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Diagnosis of Crohn's disease in India where tuberculosis is widely prevalent

World Journal of Gastroenterology 2008年第5期14卷 741-746页

作者： deepak N Amarapurkar Nikhil D Patel Priyamvada S Rane Department of Gastroenterology Bombay Hospital & Medical Research Centre Mumbai 400025 India

AIM:To define the parameters that positively predict diagnosis of Crohn's disease (CD) and differentiate it from gastrointestinal tuberculosis (GITB). METHODS:This prospective study over 3 years was carried out in the consecutive Indian patients with definite diagnosis of CD and equal numbers of patients with definite diagnosis of GITB. Demographic, clinical, laboratory, morphological and histological features were noted in all the patients. Serological tests such as p-ANCA, c-ANCA, IgA ASCA and IgG ASCA, were performed. Endoscopic biopsy and/or surgical tissue specimens were subjected to smear and culture for acid-fast bacilli (AFB) and tissue polymerase chain reaction for tuberculosis (TB PCR). Diagnosis of CD and GITB was based on the standard criteria. Data were analyzed using univariate Chi-square test and multiple logistic regression (MLR). RESULTS:The study is comprised of 26 patients with CD (age 36.6 ± 8.6 year, male:female, 16:10) and 26 patients with GITB (age 37.2 ± 9.6 year, male:female, 15:11). The following clinical variables between the two groups (CD vs TB) were significant in univariate analysis:duration of symptoms (58.1 ± 9.8 vs 7.2 ± 3.4 mo), diarrhoea (69.2% vs 34.6%), bleeding per rectum (30.7% vs 3.8%), fever (23.1% vs 69.2%), ascites (7.7% vs 34.6%) and extra-intestinal manifestations of inflammatory bowel disease (61.5% vs 23.1%). Of these, all except ascites and extra-colonic manifestations were found statistically significant by MLR. Accuracy of predicting CD was 84.62% based on the fever, bleeding P/R, diarrhoea and duration of symptoms while it was 63.4% when histology was reported as inflammatory bowel disease and 42.3% when there was recurrence of disease after surgery. Accuracy of predicting GITB was 73.1% when there was co-existing pulmonary lesions and/or abdominal lymphadenopathy;75% when tuberculosis was reported in histology;63.4% when granuloma was found in histology;82.6% when TB PCR was positive;and 61.5% when smear and/ or c

关键词： Crohn's disease Gastrointestinal tuberculosis Differential diagnosis Inflammatory bowel disease Anti-neutrophil cytoplasmic antibody Anti-Saccharomyces Cerevisiae antibody Tissue polymerase chain reaction Mycobacterium Tuberculosis Acid-fact bacilli

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Ultrasound liver tumor segmentation using adaptively regularized kernel-based fuzzy C means with enhanced level set algorithm

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International Journal of Intelligent Computing and Cybernetics 2022年第3期15卷 438-453页

作者： deepak S.Uplaonkar Virupakshappa Nagabhushan Patil Research Scholar in Electrical and Electronics Engineering Department Poojya Doddappa Appa College of EngineeringKalaburagiIndia Computer Science and Engineering Department Sharnbasva UniversityKalaburagiIndia Electrical and Electronics Engineering Department Poojya Doddappa Appa College of EngineeringKalaburagiIndia

Purpose-The purpose of this study is to develop a hybrid algorithm for segmenting tumor from ultrasound images of the ***/methodology/approach-After collecting the ultrasound images,contrast-limited adaptive histogram equalization approach(CLAHE)is applied as preprocessing,in order to enhance the visual quality of the images that helps in better ***,adaptively regularized kernel-based fuzzy C means(ARKFCM)is used to segment tumor from the enhanced image along with local ternary pattern combined with selective level set ***-The proposed segmentation algorithm precisely segments the tumor portions from the enhanced images with lower computation *** proposed segmentation algorithm is compared with the existing algorithms and ground truth values in terms of Jaccard coefficient,dice coefficient,precision,Matthews correlation coefficient,f-score and *** experimental analysis shows that the proposed algorithm achieved 99.18% of accuracy and 92.17% of f-score value,which is better than the existing *** implications-From the experimental analysis,the proposed ARKFCM with enhanced level set algorithm obtained better performance in ultrasound liver tumor segmentation related to graph-based ***,the proposed algorithm showed 3.11% improvement in dice coefficient compared to graph-based ***/value-The image preprocessing is carried out using CLAHE *** preprocessed image is segmented by employing selective level set model and Local Ternary Pattern in ARKFCM *** this research,the proposed algorithm has advantages such as independence of clustering parameters,robustness in preserving the image details and optimal in finding the threshold value that effectively reduces the computational cost.

