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Prevalence of Preoperative Anemia in Elective Rheumatic Valve Surgery at a Tertiary Care Center in Nepal

World Journal of Cardiovascular Surgery 2023年第1期13卷 1-9页

作者： Priska Bastola Bibhush Shrestha bishwas pradhan Arjun Gurung Basanta Ghimire Anil Bhattarai Department of Cardiothoracic and Vascular Anaesthesiology Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal Department of Cardiothoracic & Vascular Surgery Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal

Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia;however its burden is often overlooked. Anemic patients undergoing surgery are likely to receive blood transfusion, increasing morbidity and mortality. Prevalence of anemia in cardiac surgical patients are studied extensively, however its burden in RVHD is lacking. This study attempted to investigate the prevalence of preoperative anemia in RVHD and its effect on blood transfusion, morbidity and mortality in patients undergoing valve surgery. Methods: This is a retrospective observational study conducted at a tertiary care hospital in Nepal. We considered 340 patients who underwent Rheumatic valve replacement surgery from 2014 January to December 2016 and data on their socio-demographic and clinical characteristics were extracted from the patient’s records. The analyses meeting the study objectives were conducted using IBM SPSS v25 for Windows (IBM Statistical Package for Social Sciences, 2015IBM Corporation, New York, United States). Results: The prevalence of no anemia, mild, moderate, and severe anemia was 34.1%, 57.7%, 39.6%, 2.5%, respectively. The units of Red Blood Cell used for transfusion were 1.2 units, 2.0 units, 2.3 units, and 1.6 units in patients without anemia, and those with mild, moderate and severe anemia respectively. The incidence of reexploration was higher in patients with severe anemia as compared to the non anemic with an incidence of 66.6%. A proportion of the patients with no anemia, mild, moderate and severe anemia with less than 7 days stay in the intensive care unit were 89%, 82%, 84.7% and 100% respectively. The length of hospital stay more than 10 days was seen in 58.9%, 71.6%, 63% and 100% in patients with no anemia, mild, moderate and severe anemia. An overall incidence of mortality in anemic patients was 11% while in non anemic patients was 5.3%. Conclusions: The prevalence of anemia was high in the Nepalese patients wi

关键词： Anemia Rheumatic Heart Disease Elective Valve Surgery Blood Transfusion

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Microbiological and Antibiotic Susceptibility Patterns in Cardiothoracic and Vascular Intensive Care Unit of a Tertiary Level Hospital in Nepal

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World Journal of Cardiovascular Surgery 2023年第3期13卷 61-70页

作者： Bibhush Shrestha Priska Bastola bishwas pradhan Arjun Gurung Basanta Ghimire Anil Bhattarai Department of Cardiothoracic and Vascular Anesthesiology Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal Department of Cardiothoracic and Vascular Surgery Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal

Background: Sepsis has been one of the most important conditions for morbidity and mortality of Intensive care unit (ICU) patients. Antibiotics remain one of the major combating factors for it. Indiscriminate antimicrobial usage and poor prescription practices have contributed to the development of multidrug resistant (MDR) organisms. Therefore, the current study was designed to evaluate the spectrum, and susceptibility patterns of pathogens isolated from patients admitted to our Cardiothoracic and Vascular Intensive care unit. Materials and Methods: The study was conducted in Cardiothoracic and Vascular ICU of a tertiary care teaching hospital from February 2019 to March 2021. Samples (blood, urine, wound swab, tracheal aspirate, and central venous catheter tip) for culture were taken from all the patients in Sepsis admitted in Cardiothoracic and Vascular ICU above 18 years of age during the study period. The culture reports (microbiological profile and their susceptibility pattern) were collected and data collection of all enrolled patients was done. Results: Out of the total 128 samples studied 75 (58.5%) were culture positive. The predominant organisms isolated were Gram negative organisms (Klebsiella, Pseudomonas, Acinetobacter, followed by E. coli). The highest prevalence of microbial growth was found in tracheal aspirate (46.8%), followed by blood (21.8%). Antibiotic susceptibility results showed the highest sensitivity of those common pathogens towards higher antibiotics only (especially Polymyxin B and Colistin). Conclusion: The emergence of multidrug resistant organisms and lesser availability of a higher group of antibiotics is a major concern. So there is a need for regular hospital based antibiograms, strict infection control programs, and implementation of antimicrobial stewardship programmes for guiding clinicians in choosing appropriate therapy and preventing the surge of multidrug resistant organisms.

