检索结果-南通市图书馆

Borderline resectable pancreatic tumors:Is there a need for further refinement of this stage?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2011年第3期10卷 319-324页

作者： Shailesh V Shrikhande Supreeta Arya Savio George Barreto Sachin Ingle Melroy A D'Souza Rohini Hawaldar parul J shukla Department of Hepato-Pancreato-Biliary Surgical Oncology Department of Radiology Tata Memorial Hospital Department of Surgery Royal Adelaide Hospital Clinical Research Secretariat

BACKGROUND:The ideal treatment of patients with 'borderline resectable pancreatic tumors (BRTs)' needs to be *** protocols advise neoadjuvant chemo(radio)therapy,although some patients may appear to have BRT on preoperative imaging and a complete resection may be achieved without the need for vascular *** aim of the present study was to identify specific findings on preoperative imaging that could help predict in which patients with BRT a complete resection,with or without vascular resection (VR),could be ***:Twelve patients with BRTs were *** location,maximum degree of circumferential contact (CC),length of contact of the tumor with major vessels (LC),and luminal narrowing of vessels at the point of contact with the tumor (venous deformity,VD) were graded on preoperatively acquired multidetector computed tomography (MDCT) images and then compared with the intraoperative findings and need for ***:A complete resection (R0) was achieved in 10 patients with 2 having microscopic positive margins (R1) on histopathology at the uncinate *** of the 10 patients required VR (40%).In 3 of the 4 patients whose tumors required VRs,CC was ≥grade III and VD was grade *** did not influence the need for ***:It is possible to achieve a complete resection at the first instance in patients found to have BRTs on preoperative *** MDCT-based grading systems and our proposed criteria may help identify such patients,thus avoiding any delay in curative resections in such patients.

关键词： pancreatic head carcinoma pancreatic cancer pancreatic neoplasms resection

Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elijah Dixon parul J shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed Neil W Pearce Wesley Francis Shaneeta Johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGROUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-PD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： Pancreas Complication Rescue Failure Morbidity Mortality Pancreaticoduodenectomy

Virtual reality based apps are the future of patient:Counseling

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2025年第6期13卷 58-60页

作者： Ranjan K Behera Arvind K Morya parul C Gupta Arshi Singh Department of Ophthalmology MMIMSR Mullana AmbalaAmbala 133207HaryānaIndia Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia Department of Ophthalmology Post Graduate Institute of Medical Education and ResearchChandigarh 160012PunjabIndia Department of Ophthalmology Guru Nanak Eye CentreNew Delhi 110001New DelhiIndia

The use of virtual reality to educate preoperative patients has a positive impact on nurses as well as patients undergoing *** can help improve patient satisfaction and improve favorable outcomes by reducing patient anxiety and proving adequate knowledge about the procedure and possible outcomes to the *** also reduces burden on nursing staff and *** and more diverse cohort studies will help us understand the wider application of this tool on the patient *** may be difficult to apply this tool on elderly patients with failing eyesight,multiple physical ***,there may be reduced acceptance of this modality by older nursing staff and practitioners who may prefer the traditional verbal version for *** will benefit from a combined approach of using virtual reality apps with tradition one-on-one counselling to help alleviate patient concerns and improve patient and healthcare professional satisfaction.

关键词： Nurse Patient Virtual reality Counselling Healthcare

Intricacies during pregnancy with gestational diabetes mellitus

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2025年第1期13卷 62-64页

作者： Richa Rattan Rimesh Pal parul Chawla Gupta Arvind Kumar Morya Ripunjay Prasad Department of Endocrinology Post Graduate Institute of Medical Education and ResearchChandigarh 160012India Department of Ophthalmology Post Graduate Institute of Medical Education and ResearchChandigarh 160012PunjabIndia Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia Department of Ophthalmology RP Eye InstituteDelhi 110001India