关键词： Adaptively regularized kernel-based fuzzy C means Contrast-limited adaptive histogram equalization Level set algorithm Liver tumor segmentation Local ternary pattern

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Reflection of plane waves from a micropolar thermoelastic solid half-space with impedance boundary conditions

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Journal of Ocean Engineering and Science 2019年第2期4卷 122-131页

作者： Baljeet Singh Anand Kumar Yadav deepak Gupta Department of Mathematics Post Graduate Government CollegeSector 11ChandigarhIndia Department of Mathematics M.M.University MullanaAmbalaIndia

In this paper,the governing equations of linear,isotropic,homogeneous and generalized micropolar thermoelasticity are specialized in a *** governing equations are solved for plane harmonic wave *** separate velocity equations are obtained which indicate the existence of four plane waves with distinct speeds.A problem on reflection of plane waves from a thermally insulated/isothermal surface is considered with impedance boundary *** potentials for incident and reflected waves are formulated which satisfy the boundary conditions at a plane *** between reflection coefficients as well as the expressions of energy ratios for various reflected waves are *** illustration,the reflection coefficients and energy ratios of reflected waves are computed for relevant material parameters of an aluminium-epoxy *** of impedance parameters on all reflected waves is shown graphically at each angle of incidence.

关键词： Micropolar thermoelasticity Impedance boundary Plane waves Reflection coefficients Energy ratios.

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Clinical Management of Mid-Root Fracture in Maxillary Central Incisors:Case Reports

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International Journal of Oral Science 2010年第4期2卷 215-221页

作者： deepak J. Parekh Ramarao Sathyanarayanan Mangala Tiptur Manjunath Department of Conservative Dentistry and Endodontics Bapuji Dental College and Hospital

Management of mid-root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This article presents two varied treatment options for mid-root fractures. A 15-year-old female reported an impact injury to the maxillary anterior teeth 2 days after its occurrence. Clinically,the maxillary left central incisor was palatally-extruded with a negative vitality response and radiographic evidence of an oblique fracture at the middle third of the root. An endodontic implant was employed which utilized an open technique and has been on follow-up for ten months. A 32-year-old male reported an injury,which resulted in a mobile maxillary right central incisor,three months after its occurrence. Through clinical and radiographic means,a discolored,extruded,and non-vital maxillary right central incisor with an oblique root fracture at the alveolar-crest level was observed. Exploratory surgery was performed; an apical barrier was created with a mineral trioxide aggregate and obturated with gutta percha. The fragments were stabilized with a fiber post and patient has been on follow-up for five months. Short-term follow-up for both of the cases showed promising results both clinically and radiographically.

关键词： endodontic implant fiber post maxillary central incisor root fracture titanium min screw

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Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment

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World Journal of Gastroenterology 2008年第2期14卷 278-285页

作者： deepak N Amarapurkar Sundeep J Punamiya Nikhil D Patel Department of Gastroenterology Bombay Hospital and Medical Research Centre Mumbai India Department of Interventional Radiology Bombay Hospital and Medical Research Centre Mumbai India

