2期22卷 90-101页

作者： k.vita Devi Ashima Sharma Rajesh k.mar baljit Singh Department of Chemistry Himachal Pradesh UniversityShimla171005India Department of Physiology Indira Gandhi Medical CollegeShimlaIndia

Bioactive tragacanth gum(TG)was functionalized by covalent crosslink.ng of poly[2-(methacryloyloxy)ethyl]dimethyl-(3-sulfopropyl)ammonium hydroxide(PMEDSAH)to design network.structure in form of hydrogel wound dressings(HWD).These copolymers were encapsulated with antibiotic drug vancomycin to enhance wound healing potential of the *** copolymers were characterized by SEM,AFM,FTIR,13C NMR,XRD,and TGA-DSC *** demonstrated uneven heterogeneous morphology and AFM revealed rough surface of *** of synthetic component into HD was confirmed by FTIR and 13C *** dressings absorbed 8.491.03 g/g simulated wound fluid and exhibited non-hemolytic(3.70.02%hemolytic potential)and antioxidant(37.421.54%free radical scavenging in DPPH assay)*** required 35.05.0 mN detachment force to get it detach from the mucosal surface during mucoadhesive *** strength was found to be 1.880.13 N/mm2 during mechanical stability *** dressings were permeable to O2/H2O and impermeable to *** of drug vancomycin occurred through non-Fick.an diffusion mechanism and release profile was best described by k.rsmeyer-Peppas k.netic ***,these results revealed that these hydrogels could be explored as materials for hydrogel wound dressings.

关键词： Hydrogel dressings Drug delivery Wound dressings Vancomycin

Design of polysaccharide gum based network.copolymeric hydrogels for drug delivery and wound dressing applications

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Medicine in Novel Technology and Devices 2023年第4期20卷 23-31页

作者： baljit Singh Rajender k.mar Sushil k.mar Nistha Thak.r k.k. Ram Department of Chemistry Himachal Pradesh UniversityShimla171005India

This article deals with the exploration of the design of network.crosslink.d structure by covalent bonding for use as wound dressing materials k.eping in view inherent therapeutic role of neem gum in wound *** copolymeric hydrogels were prepared by graft-copolymerization reaction of carbopol and poly(N-vinylpyrrolidone)(poly(NVP).Antibiotic drug levofloxacin was encapsulated in dressings for better wound *** scanning electron microscopy(SEM),atomic force microscopy(AFM),Fourier transform infrared(FTIR)spectroscopy,^(13)C nuclear magnetic resonance(NMR)spectroscopy,X-ray diffraction(XRD),thermogravimetric analysis(TGA),differential thermal gravimetry(DTG),and differential scanning calorimetry(DSC)techniques were applied for *** and FTIR demonstrated incorporation of carbapol and poly(NVP)in *** indicated amorphous state in copolymeric *** of copolymers with drug,blood and bio membrane were studied to evaluate biomedical properties which revealed controlled release of drug from hydrogel dressings which were possessing blood-compatible(haemolytic value=2.4±0.82)and mucoadhesive(detachment force=124±41 mN)*** were permeable to O2 and H2O vapour and absorbed 6.68±±0.62 g/g wound fluid which is ideal dressing *** mechanism type of drug levofloxacin was Fick.an with k.netic model First *** properties suggested use of hydrogel material for wound dressing and drug delivery applications for better wound care *** article deals with the exploration of the design of network.crosslink.d structure by covalent bonding for use as wound dressing materials k.eping in view inherent therapeutic role of neem gum in wound *** copolymeric hydrogels were prepared by graft-copolymerization reaction of carbopol and poly(N-vinylpyrrolidone)(poly(NVP).Antibiotic drug levofloxacin was encapsulated in dressings for better wound *** scanning electron microscop

关键词： Graft-copolymerization Hydrogel wound dressing Levofloxacin Neem gum Drug delivery

Lessons learned from an audit of 1250 anal fistula patients operated at a single center:A retrospective review

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World Journal of Gastrointestinal Surgery 2021年第4期13卷 340-354页

作者： Pank.j Garg baljit k.ur Ank.ta Goyal Vipul D Yagnik.Sushil Dawk. Geetha R Menon Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of Colorectal Surgery Indus International HospitalMohali 140201PunjabIndia Department of Radiology SSRD Magnetic Resonance Imaging InstituteChandigarh 160011ChandigarhIndia Department of Pathology Gian Sagar Medical College and HospitalPatiala 140601PunjabIndia Department of Surgical Gastroenterology Nishtha Surgical Hospital and Research CenterPatan 384265GujaratIndia Department of Surgery SSR Medical CollegeBelle Rive 744101Mauritius Department of Statistics Indian Council of Medical ResearchNew Delhi 110029New DelhiIndia

BACk.ROUND A complex anal fistula is a challenging disease to *** To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula *** Anal fistulas operated on by a single surgeon over 14 years were *** magnetic resonance imaging was done in all *** procedures were performed:fistulotomy;two novel sphincter-saving procedures,proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts(PERFACT)and transanal opening of intersphincteric space(TROPIS),and anal fistula *** was initiated before *** per the institutional GFRI algorithm,fistulotomy was done in simple fistulas,and TROPIS was done in complex *** with associated abscesses were treated by definitive *** was evaluated objectively by Vaizey incontinence *** A total of 1351 anal fistula operations were performed in 1250 *** overall fistula healing rate was 19.4%in anal fistula plug(n=56),50.3%in PERFACT(n=175),86%in TROPIS(n=408),and 98.6%in fistulotomy(n=611)*** did not change significantly after surgery in any *** per the new algorithm,1019 patients were operated with either the fistulotomy or TROPIS *** overall success rate was 93.5%in those *** a subgroup analysis,the overall healing rate in supralevator,horseshoe,and fistulas with an associated abscess was 82%,85.8%,and 90.6%,*** 90.6%healing rate in fistulas with an associated abscess was comparable to that of fistulas with no abscess(94.5%,P=0.057,not significant).CONCLUSION Fistulotomy had a high 98.6%healing rate in simple fistulas without deterioration of continence if the patient selection was done *** sphincter-sparing procedure,TROPIS,was safe,with a satisfactory 86%healing rate for complex *** is the largest anal fistula series to date.

关键词： Anal fistula Fistulotomy Incontinence Surgery Recurrence