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Potent antiviral therapy improves survival in acute on chronic liver failure due to hepatitis B virus reactivation

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World Journal of Gastroenterology 2014年第43期20卷 16037-16052页

作者： Cyriac Abby Philips shiv kumar Sarin Department of Hepatology Institute of Liver and Biliary SciencesNew Delhi 110070India

Acute on chronic liver failure(ACLF)is a disease entity with a high mortality *** acute event arises from drugs and toxins,viral infections,bacterial sepsis,interventions(both surgical and non-surgical)and vascular events on top of a known or occult chronic liver *** secondary to reactivation of chronic hepatitis B virus is a distinct condition;the high mortality of which can be managed in the wake of new potent antiviral *** example,lamivudine and entecavir use has shown definite short-term survival benefits,even though drug resistance is a concern in the *** renoprotective effects of telbivudine have been shown in a few studies to be useful in the presence of renal *** with newer agents such as tenofovir and a combination of nucleos(t)ides is promising for improving survival in this special group of liver disease *** review describes the current status of potent antiviral therapy in patient with acute on chronic liver failure due to reactivation of chronic hepatitis B,thereby providing an algorithm in management of such patients.

关键词： Acute on chronic liver failure Chronic hepatitis B infection Reactivation of hepatitis B Flare of hepatitis B Anti-viral therapy Nucleoside analogue Nucleotide analogue

Dynamic properties and liquefaction behaviour of cohesive soil in northeast India under staged cyclic loading

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Journal of Rock Mechanics and Geotechnical Engineering 2018年第5期10卷 958-967页

作者： shiv Shankar kumar A.Murali Krishna Arindam Dey Department of Civil Engineering Indian Institute of Technology Guwahati

Estimation of strain-dependent dynamic soil properties, e.g. the shear modulus and damping ratio, along with the liquefaction potential parameters, is extremely important for the assessment and analysis of almost all geotechnical problems involving dynamic loading. This paper presents the dynamic properties and liquefaction behaviour of cohesive soil subjected to staged cyclic loading, which may be caused by main shocks of earthquakes preceded or followed by minor foreshocks or aftershocks, respectively. Cyclic triaxial tests were conducted on the specimens prepared at different dry densities （1.5 g/cm3 and 1.75 g/cm3） and different water contents ranging from 8% to 25%. The results indicated that the shear modulus reduction （G/Gmax） and damping ratio of the specimen remain unaffected due to the changes in the initial dry density and water content. Damping ratio is significantly affected by confining pressure, whereas G/Gmax is affected marginally. It was seen that the liquefaction criterion of cohesive soils based on single-amplitude shear strain （3.75% or the strain at which excess pore water pressure ratio becomes equal to 1, whichever is lower） depends on the initial state of soils and applied stresses. The dynamic model of the regional soil, obtained as an outcome of the cyclic triaxial tests, can be successfully used for ground response analysis of the region.

关键词： Cohesive soil Dynamic soil properties Liquefaction potential Cyclic triaxial tests Staged cyclic loading

Antitubercular therapy in patients with cirrhosis:Challenges and options

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World Journal of Gastroenterology 2014年第19期20卷 5760-5772页

作者： Naveen kumar Chandan kumar Kedarishetty Sachin kumar Vikas Khillan shiv kumar Sarin Departments of Hepatology Institute of Liver and Biliary SciencesVasant KunjNew Delhi 110070India Departments of Pulmonology Institute of Liver and Biliary SciencesVasant KunjNew Delhi-110070India Departments of Microbiology Institute of Liver and Biliary SciencesVasant KunjNew Delhi-110070India

Tuberculosis(TB)has been a human disease for *** frequency is increased manyfold in patients with liver *** gold standard of TB management is a 6-mo course of isoniazid,rifampicin,pyrazinamide and *** good results are seen with this treatment in general,the management of patients with underlying cirrhosis is a *** underlying depressed immune response results in alterations in many diagnostic *** tests used for latent TB have many flaws in this group of *** of four first-line antitubercular drugs are hepatotoxic and baseline liver function is often disrupted in patients with underlying *** of hepatotoxicity is increased in patients with liver cirrhosis,frequently leading to severe liver *** are no established guidelines for the treatment of TB in relation to the severity of liver *** is no consensus on the frequency of liver function tests required or the cutoff used to define *** specific treatment exists for prevention or treatment of hepatotoxicity,making monitoring even more important.A high risk of multidrug-resistant TB is another major worry due to prolonged and interrupted treatment.

