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Patients with Cirrhosis of Liver Operated for Non-transplant Surgery: A Retrospective Analysis

Journal of Clinical and Translational Hepatology 2019年第1期7卷 9-14页

作者： Kishore Kumar Kuduva Subramanian Manish Tandon chandra kant pandey Priyanka Jain Department of Anaesthesiology Institute of Liver and Biliary SciencesNew DelhiIndia Department of Research Institute of Liver&Biliary Sciences(ILBS)New DelhiIndia

Background and Aims:Patients with cirrhosis of the liver have high mortality after *** investigated the mortality in patients with cirrhosis of the liver who underwent surgery other than liver transplant and applied the Mayo clinic model to predict mortality and compare with the observed *** also studied the association of the observed mortality with the Child-Turcotte-Pugh(CTP)class and the model for end-stage liver disease(MELD)and model for end-stage liver disease-sodium(MELD-Na)***:The electronic records database of our hospital was accessed to analyze the data of 133 cirrhotic patients who underwent various surgeries under general anesthesia from October 2009 to June *** Mayo risk score was applied to each and used to calculate predicted mortality;the MELD and MELD-Na scores were also *** interview was performed with the patients and or their relative to ascertain survival or time of death after surgery,when the information was not available from the hospital ***:The all-cause observed mortality rates at postoperative days 30 and 90 and at 1 year were 12%,20.3%and 26.3%*** area under the receiver operating characteristic curve values for the Mayo model as a predictor of 30-day,90-day and 1-year mortality were 0.836,0.828 and 0.744 *** correlation was seen for observed mortality with CTP class and with MELD and MELD-Na ***:The Mayo model for predicting postoperative mortality in patients with cirrhosis of the liver demonstrated good correlation in this *** strength of prediction of mortality by Mayo risk score calculation was similar at postoperative days 30 and 90 but decreased at 1-year after the *** correlation was seen for the observed mortality with MELD,MELD-Na and CTP scores.

关键词： Cirrhosis of the liver Mayo risk model CTP score MELD score

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Diagnostic and therapeutic challenge of heart failure after liver transplant:Case series

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World Journal of Hepatology 2017年第33期9卷 1253-1260页

作者： Manish Tandon Sunaina Tejpal Karna chandra kant pandey Ravindra Chaturvedi Institute of Liver and Biliary Sciences New Delhi 110070India

Heart failure(HF) following liver transplant(LT) surgery is a distinct clinical entity with high mortality. It is known to occur in absence of obvious risk factors. No preoperative workup including electrocardiogram, echocardiography at rest and on stress, reasonably prognosticates the risk. In patients of chronic liver disease, cirrhotic cardiomyopathy, alcoholic cardiomyopathy, and stress induced cardiomyopathy have each been implicated as a cause for HF after LT. However distinguishing one etiology from another not only is difficult, several etiologies may possibly coexist in a given patient. Diagnostic dilemma is further compounded by the fact that presentation and management of HF irrespective of the possible underlying cause, remains the same. In this case series, 6 cases are presented and in the light of existing literature modification in the preoperative workup are suggested.

关键词： Liver transplant Heart failure Cirrhotic cardiomyopathy Stress cardiomyopathy Alcohol cardiomyopathy

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Perioperative risk factors in patients with liver disease undergoing non-hepatic surgery

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World Journal of Gastrointestinal Surgery 2012年第12期4卷 267-274页

作者： chandra kant pandey Sunaina Tejpal Karna Vijay kant pandey Manish Tandon Amit Singhal Vivek Mangla Department of Anaesthesiology Institute of Liver and Biliary Sciences Vasant Kunj New Delhi 110070 India Department of HPB Surgery Institute of Liver and Biliary Sciences Vasant Kunj New Delhi 110070 India

The patients with liver disease present for various surgical interventions. Surgery may lead to complications in a significant proportion of these patients. These complications may result in considerable morbidity and mortality. Preoperative assessment can predict survival to some extent in patients with liver disease undergoing surgical procedures. A review of literature suggests nature and the type of surgery in these patients determines the peri-operative morbidity and mortality. Optimization of premorbid factors may help to reduce perioperative mortality and morbidity. The purpose of this review is to discuss the effect of liver disease on perioperative outcome; to understand various risk scoring systems and their prognostic significance; to delineate different preoperative variables implicated in postoperative complications and morbidity; to establish the effect of nature and type of surgery on postoperative outcome in patients with liver disease and to discuss optimal anaesthesia strategy in patients with liver disease.

