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Comparative study of endoscopy *** intrahepatic portosystemic shunt in the management of gastric variceal bleeding

Gastroenterology Report 2015年第1期3卷 75-82页

作者： Gursimran Singh Kochhar Udayakumar Navaneethan Jason Hartman Jose Mari Parungao Rocio Lopez Ranjan Gupta Baljendra Kapoor paresh mehta Madhu Sanaka Department of Gastroenterology and Hepatology Cleveland Clinic FoundationClevelandOHUSA Case Western School of Medicine ClevelandOHUSA Department of Vascular and Interventional Radiology Cleveland Clinic FoundationClevelandOHUSA

Background and Aim:Gastric varices are associated with high *** have been conflicting reports on whether endoscopic treatment with cyanoacrylate or the placement of a transjugular intrahepatic portosystemic shunt(TIPS)is more effective in the treatment of gastric *** compared the outcomes of patients treated with cyanoacrylate glue or TIPS for the management of acute gastric variceal ***:The study was designed as a retrospective cohort analysis of patients undergoing either TIPS or endoscopic treatment with cyanoacrylate for acute gastric variceal bleeding at our institution from 2001 to *** compared to studied between the two treatment modalities were the short-term treatment outcomes,including re-bleeding within 30 days,length of hospital stay and in-hospital ***-Meier survival analysis was performed to assess factors associated with in-hospital ***:A total of 169 patients were included in the *** TIPS arm contained 140 patients and the cyanoacrylate arm contained 29 *** was no evidence to suggest any significant differences in demographics or disease *** were no differences between the TIPS arm and the cyanoacrylate armtwo groups in treatment outcomes including re-bleeding within 30 days(17.4%vs.17.2%;P=0.98),median length of stay in the hospital(4.5 days vs.6.0 days;P紏0.35)or in-hospital mortality(9.0%vs.11.1%;P=0.74).In-hospital mortality was evaluated for 149 patients and lower albumin(P=0.015),higher MELD score(P<0.001),higher CTP score(P=0.005)and bleeding(P=0.008)were all significantly associated with in-hospital ***:These findings suggest that both treatments are equally *** offers a safe,effective alternative to TIPS for gastric varices,and physician may choose the best therapy for each patient,factoring in the availability of TIPS or cyanoacrylate,the individual patient’s presentation,and cost.

关键词： transjugular intrahepatic portosystemic shunt(TIPS) cyanoacrylate injection gastric varices gastrointestinal bleeding

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A rare cause of gastro-intestinal hemorrhage in a patient with a Roux-en-Y gastric bypass

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Gastroenterology Report 2016年第1期4卷 84-86,I0003页

作者： Richard H.Cartabuke paresh P.mehta Kevin El-Hayek J.Michael Henderson Carol A.Burke Department of Internal Medicine Cleveland ClinicClevelandOhioUSA Department of Gastroenterology and Hepatology Cleveland ClinicClevelandOhioUSA Department of General Surgery Cleveland ClinicClevelandOhioUSA

This case illustrates a rare cause of gastro-intestinal bleeding following bariatric *** it is essential to rule out common causes of variceal formation accompanied by intermittent,profuse bleeding,there should be a high degree of suspicion of this rare etiology in patients who have previously undergone alteration of their anatomy,especially Roux-en-Y gastric bypass(RYGB).The case emphasizes the need for a multidisciplinary medical-surgical team in evaluating and treating patients who present with complex intra-abdominal pathology.

