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Autologous bone marrow derived stem cell therapy in patients with type 2 diabetes mellitus-defining adequate administration methods

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World Journal of Diabetes 2017年第7期8卷 381-389页

作者： Vikas Sood Anil Bhansali Bhagwant Rai Mittal Baljinder Singh Neelam Marwaha Ashish Jain niranjan khandelwal 2^nd Nuclear Medicine Centre RCC Indira Gandhi Medical College Departments of Nuclear Medicine Postgraduate Institute of Medical Education and Research Endocrinology Postgraduate Institute of Medical Education and Research Transfusion Medicine Post-graduate Institute of Medical Education and Research Radiodiagnosis Postgraduate Institute of Medical Education and Research

AIM To carry out randomized trial for evaluating effects of autologous bone marrow derived stem cell therapy(ABMSCT) through different *** Bone marrow aspirate was taken from the iliac crest of patients. Bone marrow mononuclear cells were separatedand purified using centrifugation. These cells were then infused in a total of 21 patients comprising three groups of 7 patients each. Cells were infused into the superior pancreaticoduodenal artery(Group Ⅰ), splenic artery(Group Ⅱ) and through the peripheral intravenous route(Group Ⅲ). Another group of 7 patients acted as controls and a sham procedure was carried out on them(Group Ⅳ). The cells were labelled with the PET tracer F18-FDG to see their homing and in vivo distribution. Data for clinical outcome was expressed as mean ± SE. All other data was expressed as mean ± SD. Baseline and post treatment data was compared at the end of six months, using paired t-test. Cases and controls data were analyzed using independent t-test. A probability(P) value of < 0.05 was regarded as statistically significant. Measures of clinical outcome were taken as the change or improvement in the following parameters:(1) C-peptide assay;(2) HOMA-IR and HOMA-B;(3) reduction in Insulin dose; subjects who showed reduction of insulin requirement of more than 50% from baseline requirement were regarded as responders; and(4) reduction in HbA 1c. RESULTS All the patients, after being advised for healthy lifestyle changes, were evaluated at periodical intervals and at the end of 6 mo. The changes in body weight, body mass index, waist circumference and percentage of body fat in all groups were not significantly different at the end of this period. The results of intra-group comparison before and after ABMSCT at the end of six months duration was as follows:(1) the area under C-peptide response curve was increased at the end of 6 mo however the difference remained statistically non-significant(P values for fasting C-peptide were 0.973, 0

关键词： Autologous bone marrow derived stem cell therapy Type 2 diabetes mellitus

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Radiation dose analysis of computed tomography coronary angiography in Children with Kawasaki disease

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World Journal of Clinical Pediatrics 2023年第4期12卷 230-236页

作者： Mahesh Chandra Bhatt Manphool Singhal Rakesh Kumar Pilania Subhash Chand Bansal niranjan khandelwal Pankaj Gupta Surjit Singh Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Pediatric Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CentrePost Graduate Institute of Medical Education and ResearchChandigarh 160012India

BACKGROUND There is evolving role of computed tomography coronary angiography(CTCA)in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease(KD).Despite this,there is lack of data on radiation dose in this group of children undergoing *** To audit the radiation dose of CTCA in children with *** Study(December 2013-February 2018)was performed on dual source CT scanner using adaptive prospective *** dose length product(DLP in ***)was *** radiation dose(millisieverts-mSv)was calculated by applying appropriate age adjusted conversion factors as per recommendations of International Commission on Radiological *** dose was compared across the groups(0-1,1-5,5-10,and>10 years).RESULTS Eighty-five children(71 boys,14 girls)with KD underwent *** median age was 5 years(range,2 mo-11 years).Median DLP and effective dose was 21 ***,interquartile ranges(IQR)=15(13,28)and 0.83 mSv,IQR=0.33(0.68,1.01)*** DLP increased significantly across the age *** effective dose in infants(0.63 mSv)was significantly lower than the other age groups(1-5 years 0.85 mSv,5-10 years 1.04 mSv,and>10 years 1.38 mSv)(P<0.05).There was no significant difference in the effective dose between the other groups of *** the CTCA studies were of diagnostic *** child required a repeat *** CTCA is feasible with submillisievert radiation dose in most children with ***,CTCA has the potential to be an important adjunctive imaging modality in children with KD.

