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Endoscopic management of biliary disorders during pregnancy

Hepatobiliary & Pancreatic Diseases International 2010年第2期9卷 180-185页

作者： Vui Heng Chong anand Jalihal Gastroenterology Unit Department of MedicineRaja Isteri Pengiran Anak Saleha(RIPAS)Hospital

BACKGROUND:Biliary interventions during pregnancy are associated with risks to both the pregnancy and developing *** this report we summarize our experience with endoscopic interventions including endoscopic ultrasound (EUS)in the management of biliary disorders during pregnancy. METHODS:Endoscopic retrograde cholangiopancreatographies (ERCPs)performed between May 2003 through January 2010(n=607)were identified from our database,and cases of interventions during pregnancy were *** procedures were done using conscious sedation and lead shielding. RESULTS:Nine ERCPs(1.5%)were performed in 8 pregnant *** median gestational period was 22 weeks (range,<2-36 weeks).Two,5 and 2 patients were in their first,second and third trimester,*** for ERCP included obstructive jaundice(6 patients)cholangitis (2),and acute pancreatitis/obstructive jaundice(1).Two patients underwent EUS before *** was used in 5 ERCPs(median 12 seconds;range 2-20 seconds),and the overall time for a ERCP ranged from 5 to 25 minutes. During ERCP endoscopic sphincterotomy was performed in 5 patients,stenting in 6,and balloon clearance in *** procedure caused complication in induction of *** pregnancy,there were 4 non-procedure related complications including acute cholecystitis(1),HELLP syndrome resulting in spontaneous abortion(1)and stent migrations(2).Five pregnancies had uncomplicated term deliveries,whereas 2 required urgent caesarian sections(one for fetal distress and 1 for cholangitis secondary to stent migration).One patient was well in her second trimester during *** babies were well at birth with median APGAR scores of 9,and 10 at 5 and 10 minutes,*** baby died of sudden death syndrome at age of 40 days. CONCLUSIONS:ERCP is a safe procedure for pregnant *** can be conducted for biliary stenting and subsequent clearance after *** has a complementary role. Different strategies can be appl

关键词： choledocholithiasis cholangitis obstructive jaundice pregnancy endoscopy endoscopic ultrasound

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Geospatial analysis of salmonellosis and its association with socioeconomic status in Texas

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Family Medicine and Community Health 2021年第4期9卷 71-77页

作者： anand Gourishankar Division of Pediatric Hospital Medicine Children's National HospitalWashingtonDistrict of ColumbiaUSA

Objective The study’s objective was to find the association between salmonellosis and socioeconomic status(SES)in hot spot areas and statewide *** A retrospective cohort *** The data were recorded regarding salmonellosis in 2017 from the Texas surveillance *** included assessment of hot spot analysis and SES association with salmonellosis at the county *** Patients with salmonellosis of all age groups in *** There were a total of 5113 salmonellosis from 254 counties with an unadjusted crude rate of 18 per 100000 *** SES risk factors in the hot spot counties were as follows:low values of the severe housing problem,unemployment,African American and high values of social association rate,fast food/full-service restaurant use,Hispanic and Hispanic senior low access-to-store(p<0.05).A 12%difference existed between local health departments in hot(25%)and cold spot(37%)counties(χ^(2)(1,n=108)=0.5,p=0.81).Statewide independent risk factors were severe housing problem(incidence rate ratio(IRR)=1.1;95%CI:1.05 to 1.14),social association rate(IRR=0.89;95%CI:0.87 to 0.92),college education(IRR=1.05;95%CI:1.04 to 1.07)and non-Hispanic senior local access-to-store(IRR=1.98;95%CI:1.26 to 3.11).The severe housing problem predicted zero occurrences of infection in a county(OR=0.51;95%CI:0.28 to 0.95).Conclusions Disparity exists in salmonellosis and *** to unmet needs will decrease *** housing problem is a notable risk.

关键词： analysis store counties

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Interference Cancellation and FEC in S/CDMA Networks with PIN+OA Receiver

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光学学报 2003年第S1期23卷 723-724页

作者： anand Srivastava Centre for Development Of Telematics 39 Main Pusa Road New Delhi-110005 INDIA

For reducing the effects of optical multiple access interference (OMAI) and receiver noise in code-division multiple access (OCDMA) networks with STM-1 input, use of parallel cancellation and forward error correcting ... 详细信息

关键词： FEC et OCDMA in PIN with OA length that of for

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Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

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World Journal of Gastroenterology 2011年第12期17卷 1600-1605页

作者： Geoffrey C Nguyen Justina Sam Nitasha anand Mount Sinai Hospital Division of Gastroenterology University of Toronto Faculty of MedicineTorontoOntario M5G 1X5Canada Division of Gastroenterology and Hepatology Johns Hopkins University School of MedicineBaltimoreMD 21205United States

