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Percutaneous direct endoscopic pancreatic necrosectomy

World Journal of Gastrointestinal Surgery 2022年第8期14卷 731-742页

作者： Manoj A Vyawahare Sushant Gulghane rajkumar titarmare Tushar Bawankar Prashant Mudaliar Rahul Naikwade Jayesh M Timane Department of Medical Gastroenterology American Oncology Institute at Nangia Specialty HospitalNagpur 440028MaharashtraIndia Department of Internal Medicine and Critical Care American Oncology Institute at Nangia Specialty HospitalMIDC HingnaNagpur 440028MaharashtraIndia Department of Anaesthesiology American Oncology Institute at Nangia Specialty HospitalMIDC HingnaNagpur 440028MaharashtraIndia Department of Radiology American Oncology Institute at Nangia Specialty HospitalMIDC HingnaNagpur 440028MaharashtraIndia Department of Surgery American Oncology Institute at Nangia Specialty HospitalMIDC HingnaNagpur 440028MaharashtraIndia

Approximately 10%-20% of the cases of acute pancreatitis have acute necrotizing pancreatitis. The infection of pancreatic necrosis is typically associated with a prolonged course and poor prognosis. The multidisciplinary, minimally invasive “step-up” approach is the cornerstone of the management of infected pancreatic necrosis(IPN). Endosonography-guided transmural drainage and debridement is the preferred and minimally invasive technique for those with IPN. However, it is technically not feasible in patients with early pancreatic/peripancreatic fluid collections(PFC)(< 2-4 wk) where the wall has not formed;in PFC in paracolic gutters/pelvis;or in walled off pancreatic necrosis(WOPN) distant from the stomach/duodenum. Percutaneous drainage of these infected PFC or WOPN provides rapid infection control and patient stabilization. In a subset of patients where sepsis persists and necrosectomy is needed, the sinus drain tract between WOPN and skin-established after percutaneous drainage or surgical necrosectomy drain, can be used for percutaneous direct endoscopic necrosectomy(PDEN). There have been technical advances in PDEN over the last two *** esophageal fully covered self-expandable metal stent, like the lumen-apposing metal stent used in transmural direct endoscopic necrosectomy, keeps the drainage tract patent and allows easy and multiple passes of the flexible endoscope while performing PDEN. There are several advantages to the PDEN procedure. In expert hands, PDEN appears to be an effective, safe, and minimally invasive adjunct to the management of IPN and may particularly be considered when a conventional drain is in situ by virtue of previous percutaneous or surgical intervention. In this current review, we summarize the indications, techniques, advantages, and disadvantages of PDEN. In addition, we describe two cases of PDEN in distinct clinical situations, followed by a review of the most recent literature.

关键词： Infected pancreatic necrosis Direct endoscopic necrosectomy Percutaneous endoscopic necrosectomy Sinus tract endoscopy Stent-assisted percutaneous direct endoscopic necrosectomy

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Effect of α-Ketoglutarate on Cyanide-induced Biochemical Alterations in Rat Brain and Liver

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Biomedical and Environmental Sciences 2006年第1期19卷 61-66页

作者： rajkumar TULSAWANI R. BHATTACHARYA Division of Pharmacology and Toxicology Defence Research and Development Establishment Jhansi Road Gwalior 474002 (M. P.) India