关键词： gastro-intestinal bleeding superior mesenteric venous thrombosis Roux-en-Y gastric bypass

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Utility of urgent colonoscopy in acute lower gastro-intestinal bleeding:a single-center experience

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Gastroenterology Report 2014年第4期2卷 300-305页

作者： Mazen Albeldawi Duc Ha paresh mehta Rocio Lopez Sunguk Jang Madhusudhan R.Sanaka John J.Vargo Department of Gastroenterology and Hepatology Cleveland ClinicClevelandOHUSA Department of Internal Medicine Cleveland ClinicClevelandOHUSA Department of Quantitative Sciences Cleveland ClinicClevelandOHUSA

*** role of urgent colonoscopy in lower gastro-intestinal bleeding(LGIB)remains *** the last two decades,a number of studies have indicated that urgent colonoscopy may facilitate the identification and treatment of bleeding lesions;however,studies comparing this approach to elective colonoscopy for LGIB are *** determine the utility and assess the outcome of urgent colonoscopy as the initial test for patients admitted to the intensive care unit(ICU)with acute *** patients who underwent colonoscopy at our institution for the initial evaluation of acute LGIB between January 2011 and January 2012 were analysed *** were grouped into urgent *** colonoscopy,depending on the timing of colonoscopy after admission to the *** colonoscopy was defined as being performed within 24 hours of admission and those performed later than 24 hours were considered *** included length of hospital stay,early re-bleeding rates,and the need for additional diagnostic or therapeutic *** logistic regression analysis was performed to identify factors associated with increased transfusion ***-seven patients underwent colonoscopy for the evaluation of suspected LGIB,24 of which were *** was no significant difference in patient demographics,co-morbidities,or medications between the two *** who underwent urgent colonoscopy were more likely to present with hemodynamic instability(P=0.019)and require blood transfusions(P=0.003).No significant differences in length of hospital stay,re-bleeding rates,or the need for additional diagnostic or therapeutic interventions were *** requiring blood transfusions(n=27)were more likely to be female(P=0.016)and diabetics(P=0.015).Fourteen patients re-bled at a median of 2 days after index *** with hemodynamic instability were more likely to re-bleed[HR 3.8(CI 1.06–13.

关键词： acute lower gastro-intestinal bleeding urgent colonoscopy elective colonoscopy outcomes

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Association of procedure length on outcomes and adverse events of endoscopic retrograde cholangiopancreatography

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Gastroenterology Report 2014年第2期2卷 140-144页

作者： paresh P.mehta Madhusudhan R.Sanaka Mansour A.Parsi Mazen J.Albeldawi John A.Dumot Rocio Lopez Gregory Zuccaro John J.Vargo Digestive Disease Institute Department of Gastroenterology and HepatologyCleveland ClinicCleveland OHUSA Department of Quantitative Health Sciences Cleveland ClinicClevelandOHUSA

Objective:The aims of this study were to determine the effects of length of procedure on endoscopic retrograde cholangiopancreatography(ERCP)outcomes and adverse ***:All ERCP procedures,performed by experienced advanced endoscopists,in patients without prior papillary intervention from 2006 to 2008 were *** were arbitrarily divided into two groups:shorter procedures(SP),with a duration shorter than the overall mean procedure length,and longer procedures(LP),with a duration longer than overall mean procedure *** of procedure was defined as the time from endoscope insertion to endoscope ***:Two hundred and ninety-five procedures were included in the *** procedure length was 45.630.1 *** hundred and seventy-seven procedures(60%)were SP and 118(40%)were *** were no differences between the groups with regard to patients’ages,genders,race,or trainee *** cases were more likely to be biliary vs pancreatic or bi-ductal evaluations(P=0.03).LP had significantly higher complexity scores(34%with>3 vs 13%;P=0.046)and were more likely to require pre-cut papillotomy(39%vs 15%;P<0.001).There was no significant difference between the groups in overall completion rates(91.5%LP vs 96%SP;P=0.10)or adverse events(10.2%LP vs 6.2%SP;P=0.21).However,LP cases were associated with higher rates of post-ERCP bleeding(4.2%vs 0.6%;P=0.029).Conclusion:There was no significant difference in outcomes or overall adverse events between shorter and longer ERCP ***,longer procedures were associated with higher procedure complexity,higher utilization of pre-cut technique,and increased risk of bleeding.

