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Placenta Percreta Causing Rupture of Uterus in Second Trimester of Pregnancy in Non Scarred Uterus with an Unusual Presentation: A Case Report and Review of Literature

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Open Journal of Obstetrics and Gynecology 2014年第11期4卷 695-698页

作者： reena Pal Deepmala Prasad Suchitra Jain Department of Obstetrics & Gynaecology V.C.S.G.G.M.S. & R.I. Srinagar India

Placenta percreta causing second trimester, spontaneous uterine rupture in non high risk women is less frequent and fewer cases have been reported in the literature. We report a case of uterine rupture in second trimester of pregnancy due to placenta percreta with non specific symptoms in otherwise uncomplicated pregnancy without any high risk factors. This case report describes the case of young woman presenting second gravid with 21 weeks pregnancy with complaints of whole abdomen pain and dysuria. Ultrasonography shows single intrauterine dead fetus;placenta was fundoposterior in upper segment, a hypoechoic area seen below the placenta suggestive of abruption placentae or placenta accreta. Suddenly patient deteriorated in two hours of hospital stay, frank hemoperitoneum detected, emergency laparotomy done, per operatively whole fundal area of uterus became papery thin and cystic on touch, a small rent seen on fundal surface of uterus. The placenta was densely adhered to the fundoposterior aspect of the uterus. Patient had emergency subtotal hysterectomy. This case highlights that placenta percreta is a rare but serious complication of pregnancy which may present in early pregnancy without any associated high risk factors for placenta percreta with unusual symptoms.

关键词： Placenta Percreta Spontaneous Uterine Rupture Second Trimester Non Scarred Uterus

Impact of primary tumour location on colorectal liver metastases: A systematic review

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World Journal of Clinical Oncology 2020年第5期11卷 294-307页

作者： George Bingham Alysha Shetye reena Suresh Reza Mirnezami Department of General Surgery St.Thomas’s HospitalLambethLondon SE17EHUnited Kingdom Department of Colorectal Surgery Royal Free HospitalHampsteadLondon NW32QGUnited Kingdom

BACKGROUND Colorectal cancer(CRC)is the third most common cause of cancer-related death *** significant advances in screening,surgical management and adjuvant therapies,average 5-year survival seldom exceeds 60%in most developed *** disease represents the primary cause of mortality in patients with CRC,and the liver is the most common location for distant tumour *** to 25%of patients are found to have synchronous liver metastases at the time of diagnosis and a further 30%-40%will develop metachronous disease in the course of *** has been suggested that primary tumour location[right side versus left side,primary tumour location(PTL)]can influence oncological outcomes in this patient group and that this should be considered in prognostic models and therapeutic decision-making *** suggestion is not universally accepted and there have been conflicting reports in the literature to *** To provide a comprehensive summary of the available evidence regarding the impact of PTL on oncological outcomes in patients with colorectal cancer liver metastases(CRCLM).METHODS MEDLINE,EMBASE and COCHRANE were searched for relevant publications using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses *** on oncological outcomes was then extracted from full text articles that met the predefined inclusion *** A total of 41 studies were identified that met predefined inclusion criteria for this *** 21 out of 38 studies that provided data on overall survival,a statistically significant improvement in overall survival was reported in patients with left sided primary *** studies included a total of 13897 patients compared with 4306 patients in the studies that did not show a significant *** studies noted a similar trend towards improved disease-free or progression-free *** authors observed distinct patterns of relapse after treatment of hepatic me

关键词： Liver metastasis Colorectal cancer Location Primary tumour Outcome

Multimodal single-cell omics analysis identifies epithelium-immune cell interactions and immune vulnerability associated with sex differences in COVID-19

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Signal Transduction and Targeted Therapy 2021年第8期6卷 2586-2599页

作者： Yuan Hou Yadi Zhou Michaela U.Gack Justin D.Lathia Asha Kallianpur reena Mehra Timothy A.Chan Jae U.Jung Lara Jehi Charis Eng Feixiong Cheng Genomic Medicine Institute Lerner Research InstituteCleveland ClinicClevelandOHUSA Florida Research and Innovation Center Cleveland ClinicPort Saint LucieFLUSA Department of Cardiovascular and Metabolic Science Lerner Research InstituteCleveland ClinicClevelandOHUSA Department of Molecular Medicine Cleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandOHUSA Department of Population and Quantitative Health Sciences Case Western Reserve UniversityClevelandOHUSA Neurological Institute Cleveland ClinicClevelandOHUSA Center for Immunotherapy and Precision Immuno-Oncology Cleveland ClinicClevelandOHUSA Department of Cancer Biology Lerner Research InstituteCleveland ClinicClevelandOHUSA Department of Genetics and Genome Sciences Case Western Reserve University School of MedicineClevelandOHUSA Case Comprehensive Cancer Center Case Western Reserve University School of MedicineClevelandOHUSA