AIM： To evaluate patterns of obstruction, etiological spectrum and non-surgical treatment in patients with Budd-Chiari syndrome in India. METHODS： Forty-nine consecutive cases of Budd- Chiari syndrome （BCS） were prospectively evaluated. All patients with refractory ascites or deteriorating liver function were, depending on morphology of inferior vena cava （IVC） and/or hepatic vein （HV） obstruction, triaged for radiological intervention, in addition to anticoagulation therapy. Asymptomatic patients, patients with diuretic-responsive ascites and stable liver function, and patients unwilling for surgical intervention were treated symptomatically with anticoagulation. RESULTS： Mean duration of symptoms was 41.5 ± 11.2 （range = 1-240） too. HV thrombosis （HVT） was present in 29 （59.1%）, IVC thrombosis in eight （16.3%）, membranous obstruction of IVC in two （4%） and both IVC-HV thrombosis in 10 （20.4%） cases. Of 35 cases tested for hypercoagulability, 27 （77.1%） were positive for one or more hypercoagulable states. Radiological intervention was technically successful in 37/38 （97.3%）： IVC stenting in seven （18.9%）, IVC balloon angioplasty in two （5.4%）, combined IVC-HV stenting in two （5.4%）, HV stenting in 11 （29.7%）, transjugular intrahepatic portosystemic shunt （TIPS） in 13 （35.1%） and combined TIPS-IVC stenting in two （5.4%）. Complications encountered in follow-up： death in five, re-stenosis of the stent in five （17.1%）, hepatic encephalopathy in two and hepatocellular carcinoma in one patient. Of nine patients treated medically, two showed complete resolution of HVT. CONCLUSION： IN our series, HVT was the predominant cause of BCS. In the last five years with the availability of sophisticated tests for hypercoagulability, etiologies were defined in 85.7% of cases. Non-surgical management was successful in most cases.

关键词： Budd-Chiari syndrome Interventional radiology Ascites Hepatic vein thrombosis Percutaneoustransluminal angioplasty Stent Transjugular intrahepatic portosystemic shunt Thrombophilia

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Special Considerations in the Management of Autoimmune Hepatitis in COVID-19 Hotspots:A Review

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Journal of Clinical and Translational Hepatology 2021年第4期9卷 568-575页

作者： deepak Madhu Sanchit Sharma Ashish Agarwal Anoop Saraya Department of Gastroenterology Aster MIMS CalicutKeralaIndia Department of Gastroenterology Caritas HospitalKottayamKeralaIndia Department of Gastroenterology and Human Nutrition All India Institute of Medical SciencesNew DelhiIndia Department of Gastroenterology All India Institute of Medical SciencesJodhpurRajasthanIndia

The ongoing coronavirus disease-2019(COVID-19)pandemic has necessitated special considerations in the management of *** way presence of pre-existing diseases or treatment for it predisposes to,alters course of,and changes the management of COVID-19,is of relevance and is being extensively *** hepatitis(AIH)is unique in that it is an autoimmune disease mandating treatment with immunosuppressive drugs,as well as a liver disease with potential for varying degrees of underlying *** use of immunosuppressive drugs could alter the risk of acquiring COVID-19,the clinical course and severity of COVID-19 and the degree of underlying liver fibrosis could alter the clinical outcomes of patients with *** this review,we try to summarize key areas relevant in understanding and improving the clinical care of patients with AIH in the current *** considerations required in the management of patients with AIH in COVID-19 hotspots have been outlined based on the current evidence.

关键词： Hepatitis Autoimmune Liver cirrhosis COVID-19 SARS-CoV-2 infection Immunosuppressive agents

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Synthesis of Aligned ZnO Nanorod Array on Silicon and Sapphire Substrates by Thermal Evaporation Technique

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Journal of Materials Science & Technology 2011年第8期27卷 701-706页

作者： K.M.K. Srivatsa deepak Chhikara M. Senthil Kumar Materials Physics and Engineering Division National Physical Laboratory Council of Scientific & Industrial Research (CSIR) Physics of Energy Harvesting Division National Physical Laboratory Council of Scientific & Industrial Research (CSIR)

High density ZnO nanorods were grown by thermal evaporation of Zn powder at 700℃ on Si （100） and sapphire （0001） substrates at atmospheric pressure without adding any catalyst. The nanorods were characterizated in terms of their structural and optical properties. The nanorods grown on Si have a diameter of 350-400 nm and a length of 1.2 μm while those on sapphire have a diameter of 600-800 nm and a length of 2.5 μm. During the structural characterization, it is noticed that the rods grow along the （0002） plane with perfect hexagonal facet. The room temperature photoluminescence spectrum showed a strong UV emission peak at 385 nm with a weak green band emission, which confirms that nanorods have good optical properties. It is observed that the oxygen partial pressure plays an important role to control the shape and size of the nanorods in thermal evaporation growth technique.