关键词： endoscopic retrograde cholangiopancreatography(ERCP) duration of procedure adverse events pancreatitis

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Glucagon-like peptide-1 receptor agonists as a possible intervention to delay the onset of type 1 diabetes:A new horizon

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World Journal of Diabetes 2024年第2期15卷 133-136页

作者： Mahmoud Nassar Ajay Chaudhuri Husam Ghanim paresh Dandona Department of Internal Medicine Division of EndocrinologyDiabetes and MetabolismJacobs School of Medicine and Biomedical SciencesUniversity of BuffaloBuffaloNY 14221United States

Type 1 diabetes(T1D)is a chronic autoimmune condition that destroys insulinproducing beta cells in the pancreas,leading to insulin deficiency and *** management of T1D primarily focuses on exogenous insulin replacement to control blood glucose ***,this approach does not address the underlying autoimmune process or prevent the progressive loss of beta *** research has explored the potential of glucagon-like peptide-1 receptor agonists(GLP-1RAs)as a novel intervention to modify the disease course and delay the onset of ***-1RAs are medications initially developed for treating type 2 *** exert their effects by enhancing glucose-dependent insulin secretion,suppressing glucagon secretion,and slowing gastric *** evidence suggests that GLP-1RAs may also benefit the treatment of newly diagnosed patients with *** article aims to highlight the potential of GLP-1RAs as an intervention to delay the onset of T1D,possibly through their potential immunomodulatory and anti-inflammatory effects and preservation of *** article aims to explore the potential of shifting the paradigm of T1D management from reactive insulin replacement to proactive disease modification,which should open new avenues for preventing and treating T1D,improving the quality of life and long-term outcomes for individuals at risk of T1D.

关键词： Type 1 diabetes Semaglutide Glucagon-like peptide-1 receptor agonists Insulin therapy Autoimmune response Blood glucose monitoring Β-cell preservation Early screening Teplizumab Randomized controlled trials

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心力衰竭的流行病学和病理生理学

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国际内科双语杂志（中英文） 2007年第3期7卷 4-8,37-41页

作者： paresh a mehta Martin R Cowie 陈益和（译）纪宝华（校）英国伦敦帝国学院的临床心脏病学研究员英国伦敦帝国学院的心脏病学教授和英国伦敦皇家布朗普顿医院的荣誉心脏病学顾问医师不详

心力衰竭是一种以呼吸困难、乏力和液体潴留为特征的综合征.该综合征可由任一种心脏疾病引起,并可通过一组由针对潜在心功能不全的循环和神经激素反应所引起的症状和体征来识别.心力衰竭使预期寿命缩短并提高了发病率,同时降低了生活质... 详细信息

心力衰竭是一种以呼吸困难、乏力和液体潴留为特征的综合征.该综合征可由任一种心脏疾病引起,并可通过一组由针对潜在心功能不全的循环和神经激素反应所引起的症状和体征来识别.心力衰竭使预期寿命缩短并提高了发病率,同时降低了生活质量并增加了频繁入院的危险.

关键词：心力衰竭流行病学病理生理学患病率发病率病因学

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Effect of KiwiBiotic on functional constipation and related symptoms:A prospective,single-center,randomized,comparative,crossover study

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2024年第5期15卷 40-49页

作者： Ashwin D Porwal paresh M Gandhi Deepak K Kulkarni Gajanan B Bhagwat Pravin P Kamble Department of Proctology Healing Hands ClinicMahārāshtraPune 411001India R&D Center Healing Hands and Herbs Pvt.Ltd.MahārāshtraPune 411002India

BACKGROUND Functional constipation(FC)is a common gastrointestinal disorder characterized by abdominal pain and bloating,which can greatly affect the quality of life of *** treatments often yield suboptimal results,leading to the exploration of alternative therapeutic *** To evaluate the efficacy of KiwiBiotic in the management of FC and related *** This prospective,interventional,single-center,crossover study compared the safety and effectiveness of KiwiBiotic®vs psyllium husk in managing FC,abdominal pain,and *** diagnosed with FC were randomly assigned to receive KiwiBiotic or psyllium husk during the two treatment periods,with a 14-day washout period between *** Seventy participants were enrolled,32 of whom received KiwiBiotic followed by psyllium husk,and 33 received *** showed superiority over psyllium husk in alleviating abdominal pain and bloating,as evidenced by significantly lower mean ***,KiwiBiotic resulted in more than 90.0%of patients experiencing relief from various constipation symptoms,while psyllium husk showed comparatively lower *** KiwiBiotic is an effective treatment option for FC,abdominal pain,and bloating,highlighting its potential as a promising alternative therapy for patients with FC and its associated symptoms.