关键词： Antitubercular therapy Drug hepatotoxicity Multidrug-resistant tuberculosis Immune dysfunction

A randomized controlled trial of peeling and aspiration of Elschnig pearls and neodymium: yttrium-aluminiumgarnet laser capsulotomy

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International Journal of Ophthalmology(English edition) 2015年第3期8卷 590-596页

作者： Rahul Bhargava Prachi kumar shiv kumar Sharma Avinash Kaur Department of Ophthalmology Laser Eye Clinic Department of Pathology Santosh Medical College and Hospital Department of Ophthalmology Rotary Eye Hospital Department of Ophthalmology Santosh Medical College and Hospital

AIM: To compare surgical peeling and aspiration and neodymium yttrium garnet laser capsulotomy for pearl form of posterior capsule opacification(PCO).METHODS: A prospective, randomized, double blind,study was done at Rotary Eye Hospital, Maranda,Palampur, India, Santosh Medical College Hospital,Ghaziabad, India and Laser Eye Clinic, Noida *** patients with pearl form of PCO following surgery, phacoemulsification, manual small incision cataract surgery and conventional extracapsular cataract extraction(ECCE) for age related cataract, were randomized to have peeling and aspiration or neodymium yttrium garnet laser capsulotomy. Corrected distance visual acuity(CDVA), intra-operative and postoperative complications were ***: A total of 634 patients participated in the study, and 314(49.5%) patients were randomized to surgical peeling and aspiration group and 320(50.5%) to the Nd:YAG laser group. The mean pre-procedural log MAR CDVA in peeling and neodymium: yttrium-aluminium-garnet(Nd:YAG) laser group was 0.80 ±0.25 and 0.86 ±0.22, respectively. The mean final CDVA in peeling group(0.22 ±0.23) was comparable to Nd:YAG group(0.24 ±0.28; t-test, P =0.240). There was a significant improvement in vision after both the procedures(P <0.001). A slightly higher percentage of patients in Nd:YAG laser group(283/88.3%) than in peeling group(262/83.4%) had a CDVA of 0.5(20/63) or better at 9mo(P <0.001). On the contrary, patients havingCDVA worse than 1.00(20/200) was also significantly higher in Nd:YAG laser group as compared to peeling group(25/7.7% vs 15/4.7%, respectively). On application of ANCOVA, there was less than 0.001% risk that PCO thickness and total laser energy had no effect on rate of complications in Nd:YAG laser group and less than 0.001% risk that PCO thickness had no effect on complications in peeling group respectively. Sum of square analysis suggests that in the Nd:YAG laser group,thick PCO had a stronger impact on complication

关键词： posterior capsule neodymium Elschnig pearls yttrium-aluminium-garnet capsulotomy

Phacoemulsification versus small incision cataract surgery in patients with uveitis

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International Journal of Ophthalmology(English edition) 2015年第5期8卷 965-970页

作者： Rahul Bhargava Prachi kumar shiv kumar Sharma Manoj kumar Avinash Kaur Department of Ophthalmology Laser Eye Clinic Department of Pathology Santosh medical College and Hospital Department of Ophthalmology Rotary Eye Hospital

AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic *** a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically *** hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance

关键词： small incision cataract surgery phacoemulsification uveitis corrected distance visual acuity uncorrected distance visual acuity

Population structure analysis and determination of neurotoxin content in a set of grass pea (Lathyrus sativus L.) accessions of Bangladesh origin

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The Crop Journal 2018年第4期6卷 435-442页

作者： Priyanka Gupta Sripada M. Udupa Debjyoti Sen Gupta Jitendra kumar shiv kumar International Center for Agricultural Research in the Dry Areas Rabat Institute Rabat Morocco Department of Plant Sciences North Dakota State University Fargo ND 58105 USA ICAR-Indian Institute of Pulses Research Kanpur Uttar Pradesh 208024 India

Grass pea(Lathyrus sativus L.) is a crop that is considered one of the more resilient to climate change. With protein-rich seeds and leaves, it has strong potential as human food as well as animal feed and fodder. However, genetic improvement in this crop remains stagnant owing to the poor characterization of its genetic resources. In this study, we characterized 118 accessions of grass pea with 18 EST-SSR markers. A total of 118 accessions, 101 of L. sativus(100 cultivated accessions from Bangladesh and one wild accession) and 17 wild accessions of other Lathyrus species, were used. A total of 67 alleles were detected, with an average of 3.72 alleles per locus and average polymorphism information content of 0.52. A dissimilarity matrix was formed and hierarchical cluster analysis performed using the UPGMA method grouped genotypes into four main clusters. Cluster analysis based on the genetic dissimilarity revealed a clear grouping of the 100 cultivated and 18 wild accessions into four main groups. Group I consisted of 20 accessions with high β-N-oxalyl-L-α,β-diaminopropionic acid(β-ODAP) concentration. Of these 20 accessions, 17 were wild accessions. Only one wild accession(L. cicera) was clustered in group II, which contained 35 accessions. Most of the group II accessions contained low β-ODAP. Group III was represented by 34 accessions, many of them with high β-ODAP. Group IV consisted of 29 accessions, a few of which had very high β-ODAP concentrations. Analysis of molecular variance of the microsatellite data showed significantly higher values of molecular variance between(83%) than within(17%) populations. These characterized accessions will be useful in grass pea breeding programs.

