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Enhanced recovery after surgery protocol enhances early postoperative recovery after pancreaticoduodenectomy

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Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 188-193页

作者： Ramasamy Mahendran mallika tewari Vinod Kumar Dixit Hari Shankar Shukla Department of Surgical Oncology Institute of Medical Sciences Banaras Hindu University Department of Gastroenterology Institute of Medical Sciences Banaras Hindu University

Background: Enhanced recovery after surgery(ERAS) protocol is a multimodal, multidisciplinary and evidence-based approach to reduce surgical stress and enhance recovery in the postoperative period. This study aimed to analyze the outcome of ERAS protocol in patients after pancreaticoduodenectomy(PD). Methods: A total of 50 consecutive patients with pancreatic/periampullary cancer who underwent PD between January 2016 to August 2017 were included in the study. As per the institute ERAS protocol, nasogastric tube(NGT) was removed on postoperative day(POD) 1 if output was less than 200 mL and oral sips were allowed; oral liquids were allowed on POD2; semisolid diet by POD3; abdominal drain was removed on POD 4 if output was less than 100 mL with no evidence of postoperative pancreatic fistula(POPF); normal diet was allowed on POD5. Discharge criteria on POD6 were afebrile, tolerating oral normal diet, pain free and no surgery related complications(defined as per the ISGPS definitions). Results: NGT was removed on POD1 in 45(90%) patients, abdominal drain removed by POD4 in 41(82%) and 43(86%) patients were discharged on POD6. There was no 30-day postoperative mortality. Three(6%) patients had delayed gastric emptying(DGE). None had postoperative hemorrhage and POPF. Readmission rate was 8%. A significant relation was found between the length of hospital stay(LOS) with age( P < 0.05) and a marginal relation between LOS and postoperative albumin( P = 0.05). Conclusions: ERAS protocol can be safely followed in the perioperative care of patients who undergo PD. Early removal of NGT and allowing oral diet restore bowel function early. ERAS decreases the LOS and postoperative complications.

关键词： Enhanced recovery protocol Pancreatic cancer Periampullary cancer Pancreaticoduodenectomy Early discharge

Salmonella typhi and gallbladder cancer:report from an endemic region

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Hepatobiliary & Pancreatic Diseases International 2010年第5期9卷 524-530页

作者： mallika tewari Raghvendra R Mishra Hari S Shukla Department of Surgical Oncology Institute of Medical SciencesBanaras Hindu University

BACKGROUND:Evidence exists of a link between chronic infection by Salmonella typhi(***) and the development of gallbladder cancer(GBC),but several studies from endemic regions contradict its role in the etiopathogenesis of *** study used various tools to assess the prevalence of *** in patients with GBC and gallstone disease(GSD) in this region with a high incidence of ***:*** was detected in tissue and bile by PCR and culture and in serum by the Widal test and indirect hemagglutination assay(IHA).PCR with two pairs of *** specific primers(flagellin gene H1d and SOP E gene) could detect 0.6 ng of *** ***-four patients with GBC(cases) were matched with 54 patients with GSD(controls).RESULTS:Of the 54 cases,24(44.44%) were positive on the Widal test and 12(22.22%) on IHA,compared to 13(24.07%) and 5(9.26%) respectively in the ***(33.33%) cases showed a positive result on PCR(tissue) and 2 on PCR(bile) *** in the *** culture revealed no Salmonella colonies in either cases or *** 3 cases were positive for Salmonella on tissue culture compared to none in the *** sensitivity of PCR(tissue) relative to the Widal test,IHA,culture(bile and tissue) and PCR(bile) was 100% vs.66.67%,11.11%,and 11.11%,and the specificity was 83.33% vs.100%,100%,and 100%,***:*** is significantly associated with GBC compared to GSD(33% vs.0%).PCR appears to be the most specific diagnostic tool,the gold standard for *** in tissue samples.