The study by Cao et al aimed to identify early second-trimester biomarkers that could predict gestational diabetes mellitus(GDM)development using advanced proteomic techniques,such as Isobaric tags for relative and absolute quantitation isobaric tags for relative and absolute quantitation and liquid chromatography-mass spectrometry liquid chromatography-mass *** analysis revealed 47 differentially expressed proteins in the GDM group,with retinol-binding protein 4 and angiopoietin-like 8 showing significantly elevated serum levels compared to *** these findings are promising,the study is limited by its small sample size(n=4 per group)and lacks essential details on the reproducibility and reliability of the protein quantification methods ***,the absence of experimental validation weakens the interpretation of the protein-protein interaction network identified through bioinformatics *** study's focus on second-trimester biomarkers raises concerns about whether this is a sufficiently early period to implement preventive interventions for *** GDM risk during the first trimester or pre-conceptional period may offer more clinical *** its limitations,the study presents valuable insights into potential GDM biomarkers,but larger,well-validated studies are needed to establish their predictive utility and generalizability.

关键词： Gestational diabetes mellitus Biomarkers Differentially expressed proteins Retinol-binding protein 4 Angiopoietin-like 8 Proteomics Lifestyle interventions Early prediction

MATHEMATICAL MODELING OF QUINTIC DUFFING EQUATION AND NUMERICAL SIMULATION USING MULTIPLE SCALES MODIFIED LINDSTEDT–POINCARE METHOD

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International Journal of Modeling, Simulation, and Scientific Computing 2012年第3期3卷 21-37页

作者： MANOJ KUMAR parul Department of Mathematics Motilal Nehru National Institute of Technology Allahabad-211004 U.P.India

A perturbation algorithm Multiple Scales Modified Lindstedt–Poincare(MSMLP),combination of method of Multiple Scales and modified Lindstedt–Poincare is proposed for the solution of Quintic Duffing equation which combines the advantages of both the *** obtained by the MSMLP method is compared with the Multiple Scales method and accurate closed form approximate solution of the Quintic Duffing *** proposed method produces better results for a wide range of amplitude values of oscillations and strong *** simulation has been performed in MATHEMATICA 7.0.

关键词： Perturbation methods multiple scales method modified Lindstedt-Poincare method perturbation problems.

Current and New Drugs for COVID-19 Treatment and Its Effects on the Liver

在线全文

学校读者我要写书评

暂无评论

Journal of Clinical and Translational Hepatology 2021年第3期9卷 436-446页

作者： Sandeep Satsangi Nitin Gupta parul Kodan Department of Apollo comprehensive Liver Care Apollo HospitalBangaloreKarnatakaIndia Department of Infectious Diseases Kasturba Medical CollegeManipal Academy of Higher EducationManipalKarnatakaIndia Department of Medicine All India Institute of Medical SciencesNew DelhiIndia

Corona virus disease(COVID)-19 is caused by the novel severe acute respiratory syndrome coronavirus-2(commonly referred to as SARS-CoV-2).In March 2020,the World Health Organization declared the COVID-19 outbreak a *** the target organ for the virus is primarily the lungs,with the recent understanding of the pathobiology of this disease and the immune dysregulation associated with it,it is now clear that COVID-19 affects multiple organ *** drugs and therapies have been tried or repurposed to combat the wrath posed by this *** October 22,2020,the USA Food and Drug Administration approved remdesivir for use in adults and pediatric patients(12 years of age and older).Several of the drugs being tried against COVID-19 have hepatotoxicity as their potential side *** review aims to provide the latest insights on various drugs being used in the treatment of COVID-19 and their effects on the liver.

关键词： COVID-19 Drugs Liver Drug-induced liver injury

Development of a physiologically relevant dripping analytical method using simulated nasal mucus for nasal spray formulation analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Pharmaceutical Analysis 2016年第5期6卷 283-291页

作者： Tina Masiuk parul Kadakia Zhenyu Wang Respiratory Product Development Merck Research Laboratories Merck & Co.Inc.