关键词： Cirrhosis Liver disease Perioperative risk

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Intraoperative blood loss in orthotopic liver transplantation:The predictive factors

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World Journal of Gastrointestinal Surgery 2015年第6期7卷 86-93页

作者： chandra kant pandey Anshuman Singh Kamal Kajal Mandeep Dhankhar Manish Tandon Vijay kant pandey Sunaina Tejpal Karna Department of Anaesthesiology Institute of Liver and Biliary Sciences

Liver transplantation has been associated with massive blood loss and considerable transfusion requirements. Bleeding in orthotopic liver transplantation is multifactorial. Technical difficulties inherent to this complex surgical procedure and pre operative derangements of the primary and secondary coagulation system are thought to be the principal causes of perioperative hemorrhage. Intraoperative practices such as massive fluid resuscitation and resulting hypothermia and hypocalcemia secondary to citrate toxicity further aggravate the preexisting coagulopathy and worsen the perioperative bleeding. Excessive blood loss and transfusion during orthotopic liver transplant are correlated with diminished graft survival and increased septic episodes and prolonged ICU stay. With improvements in surgical skills, anesthetic technique, graft preservation, use of intraoperative cell savers and overall perioperative management, orthotopic liver transplant is now associated with decreased intra operative blood losses. The purpose of this review is to discuss the risk factors predictive of increased intra operative bleeding in patients undergoing orthotopic liver transplant.

关键词： Liver transplantation Intraoperative bloodloss Liver disease

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Tongue thickness in health vs cirrhosis of the liver:Prospective observational study

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2020年第3期11卷 59-68页

作者： Manish Tandon Harshita Singh Nishant Singla Priyanka Jain chandra kant pandey Department of Anesthesia Institute of Liver and Biliary SciencesNew Delhi 110070India Department of Intervention Radiology Institute of Liver and Biliary SciencesNew Delhi 110070India Department of Research Institute of Liver and Biliary SciencesNew Delhi 110070India

BACKGROUNDMalnutrition affects 40%-90% of patients with cirrhosis of the liver. L3 skeletalmuscle index (L3SMI) is presently accepted as the most objective and quantitativemeasure available for sarcopenia, a surrogate marker of malnutrition. L3SMIapplication is, however, limited by non-availability of computed tomographyscanning in remote areas, cost, need for extensive training, and the risk ofexposure to radiation. Therefore, an alternative dependable measure with wideravailability is needed. Malnutrition causes sarcopenia not only in skeletal musclesbut also in other muscular structures such as the psoas muscle, diaphragm andtongue. We therefore hypothesised that the tongue, being easily accessible forinspection and for measurement of thickness using ultrasonography, may be usedto document *** measure and compare tongue thickness in healthy individuals and in patientswith cirrhosis of the liver and to study its correlation with conventionalprognostic scores for patients with cirrhosis of the *** thickness was measured using ultrasonography. One hundred twentysubjects of either gender aged 18 to 65 years were studied, with 30 subjects in eachgroup. The tongue thickness was compared between groups based on “ChildTurcotte Pugh” (CTP) scores. The correlations between measured tonguethickness and “Model for end stage liver disease” (MELD) score and between age and measured tongue thickness were also *** tongue thickness (mean ± SD) in patients with CTP class A, B and C was4.39 ± 0.39 cm, 4.19 ± 0.53 cm, and 3.87 ± 0.42, respectively, and was 4.33 ± 0.49 cmin normal healthy individuals. Significant differences were seen in tonguethickness between patients with CTP class C and those with CTP class A and B (P< 0.05). Patients with CTP class C also had a significantly reduced tonguethickness than normal individuals (P < 0.05). However, no significant differencewas seen in tongue thickness between patients with CTP class A and

关键词： Sarcopenia Malnutrition Cirrhosis of the liver Child Turcotte Pugh class Model for end stage liver disease score Ultrasonography