关键词： Salmonella typhi gallbladder cancer polymerase chain reaction Widal indirect hemagglutination assay culture

Helicobacter species and pathogenesis of gallbladder cancer

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Hepatobiliary & Pancreatic Diseases International 2010年第2期9卷 129-134页

作者： Raghvendra Raman Mishra mallika tewari Hari S.Shukla Department of Surgical Oncology Institute of Medical SciencesBanaras Hindu University

BACKGROUND:Gallbladder cancer(GBC)is a rare disease but a leading cause of cancer-related death worldwide.A number of etiological factors have been implicated in the causation of GBC and pathogenic infection by bacteria is one of these. DATA SOURCES:A PubMed search on'helicobacter','gall- bladder cancer',and'biliary tract malignancies'was done on the topic,and the relevant data were collected,reviewed,and analyzed. RESULTS:Helicobacter is an epsilon proteobacterium that infects the mucosal lining of the human gastrobiliary system. Infection with helicobacter is an important risk factor for the development of cancer and the bacterium has been categorized as a group-Ⅰcarcinogen by the International Agency for Research on Cancer(IARC).These microbes enter the human body by means of contaminated food and *** they invade the tissues and produce chemical carcinogens that lead to DNA damage and subsequently a series of gene mutations transform normal cells into cancer *** this review,we focus our attention on the role of helicobacter in the causation of biliary tract malignancies. CONCLUSIONS:The review attempts to summarize the current available data on the role of helicobacter in the causation of *** are accountable data available to suggest the role of helicobacter species in the causation of GBC although larger studies are urgently required for confirmation.

关键词： helicobacter genus gallbladder cancer DNA damage carcinogen pathogenesis

Gallbladder carcinoid masquerading as gallbladder carcinoma

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Hepatobiliary & Pancreatic Diseases International 2009年第3期8卷 326-328页

作者： mallika tewari Vinay Kumar Raghvendra Raman Mishra Hari S Shukla Department of Surgical Oncology Institute of Medical SciencesBanaras Hindu University

BACKGROUND:Carcinoid of the gallbladder is *** it often presents as a gallbladder mass it may be confused with gallbladder carcinoma. METHODS:A 35-year-old lady presented with pain in the right upper abdomen,and was radiologically found to have a gallbladder mass.A provisional diagnosis of gallbladder carcinoma was *** revealed a 20×20 cm, exophytic,friable growth arising from the fundus of the *** was excised with segmentⅣb andⅤof the liver and regional lymphadenectomy. RESULT:Histopathological examination revealed it was a neuroendocrine carcinoma,atypical carcinoid of the gallbladder. CONCLUSION:Gallbladder carcinoid has a poor outcome, requires aggressive treatment,and should be considered as one of the rare but possible gallbladder lesions.

关键词： carcinoid gallbladder carcinoma,gallbladder

Expression profile of cholecystokinin type-A receptor in gallbladder cancer and gallstone disease

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Hepatobiliary & Pancreatic Diseases International 2011年第4期10卷 408-414页

作者： Rajani Rai mallika tewari Mohan Kumar Tej Bali Singh Hari S Shukla Department of Surgical Oncology the Institute of Medical SciencesBanaras Hindu UniversityVaranasi 221005 (UP)India Department of Pathology the Institute of Medical SciencesBanaras Hindu UniversityVaranasi 221005 (UP)India Department of Community Medicine the Institute of Medical SciencesBanaras Hindu UniversityVaranasi 221005 (UP)India

BACKGROUND:Regulatory peptide receptors have attracted the interest of oncologists as a new promising approach for cancer pathology,imaging and *** cholecystokinin (CCK) is a potent modulator of gallbladder contractility and plays a potential role in pancreatic carcinogenesis through CCK type-A receptor (CCKAR),its role in gallbladder cancer (GBC) is still unknown and immunohistochemical detection of CCKAR in the gallbladder has not yet been *** novel case-control study aimed to investigate the expression profile of CCKAR in GBC and gallstone disease (GSD).METHODS:This study included 162 samples of gallbladder:94 from GBC and 68 from *** of CCKAR was analyzed by immunohistochemistry and *** results were statistically correlated with disease history including age,sex,presence of gallstone,stage and ***:CCKAR was positive in 30/68 (44.1%) of GSD and 72/94 (76.6%) of GBC ***-one of the 72 (70.8%) CCKAR-positive GBC samples showed ***,consistent results also appeared in the immunoblotting ***:CCKAR expression was significantly increased in GBC compared to ***,CCKAR expression was associated with the degree of tumor differentiation,i.e.,less expression in poorly-differentiated ***,it has future prognostic and therapeutic implications in the management of GBC.

