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Sodium-glucose Cotransporter-2 Inhibitors induced euglycemic diabetic ketoacidosis:A meta summary of case reports

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World Journal of Diabetes 2023年第8期14卷 1314-1322页

作者： Deven Juneja Prashant Nasa ravi Jain Omender Singh Institute of Critical Care Medicine Max Super Speciality HospitalSaketNew Delhi 110017India Department of Critical Care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Department of Internal Medicine College of Medicine and Health SciencesAl Ain 15551Abu DhabiUnited Arab Emirates Department of Critical Care Medicine Mahatma Gandhi Medical College and HospitalJaipur 302022RajasthanIndia

BACKGROUND Sodium-glucose cotransporter-2 inhibitors(SGLT2i)are commonly prescribed to manage patients with diabetes *** agents may rarely lead to the development of euglycemic diabetic ketoacidosis(EDKA),which may complicate the disease course of these *** To analyze the demographic profile,predisposing factors,symptomology,clinical interventions and outcomes of patients presenting with EDKA secondary to SGLT2i use by reviewing the published case reports and *** We performed a systematic search of PubMed,Science Direct,Google Scholar and Reference Citation Analysis databases using the terms“canagliflozin”OR“empagliflozin”OR“dapagliflozin”OR“SGLT2 inhibitors”OR“Sodium-glucose cotransporter-2”AND“euglycemia”OR“euglycemic diabetic ketoacidosis”OR“metabolic acidosis”.The inclusion criteria were:(1)Case reports or case series with individual patient details;and(2)Reported EDKA secondary to ***,the data were filtered from the literature published in the English language and on adults(>18 years).We excluded:(1)Conference abstracts;and(2)Case reports or series which did not have individual biochemical *** the case reports and case series were *** data extracted included patient demographics,clinical symptomatology,clinical interventions,intensive care unit course,need for organ support and *** Overall,108 case reports and 17 cases series with 169 unique patients that met all the inclusion criteria were *** majority of patients were females(54.4%,n=92),and the commonly reported symptoms were gastrointestinal(nausea/vomiting 65.1%,abdominal pain 37.3%)and respiratory(breathlessness 30.8%).One hundred and forty-nine(88.2%)patients had underlying type II diabetes,and the most commonly involved SGLT-2 inhibitor reported was empagliflozin(46.8%).A triggering factor was reported in most patients(78.7%),the commonest being acute severe infection(37.9%),which included patients with sepsis,coronavirus

关键词： Canagliflozin Empagliflozin Euglycemia Diabetes mellitus Diabetic ketoacidosis Sodium-glucose cotransporter-2 inhibitors Sodium-glucose cotransporter-2

Epidemiology of inflammatory bowel disease in racial and ethnic migrant groups

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World Journal of Gastroenterology 2018年第3期24卷 424-437页

作者： ravi Misra Omar Faiz Pia Munkholm Johan Burisch Naila Arebi Department of Gastroenterology St.Marks Academic Institute Surgical Epidemiology Trials and Outcome CentreSt.Marks Academic Institute Department of Gastroen-terology North Zealand University Hospital

AIM To summarise the current literature and define patterns of disease in migrant and racial *** A structured key word search in Ovid Medline and EMBASE was undertaken in accordance with PRISMA guidelines. Studies on incidence, prevalence and disease phenotype of migrants and races compared with indigenous groups were eligible for inclusion. RESULTS Thirty-three studies met the inclusion criteria. Individual studies showed significant differences in incidence, prevalence and disease phenotype between migrants or race and indigenous groups. Pooled analysis could only be undertaken for incidence studies on South Asians where there was significant heterogeneity between the studies [95% for ulcerative colitis(UC), 83% for Crohn's disease(CD)]. The difference between incidence rates was not significant with a rate ratio South Asian: Caucasian of 0.78(95%CI: 0.22-2.78) for CD and 1.39(95%CI: 0.84-2.32) for UC. South Asians showed consistently higher incidence and more extensive UC than the indigenous population in five countries. A similar pattern was observed for Hispanics in the United States. Bangladeshis and African Americans showed an increased risk of CD with perianal disease. CONCLUSION This review suggests that migration and race influence the risk of developing inflammatory bowel disease. This may be due to different inherent responses upon exposure to an environmental trigger in the adopted country. Further prospective studies on homogenous migrant populations are needed to validate these observations, with a parallel arm for in-depth investigation of putative drivers.