关键词： Lathyrus Population structure EST-SSRβ-ODAP Genetic diversity

Critical flicker frequency for diagnosis and assessment of recovery from minimal hepatic encephalopathy in patients with cirrhosis

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 27-32页

作者： Praveen Sharma Barjesh Chander Sharma shiv kumar Sarin Department of Gastroenterology G.B.Pant Hospital

BACKGROUND:Minimal hepatic encephalopathy (MHE) impairs quality of life and predicts overt hepatic encephalopathy (HE) in cirrhotic *** of MHE requires cumbersome *** is effective in the treatment of *** study aimed to evaluate the use of critical flicker frequency (CFF) for the diagnosis of MHE in cirrhotic patients after ***:One hundred and ten patients were evaluated by psychometry (number connection tests A,B or figure connection tests A,B),P300 auditory event related potential (P300ERP),venous ammonia,and CFF for *** was diagnosed by abnormal psychometry (>2SD age matched controls) and *** patients were treated with lactulose for one *** was defined by normalization (<2SD of matched controls) of both psychometry and ***:Of the 110 patients [Child Turcott Pugh score A:B:C 39:42:29,(age 41.6±11.6 years,M:F 82:28)],75 (68%) had abnormal results of psychometric tests,and 74 (67%) had prolonged *** (20%) patients with abnormal results of psychometric tests had normal *** sixty (54.5%) patients were diagnosed as having *** treatment for one month,34 (57%) recovered while 26 (43%) continued to have abnormal resents of psychometric or P300ERP *** was <39 Hz in 72 (65.4%) patients before treatment and in 20 (33.3%) after *** sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy for the assessment of recovery of MHE were 65%,91%,85%,77% and 80%,***:CFF is a simple,relatively reliable,and accurate test without any dependence on age or literacy in the diagnosis and assessment of recovery of patients with MHE.

关键词： minimal hepatic encephalopathy critical flicker frequency lactulose

Identification and characterization of genotype A and D recombinant hepatitis B virus from Indian chronic HBV isolates

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World Journal of Gastroenterology 2008年第40期14卷 6228-6236页

作者： Ranjit Chauhan Syed Naqui Kazim Manoj kumar Jayashree Bhattacharjee Narayanasamy Krishnamoorthy shiv kumar Sarin Department of Gastroenterology and Advanced Center for Liver Diseases G.B.Pant Hospital Department of Biochemistry Lady Hardinge Medical College Centre for Interdisciplinary Research in Basic Sciences The Centre for Genomic Application

AIM： To confirm the presence of recombination, fulllength hepatitis B virus （HBV） from chronic patients was sequenced and analyzed. METHODS： Full-length HBV genomes from 12 patients were amplified and sequenced in an automated sequencer. Phylogenetic analysis was carried out on full-length, Core and preS2/Surface regions using MEGA software. SimPIot Boot Scanning and amino acid sequence analysis were performed for confirmation of recombination. RESULTS： Eight patients were infected with genotype D strain; one patient with genotype A and three patients had genotype A and D recombination; two of them had cirrhosis and one had hepatocellular carcinoma. Phylogenetic analysis of core and preS2/surface regions separately showed evidence of genotype A and D recombination. The breakpoints of recombination were found to be at the start of preS2 and at the endof surface coding regions. CONCLUSION： We identified and characterized recombinant A and D genotype HBV in hepatitis B surface antigen （HBsAg）-positive patients.

关键词： Hepatitis B virus Genotype Variation Evolution Recombination

Clinical Impact of Budesonide/formoterol (Symbicort) in Children with Acute Exacerbation of Bronchial Asthma

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Clinical Impact of Budesonide/formoterol (Symbicort) in Chil...

作者： shiv kumar Yadav 重庆医科大学

学位级别：硕士

Objective: To investigate the budesonide/formoterol (Symbicort) whether it’s ability to effect rapidly and improve lung function effectively in children with bronchial asthma, as well as to alleviate the symptoms of acute attack.Methods: 20 participants were selected according to the standard diagnosis criteria of asthma, and in the course of an acute attack. Pulmonary function test and wheezing conditions were investigated and its improvement was measured at 5, 15 and 30 minutes post-inhalation of symbicort with 2puff.Results: Inhalation therapy with Symbicort, it’s taking effect within 30 minutes in all cases. Lung function was improved, bronchial dilation test was positive, and it reduced the wheezing sound over lung after inhalation of the drug. In 20 children, 15 cases showed Symbicort taking effect within 5 minutes, their lung function test improved & bronchial dilation test were positive but it’s taking effect within 15 minutes in the other 5 cases, their lung function test improved & bronchial dilation test were positive as well.Conclusion: The Symbicort can be used as maintenance and reliever inhalation therapy in children with acute exacerbations of bronchial asthma.

关键词： Budesonide Formoterol Bronchial Asthma Wheezing Pulmonary Function Test (PFT)