AIM:To characterize the increasing incidence and geographic variation of acute ***:Using the nationwide inpatient sample (NIS) we identified a cohort who had been admitted with diverticulitis between 1998 and *** calculated age-,sex-,and region-specific rates of hospitalizations for diverticulitis over ***:The age-adjusted hospitalization rate for diverticulitis increased from 61.8 per 100000 to 75.5 per 100 000 between 1998 and 2005,and increased similarly in both ***-associated admissions were male-predominant in those younger than age 45 years but were female-predominant *** rates increased the most among those<45 years,while remaining unchanged for those≥65 *** 2005,the majority of hospitalized patients were<65 ***-adjusted rates of diverticulitis-associated hospitalizations were lower in the West(50.4/100000) compared to the Northeast(77.7/100000),South (73.9/100000),and Midwest(71.0/100000).CONCLUSION:Diverticulitis-associated hospitalizations have steeply risen,especially in young *** epidemiological trends vary by geographic region and warrant further investigation into potential dietary and environmental etiologies.

关键词： Diverticulitis Geographic variation Hospitalization Young adults

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Clinical presentation and endoscopic management of Dieulafoy's lesions in an urban community hospital

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World Journal of Gastroenterology 2007年第32期13卷 4333-4335页

作者： Srikrishna Nagri Suryanarayan anand Yashpal Arya Department of Gastroenterology Brooklyn Hospital CenterBrooklynNY 11201United States Wyckoff Heights Medical Center Department of GastroenterologyWyckoff Heights Medical Center374 Stockholm StBrooklynNY 11237United States

AIM:To identify rates of occurrence,common clinical and endoscopic features,and to review the outcome of endoscopic management of Dieulafoy's lesions in the upper gastrointestinal (GI) tract in an urban community hospital setting. METHODS:Endoscopic data from esophagogastroduo denoscopies (EGDs),done at Wyckoff Heights Medical Center,Brooklyn,NY between 2000 and 2006 were reviewed to identify patients with Dieulafoy's lesions. Demographic data,medical history,examination findings,lab data,endoscopic findings and details of therapy for patients treated for Dieulafoy's lesions were reviewed retrospectively. RESULTS:Dieulafoy's lesions were documented to be the cause of bleeding in approximately 1% of patients presenting with upper gastrointestinal bleeding,while they were detected in only 2 patients when the indications for EGDs were different from active GI bleeding. When we analyzed EGDs performed in patients above age 65 years presenting with gastrointestinal bleeding,prevalence of Dieulafoy's lesions approached 10 percent. The most common location of the lesion was the body of stomach (7),followed by the cardia (4) and the esophagus (2). One patient had this lesion in the fundus and one patient in the duodenal apex. All patients were initially treated endoscopically with epinephrine injection,in eight cases heater probe was applied following epinephrine and endoscopic clips were applied in two cases. All but one of the patients did well in near and intermediate term follow-up (average follow-up period of 18 mo). One patient died of multi-organ failure during the same hospital stay. Average length hospital stay was 7 ***:Community hospital gastroenterologists and endoscopists should be aware that Dieulafoy's lesions are an uncommon cause of upper GI bleeding among elderly patients. Early accurate diagnosis through emergent endoscopy and endoscopic therapy,especially in patients with multiple co-morbid conditions,can be very effective and life saving.

关键词： Dieulafoy's lesion Gastrointestinal bleeding Community Hospital Endoscopic treatment Obscure GI bleeding

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Sliding mode controller design for frequency regulation in an interconnected power system

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Protection and Control of Modern Power Systems 2021年第1期6卷 77-88页

作者： anand Kumar Md Nishat Anwar Shekhar Kumar Department of Electrical Engineering National Institute of Technology PatnaPatnaBiharIndia

In this paper, a Sliding mode controller design method for frequency regulation in an interconnected power system is presented. A sliding surface having four parameters has been selected for the load frequency control (LFC) system model. In order to achieve an optimal result, the parameter of the controller is obtained by grey wolf optimization (GWO) and particle swarm optimization (PSO) techniques. The objective function for optimization has been considered as the integral of square of error of deviation in frequency and tie-line power exchange. The method has been validated through simulation of a single area as well as a multi-area power system. The performance of the Sliding mode controller has also been analyzed for parametric variation and random loading patterns. The performance of the proposed method is better than recently reported methods. The performance of the proposed Sliding mode controller via GWO has 88.91% improvement in peak value of frequency deviation over the method of Anwar and Pan in case study 1 and similar improvement has been observed over different case studies taken from the literature.