关键词： KiwiBiotic Psyllium husk Constipation Abdominal pain Bloating

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Differential Power Based Selective Phase Tripping for Fault-resilient Microgrid

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Journal of Modern Power Systems and Clean Energy 2022年第2期10卷 459-470页

作者： Bhatraj Anudeep paresh Kumar Nayak the Department of Electrical Engineering Indian Institute of Technology(ISM)DhanbadDhanbadIndia

Modern fault-resilient microgrids(MGs)require the operation of healthy phases during unbalanced short-circuits to improve the system *** study proposes a differential power based selective phase tripping scheme for MGs consisting of synchronous and inverter-interfaced distributed generators(DGs).First,the differential power is computed using the line-end superimposed voltage and current ***,to make the scheme threshold-free,a power coefficient index is derived and used for identifying faulted phases in an *** protection scheme is tested on a standard MG operating in either grid-connected or islanding mode,which is simulated using PSCAD/*** efficacy of the scheme is also assessed on the OPAL-RT manufactured real-time digital simulation(RTDS)***,the performance of the proposed protection scheme is compared with a few existing *** results show that the selective tripping of faulted phases in MGs can be achieved quickly and securely using the proposed scheme.

关键词： Distributed generator differential power fault detection microgrid protection selective phase tripping.

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Multi-period Power System State Estimation with PMUs Under GPS Spoofing Attacks

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Journal of Modern Power Systems and Clean Energy 2020年第4期8卷 597-606页

作者： paresh Risbud Nikolaos Gatsis Ahmad Taha Department of Electrical and Computer Engineering University of Texas at San AntonioSan AntonioUSA IEEE

This paper introduces a dynamic network model together with a phasor measurement unit(PMU)measurement model suitable for power system state estimation under spoofing attacks on the global positioning system(GPS)receivers of *** spoofing attacks may introduce time-varying phase offsets in the affected PMU *** algorithm is developed to jointly estimate the state of the network,which amounts to the nodal voltages in rectangular coordinates,as well as the time-varying *** algorithm features closedform *** effectiveness of the algorithm is verified on the standard IEEE transmission *** is numerically shown that the estimation performance is improved when the dynamic network model is accounted for compared with a previously reported static approach.

关键词： Dynamic state equation global positioning system(GPS)spoofing phasor measurement unit(PMU) state estimation time synchronization weighted least squares

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State-of-the-art on the protection of FACTS compensated high-voltage transmission lines:a review

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High Voltage 2018年第1期3卷 21-30页

作者： Sauvik Biswas paresh Kumar Nayak Department of Electrical Engineering Indian Institute of Technology(ISM)Dhanbad 826004India

In recent years,the inclusion of flexible AC transmission systems(FACTS)-based compensating devices such as a thyristor-controlled series capacitor(TCSC)and a unified power flow controller(UPFC)has been increased in high-voltage power transmission systems due to numerous technical and economical ***,the operation of such FACTS devices introduces harmonics and non-linearity in power system and causes fast changes in line *** a result,the most widely used fixed impedance setting based distance relaying scheme finds limitation in protecting such compensated *** research has been carried out in recent years to develop new algorithms and methods to address the *** paper presents a comprehensive review of recent developments in the protection of TCSC/UPFC compensated high-voltage transmission *** relative merits and demerits of each of the available methods are also presented for *** to detail review,the impact of TCSC/UPFC on distance protection is evaluated by using data generated through EMTDC/PSCAD on a 400 kV two-bus test power *** study can be useful to both academic researchers and practicing engineers to gain insight on the protection of FACTS compensated transmission lines and for further development of newer algorithms.

关键词： impedance harmonics protection

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