Objective To investigate the biochemical changes in rat brain and liver following acute exposure to a lethal dose of cyanide, and its response to treatment of α-ketoglutarate （α-KG） in the absence or presence of sodium thiosulfate （STS）. Methods Female rats were administered 2.0 LD50 potassium cyanide （KCN; oral） in the absence or presence of pre-treatment （-10 rain）, simultaneous treatment （0 rain） or post-treatment （＋2-3 min） of α-KG （2.0 g/kg, oral） and/or STS （1.0 g/kg, intraperitoneal, -15 min, 0 rain or ＋ 2-3 min）. At the time of onset of signs and symptoms of KCN toxicity （2-4 min） and at the time of death （5-15 min）, various parameters particularly akin to oxidative stress viz. cytochrome oxidase （CYTOX）, superoxide dismutase （SOD）, glutathione peroxidase （GPx）, reduced glutathione （GSH） and oxidized glutathione （GSSG） in brain, and CYTOX, sorbitol dehydrogenase （SDH）, alkaline phosphatase （ALP）, GSH and GSSG in liver homogenate were measured. Results At both time intervals brain CYTOX, SOD, GPx, and GSH significantly reduced （percent inhibition compared to control） to 24%, 56%, 77%, and 65%, and 44%, 46%, 78%, and 57%, respectively. At the corresponding time points liver CYTOX and GSH reduced to 74% and 63%, and 44% and 68%, respectively. The levels of GSSG in the brain and liver, and hepatic ALP and SDH were unchanged, Pre-treatment and simultaneous treatment of α-KG alone or with STS conferred significant protection on above variables. Post-treatment was effective in restoring the changes in liver but failed to normalize the changes in the brain. Conclusions Oral treatment with α-KG alone or in combination with STS has protective effects on cyanide-induced biochemical alterations in rat brain and liver.

关键词： Gyanide Neurotoxicity Hepatotoxicity Protection a-ketoglutarate Sodium thiosulfate

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STOCHASTIC SYNCHRONIZATION OF CIRCADIAN RHYTHMS

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Journal of Systems Science & Complexity 2010年第5期23卷 978-988页

作者： rajkumar Brojen SINGH Vikram SINGH Ram RAMASWAMY Centre for Interdisciplinary Research in Basic Sciences Jamia Milia Islamia New Delhi 110025 India Center for Computational Biology and Bioinformatics School of Information Technology Jawaharlal Nehru University New Delhi 110067 India Center for Computational Biology and Bioinformatics School of Information Technology and School of Physical Sciences Jawaharlal Nehru University New Delhi 110067 India

Models of circadian genetic oscillators involving interlinked feedback processes in molecular level genetic networks in Drosophila melanogaster and Neurospora crassa are studied, and mechanisms whereby synchronization can arise in an assembly of cells are examined. The individual subcellular circadian oscillatory processes are stochastic in nature due to the small numbers of molecules that are involved, and are subject to large fluctuations. The authors investigate and present the simulations of the stochastic dynamics of ensembles of clock-regulating proteins in different nuclei that communicate via ancillary small molecules, environmental parameters, additive cellular noise, or through diffusive processes. The results show that the emergence of collective oscillations is a macroscopic observable which has its origins in the microscopic coupling between distinct cellular oscillators.

关键词： Coupling stochastic dynamics synchrony.

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Influence of B4C and ZrB2 reinforcements on microstructural,mechanical and wear behaviour of AA 2014 aluminium matrix hybrid composites

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Defence Technology（防务技术） 2024年第10期40卷 242-254页

作者： Ramesh Babu R Rajendran C Saiyathibrahim A rajkumar Velu Department of Mechanical Engineering Karpagam Institute of TechnologyCoimbatore 641105India Department of Mechanical Engineering Sri Krishna College of Engineering and TechnologyCoimbatore 641008India Department of Mechanical Engineering Indian Institute of Technology JammuJammu and Kashmir 181221India