关键词： Epidemiology Ethnicity Migration

Liver injury from direct oral anticoagulants

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World Journal of Hepatology 2023年第6期15卷 841-849页

作者： Deven Juneja Prashant Nasa ravi Jain Institute of Critical Care Medicine Max Super Specialty HospitalNew Delhi 110017India Critical Care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Internal Medicine College of Medicine and Health SciencesAl Ain 15551United Arab Emirates Critical Care Medicine Mahatma Gandhi Medical College and HospitalJaipur 302001RajasthanIndia

BACKGROUND Drug-induced liver injury(DILI)can be caused by any prescribed drug and is a significant reason for the withdrawal of newly launched ***-acting oral anticoagulants(DOACs)are non-vitamin K-based antagonists recently introduced and increasingly used for various clinical conditions.A meta-analysis of 29 randomised controlled trials and 152116 patients reported no increased risk of DILI with ***,it is challenging to predict the risk factors for DILI in individual patients with exclusion of patients with pre-existing liver disease from these *** To determine the risk factors and outcomes of patients who developed DILI secondary to DOACs by systematic review and meta-summary of recent case reports and *** A systematic search was conducted on multiple databases including PubMed,Science Direct,Reference Citation Analysis,and Google *** search terms included“Acute Liver Failure”OR“Acute-On-Chronic Liver Failure”OR“Acute Chemical and Drug Induced Liver Injury”OR“Chronic Chemical and Drug Induced Liver Injury”AND“Factor Xa Inhibitors”OR“Dabigatran”OR“Rivaroxaban”OR“apixaban”OR“betrixaban”OR“edoxaban”OR“Otamixaban”.The results were filtered for literature published in English and on adult *** case reports and case studies reporting cases of DILI secondary to DOACs were *** on demographics,comorbidities,medication history,laboratory investigations,imaging,histology,management,and outcomes were *** A total of 15 studies(13 case reports and 2 case series)were included in the analysis,comprising 27 patients who developed DILI secondary to *** was the most commonly implicated DOAC(n=20,74.1%).The mean time to onset of DILI was 40.6 *** most common symptoms were jaundice(n=15,55.6%),malaise(n=9,33.3%),and vomiting(n=9,33.3%).Laboratory investigations showed elevated liver enzymes and bilirubin *** studies and liver biopsies revealed features of acute hepatitis and cho

关键词： Anticoagulants Direct-acting oral anticoagulants Drug induced liver injury Drug reactions Hepatotoxicity Novel oral anticoagulants

Phytoremediation of Pb Spiked Soils Amended with Iron ImpregnatedRice Husk Ash Using Ricinus communis L. (Castor bean)

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Journal of Botanical Research 2019年第3期1卷 1-7页

作者： Boda ravi Kiran M.N.v.Prasad Department of Plant Sciences School of Life SciencesUniversity of HyderabadHyderabadTelangana500046India

Heavy metals pose a serious risk to the environment and living biota. Potstudies were carried out to determine the competence of Fe-coated ricehusk in Pb spiked soils vegetated with Ricinus communis. Physicochemicalproperties of Fe- coated rice husk ash (Fe-RHA) were characterizedon dry weight basis. Pot experiments were carried out with seedlings *** for 60 days amended with Fe-RHA (0, 2.5% and 5% w/w)and Pb(NO3) [0, 400 and 800 mg kg?1]. Addition of Fe-coated rice huskash to Pb cntaminated soils improved soil pH and fertility. Treatment with5% Fe-RHA decreased Pb accumulation in roots by 84%. Addition of Fe-RHA significantly (pvironmentally friendlyand efficient adsorbent for stabilization of Pb spiked soils.

