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Intracapsular fracture of the proximal femur in a bilateral above-knee amputee: A case report with technical tips for intraoperative positioning and literature review

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Chinese Journal of Traumatology 2022年第5期25卷 306-310页

作者： Aditya Jain hemant Bansal Samarth Mittal Arvind kumar Vivek Trikha Primus Super Specialy Hospital New DelhiIndia Department of orthopaedics Jay Prakash Narayan Apex Trauma Center All India Institute of Medical SciencesNew DelhiIndia Department of Orthopaedis Hamdard Institute of Medical Sciences&ResearchNew DelhiIndia

Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.

关键词： Femoral neck fractures Bilateral amputee Above-knee amputation Intraoperative positioning Surgical management

Sarcopenia in hepatocellular carcinoma:Current knowledge and future directions

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World Journal of Gastroenterology 2022年第4期28卷 432-448页

作者： Abhilash Perisetti hemant Goyal Rachana Yendala Saurabh Chandan Benjamin Tharian Ragesh BabuThandassery Department of Internal Medicine Gastroenterology and Hepatology DivisionUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Interventional Oncology and Surgical Endoscopy Parkview HealthFort WayneIN 46825United States Department of Internal Medicine The Wright Center for Graduate Medical EducationThe Wright Center for Graduate Medical EducationScrantonPA 18501United States Department of Hematology and Oncology Conway Regional Medical CenterConwayAR 72034United States Department of Internal Medicine Gastroenterology and Hepatology DivisionCHI Creighton University Medical CenterOmahaNE 68107United States Department of Medicine Central Arkansas Veterans Healthcare SystemLittle RockAR 72205United States

Liver cancer is the second most occurring cancer worldwide and is one of the leading causes of cancer-related *** carcinoma(HCC)is the most common(80%-90%)type among malignant liver *** occurs very early in HCC and can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant *** prognostic stating systems have been developed in HCC,such as Barcelona Clinic Liver Cancer,Child-Pugh score and Albumin-Bilirubin ***,the evaluation of patients’performance status is a major limitation of these scoring *** this review,we aim to summarize the current knowledge and recent advances about the role of sarcopenia in cirrhosis in general,while focusing specifically on ***,the role of sarcopenia in predicting clinical outcomes and prognostication in HCC patients undergoing loco-regional therapies,liver resection,liver transplantation and systematic therapy has been discussed.A literature review was performed using databases PubMed/MEDLINE,EMBASE,Cochrane,Web of Science,and CINAHL on April 1,2021,to identify published reports on sarcopenia in *** can independently predict HCC-related mortality especially in patients undergoing treatments such as loco-regional,surgical liver transplantation and systemic *** research is focused on evaluating a balance of anabolic and catabolic pathways responsible for muscle *** clinical studies have shown promising results in methods to improve sarcopenia in HCC which can potentially increase prognosis in these *** sarcopenia occurs very early in HCC,it can predict and provide an opportunity to improve muscle health before engaging in the treatment options such as loco-regional,systemic,and transplant ***,sarcopenia measurement can obviate the confounding caused by the abdominal ascites in these *** use of sarcopenia can

关键词： Sarcopenia Skeletal muscle Hepatocellular carcinoma Cirrhosis Outcomes Liver cancer

Training medical undergraduates in the core disciplines of community medicine through community postings-an experience from India

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Family Medicine and Community Health 2016年第3期4卷 45-50页

作者： hemant Deepak Shewade Chinnakali Palanivel Kathiresan Jeyashree Department of Community Medicine Indira Gandhi Medical College and Research InstitutePuducherryIndia Department of Community Medicine Velammal Medical College Hospital&Research InstituteMaduraiIndia International Union Against Tuberculosis and Lung Disease(The Union) South-East Asia OfficeC-6Qutub Institutional AreaNew DelhiIndia Department of Preventive and Social Medicine Jawaharlal Insti-tute of Postgraduate Medical Edu-cation and Research(JIPMER)PuducherryIndia