关键词： Thermal evaporation technique ZnO nanorods X-ray diffraction Photoluminescence

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STEP AP 242 Managed Model-based 3D Engineering:An Application Towards the Automation of Fixture Planning

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International Journal of Automation and computing 2021年第5期18卷 731-746页

作者： Remil George Thomas deepak Lawrence K. Manu R. Department of Mechanical Engineering National Institute of Technology CalicutKerala 673601India

Fixture design and planning is one of the most important manufacturing activities, playing a pivotal role in deciding the lead time for product development. Fixture design, which affects the part-quality in terms of geometric accuracy and surface finish, can be enhanced by using the product manufacturing information(PMI) stored in the neutral standard for the exchange of product model data(STEP) file, thereby integrating design and manufacturing. The present paper proposes a unique fixture design approach, to extract the geometry information from STEP application protocol(AP) 242 files of computer aided design(CAD) models, for providing automatic suggestions of locator positions and clamping surfaces. Automatic feature extraction software "FiXplan", developed using the programming language C#, is used to extract the part feature, dimension and geometry information. The information from the STEP AP 242 file is deduced using geometric reasoning techniques, which in turn is utilized for fixture planning. The developed software is observed to be adept in identifying the primary, secondary, and tertiary locating faces and locator position configurations of prismatic components. Structural analysis of the prismatic part under different locator positions was performed using commercial finite element method software, ABAQUS, and the optimized locator position was identified on the basis of minimum deformation of the *** area-ratio(base locator enclosed area(%)/work piece base area(%)) for the ideal locator configuration was observed as 33%. Experiments were conducted on a prismatic workpiece using a specially designed fixture, for different locator configurations. The surface roughness and waviness of the machined surfaces were analysed using an Alicona non-contact optical profilometer. The best surface characteristics were obtained for the surface machined under the ideal locator positions having an area-ratio of 33%, thus validating the predicted numerical resul

关键词： Standard for the exchange of product model data(STEP)application protocol(AP)242 product manufacturing information computer-aided fixture design computer aided design(CAD)/computer aided manufacturing(CAM) automation computer integrated manufacturing 3D surface roughness

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Recent progress in the structure optimization and development of proton-conducting electrolyte materials for low-temperature solid oxide cells

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International Journal of Minerals,Metallurgy and Materials 2022年第4期29卷 848-869页

作者： Jia Song Yuvraj Y.Birdja deepak Pant Zhiyuan Chen Jan Vaes Separation and Conversion Technology Flemish Institute for Technological Research(VITO)Mol 2400Belgium

This work reviews technologies that can be used to develop low-temperature solid oxide cells(LT-SOCs)and can be applied in fuel cells and electrolyzers operating at temperatures below 500℃,thus providing a more cost-effective alternative than conventional high-temperature *** routes showing potential to reduce the operating temperature of SOCs to below 500℃ are *** first route is the principal way to enhance cell performance,namely,structure *** technique includes the reduction of electrolyte thickness to the nanometer scale and the exploration of electrode structure with low polarization *** other route is the development of novel protonconducting electrolyte materials,which is in the frontier of SOCs *** fundamentals of proton conduction and the design principles of commonly used electrolyte materials are briefly *** most widely studied electrolyte materials for LT-SOCs,namely,perovskitetype BaCeO_(3) -and BaZrO_(3) -based oxides,and the effect of doping on the physical-chemical properties of these oxide materials are summarized.

关键词： low-temperature solid oxide cells perovskite doping thin-film

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Small bowel bleeding:a comprehensive review

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Gastroenterology Report 2014年第4期2卷 262-275页

作者： deepak Gunjan Vishal Sharma Surinder S Rana deepak K Bhasin Department of Gastroenterology Postgraduate Institute of Medical Education and Research(PGIMER)ChandigarhIndia

The small intestine is an uncommon site of gastro-intestinal(GI)bleeding;however it is the commonest cause of obscure GI *** may require multiple blood transfusions,diagnostic procedures and repeated *** is the commonest cause of obscure GI bleeding,particularly in the *** lesions and tumours are the usual causes of small intestinal bleeding in younger *** endoscopy and deep enteroscopy have improved our ability to investigate small bowel *** enteroscopy has also an added advantage of therapeutic *** tomography is helpful in identifying extra-intestinal *** cases of difficult diagnosis,surgery and intra-operative enteroscopy can help with diagnosis and *** treatment is dependent upon the aetiology of the *** overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate *** bowel bleeding can be managed by conservative,radiological,pharmacological,endoscopic and surgical methods,depending upon indications,expertise and *** patients,especially those with multiple vascular lesions,can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician.

关键词： small intestine bleed aetiology diagnostic approach management.

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