Sex differences in the susceptibility of SARS-CoV-2 infection and severity have been controversial,and the underlying mechanisms of COVID-19 in a sex-specific manner remain *** we inspected sex differences in SARS-CoV-2 infection,hospitalization,admission to the intensive care unit(ICU),sera inflammatory biomarker profiling,and single-cell RNA-sequencing(scRNA-seq)profiles across nasal,bronchoalveolar lavage fluid(BALF),and peripheral blood mononuclear cells(PBMCs)from COVID-19 patients with varying degrees of disease *** propensity score-matching observations revealed that male individuals have a 29%elevated likelihood of SARS-CoV-2 positivity,with a hazard ratio(HR)1.32(95%confidence interval[Cl]1.18-1.48)for hospitalization and HR 1.51(95%Cl 1.24-1.84)for admission to *** from male patients at hospital admission had elevated neutrophil-lymphocyte ratio and elevated expression of inflammatory markers(C-reactive protein and procalcitonin).We found that SARS-CoV-2 entry factors,including ACE2,TMPRSS2,FURIN,and NRP1,have elevated expression in nasal squamous cells from male individuals with moderate and severe *** observed male-biased transcriptional activation in SARS-CoV-2-infected macrophages from BALF and sputum samples,which offers potential molecular mechanism for sex-biased susceptibility to viral ***-cell interaction network analysis reveals potential epithelium-immune cell interactions and immune vulnerability underlying male-elevated disease severity and mortality in ***,monocyte-elevated expression of Toll-like receptor 7{TLR7)and Bruton tyrosine kinase{BTK)is associated with severe outcomes in males with *** summary,these findings provide basis to decipher immune responses underlying sex differences and designing sex-specific targeted interventions and patient care for COVID-19.

关键词： elevated epithelium analysis

Role of Complements and Immunoglobulins in Alzheimer’s Disease

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Open Journal of Applied Sciences 2014年第6期4卷 285-298页

作者： Sanjeev Kumar reena Mittal Shweta Chaudhary Depp Chand Jain Department of Mathematics Shri.K.K.JAIN. College Muzaffarnagar India Department of Neurology Safdarganj Hospital New Delhi India Department of Physics Central Medical Physics Research Laboratory D.A.V. (P.G.) College Muzaffarnagar India

Our findings show that the value of IgG in serum of Alzheimer’s Disease patients is (17.2059 ± 2.6317) g/l and in controls i.e. (17.6720 ± 3.1457) g/l. Values of IgM in AD patients go down up to 62.5% in comparison to healthy subjects. A sudden change was observed in the levels of IgA of AD patients. It has been put on the value 137.9% high in comparison to healthy subjects. The levels of complement C3 have also value of lower side and go down up to 52.66% in AD patients. The value of levels of complement C4 shows no deflection from the control values. On the basis of regression and multiple correlation analysis, we found that the partial correlation coefficients rGA.M, which has value 0.44815 in AD patients and 0.45555 in controls, do not show any resemblance. The multiple partial correlation rAM.G has value 0.3082 in AD patients and 0.3912 in controls slightly better correlated in comparison to healthy controls. Multiple *** has strongly correlation in comparison to controls. *** is also strongly correlated. Regression coefficients and regression equations are basic foundations of correlation measurements and show a specific character of variation. A relation between all the three multiple correlations has been established in the present work and it is given by the following relation *** > *** > ***.