Current methods for nasal spray formulations have been elementary evaluating the dripping characteristics of a formulation and have not assessed the behavior of the nasal formulation in the presence of varying types of mucus depending on the indication or diseased state. This research investigated the effects of nasal mucus on the dripping behavior of nasal formulations and focused on developing an improved in vitro analytical test method that is more physiologically relevant in characterizing nasal formulation dripping behavior. Method development was performed using simulated nasal mucus preparations for both healthy and diseased states as coatings for the dripping experiment representing a wide range of viscosity. Factors evaluated during development of this in vitro test method included amount of mucus, application of mucus, drying times, and compatibility of the mucus on a C18 Thin Layer Chromatography(TLC) substrate. The dripping behavior of nasal formulations containing a range of 1%Avicel to 3.5% Avicel was assessed by actuating the nasal spray on a perpendicular TLC plate coated with either healthy or diseased simulated nasal mucus. After actuation of the nasal spray, the dripping of the formulation on the coated TLC plate was measured after the plate was repositioned vertically. The method that was developed generated reproducible results on the dripping behavior of nasal formulations and provided critical information about the compatibility of the formulation with the nasal mucus for different diseased states, aiding in nasal spray formulation development and physical characterization of the nasal spray.

关键词： Nasal spray Nasal spray dripping method Nasal mucus Nasal formulation dripping

Pathways of nanotoxicity:Modes of detection,impact,and challenges

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Frontiers of Materials Science 2021年第4期15卷 512-542页

作者： Deepshikha GUPTA parul YADAV Devesh GARG Tejendra K.GUPTA Amity Institute of Applied Sciences Amity University Uttar PradeshNoida 201301India

Nanotoxicology has become the subject of intense research for more than two *** of articles have been published but the space in understanding the nanotoxicity mechanism and the assessment is still *** researches clearly show potential benefits of nanomaterials(NMs)in diagnostics and treatment,targeted drug delivery,and tissue engineering owing to their excellent physicochemical ***,these NMs display hazardous health effect then to the greater part of the materials because of small size,large surface area-to-volume ratio,quantum size effects,and environmental ***,a large number of NMs are used in industrial products including several medical applications,consumer,and healthcare ***,they came into the environment without any safety *** measurement of toxicity level has become important because of increasing toxic effects on living *** realistic mechanism-based strategies are still needed to determine the toxic effects of *** the assessment of NMs toxicity,reliable and standardized procedures are *** review article provides systematic studies on toxicity of NMs involving manufacturing,environmental factors,eco-toxic and genotoxic effects,some parameters which have been ignored of NMs versus their biological counterparts,cell heterogeneity,and their current challenges and future perspectives.

关键词： nanomaterial nanotoxicity cytotoxicity,genotoxicity in-vivo and in-vitro toxicity reactive oxygen species

Role of endoscopy in inflammatory bowel disease

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Gastroenterology Report 2018年第2期6卷 75-82,I0001页

作者： Shishira Bharadwaj Neeraj Narula parul Tandon Mohammad Yaghoobi Department of Gastroenterology/Hepatology Beth Israel Deaconess Medical Center330 Brookline AveBostonMA 02215USA Division of Gastroenterology McMaster University1280 Main St WHamiltonON L8S 4L8Canada Department of Medicine The Ottawa Hospital501 Smyth RdOttawaON K1H 8L6Canada

Crohn’s disease(CD)and ulcerative colitis(UC)constitute the twomost common phenotypes of inflammatory bowel disease(IBD).Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of *** diagnosis of CD and UC is important,as theirmedical and surgical treatmentmodalities and prognoses can be ***,approximately 15%of patients with IBD aremisdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or ***,there has been increased recognition of the role of the therapeutic endoscopist in the field of *** imaging techniques have been developed to aid in the differentiation of UC vs ***,endoscopic balloon dilation and stenting have become an integral part of the therapeutic armamentariumof CD *** ultrasound has been recognized as beingmore accurate thanmagnetic resonance imaging in detecting perianal fistulae in patientswith ***,chromoendoscopymay help to detect dysplasia earlier compared with white-light ***,interventional endoscopy has become a cornerstone in the diagnosis,treatment andmanagement of IBD *** role of endoscopy in the field of IBD has significantly evolved in recent years fromsmall-bowel imaging to endoscopic balloon dilation and use of chormoendoscopy in dysplasia *** this reviewarticle,we discuss the current evidence on interventional endoscopy in the diagnosis,treatment andmanagement of IBD compications.

关键词： Inflammatory bowel disease small-bowel imaging therapeutic endoscopy chromoendoscopy endoscopic balloon dilation