关键词： Sepsis Antibiotics Intensive Care Unit

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Translocator protein and neurodegeneration: insights from Alzheimer’s disease

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Neural Regeneration Research 2025年第4期20卷 1090-1091页

作者： Arpit Kumar pradhan Rainer Rupprecht Gerhard Rammes Klinik für Anaesthesiologie und Intensivmedizin der Technischen Universität München Klinikum rechts der IsarMunichGermany Graduate School of Systemic Neurosciences Ludwig-Maximilians-Universität MünchenMartinsriedGermany Department of Psychiatry and Psychotherapy University RegensburgRegensburgGermany

The 18 kDa translocator protein(TSPO)located on the outer mitochondrial membrane regulates several key cellular processes including mitochondrial homeostasis,cholesterol transport,apoptosis,cell proliferation,and maintenance of mitochondrial health(Rupprecht et al.,2022,2023).TSPO is expressed in both peripheral organs and the central nervous system,with a more pronounced expression in tissues that produce *** main reason why TSPO has garnered so much attention is because it plays a key role in neurosteroidogenesis by transferring cholesterol from the outer to the inner mitochondrial membrane,which is the rate-limiting step in neurosteroid synthesis.A cholesterol-recognizing amino acid consensus domain has been identified in the cytosolic C terminus of the TSPO protein by both in vitro and site-directed mutagenesis experiments(Li et al.,2001).However,the role of TSPO in the process of neurosteroid synthesis has been challenged by several studies,particularly TSPO knockout models,which suggest that TSPO removal does not affect the phenotype or the system’s viability(Tu et al.,2014).However,ligands targeting TSPO have been shown to enhance levels of neurosteroids which suggests that neurosteroidogenesis is one of the major functional roles mediated by the TSPO protein.

关键词： cholesterol organs

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A threefold approach to rescue the 2030 Agenda from failing

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National Science Review 2023年第7期10卷 13-15页

作者： Prajal pradhan Bauhaus Earth GmbH Potsdam Institute for Climate Impact Research (PIK) Member of the Leibniz Association

Countries are not on track to meet the2030 Agenda for Sustainable Development [1] that calls for transformative changes to shift the world onto a sustainable and resilient *** 2030Agenda comprises 17 Sustainable Development Goals (SDGs) and 169 targets to be achieved by 2030,balancing the three sustainability dimensions—social,economic,and *** far,SDGs have had a limited transforma-tive impact [2] because of their selective implementation without considering their complex *** interact positively (***) or negatively(***-offs) depending on contextand location-specific *** to meet SDGs will negatively affect the lives of billions of people and worsen socioeconomic and environmental crises.

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Anisotropic Bianchi Type-I Magnetized String Cosmological Models with Decaying Vacuum Energy Density A(t)

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Communications in Theoretical Physics 2011年第5期55卷 931-941页

作者： Anirudh pradhan Department of Mathematics Hindu Post-graduate College

The present study deals with a spatially homogeneous and anisotropic Bianehi-I cosmological models representing massive strings with magnetic field and decaying vacuum energy density A. The energy-momentum tensor, as formulated by Letelier （1983）, has been used to construct massive string cosmological models for which we assume the expansion scalar in the models is proportional to one of the components of shear tensor. The Einstein＇s field equations have been solved by applying a variation law for generalized Hubble＇s parameter in Bianchi-I space-time. The variation law for Hubble＇s parameter generates two types of solutions for the average scale factor, one is of power-law type and other is of the exponential form. Using these two forms, Einstein＇s field equations are solved separately that correspond to expanding singular and non-singular models of the universe respectively. We have made a comparative study of accelerating and decelerating models in the presence of string scenario. The study reveals that massive strings dominate in the decelerating universe whereas strings dominate in the accelerating universe. The strings eventually disappear from the universe for sufficiently large times, which is in agreement with current astronomical observations. The cosmological constant A is found to be a positive decreasing function of time which is corroborated by results from recent supernovae Ia observations. The physical and geometric properties of the models have been also discussed in detail.

关键词： cosmic strings Bianchi-I universe variable cosmological constant Hubble's parameter

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Thick Domain Walls in Lyra Geometry with Bulk Viscosity

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Communications in Theoretical Physics 2009年第2期51卷 378-384页

作者： Anirudh pradhan Department of Mathematics Hindu Post-graduate College

In this paper, we evaluate the general solutions for plane-symmetric thick domain walls in Lyra geometry in presence of bulk viscous fluid. Expressions for the energy density and pressure of domain walls are derived in both cases of uniform and time varying displacement field β. Some physical consequences of the models are also given. Finally, the geodesic equations and acceleration of the test particle are discussed.

关键词： cosmology plane symmetric domain walls bulk viscous model Lyra geometry

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Building Resilience Through Disaster Waste Management——UN Environment's Experiences and Approaches

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工程科学与技术 2018年第3期50卷 15-23页

作者： pradhan Mahesh XU Qing International Environmental Technology Centre United Nations Environment Programme Sichuan Academy of Environmental Sciences

Integrating disaster waste issue is a critical component of making humanitarian action fit for the future,anticipating global risks and challenges such as increased vulnerability due to climate change and environmental *** requires a fundamental shift towards a model that not only strengthens the response to crises but also learns and adapts in order to anticipate and act before such waste *** article conducted analyses on the characteristics of disasters in the past two *** confound disaster waste management,including the timing and magnitude of each disaster,and the amounts and types of waste that will be *** these reasons alone,disaster waste management must be an integral part of development planning and *** 10 years since the 2008 Wenchuan earthquake,this article highlights that disaster waste management is not only debris clearance or waste management following a disaster,but also includes prevention and pre-disaster preparedness aspects in terms of enhancing resilience of local ***"mainstreaming,"ensures that disaster waste management(DWM)will be treated as a priority issue,on an ongoing *** on UN Environment's experiences and approaches,this paper emphasises that preparedness is the key,and that priority should be accorded to integrating disaster contingency planning in national and city level waste management strategies as well as mainstreaming waste management issues within broader disaster preparedness and response plans and *** is envisaged that the issues presented and the gaps identified in this paper will provide a basis for future comprehensive and cohesive research on disaster waste *** turn,this research can lead to better preparedness and response on disaster waste management.