Considering their affordability and high strength-to-weight ratio,lightweight aluminium alloys are the subject of intensive research aimed at improving their properties for use in the aerospace *** research effort aims to develop novel hybrid composites based on AA 2014 alloy through the use of liquid metallurgy stir casting to reinforce dual ceramic particles of Zirconium Diboride(ZrB_(2))and Boron Carbide(B4C).The weight percentage(wt%)of ZrB_(2) was varied(0,5,10,and 15),while a constant 5 wt%of B4C was maintained during this *** as-cast samples have been assessed using an Optical Microscope(OM)and a Scanning Electron Microscope(SEM)with Energy Dispersive Spectroscopy(EDS).The properties such as hardness,tensile strength,and wear characteristics of stir cast specimens were assessed to examine the impact of varying weight percentages of reinforcements in AA 2014 *** particular,dry sliding wear behaviour was evaluated considering varied loads using a pin-on-disc *** the weight%of ZrB_(2) grew and B4C was incorporated,hybrid composites showed higher hardness,tensile strength,and wear ***,the incorporation of a cumulative reinforcement consisting of 15 wt%ZrB_(2) and 5 wt%B4C resulted in a significant 31.86%increase in hardness and a 44.1%increase in tensile strength compared to AA 2014 *** addition,it has been detected that wear resistance of hybrid composite pin(containing 20 wt%cumulative reinforcement)is higher than that of other stir cast wear test pins during the whole range of applied *** surfaces of tensile specimens showed ductile fracture in the AA 2014 matrix and mixed mode for hybrid *** surfaces obtained employing higher applied load indicated abrasive wear with little plastic deformation for hybrid composites and dominant adhesive wear for matrix ***,the superior mechanical and tribological performance of hybrid composites can be attributed to dual reinforcement pa

关键词： AA 2014 alloy Stir casting Hybrid composite Hardness Tensile strength Specific wear rate

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An Evolutionary Normalization Algorithm for Signed Floating-Point Multiply-Accumulate Operation

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Computers, Materials & Continua 2022年第7期72卷 481-495页

作者： rajkumar Sarma Cherry Bhargava Ketan Kotecha Department of Electrical&Electronics Engineering Faculty of Engineering&TechnologyJain(Deemed-to-be-University)Ramanagar562112KarnatakaIndia Symbiosis Institute of Technology Symbiosis International(Deemed University)LavalePune412115India Symbiosis Centre for Applied Artificial Intelligence Symbiosis International(Deemed University)LavalePune412115India

In the era of digital signal processing,like graphics and computation systems,multiplication-accumulation is one of the prime operations.A MAC unit is a vital component of a digital system,like different Fast Fourier Transform(FFT)algorithms,convolution,image processing algorithms,*** the domain of digital signal processing,the use of normalization architecture is very *** main objective of using normalization is to performcomparison and shift *** this research paper,an evolutionary approach for designing an optimized normalization algorithm is proposed using basic logical blocks such as Multiplexer,Adder *** proposed normalization algorithm is further used in designing an 8×8 bit Signed Floating-Point Multiply-Accumulate(SFMAC)*** the SFMAC can accept an 8-bit significand and a 3-bit exponent,the input to the said architecture can be somewhere between−(7.96872)_(10) to+(7.96872)_(10).The proposed architecture is designed and implemented using the Cadence Virtuoso using 90 and 130 nm technologies(in Generic Process Design Kit(GPDK)and Taiwan Semiconductor Manufacturing Company(TSMC),respectively).To reduce the power consumption of the proposed normalization architecture,techniques such as“block enabling”and“clock gating”are used *** to the analysis done on Cadence,the proposed architecture uses the least amount of power compared to its current predecessors.

关键词： Data normalization cadence virtuoso signed-floating-point MAC evolutionary optimized algorithm block enabling clock gating

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Engaging the spikes: heparan sulfate facilitates SARS-CoV-2 spike protein binding to ACE2 and potentiates viral infection

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Signal Transduction and Targeted Therapy 2021年第2期6卷 211-212页

作者： rajkumar Singh Kalra Ramesh Kandimalla IST-INDIA DAILAB National Institute of Advanced Industrial Science&Technology(AIST)Higashi 1-1-1TsukubaJapan Applied Biology CSIR-Indian Institute of Chemical Technology(IICT)Uppal RoadTarnakaHyderabadTelangana StateIndia Department of Biochemistry Kakatiya Medical CollegeWarangalTelangana 506004India

In a recent report published in Cell,Clausen et al.1 reveal that heparan sulfate(HS)functions as a necessary cofactor for SARSCoV-2 binding to the ACE2 at the host cell *** analysis identified that HS interacts with the receptor-binding domain(RBD)at the SI subunit of the SARS-CoV-2 trimeric S-protein,which facilitates the opening of S-protein conformation for ACE2 binding.