关键词： Complements Immunoglobulins Alzheimer’s Disease Regression Coefficients Multiple Correlation Coefficients

Capsule endoscopy:Current practice and future directions

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World Journal of Gastroenterology 2014年第24期20卷 7752-7759页

作者： Melissa F Hale reena Sidhu Mark E McAlindon Department of Gastroenterology Royal Hallamshire HospitalSheffield S10 2JFUnited Kingdom

Capsule endoscopy(CE)has transformed investigation of the small bowel providing a non-invasive,well tolerated means of accurately visualising the distal duodenum,jejunum and *** the introduction of small bowel CE thirteen years ago a high volume of literature on indications,diagnostic yields and safety profile has been *** in national and international guidelines has placed small bowel capsule endoscopy at the forefront of investigation into suspected diseases of the small *** commonly,small bowel CE is used in patients with suspected bleeding or to identify evidence of active Crohn’s disease(CD)(in patients with or without a prior history of CD).Typically,CE is undertaken after upper and lower gastrointestinal flexible endoscopy has failed to identify a *** bowel radiology or a patency capsule test should be considered prior to CE in those at high risk of strictures(such as patients known to have CD or presenting with obstructive symptoms)to reduce the risk of capsule *** also has a role in patients with coeliac disease,suspected small bowel tumours and other small bowel *** the advent of small bowel CE,dedicated oesophageal and colon capsule endoscopes have expanded the fields of application to include the investigation of upper and lower gastrointestinal *** CE may be used to diagnose oesophagitis,Barrett’s oesophagus and varices but reliability in identifying gastroduodenal pathology is unknown and it does not have biopsy *** CE provides an alternative to conventional colonoscopy for symptomatic patients,while a possible role in colorectal cancer screening is a fascinating *** research is already addressing the possibility of controlling capsule movement and developing capsules which allow tissue sampling and the administration of therapy.

关键词： Capsule endoscopy Small bowel Indications Technolo

Endocrine hypertension:An overview on the current etiopathogenesis and management options

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World Journal of Hypertension 2015年第2期5卷 14-27页

作者： reena M Thomas Ewa Ruel Prapimporn Ch Shantavasinkul Leonor Corsino Division of Endocrinology Metabolism and NutritionDepartment of MedicineDuke University Medical Center Division of Nutrition and Biochemical Medicine Department of MedicineRamathibodi HospitalFaculty of MedicineMahidol University

Endocrine causes of secondary hypertension include primary aldosteronism,pheochromocytoma,cushing's syndrome,hyperparathyroidism and hypo-and *** comprise 5%-10% of the causes of secondary *** hyperaldosteronism,the most common of the endocrine cause of hypertension often presents with resistant or difficult to control hypertension associated with either normo-or ***,a great mimicker of many conditions,is associated with high morbidity and mortality if left untreated.A complete history including pertinent family history,physical examination along with a high index of suspicion with focused biochemical and radiological evaluation is important to diagnose and effectively treat these *** cost effective targeted genetic screening for current known mutations associated with pheochromocytoma are important for early diagnosis and management in family *** current review focuses on the most recent evidence regarding causes,clinical features,methods of diagnosis,and management of these conditions.A multidisciplinary approach involving internists,endocrinologists and surgeons is recommended in optimal management of these conditions.

关键词： Primary aldosteronism Hyperaldosteronism Adrenal Adenoma Pheochromocytoma

Nonalcoholic steatohepatitis in Asian Indians is neither associated with iron overload nor with HFE gene mutations

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World Journal of Gastroenterology 2005年第3期11卷 393-395页

作者： Ajay Duseja reena Das Mohit Nanda Ashim Das Gurjeewan Garewal Yogesh Chawla Department of Hepatology Department of Hematology Department of Histopathology

AIM: The pathogenesis of occurrence of liver inflammation and fibrosis in patients with nonalcoholic steatohepatitis (NASH) is not completely understood. Other than insulin resistance, iron abnormalities have been thought to be one of the triggering factors. Therefore, our aim was to study the role of iron abnormalities and HFE gene mutations in patients with ***: Thirty-one patients of NASH diagnosed on the basis of clinical examination biochemistry, ultrasonography and liver biopsy (n = 14) were included in the study. Serum iron parameters (n = 23) (iron, ferritin, total iron-binding capacity and transferrin saturation), Peris' iron staining on liver biopsies (n = 14) and HFE gene mutations (C282Y and H63D) (n = 16) were studied in these patients. The association between iron staining, necroinflammatory activity and fibrosis stage on liver biopsies was also ***: Elevated serum iron, ferritin and transferrin saturation above 55% were observed in 4.3% of *** histology, 71% of the patients had negative iron staining,21.4% had 1+ staining, 7.2% had 2+ staining and none had 3+ or 4+ staining. There was no association between the degree of iron staining and necroinflammatory activity (P = 0.55) and fibrosis stage (P = 0.09) on histology. None of the patients had C282Y HFE gene mutation and four patients (25%) were found to be heterozygotes for H63D gene ***: Our study does not favor iron overload and HFE gene mutations as major factors in the pathogenesis of NASH in Asian Indians.