Objective:Family medicine,epidemiology,health management and health promotion are the core disciplines of community *** this paper,we discuss the development of a commu-nity posting program within the framework of community medicine core disciplines at a primary health centre attached to a teaching hospital in Puducherry,***:This is a process documentation of our ***:There were some shortcomings which revolved around the central theme that post-ings were conducted with department in the teaching hospital as the focal point,not the primary health centre(PHC).To address the shortcomings,we made some changes in the existing com-munity posting program in *** feedback aimed at Kirkpatrick level 1(satisfaction)evaluation revealed that they appreciated the benefits of having the posting with PHC as the focal *** recommended some further changes in the community posting which could be addressed through complete administrative control of the primary health centre as urban health and training center of the teaching hospital;and also through practice of core disciplines of com-munity medicine by faculty of community ***:It is important to introduce the medical undergraduates to the core disciplines of community medicine early through community *** postings should be con-ducted with primary health centre or urban health and training centre as the focal point.

关键词： Family medicine community posting clinical posting community-based medical education undergraduate medical education epidemiology health management health promotion

Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques

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World Journal of Gastroenterology 2021年第40期27卷 6874-6887页

作者： Rupinder Mann hemant Goyal Abhilash Perisetti Saurabh Chandan Sumant Inamdar Benjamin Tharian Department of Internal Medicine Saint Agnes Medical CenterFresnoCA 93730United States Department of Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18503United States Department of Gastroenterology and Hepatology The University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68107United States Department of Internal Medicine Gastroenterology and Hepatology DivisionUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States

Endoscopic ultrasound(EUS)is one of the significant breakthroughs in the field of advanced *** the last two decades,EUS has evolved from a diagnostic tool to a real-time therapeutic *** luminal gastrointestinal(GI)tract provides a unique opportunity to access multiple vascular structures,especially in the mediastinum and abdomen,thus permitting a variety of EUS-guided vascular *** addition of the doppler and contrast-enhanced capability to EUS has further helped provide real-time visualization of blood flow in vessels through the GI ***-guided vascular interventions rely on standard endoscopic accessories and interventional tools such as fine-needle aspiration needles and fine-needle *** allows the visualization of various structures in real-time by differentiating tissue densities and vascularity,thus,avoiding radiation ***-guided techniques also allow real-time microscopic examination after target ***,many necessary interventions can be done during the same procedure after *** article provides an overview of EUS-guided vascular interventions such as variceal,non-variceal bleeding interventions,EUSguided portal vein(PV)access with the formation of an intrahepatic portosystemic shunt,and techniques related to diagnosis of GI ***,we discuss current insights and future outlook of therapeutic modalities like PV embolization,PV sampling,angiography,drug administration,and portal pressure measurement.

关键词： Endoscopic ultrasound Vascular intervention Esophageal varices Gastric varices Portal vein Therapeutic endoscopy

Prognostic significance of red blood cell distribution width in gastrointestinal disorders

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World Journal of Gastroenterology 2017年第27期23卷 4879-4891页

作者： hemant Goyal Giuseppe Lippi Altin Gjymishka Bijo John Rajiv Chhabra Elizabeth May Department of Internal Medicine Mercer University School of Medicine Section of Clinical Biochemistry University of Verona Texas Digestive Disease Consultants Department of Gastroenterology Saint Luke’s HospitalSchool of MedicineUniversity of Missouri Kansas City Gastroenterology Attending Mc Laren Northern Hospital