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Need for operational simplicity and timely disbursal of benefits—a qualitative exploration of the implementation of a direct benefit transfer scheme for persons with tuberculosis in India

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贫困所致传染病(英文) 2024年第3期13卷 1-15页

作者： Mohan Malu Thangaraj Jeromie W. V. pandey Sumit Priya G. Sri Lakshmi Arunachalam Sivavallinathan Sharma Rahul Shewade Hemant Deepak Aishwarya B. Afeeq K. Khatoon Afsana Gokulvijay B. Sireesha Gude chandra Kavita Nandhakumar S. Samuel Prince Viswanathan C. Nanditha Shanmugasundaram Devika Rao Raghuram Murhekar Manoj V. Jeyashree Kathiresan Indian Council of Medical Research-National Institute of Epidemiology R-127 TNHB Ayapakkam Chennai Tamil Nadu India TB Support Network WHO Country Office for India New Delhi India Central Tuberculosis Division Government of India New Delhi India

Background Ni-kshay Poshan Yojana (NPY) is a direct benefit transfer scheme of the Government of India introduced in 2018 to support the additional nutritional requirements of persons with TB (PwTB). Our recent nationwide evaluation of implementation and utilization of NPY using programmatic data of PwTB from nine randomly selected Indian states, reported a 70% coverage and high median delay in benefit credit. We undertook a qualitative study between January and July 2023, to understand the detailed implementation process of NPY and explore the enablers and barriers to effective implementation and utilization of the NPY *** We followed a grounded theory approach to inductively develop theoretical explanations for social phenomena through data generated from multiple sources. We conducted 36 in-depth interviews of national, district and field-level staff of the National Tuberculosis Elimination Programme (NTEP) and NPY beneficiaries from 30 districts across nine states of India, selected using theoretical sampling. An analytical framework developed through inductive coding of a set of six interviews, guided the coding of the subsequent interviews. Categories and themes emerged through constant comparison and the data collection continued until theoretical *** Stakeholders perceived NPY as a beneficial initiative. Strong political commitment from the state administration, mainstreaming of NTEP work with the district public healthcare delivery system, availability of good geographic and internet connectivity and state-specific grievance redressal mechanisms and innovations were identified as enablers of implementation. However, the complex, multi-level benefit approval process, difficulties in accessing banking services, perceived inadequacy of benefits and overworked human resources in the NTEP were identified as barriers to implementation and *** The optimal utilization of NPY is enabled by strong political commitment and

关键词： National Tuberculosis Elimination Programme Nutritional status Direct benefit transfer Ni-kshay Poshan Yojana Implementation Cash transfer scheme Grounded theory India

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Process-structure-property relationship for plasma-sprayed iron-based amorphous/crystalline composite coatings

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International Journal of Minerals,Metallurgy and Materials 2022年第1期29卷 144-152页

作者： Abhishek Pathak Biswajyoti Mukherjee Krishna kant pandey Aminul Islam Pavan Bijalwan Monojit Dutta Atanu Banerjee Anup Kumar Keshri Research and Development Unit Tata SteelJamshedpur 831001India Plasma Spray Coating Laboratory Metallurgical and Materials EngineeringIndian Institute of Technology PatnaBihta 801106India

This study explores the fabrication of Fe-based amorphous/crystalline coating by air plasma spraying and its dependency on the coating parameters(plasma power,primary gas flow rate,powder feed rate,and stand-off distance).X-ray diffraction of the coatings deposited at optimized spray parameters showed the presence of amorphous/crystalline *** deposited at a lower plasma power and highest gas flow rate exhibited better density,hardness,and wear *** coatings demonstrated equally good resistance against the corrosive environment(3.5wt%NaCl solution).Mechanical,wear,and tribological studies indicated that a single process parameter optimization cannot provide good coating performance;instead,all process parameters have a unique role in defining better properties for the coating by con-trolling the in-flight particle temperature and velocity profile,followed by the cooling pattern of molten droplet before impingement on the substrate.

