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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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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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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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Roux-en-Y胃旁路术患者胃肠出血的一个罕见原因

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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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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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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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Power enhancement using improved maximum power point tracking for solar photovoltaic systems under partial shading

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Clean Energy 2022年第6期6卷 810-816页

作者： Chandrakant D.Bhos Javed Sayyad paresh Nasikkar Department of Electronics and Telecommunication Engineering Symbiosis Institute of Technology(SIT)Symbiosis International(Deemed University)(SIU)LavalePune412115MaharashtraIndia Department of Robotics and Automation Engineering Symbiosis Institute of Technology(SIT)Symbiosis International(Deemed University)(SIU)LavalePune412115MaharashtraIndia

One of the key reasons contributing to a reduction in the performance of a solar photovoltaic(SPV)system is the presence of partial shade on the solar *** is necessary to use maximum power point tracking(MPPT)in SPV systems to get around the non-linear behaviour of photovoltaic *** research analyses the reduction in power output of SPV systems caused by partial *** the latter part of the paper,the improved dynamic behaviour-based ant colony optimization MPPT approach under the effect of module-level partial shading is implemented in MATLAB®/Simulink®.Various partial shading levels were applied to SPV modules to evaluate the system *** proposed system follows the maximum power point with 99.9%accuracy and a response time of 2 *** addition of a weight coefficient accelerates the convergence of the algorithm.

关键词： solar photovoltaic MPPT shading optimization

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The role of R&D and economic policy uncertainty in Sri Lanka’s economic growth

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Financial Innovation 2022年第1期8卷 214-232页

作者： Chandranath Amarasekara Bernard Njindan Iyke paresh Kumar Narayan Central Bank of Sri Lanka ColomboSri Lanka Monash Business School Monash UniversityMelbourneAustraliaWellington Road Monash Business School Monash UniversityWellington RoadMelbourneAustralia

In this paper,we assess the role of investment in research and development(R&D)and economic policy uncertainty(EPU)in Sri Lanka’s economic growth *** do this by first determining which endogenous growth theories best explain the evolution of total factor productivity(TFP)in the *** historical time series data(1980–2018),we find that semi-endogenous growth theories best explain the evolution of TFP in Sri *** evidence suggests that R&D is critical to the country’s TFP *** find that,through R&D,EPU has a crucial detrimental impact on TFP growth,although it is *** findings are robust and have important implications for R&D investment and for moderating EPU.

关键词： Total factor productivity Research and development Endogenous growth theories Economic policy uncertainty Sri Lanka

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Did green debt instruments aid diversification during the COVID-19 pandemic?

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Financial Innovation 2022年第1期8卷 681-695页

作者： paresh Kumar Narayan Syed Aun R.Rizvi Ali Sakti Monash University MelbourneAustralia Lahore University of Management Sciences LahorePakistan Bank Indonesia JakartaIndonesia

Faced with a persistent pandemic,investors are concerned about portfolio *** the literature on COVID-19 has evolved impressively,limited work remains on diversification *** contribute to the literature by exploring the volatility and co-movement of different sovereign debt instruments,including green sukuk,sukuk,bond and Islamic and conventional equity indices for *** results consistently point towards increased asset co-movement and weak profitability during the ***,sukuk and green sukuk have a 14%correlation with stocks,suggesting potential diversification prospects in times of extreme shocks.

关键词： COVID-19 Green Sukuk Indonesia Capital market

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