关键词： Load frequency control Sliding mode control(SMC) Grey wolf optimization Particle swarm optimization Multi-area power system

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Performance Enhancement of PV Based Boost Cascaded Fifteen Level Inverter for AC Loads

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Computer Systems Science & Engineering 2022年第7期42卷 165-181页

作者： M.P.Viswanathan B.anand Department of Electrical and Electronics Engineering Hindusthan College of Engineering and TechnologyCoimbatore641032India

In this research work,single-stageﬁfteen levels cascaded DC-interface converter(CDDCLC)is proposed for sun arranged photovoltaic technology(PV)*** proposed geography is joined with help DC chopper and H-associate inverter to upgrade the power converter to accomplish the diminished harmonic proﬁ*** assessment with the customary inverter structures,the proposed system is used with diminished voltage stress,decreased switch count and DC source *** proposed research work with cascaded DC link conver-ter design requires three DC sources for combiningﬁfteen-level AC *** investigation structure switching technique is phase opposition and disposition pulse width modulation technique(POPD)which results in improved quality of obtained output AC power with 6.73%THD and also determinedly recommended for power converters used in UPS and drive applications since it is extremely affordable.A simulation and prototype model ofﬁfteen-level CDDCLC system is deployed and its performance is analyzed for various operating conditions.

关键词： Cascaded DClinkconverter(CDDCLC) modified phaseopposition and disposition(MPOPDPWM) photovoltaic(PV) DCinterfaceboostconverter

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Ulam-Hyers stability and analytical approach for m-dimensional Caputo space-time variable fractional order advection-dispersion equation

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International Journal of Modeling, Simulation, and Scientific Computing 2022年第1期13卷 131-174页

作者： Pratibha Verma Manoj Kumar anand Shukla Department of Mathematics Motilal Nehru National Institute of Technology Allahabad Prayagraj–211004 Uttar PradeshIndia†Department of Mathematics Wollega UniversityNekemteEthiopia

This article introduces the computational analytical approach to solve the m-dimensional space-time variable Caputo fractional order advection–dispersion equation with the Dirichlet boundary using the two-step Adomian decomposition method and obtain the exact solution in just one ***,with the help of fixed point theory,we study the existence and uniqueness conditions for the positive solution and prove some new ***,obtain the Ulam–Hyers stabilities for the proposed *** gen-eralized examples are considered to show the method’s applicability and compared with other existing numerical *** present method performs exceptionally well in terms of efficiency and ***,we solved both examples using the two most well-known numerical methods and compared them with the TSADM solution.

关键词： Fixed point theorems space-time variable Caputo’s fractional operators advection-dispersion equation Ulam-Hyers stability two-step Adomian decomposition method

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Optimal advertising duration for profit maximization

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Journal of Management Analytics 2020年第3期7卷 458-480页

作者： Adarsh anand Shakshi Singhal Ompal Singh Department of Operational Research University of DelhiDelhiIndia

The current research elucidates the advertising scheme of automotive innovation by incorporating the various stages of the product life *** study proposes an empirical model for the automotive industry to evaluate a time-point known as a switch-point or a take-off point at which firms should modify the advertising and sales promotion strategies to boost sales *** problem applies a time-series innovation diffusion model wherein adoption rate changes when a product enters a growth stage and then again when the company stops the advertising campaign in the maturity *** present paper develops a profit maximization problem,which optimizes the overall advertising duration and advertising take-off point.A numerical illustration is provided using the actual sales data of automobile industries,and sensitivity analysis is further performed to validate the effect of critical parameters on the optimization problem.

关键词： automotive industry advertising take-off point optimal advertising decisions profit maximization product life cycle stages switch-point technology diffusion

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Management of hepatitis B and C in special population

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World Journal of Gastroenterology 2021年第40期27卷 6861-6873页

作者： anand V Kulkarni Nageshwar Reddy Duvvuru Department of Hepatology Asian Institute of GastroenterologyHyderabad 500032TelanganaIndia Department of Gastroenterology Asian Institute of GastroenterologyHyderabad 500032TelanaganaIndia

Chronic viral hepatitis is one of the leading causes of cirrhosis *** hepatitis B is more common in the Asia-Pacific region due to the larger population and lower screening *** C predominates in the west due to injection drug *** discovery of(oral)direct-acting antiviral agents(DAAs)has changed the landscape of chronic hepatitis C(CHC)***(t)ide analogs(NUCs)have also changed the approach to the treatment of chronic hepatitis B(CHB).Oral NUCs and DAAs have excellent efficacy and patient acceptance as well as a lower risk of ***,certain populations have no robust data and safety and efficacy of such oral drugs is still *** this review,we provide an overview of the management of CHB and CHC in special populations,such as those with chronic kidney disease,pregnant women,healthcare workers,and those undergoing chemo-or immunosuppressive therapy.

关键词： Chronic kidney disease Pregnancy Hepatitis B Hepatitis C Health care professionals Tenofovir

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