关键词： Fe-coated rice husk ash Lead Adsorption Immobilization Ricinus communis

Study on Quality Assessment of Insulators Subjected to DC voltages

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高电压技术 2008年第12期34卷 2602-2608页

作者： v. muralidhara B. Ramachandra N. vasudev P.v. vasudevan Nambudiri Sriramulu K.N. ravi High voltage Dvivsion Central Power Research Institute PB No8066 New Bel Road Bangalore 560080 India

The failure of insulators under DC voltages is due to various factors like thermal runaway,ion migration,anode growth,surface erosion,cement growth etc..However,the rate of failure is higher in polluted zones where surface erosion and puncturing of insulators due to ion migration can ***,insulators have to be subjected to accelerated aging tests to simulate ion migration and to check their capability to withstand the *** runaway is also an important *** carrying out Thermal runaway test at higher temperature,it may be possible to identify the good *** paper presents the work carried out in order to asses the quality of DC insulators by Thermal runaway tests,Ion-migration tests and the measurement of the body resistance of the *** voltage and temperature were varied during these tests in order to clearly identify the good *** result will be useful for the design of insulators for the HvDC transmission system.

关键词：直流电压绝缘子质量评估温度

Nasogastric tube syndrome:A Meta-summary of case reports

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World Journal of Clinical Cases 2024年第1期12卷 119-129页

作者： Deven Juneja Prashant Nasa Gunjan Chanchalani ravi Jain Department of Critical Care Medicine Max Super Speciality HospitalNew Delhi 110017India Department of Critical Care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Department of Critical Care Medicine Karamshibhai Jethabhai Somaiya Hospital and Research CentreMumbai 400022India Department of Critical Care Medicine Mahatma Gandhi Medical College and HospitalJaipur 302022RajasthanIndia

BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral ***,the risks associated with its placement are often *** airway obstruction with a NGT is an uncommon but potentially life-threatening *** syndrome is characterized by the presence of an NGT,throat pain and vocal cord(vC)paralysis,usually *** is poten-tially life–threatening,and early diagnosis is the key to the prevention of fatal upper airway ***,fewer cases may have been reported than might have occurred,primarily due to the clinicians'*** lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite *** To review and collate the data from the published case reports and case series to understand the possible risk factors,early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway *** We conducted a systematic search for this meta-summary from the database of PubMed,EMBASE,Reference Citation Analysis(https://***/)and Google scholar,from all the past studies till August *** search terms included major MESH terms"Nasogastric tube","Intubation,Gastrointestinal","vocal Cord Paralysis",and“Syndrome”.All the case reports and case series were evaluated,and the data were extracted for patient demographics,clinical symptomatology,diagnostic and therapeutic interventions,clinical course and outcomes.A datasheet for evaluation was further *** Twenty-seven cases,from five case series and 13 case reports,of NGT syndrome were retrieved from our *** was male predominance(17,62.96%),and age at presentation ranged from 28 to 86 *** patients had diabetes mellitus(37.04%),and nine were hyperte

关键词： Nasogastric tube Nasogastric tube syndrome Ryle’s tube Sofferman syndrome vocal cord paralysis

Effect of Heat Treatment on Tensile and Corrosion Properties of LM6 Hybrid Metal Matrix Composite Reinforced with Cenosphere and Red Mud

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Journal of Minerals and Materials Characterization and Engineering 2019年第1期7卷 1-17页

作者： ravi Kumar v. Suresh R. Prakash Rao C. R. ravi Kumar D. v. Bharat v. Department of Mechanical Engineering Global Academy of Technology Bengaluru India Department of Industrial & Automation Engineering VTU PG Centre Mysuru India