关键词： Fe-based alloys amorphous alloys plasma spray coating mechanical corrosion and wear

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Biochemical Alterations and Termiticidal Activity of Combinatorial Essential Oil Ingredients of Citrus maxima on Indian White Termite Odontotermes obesus

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Journal of Biosciences and Medicines 2023年第4期11卷 60-81页

作者： Lokpriy pandey Ravi kant Upadhyay Department of Zoology (Environmental Science) Deen Dayal Upadhyaya Gorakhpur University Gorakhpur India

Essential oils are better alternative for synthetic termiticides with the inherent resistance by insects, environmental and health effects on humans. In present investigation, various bio-molecules i.e. glycogen, protein, amino acid, DNA, RNA and lipid were evaluated to determine the anti-termite efficacy of Citrus maxima essential oil based combinatorial formulations against Indian white termite Odontotermes obesus. For this purpose, termites were treated topically with 40% and 80% of 24 hr LD50 values of various combinatorial formulations. A significant (p > 0.05) alteration was noted in all the above biomolecules at various time intervals. Both dose response and time period was found important in physiological alteration in levels of various bio-molecules. Combinatorial mixtures of Citrus essential oils have shown synergistic activity against termites. The research outcomes of present investigation would help to open sustainable way to termite control in crop field, gardens and houses.

关键词： Citrus maxima Essential Oils Odontotermes obesus Bio-Molecules Inhibition Termiticidal Action

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Toxic Effects of Citrus maxima Based Combinatorial Formulations on Important Metabolic Enzymes in Indian White Termite Odontotermes obesus

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Advances in Enzyme Research 2023年第2期11卷 11-33页

作者： Lokpriy pandey Ravi kant Upadhyay Department of Zoology (Environmental Science) Deen Dayal Upadhyaya Gorakhpur University Gorakhpur India

In the present study, Citrus maxima essential crude oil extract was used to prepare combinatorial formulations and workers of Indian white termite Odontotermes obesus were treated topically with 40% and 80% of 24 hr LD50 values of these formulations. In subsequent bioassays levels of various enzymes i.e. alkaline phosphatase, acid phosphatase, glutamate oxaloacetate transaminase, glutamate pyruvate transaminase and acetylcholinesterase were evaluated to determine the anti-termite efficacy of Citrus maxima essential oil based combinatorial formulations. S-RET-A, S-RET-B and S-RET-C caused significant (p > 0.05) decrease in glutamate oxaloacetate transaminase i.e. 87.47%, 86.81% and 81.77% & 82.04%, 79.39% and 74.75% respectively at 16 h treatment. In vivo exposure of 40% and 80% of LD50 of combinatorial formulations caused very significant (p > 0.05) reduction in all the test enzymes i.e. alkaline phosphatase, acid phosphatase, glutamate oxaloacetate transaminase and glutamate pyruvate transaminase expect acetylcholinesterase levels after 16 h all tested treatments in comparison to control. Both dose-response and time period were found important in physiological alteration in levels of various enzymes. Combinatorial mixtures of Citrus essential oils have shown synergistic activity against termites. The research findings of the present study would help termite control in crop fields, gardens and houses in a sustainable way.

关键词： Citrus maxima Essential Oils Odontotermes obesus Enzymes Inhibition Termiticidal Action

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ON APPROXIMATE EFFICIENCY FOR NONSMOOTH ROBUST VECTOR OPTIMIZATION PROBLEMS

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Acta Mathematica Scientia 2020年第3期40卷 887-902页

作者： Tadeusz ANTCZAK Yogendra pandey Vinay SINGH Shashi kant MISHRA Faculty of Mathematics and Computer Science University of LódźBanacha 2290-238 LódźPoland Department of Mathematics Satish Chandra CollegeBallia 277001India Department of Mathematics National Institute of TechnologyAizawl-796012MizoramIndia Department of Mathematics Banaras Hindu UniversityVaranasi-221005India

In this article,we use the robust optimization approach(also called the worst-case approach)for findingε-efficient solutions of the robust multiobjective optimization problem defined as a robust(worst-case)counterpart for the considered nonsmooth multiobjective programming problem with the uncertainty in both the objective and constraint ***,we establish both necessary and sufficient optimality conditions for a feasible solution to be anε-efficient solution(an approximate efficient solution)of the considered robust multiobjective optimization *** also use a scalarizing method in proving these optimality conditions.

关键词： Robust optimization approach robust multiobjective optimization ε-efficient solution ε-optimality conditions scalarization

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