The red blood cell distribution width(RDW) is a routinely measured and automatically reported blood parameter,which reflects the degree of anisocytosis. Recently,the baseline RDW was found to have clinical significance for assessing clinical outcome and severity of various pathological conditions including cardiovascular diseases,sepsis,cancers,leukemia,renal dysfunction and respiratory diseases. A myriad of factors,most of which ill-defined,have an impact on the red cell population dynamics(i.e.,production,maturation and turnover). A delay in the red blood cell clearance in pathological conditions represents one of the leading determinants of increased anisocytosis. Further study of RDW may reveal new insight into inflammation mechanisms. In this review,we specifically discuss the current literature about the association of RDW in various disease conditions involving the gastrointestinal and hepatobiliary systems. We also present some of the related measurements for their value in predicting clinical outcomes in such conditions. According to our data,RDW was found to be a valuable prognostic index in gastrointestinal disorders along with additional inflammatory biomarkers(i.e.,C reactive protein,erythrocyte sedimentation rate,and platelet count) and current disease severity indices used in clinical practice.

关键词： Red blood cell distribution width Hepatitis Pancreatitis Inflammatory bowel diseases Crohn’s disease Ulcerative colitis Colon cancer Hepatocellular carcinoma Acute mesenteric ischemia Gastrointestinal diseases

Bidirectional graft-host hematological traffic in liver transplantation

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Hepatobiliary Surgery and Nutrition 2019年第3期8卷 253-257页

作者： hemant Sharma Mauro E.Tun-Abraham Vivian McAlister Department of Multiorgan Transplant Surgery Ochsner Medical CenterNew OrleansLAUSA Department of Surgery University of Western OntarioLondonONCanada

The highly complex immuno-hematological system of the recipient has to rebalance itself when the liver is replaced with a graft that has its own *** gives us an opportunity for *** we consider the graft-to-recipient direction with passenger lymphocyte syndrome(PLS)as well as the recipient-to-graft direction with Factor VIII(FVIII)inhibitors,paroxysmal nocturnal hemoglobinuria(PNH)and graft endothelial replacement with liver *** extends beyond the ABO blood groups to any situation where the donor has been sensitized to a recipient *** directed against ABO or minor blood group antigens is usually self limiting whereas Rhesus(Rh)PLS persists with life threatening immune *** platelet antigen(HPA)1A PLS results in life threatening immune *** of severe PLS may include reduction in immunosuppression,anti-B-cell therapy,plasmapheresis and *** transplantation into recipients with FVIII inhibitors has been *** with acquired hemophilia may transmit the capacity to make FVIII inhibitors by PLS and should be *** with PNH have been transplanted successfully but a considerable cost in the continued use of high dose *** speculate that combined bone marrow and liver transplantation would be a better option for recipients with FVIII inhibitors or *** of liver graft endothelium with recipient cells is common and may explain relative transplant tolerance that is believed to occur with liver transplantation.

关键词： Liver transplantation passenger lymphocyte syndrome(PLS) human platelet antigen(HPA) paroxysmal nocturnal hemoglobinuria(PNH) endothelium

Primary Extra-Gastrointestinal Stromal Tumor (GIST) arising from mesentery of small bowel and presenting as abdominal mass: A rare entity

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Open Journal of Gastroenterology 2013年第5期3卷 267-271页

作者： Alok kumar Tiwari Anil kumar Choudhary hemant Khowal Poras Chaudhary Mohinder P. Arora Department of Surgery Dr R.M.L Hospital New Delhi India Department of Surgery Lady Hardinge Medical College New Delhi India

Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. Though, these tumors are refractory to conventional chemotherapy or radiotherapy but show a good response to targeted adjuvant chemotherapy with tyrosine kinase inhibitors following surgical resection. Case Report: we report here a case of primary Extra-GIST tumor arising from mesentry of small bowel near duodeno-jejunal junction in a 69 years old male patient. The patient presented with a palpable mass in upper abdomen for past 15 days. On examination, a non-tender mobile lump of size around 17 × 10 cm, with bosselated surface and firm in consistency was palpable involving epigastric, left hypochondrium and umbilical region. Contrast enhanced computed tomography of abdomen revealed a heterogenous mesentric mass. On surgical intervention a mass was found involving mesentery near dudenojejunal junction without involvement of gastrointestinal tract. Complete surgical resection of the tumor was done and adjuvant chemotherapy with Imatinib mesylate was started as HPE revealing GIST with mitotic index of >10/50 HPF and 17 × 10 cm size placed the patient in high risk category. Patient was discharged on 12th of post-operative day with advice of regular follow-up. Conclusion: GIST occurrence is not restricted to bowel but can involve unusual sites also. The mainstay of treatment remains surgical resection with adequate margin. In cases where tumour has malignant potential (high mitotic figures on histopathology) adjuvent treatment with tyrosine kinase may prevent or delay relapse.