关键词： ACE2 al. infection

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Effect of Pre-treatment of α-Ketoglutarate on Cyanide-induced Toxicity and Alterations in Various Physiological Variables in Rodents

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Biomedical and Environmental Sciences 2007年第1期20卷 56-63页

作者： rajkumar TULSAWANI DEO KUMAR R.BHATTACHARYA Division of Pharmacology and Toxicology Defence Research and Development Establishment Jhansi Road Gwalior 474 002 M.P. India

Objective To investigate the effects of pre-treatment of α-ketoglutarate （α-KG） on cyanide-induced lethality and changes in various physiological parameters in rodents. Methods The LD50 of potassium cyanide （KCN） given orally （po）, intraperitoneally （ip）, subcutaneously （sc） or intravenously （iv） was determined in male mice, in the presence or absence α-KG given po, ip or iv. α-KG was administered 10, 20 or 40 min prior to KCN at 0.50, 1.0 or 2.0 g/kg by po or ip route, and at 0.10, 0.20 or 0.40 g/kg by iv route. Protection index （PI） was calculated as the ratio of LD50 of KCN in the presence of α-KG （protected animals） and LD50 of KCN in the absence of α-KG （unprotected animals）. In a separate experiment, several physiological variables viz. mean arterial pressure （MAP）, heart rate （HR）, respiratory rate （RR）, neuromuscular transmission （NMT） and rectal temperature （RT） were measured in anesthetized female rats pre-treated （-10 rain） with po （2.0 g/kg） or iv （0.125 g/kg） α-KG and then administered sub-lethal （0.75 LD50） or lethal （2.0, 4.0 or 8.0 LD50） doses of KCN （po）. Results PI of 4.52, 6.40 and 7.60 at -10 min, 3.20, 5.40 and 6.40 at -20 min, and 1.40, 3.20 and 5.40 at -40 min of po administration with α-KG was observed for 0.50, 1.0 and 2.0 g/kg doses, respectively, against KCN given by po route. When KCN was given ip, a PI of 3.38, 4.79 and 5.70 was observed for 0.50, 1.0 and 2.0 g/kg α-KG given ip （-10 min）, respectively. A lower PI of 3.37, 2.83 and 2.38 was observed when KCN given sc was challenged by 2.0 g/kg α-KG given ip at -10, -20 or -40 min, respectively. Similarly, a PI of 3.37, 2.83 and 2.0 was noted when KCN given sc was antagonized by 2.0 g/kg α-KG given po at -10, -20 or -40 rain, respectively. No appreciable protection was observed when lower doses of α-KG （ip or po） challenged KCN given by sc route. Pre-treatment of iv or po administration of α-KG did not afford any protection against KCN given po or iv route. Oral treatment of 0.75 LD50 KCN

关键词： Cyanide Toxicity Physiological variables Protection α-Ketoglutarate

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Secured Cloud Communication Using Lightweight Hash Authentication with PUF

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Computer Systems Science & Engineering 2022年第10期43卷 233-243页

作者： R.Padmavathy M.Newlin rajkumar Department of Computer Science and Engineering Anna University Regional CenterCoimbatore641046India

Internet-of-Things(IoT)is an awaited technology in real-world applications to process daily tasks using intelligent *** main process of data in IoT involves communication,integration,and coordination with other real-world *** security of transferred,stored,and processed data in IoT is not ensured in many ***-enabled smart devices are widely used among populations for all types of applications,thus increasing the popularity of IoT among widely used server *** grid is used in this article with IoT to manage large data.A smart grid is a collection of numerous users in the network with the fastest response *** article aims to provide high authentication to the smart grid,which constitutes secure communication in cloud-based *** IoT devices are deployed openly in all *** open-access is vulnerable toward cloning *** is a significant process that provides strength while *** security of the cloud and IoT must be computationally high.A lightweight authentication using hashing technique is proposed considering the aforementioned *** main factor of the authentication involves physically unclonable functions,which are utilized in improving the performance of the *** proposed approach is evaluated with the existing *** show that the performance of the proposed algorithm provides high robust security.