关键词： cholecystokinin cholecystokinin type-A receptor gallbladder cancer gallstone disease

Biosynthesis of gold nanoparticles using aqueous extract of Ricinus cummunis leaves to augment catalytic degradation of organic dyes and study of its antifungal and antibacterial activities

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Particuology 2024年第4期87卷 87-98页

作者： Mrinalini Parmar mallika Sanyal Department of Chemistry Gujarat UniversityAhmedabadGujarat 380009India St.Xaviers College NavrangpuraAhmedabadGujarat 380009India

In this study,biosynthesis of gold nanoparticles(Au NPs)using aqueous extract of fresh leaves of Ricinus cummunis plant is reported without the use of any synthetic chemical in the reaction *** prepared NPs are mostly spherical in shape with some particles having triangular or hexagonal *** average size of the particles as calculated using TEM data is 18 *** biosynthesised Au NPs were studied for their application in remediation of Congo Red,Methylene Blue,Reactive Red 120 and Rhodamine B dyes present in industrial *** degradation of dyes was confirmed spectropho-tometrically using UV-Vis *** Red 120 and Congo red dyes were most effec-tively reduced with 88%*** Au NPs were further studied for their potential as an effective antifungal agent against fungal strains namely Candida albicans and Aspergillus fumigatus and antibac-terial properties against Bacillus subtilis(Gram+ve)and Pseudomonas aeruginosa(Gram-ve)bacterial *** MIC values being 7.8 and 15.6(μg/mL)for Bacillus subtilis and Pseudomonas aeruginosa respectively.

关键词： Gold nanoparticles Photocatalysts Dye degradation Antifungal studies Antibacterial studies

A four-year investigation on wet deposition in western Thailand

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Journal of Environmental Sciences 2008年第4期20卷 441-448页

作者： PANYAKAPO mallika ONCHANG Rattapon Department of Environmental Science Faculty of ScienceSilpakorn UniversityNakhon PathomThailand 73000.

The investigation of pH variation and the chemical composition of rainwater have been studied from April 2003 to October 2006 at a rural area of Nakorn Pathom Province, western Thailand. The pH value ranged from 4.0 to 7.8 with an average of 6.1. Out of 319 rain events, 72 events were observed in acidic range （pH 〈 5.6）. The pH of rainwater gradually increased over the sampling period. The volume-weighted mean concentrations （ixeq]L） of ion species followed the order： Ca^2＋〉 NH4^＋〉 SO4^2- 〉 HCO3^- 〉 NO3^- 〉 Na^＋〉 Cl^- 〉 CH3COO^- 〉 Mg^2＋〉 K^＋〉 H^＋〉 HCOO^- 〉 PO4^3-. Neutralization factor calculations reveal that Ca^2＋ plays a major role in neutralization processes in this area. Enrichment factor calculations indicate that SO4^2-, K^＋, Ca^2＋ and Mg^2＋ were originated from non-marine sources. The statistical measure principle component analysis indicates influence of various local emission sources e.g., soil, limestone mines, biomass burning and agricultural emissions, on the chemical composition of rainwater.