关键词： Extra-Gastrointestinal Stromal Tumors GIST Mesentric Tumors Imatinib Mesylate Abdominal Mass

Multimodality Medical Image Fusion Based on Pixel Significance with Edge-Preserving Processing for Clinical Applications

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Computers, Materials & Continua 2024年第3期78卷 4317-4342页

作者： Bhawna Goyal Ayush Dogra Dawa Chyophel Lepcha Rajesh Singh hemant Sharma Ahmed Alkhayyat Manob Jyoti Saikia Department of ECE and UCRD Chandigarh UniversityMohaliPunjab140413India Chitkara University Institute of Engineering and Technology Chitkara UniversityPunjab140401India Department of ECE Uttaranchal Institute of TechnologyUttaranchal UniversityDehradun248007India IES College of Technology IES UniversityBhopal462044India College of Technical Engineering The Islamic UniversityNajaf54001Iraq Department of Electrical Engineering University of North FloridaJacksonvilleFL32224USA

Multimodal medical image fusion has attained immense popularity in recent years due to its robust technology for clinical *** fuses multiple images into a single image to improve the quality of images by retaining significant information and aiding diagnostic practitioners in diagnosing and treating many ***,recent image fusion techniques have encountered several challenges,including fusion artifacts,algorithm complexity,and high computing *** solve these problems,this study presents a novel medical image fusion strategy by combining the benefits of pixel significance with edge-preserving processing to achieve the best fusion ***,the method employs a cross-bilateral filter(CBF)that utilizes one image to determine the kernel and the other for filtering,and vice versa,by considering both geometric closeness and the gray-level similarities of neighboring pixels of the images without smoothing *** outputs of CBF are then subtracted from the original images to obtain detailed *** further proposes to use edge-preserving processing that combines linear lowpass filtering with a non-linear technique that enables the selection of relevant regions in detailed images while maintaining structural *** regions are selected using morphologically processed linear filter residuals to identify the significant regions with high-amplitude edges and adequate *** outputs of low-pass filtering are fused with meaningfully restored regions to reconstruct the original shape of the *** addition,weight computations are performed using these reconstructed images,and these weights are then fused with the original input images to produce a final fusion result by estimating the strength of horizontal and vertical *** standard quality evaluation metrics with complementary properties are used for comparison with existing,well-known algorithms objectively to validate the fusion *** results from th

关键词： Image fusion fractal data analysis biomedical diseases research multiresolution analysis numerical analysis

Genomic Tools for the Impact Assessment of 'Hotspots' for Early Warning of MDR Threats

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Biomedical and Environmental Sciences 2016年第9期29卷 656-674页

作者： Nishant A Dafale hemant J Purohit Environmental Genomic Division CSIR-National Environmental Engineering Research Institute

INTRODUCTION Antimicrobial resistance （AMR） has been a low-priority area of research in most developing countries even though it has much significant therapeutic value. The management of serious infections should include not only the treatment of patients but also the measures to ensure that microorganisms do not spread through hospital premises. Controlling the transfer of organisms among staff, patients, and the environment is important. Research related to antimicrobial use and resistance, regional variation, and intervention policies.

关键词： MDR gene Genomic Tools for the Impact Assessment of for Early Warning of MDR Threats Hotspots