关键词： disaster waste disaster risk reduction waste management Sendai Framework

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Some Magnetized Bulk Viscous String Cosmological Models in Cylindrically Symmetric Inhomogeneous Universe with Variable Λ-Term

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Communications in Theoretical Physics 2009年第2期51卷 367-374页

作者： Anirudh pradhan Department of Mathematics Hindu Post-graduate College

Some cylindrically symmetric inhomogeneous viscous fluid string cosmological models with magnetic field and cosmological term A varying with time are investigated. To get the deterministic solution, it has been assumed that the expansion （θ） in the model is proportional to the eigen value σ^11 of the shear tensor σ^ij. The value of cosmological constant for the model is found to be small and positive, which is supported by the results from recent supernovae Ia observations. The effect of bulk viscosity is to produce a change in perfect fluid and hence exhibits essential influence on the character of the solution. The physical and geometric properties of the models are also discussed in presence and absence of magnetic field.

关键词： string inhomogeneous universe cylindrical symmetry variable cosmological term bulk viscosity

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Accelerating dark energy models with anisotropic fluid in Bianchi type Ⅵ_0 space-time

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Research in Astronomy and Astrophysics 2013年第2期13卷 139-158页

作者： Anirudh pradhan Department of Mathematics Hindu Post-graduate College

Motivated by the increasing evidence for the need of a geometry that re- sembles Bianchi morphology to explain the observed anisotropy in the WMAP data, we have discussed some features of Bianchi type VI0 universes in the presence of a fluid that has an anisotropic equation of state （EoS） parameter in general relativity. We present two accelerating dark energy （DE） models with an anisotropic fluid in Bianchi type VI0 space-time. To ensure a deterministic solution, we choose the scale factor a（t） = √tnet, which yields a time-dependent deceleration parameter, representing a class of models which generate a transition of the universe from the early decelerating phase to the recent accelerating phase. Under suitable conditions, the anisotropic mod- els approach an isotropic scenario. The EoS for DE co is found to be time-dependent and its existing range for derived models is in good agreement with data from recent observations of type Ia supernovae （SNe Ia）（Knop et al. 2003）, SNe Ia data com- bined with cosmic microwave background （CMB） anisotropy and galaxy clustering statistics （Tegmark et al. 2004a）, as well as the latest combination of cosmological datasets coming from CMB anisotropies, luminosity distances of high redshift SNe Ia and galaxy clustering. For different values of n, we can generate a class of physically viable DE models. The cosmological constant A is found to be a positive decreasing function of time and it approaches a small positive value at late time （i.e. the present epoch）, which is corroborated by results from recent SN Ia observations. We also ob- serve that our solutions are stable. The physical and geometric aspects of both models are also discussed in detail.

关键词： cosmological models -- dark energy -- variable EoS parameter

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Position Control of a Flexible Manipulator Using a New Nonlinear Self-Tuning PID Controller

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IEEE/CAA Journal of Automatica Sinica 2020年第1期7卷 136-149页

作者： Santanu Kumar pradhan Bidyadhar Subudhi School of Electrical Sciences National Institute of Science and Technology BerhampurOdisha 761008India School of Electrical Sciences Indian Institute of TechnologyFarmagudiGoa 403401India

In this paper, a new nonlinear self-tuning PID controller(NSPIDC) is proposed to control the joint position and link deflection of a flexible-link manipulator(FLM) while it is subjected to carry different payloads. Since, payload is a critical parameter of the FLM whose variation greatly influences the controller performance. The proposed controller guarantees stability under change in payload by attenuating the non-modeled higher order dynamics using a new nonlinear autoregressive moving average with exogenous-input(NARMAX) model of the FLM. The parameters of the FLM are identified on-line using recursive least square(RLS) algorithm and using minimum variance control(MVC) laws the control parameters are updated in real-time. This proposed NSPID controller has been implemented in real-time on an experimental set-up. The joint tracking and link deflection performances of the proposed adaptive controller are compared with that of a popular direct adaptive controller(DAC). From the obtained results, it is confirmed that the proposed controller exhibits improved performance over the DAC both in terms of accurate position tracking and quick damping of link deflections when subjected to variable payloads.

关键词： Flexible-link manipulator position control self-tuning control NARMAX trajectory tracking

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