关键词：肝样变非酒精肝亚洲印度人铁过量 HFE基因突变消化系统

Medication adherence and quality of life among type-2 diabetes mellitus patients in India

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World Journal of Diabetes 2021年第10期12卷 1740-1749页

作者： Rakhi Mishra Suresh K Sharma Rajni Verma Priyanka Kangra Preeti Dahiya Preeti Kumari Priya Sahu Priyanka Bhakar reena Kumawat Ravinder Kaur Ravinder Kaur Ravi Kant College of Nursing All India Institute of Medical SciencesUttarakhand 249203RishikeshIndia Department of Medicine All India Institute of Medical SciencesUttarakhand 249203RishikeshIndia

BACKGROUND Diabetes mellitus(DM)is a progressively increasing metabolic disorder and a significant public health burden that demands immediate global ***,there is a paucity of data about adherence to antidiabetic drugs among patients with type-2(T2)DM in Uttarakhand,*** research reported that more than 50%of patients do not adhere to the correct administration and appropriate medicine *** has been reported that patients with chronic diseases who adhere to treatment may experience improvement in quality of life(QoL)and vice *** To assess the adherence to antidiabetic medication and QoL among patients with *** This cross-sectional descriptive study was conducted at a tertiary care hospital in Uttarakhand,*** Medication Adherence Rating Scale and World Health Organization QoL-BREF scale were used to assess medication adherence and *** Two hundred seventy-seven patients suffering from T2DM participated in the *** mean age was 50.80(±10.6)years,155(56%)had a poor adherence level and 122(44%)had a good adherence level to antidiabetic *** adjusting for sociodemographic factors,multiple linear regression analysis found patients who were adherent to antidiabetic medications had significantly higher mean overall perception of QoL and overall perception of health,with beta scores of 0.36 and 0.34,respectively(both P=0.000)points compared with nonadherent *** There was an association between medication adherence and QoL in patients with ***,there is a need to plan awareness and counseling programs followed by regular follow-up to motivate patient adherence to recommended treatment and lifestyle regimens.

关键词： Medication adherence Quality of life Diabetes mellitus Tertiary care hospital India

Vibrational Studies of Different Human Body Disorders Using FTIR Spectroscopy

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Open Journal of Applied Sciences 2014年第3期4卷 103-129页

作者： S. Kumar reena S. Chaudhary Sweety Deep Chand Jain Department of Mathematics Shri K. K. Jain College Khatauli India Department of Neurology Safdarjang Hospital New Delhi India Department of Physics Medical Physics Research Laboratory D.A.V. (P.G.) College Muzaffar Nagar India

Some of the important features of the bands occur in the present study. The band called amide A is available in all the diseased and healthy controls and the frequency of the band ranges from 3380 cm﹣1 to 3480.74 cm﹣1. The band due to C-H band and called hydrocarbon band was found only in paralytic and Alzheimer diseased along with normal healthy controls. Carbide band (C=C) is found only in Duchenne muscular dystrophy, paralytic and Alzheimer’s disease patients. Amide I was intact in all disorders with normal persons. Peroxide band (O-O) was found in all the cases of study. Amide IV band was found in paralytic, muscular dystrophy, Alzheimer’s diseases and normal controls. The amide V band was found in Alzheimer’s diseases only. The appearance or disappearance of the bands is a good sign to understand the mechanisms at the molecular level. FTIR spectroscopy may help in the diagnosis of the disease at the early stage of the onset. This spectroscopy can be used nicely for the study of hair, vaginal fluid, nails, urine, mucus, semen, synovial fluid, blood, hemoproteins, skin, and tears for human beings. We can also use it to understand the effect of adulteration on food and paint technology. FTIR is an indicator to explore the changes occurring at molecular level.

关键词： Fourier Transform Infrared (FTIR) ImmunoglobuinG (IgG) Epilepsy (E) Migraine (M) Paralysis (P) Alzheimer’s Diseases (AD) Duchenne Muscular Dystrophy (DMD)