关键词： Computed tomography coronary angiography Coronary artery abnormalities Dual source computed tomography Kawasaki disease Radiation exposure

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Locoregional treatment for hepatocellular carcinoma:The best is yet to come

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World Journal of Radiology 2015年第10期7卷 306-318页

作者： Naveen Kalra Pankaj Gupta Yogesh Chawla niranjan khandelwal Deparment of Radiodiagnosis and Imaging PGIMER Deparment of Hepatology PGIMER

Hepatocellular carcinoma(HCC) is the sixth-most common type of cancer worldwide. The only definitive treatment modalities capable of achieving a cure are hepatic resection and hepatic transplantation. However, most patients are not candidates for these therapies. Overall, treatment options are driven by the stage of HCC. Early-stage disease is treated with ablative therapies, with radiofrequency ablation the ablative therapy of choice. Microwave ablation and irreversible electroporation are the other upcoming alternatives. Intermediate-stage disease is managed with transarterial chemoembolization(TACE), while advanced-stage disease is managed by sorafenib, with TACE and radioembolization as other alternatives.

关键词： Hepatocellular carcinoma High intensity focussed u

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Utility of multi-detector row computed tomography angiography versus Doppler in localization of perforators of anterolateral thigh flaps

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Plastic and Aesthetic Research 2016年第1期3卷 52-58页

作者： Chandan N.Jadhav Surinder Singh Makkar Gautam Biswas niranjan khandelwal Department of Plastic Surgery Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Department of Radio Diagnosis Postgraduate Institute of Medical Education and ResearchChandigarh 160012India

Aim:Anterolateral thigh(ALT)flap is widely used in reconstruction of various *** imaging facilitates perforator mapping,overcoming intraoperative *** purpose of this study was to investigate the utility of multi-detector row computed tomography angiography(MDCTA)and a handheld Doppler in locating ALT ***:Twenty patients were randomized into two *** 1 patients received MDCTA and Doppler studies whereas Group 2 received only a Doppler *** number,location,course,and source of all cutaneous and sizable perforators were compared with intraoperative ***’stress levels during flap harvest and flap harvest time were ***:MDCTA findings correlated well with intraoperative findings for perforator type and segmental distribution with 100%*** alone had a 52%rate of *** sensitivity and specificity for MDCTA in demonstrating the presence of perforators were 85.71%and 97.22%,respectively;whereas for Doppler alone the sensitivity and specificity were 80%and 87.91%,*** demonstrating perforator source,MDCTA showed a sensitivity of 100%and specificity of 91.66%,with 100%*** and specificity for sizable perforators were 90%each,with 88.88%*** studies were unable to provide this *** of surgeon stress levels showed no differences between the two groups,although the time for flap harvest was significantly shorter in Group ***:MDCTA compared to Doppler is more sensitive,specific,and accurate with respect to location,course,and source of perforators.

关键词： Anterolateral thigh multi-detector row computed tomography angiography perforator

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Imaging in pulmonary hydatid cysts

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World Journal of Radiology 2016年第6期8卷 581-587页

作者： Mandeep K Garg Madhurima Sharma Ajay Gulati Ujjwal Gorsi Ashutosh N Aggarwal Ritesh Agarwal niranjan khandelwal Department of Radiodiagnosis and Imaging Post Graduate Institute of Medical Education and Research Department of Pul-monary Medicine Post Graduate Institute of Medical Education and Research

Hydatid disease is a zoonosis that can involve almost any organ in the human body. After the liver, the lungs are the most common site for hydatid disease in adults. Imaging plays a pivotal role in the diagnosis of the disease, as clinical features are often nonspecific. Classical radiological signs of pulmonary hydatid cysts have been described in the literature, aiding in the diagnosis of the disease. However, complicated hydatid cysts can prove to be a diagnostic challenge at times due to their atypical imaging features. Radiography is the initial imaging modality. Computed tomography can provide a specific diagnosis in complicated cases. Ultrasound is particularly useful in peripheral lung lesions. The role of magnetic resonance imaging largely remains unexplored.

关键词： Pulmonary Hydatid Cyst Radiography Computed tomography

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