关键词： Cloud IoT smart grid PUF lightweight authentication

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Safety and efficacy of oral HD-03/ES given for six months in patients with chronic hepatitis B virus infection

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World Journal of Gastroenterology 2007年第30期13卷 4103-4107页

作者： JS rajkumar MG Sekar SK Mitra Lifeline Rigid Hospitals Kilpauk Chennai Tamilnadu 600010 India The Himalaya Drug Company Bangalore 562123 Karnataka India

AIM： To investigate the safety and efficacy of the formulation HD-03/ES capsules in the management of patients with chronic hepatitis B infection.METHODS： A total of 25 patients were recruited to the study and were given HD-03/ES, two capsules twice daily for six months. Clinical assessment of symptoms and signs were done using the ＂clinical observation table＂ once a month before and after the treatment. Biochemical investigations of total bilirubin, ALT, AST, serum protein for liver function tests were done every month after initiating treatment. Serum was analyzed for HBV markers for HBsAg, HBeAg and HBV DNA at baseline, 4 and 6 mo alter therapy using ELISA kits from Roche.RESULTS： After 6 mo of therapy with HD-03/ES, a significant reduction of ALT values from 66.5 ± 11.1 to 39.1 ± 5.2 （P 〈 0.01） and a significant HBsAg loss （52%, P 〈 0.001）, HBeAg loss （60%, P 〈 0.05） and HBV DNA loss （60%, P 〈 0.05） was observed. Adverse effects were mild and never warranted withdrawal of the drug.CONCLUSION： The results of this pilot study indicate that HD-03/ES might be a safe and effective treatment for chronic hepatitis B infection and a long-term multicentric comparator trial is warranted and under way.

关键词： HD-03/ES Chronic hepatitis B Liver function tests Hepatitis B Virus markers Clinical trial HBsAg HBeAg

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Diabetic Retinopathy Diagnosis Using ResNet with Fuzzy Rough C-Means Clustering

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Computer Systems Science & Engineering 2022年第8期42卷 509-521页

作者： R.S.rajkumar A.Grace Selvarani Sri Ramakrishna Engineering College Coimbatore641022India

Diabetic Retinopathy(DR)is a vision disease due to the long-term prevalenceof Diabetes *** affects the retina of the eye and causes severedamage to the *** not treated on time it may lead to permanent vision lossin diabetic ***’s development in science has no medication to cureDiabetic ***,if diagnosed at an early stage it can be controlledand permanent vision loss can be *** to the diabetic population,experts to diagnose Diabetic Retinopathy are very less in particular to local *** an automatic computer-aided diagnosis for DR detection is *** paper,we propose an unsupervised clustering technique to automatically clusterthe DR into one of its five development *** deep learning based unsupervisedclustering is made to improve itself with the help of fuzzy rough c-meansclustering where cluster centers are updated by fuzzy rough c-means clusteringalgorithm during the forward pass and the deep learning model representationsare updated by Stochastic Gradient Descent during the backward pass of *** proposed method was implemented using python and the results were takenon DGX server with Tesla V100 GPU *** experimental result on the publicallyavailable Kaggle dataset shows an overall accuracy of 88.7%.The proposedmodel improves the accuracy of DR diagnosis compared to the existingunsupervised algorithms like k-means,FCM,auto-encoder,and FRCM withalexnet.

关键词： Diabetic retinopathy detection diabetic retinopathy diagnosis fuzzy rough c-means clustering unsupervised CNN clustering

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