关键词： acid rain wet deposition neutralization factor enrichment factor factor analysis

Cancer risk assessment from exposure to trihalomethanes in tap water and swimming pool water

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Journal of Environmental Sciences 2008年第3期20卷 372-378页

作者： PANYAKAPO mallika SOONTORNCHAI Sarisak PAOPUREE Pongsri Department of Environmental Science Faculty of Science Silpakorn University Nakhon Pathom 73000 Thailand. School of Health Science Sukhothai Thammathirat Open University Nonthaburi 11120 Thailand

We investigated the concentration of trihalomethanes （THMs） in tap water and swimming pool water in the area of the Nakhon Path- om Municipality during the period April 2005-March 2006. The concentrations of total THMs, chloroform, bromodichloromethane, dibromochloromethane and bromoform in tap water were 12.70-41.74, 6.72-29.19, 1.12-11.75, 0.63-3.55 and 0.08-3.40 μg/L, respectively, whereas those in swimming pool water were 26.15-65.09, 9.50-36.97, 8.90-18.01, 5.19-22.78 and ND-6.56 μg/L, respectively. It implied that the concentration of THMs in swimming pool water was higher than those in tap water, particularly, brominated-THMs. Both tap water and swimming pool water contained concentrations of total THMs below the standards of the World Health Organization （WHO）, European Union （EU） and the United States Environmental Protection Agency （USEPA） phase Ⅰ, but 1 out of 60 tap water samples and 60 out of 72 swimming pool water samples contained those over the Standard of the USEPA phase Ⅱ. From the two cases of cancer risk assessment including Case Ⅰ Non-Swimmer and Case Ⅱ Swimmer, assessment of cancer risk of nonswimmers from exposure to THMs at the highest and the average concentrations was 4.43×10^-5 and 2.19×10^-5, respectively, which can be classified as acceptable risk according to the Standard of USEPA. Assessment of cancer risk of swimmers from exposure to THMs at the highest and the average concentrations was 1.47×10^-3 and 7.99×10^-4, respectively, which can be classified as unacceptable risk and needs to be improved. Risk of THMs exposure from swimming was 93.9%-94.2% of the total risk. Cancer risk of THMs concluded from various routes in descending order was： skin exposure while swimming, gastro-intestinal exposure from tap water intake, and skin exposure to tap water and gastro-intestinal exposure while swimming. Cancer risk from skin exposure while swimming was 94.18% of the total cancer risk.

关键词： tap water swimming pool water chlorination trihalomethanes cancer risk assessment

Kinematics of faults in Bengal Basin:Constraints from GPS measurements

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Geodesy and Geodynamics 2020年第4期11卷 242-251页

作者： mallika Mullick Dhruba Mukhopadhyay Raman Centre for Applied and Interdisciplinary Sciences 16AJheel RoadKolkata700075India

The crustal deformation of Bengal Basin is constrained by motion on faults within the basin and those along the basin boundaries on all sides except the southern *** Hinge Zone(EHZ),the most prominent structure within Bengal Basin,running through Kolkata-Ranaghat-Mymensingh,shows present day reactivation by hosting 8 earthquakes of magnitude 5.3 to 7.2 on or near its vicinity since *** of GPS derived velocities of stations around the hinge belt reveals a change in crustal kinematics across the *** predicted fault model that best fits the observed GPS station velocities on the surface shows that EHZ is a low angle east dipping fault which is locked to a depth of 10 km below the alluvium cover with a maximum slip rate deficit of 1.6±0.7 mm/yr in its northern part at a shallow depth from surface while the deficit in the southern part of EHZ is 1.0±0.6 mm/*** Garh-Moyna Khandaghosh fault running almost parallel to the western basin-shield margin does not show significant slip rate *** basin-bounding faults are more active than the faults within and therefore they are greater sources of seismic hazard in the *** model results reveal that the Sylhet trough region in the northeastern corner is most vulnerable to future earthquakes as it undergoes deformation due to a maximum slip rate deficit of 9.5±2.4 mm/yr on the shallowly dipping locked megathrust along the eastern margin of the basin plus that of 7.4±2.6 mm/yr on the over thrusting Dapsi thrust and Dauki fault in the north.

关键词： Bengal basin Active faults GPS Slip rate deficit Coupling fraction