The increased expectation of automotive, aviation and marine industries pertaining to the enhanced properties and their use in elevated temperature conditions and also corrosive environments leads to the development of the newer material to meet the requirements. The requirements of the automobile and marine applications call for the increased mechanical properties and lower density accompanied with higher resistance to oxidation. Hence the present research work is aimed at the development of Hybrid metal matrix composites (HMMCs) using low-density base material and reinforcements. The aluminum of grade LM6 is preferred material in automobile industries, because it can be cast to any complex geometry and possess good machinability, further upon heat treatment, the properties of LM6 alloy can be enhanced to meet the industry requirements. However, requirements of automobile industries consist of increased mechanical properties, lower density and higher corrosion resistance. Hence, in the present research work, it is aimed to develop newer composite material using LM 6 grade Aluminum alloy as matrix material which is reinforced with varied percent Cenosphere and Red mud.

关键词： LM6 Alloy Cenosphere Red Mud HMMCs Tensile Test NaCl NaOH Salt Spray Test Immersion Corrosion Test

Prevention of macrovascular complications in patients with type 2 diabetes mellitus: Review of cardiovascular safety and efficacy of newer diabetes medications

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World Journal of Diabetes 2019年第6期10卷 324-332页

作者： ravi Kant Kashif M Munir Arshpreet Kaur vipin verma Division of Endocrinology Diabetes and Nutrition Medical University of South Carolina/Anmed Campus Anderson SC 29621 United States Division of Endocrinology Diabetes and Nutrition University of Maryland School of Medicine Baltimore MD 21201 United States Division of Endocrinology Diabetes and Nutrition Sinai Hospital Baltimore MD 21215 United States Department of Medicine Medical University of South Carolina/Anmed Campus Anderson SC 29621 United States

Lack of conclusive beneficial effects of strict glycemic control on macrovascular complications has been very frustrating for clinicians involved in care of patients with diabetes mellitus (DM). Highly publicized controversy surrounding cardiovascular (Cv) safety of rosiglitazone resulted in major changes in United States Food and Drug Administration policy in 2008 regarding approval process of new antidiabetic medications, which has resulted in revolutionary data from several large Cv outcome trials over the last few years. All drugs in glucagon-like peptide-1 receptor agonist (GLP-1 RA) and sodium-glucose cotransporter-2 (SGLT-2) inhibitor classes have shown to be Cv safe with heterogeneous results on Cv efficacy. Given twofold higher Cv disease mortality in patients with DM than without DM, GLP-1 RAs and SGLT-2-inhibitors are important additions to clinician’s armamentarium and should be second line-therapy particularly in patients with T2DM and established atherosclerotic Cv disease or high risks for Cv disease. Abundance of data and heterogeneity in Cv outcome trials results can make it difficult for clinicians, particularly primary care physicians, to stay updated with all the recent evidence. The scope of this comprehensive review will focus on all major Cv outcome studies evaluating Cv safety and efficacy of GLP-1 RAs and SGLT-2 inhibitors.

关键词： Newer antidiabetic medications Glucagon-like peptide-1 receptor agonist Sodium-glucose cotransporter-2 inhibitors Type 2 diabetes mellitus Macrovascular complications Cardiovascular outcome trials Major cardiovascular events Heart failure Prevention of heart disease

Classification of Web Services Using Bayesian Network

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Journal of Software Engineering and Applications 2012年第4期5卷 291-296页

作者： Ramakanta Mohanty v.ravi M.R.Patra Computer Science Department MLR Institute of TechnologyHyderabadIndia Institute for Development and Research in Bank-ing Technology HyderabadIndia Computer Science Department Berhampur UniversityBerhampurIndia

In this paper, we employed Na?ve Bayes, Markov blanket and Tabu search to rank web services. The Bayesian Network is demonstrated on a dataset taken from literature. The dataset consists of 364 web services whose quality is described by 9 attributes. Here, the attributes are treated as criteria, to classify web services. From the experiments, we conclude that Na?ve based Bayesian network performs better than other two techniques comparable to the classification done in literature.

关键词： Web Services Quality of Services (QoS) Bayesian Network Naive Based Bayesian Markov Blanket and Tabu search