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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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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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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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闪光对于减轻静脉置管痛的作用：一项前瞻性随机安慰剂对照研究

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麻醉与镇痛 2009年第3期5卷 73-75页

作者： Anil Agarwal GhanshvamYadav Devendra Gupta manish tandon Prabhat Kumar Singh Uttam Singh 吴志林(译) Departments of Anaesthesiology Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow India Departments of Biostatics Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow India 不详

背景尽管静脉置管时的疼痛经常让人备受困扰，但通常都是在没有任何镇痛措施下进行静脉置管的。临床上曾尝试用一些药物和非药物方法来减轻静脉置管的疼痛，但结果各异。本研究拟评价一次闪光对于减轻静脉置管痛的效果。方法90例拟择期... 详细信息

背景尽管静脉置管时的疼痛经常让人备受困扰，但通常都是在没有任何镇痛措施下进行静脉置管的。临床上曾尝试用一些药物和非药物方法来减轻静脉置管的疼痛，但结果各异。本研究拟评价一次闪光对于减轻静脉置管痛的效果。方法90例拟择期行腹腔镜胆囊切除术的ASAⅠ～Ⅱ级的成年患者（15～60岁），随机分为3组，每组30例，组1为对照组；组2为分散注意力组，即在非优势手的手背静脉进行置管前给患者照相而不使用闪光；组3为闪光组，静脉置管前照相并且使用闪光；在照相后立即使用18G的穿刺针进行静脉置管。结果每组均有2例患者首次静脉穿刺失败，在数据分析中即予以剔除，闪光组疼痛的发生率为50％（28例中14例发生），其他2组为100％（28例全部发生），通过视觉模拟评分评估的疼痛严重程度分散注意力组和闪光组显著低于对照组，而闪光组也显著低于分散注意力组。结论静脉置管前使用闪光是一种减轻疼痛的安全而简单有效的方法。

关键词：静脉置管减轻疼痛安慰剂对照闪光随机腹腔镜胆囊切除术非药物方法静脉穿刺失败

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Applications of Transition Metals in Organic Synthesis and Polymerization

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复旦学报（自然科学版） 2007年第5期46卷 753-页

作者： Praveen K.tandon manish Srivastava Santosh B.Singh Department of Chemistry University of Allahabad Allahabad-211002India

1 Results Classic oxidants require rigorous control of the experimental conditions added with the problem of lack of selectivity. Catalysis by transition metals with environmentally safe oxidants provides synthetic routes to minimize pollution by giving environmental benign by-products. Fe (Ⅵ) is a powerful and a selective oxidant with Fe(Ⅲ) as a by-product, while hydrogen peroxide is clean with water as the only by-product. Separation of sodium or potassium ferrates requires tedious processes. Associat...

关键词： Nano-particles catalysis oxidation microwaves transition metal ions

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