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World Journal of Cardiovascular Surgery 2019年第8期9卷 73-82页

作者： Manoj kumar Sahu Harsha Vardhan Niraghatam Nikhil Bansal Sarvesh Pal Singh Palleti Rajashekar shiv kumar choudhary Department of Cardiothoracic and Vascular Surgery CN Centre All India Institute of Medical Sciences New Delhi India

Background: Junctional ectopic tachycardia (JET) is one troublesome supraventricular arrhythmia in postoperative pediatric cardiac surgical patients. Unless treated timely and effectively it may lead to morbidity and even mortality. Aim: To understand the role of Ivabradine in the treatment of JET in postoperative pediatric cardiac surgical patients. Case: We present a postoperative case of complete repair of Tetralogy of Fallot who was in normal sinus rhythm in the preoperative period and developed JET 4 hours later in postoperative period which was persistent despite measures to optimize the internal milieu of the body and conventional antiarrhythmics, that was successfully treated with Ivabradine at a dose of 0.05 mg/kg/12 hourly. Conclusion: Ivabradine can be used to successfully treat postoperative JET in cases ofrefractory to other antiarrhythmic drugs like Digoxin and Amiodarone.

关键词： Tetralogy of Fallot Junctional Ectopic Tachycardia Ivabradine

Polytetrafluoroethylene Patch versus Autologous Pericardial Patch for Right Ventricular Outflow Tract Reconstruction in Patients with Tetralogy of Fallot

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World Journal of Cardiovascular Surgery 2017年第3期7卷 41-53页

作者： Sachin Talwar Intekhab Alam Vishnubhatla Srreenivas Palleti Rajashekar Sivasubramanian Ramakrishnan shiv kumar choudhary Balram Airan Department of Cardiothoracic and Vascular Surgery All India Institute of Medical Sciences New Delhi India Biostatistics All India Institute of Medical Sciences New Delhi India Cardiology All India Institute of Medical Sciences New Delhi India

Objective: For patients of TOF with pulmonary annular hypoplasia, reconstruction of right ventricular outflow tract (RVOT) often requires a trans annular patch (TAP). The present study aims to compare the outcomes of TOF repair using Polytetrafluoroethylene (PTFE) patch versus autologous glutaraldehyde fixed pericardial patch for RVOT reconstruction. Materials and methods: 103 consecutive patients undergoing TOF repair in whom TAP was required were randomized into two groups: Group I (pericardial patch), Group II (PTFE patch). Postoperative outcomes in terms of postoperative heart rhythm, duration of mechanical ventilation, mediastinal and pleural drainage, length of stay in intensive care unit (ICU) and hospital mortality were assessed. A separate team of cardiologists independently evaluated pre- and post-operative gradients across the RVOT, degree of pulmonary insufficiency, right ventricular systolic function. Results: There were no significant differences between the two groups in terms of the incidence of postoperative arrhythmias, duration of mechanical ventilation, length of intensive care unit or hospital stay. The requirement of inotropes was no different in the PTFE patch group as compared with the pericardial patch group (16.84 ± 7.04 vs. 17.90 ± 6.71, median 19 vs. 20, p = 0.825). The re-exploration rate was higher in the PTFE group as compared with the pericardial patch group (6 vs. 1). Postoperative Echocar-diography revealed no differences in the RV systolic function between the two groups before discharge. Conclusion: In patients undergoing TOF repair, using a PTFE patch yields comparable results. However, the efficacy of PTFE will only be established once;mid-term and long-term results are available.

关键词： Tetralogy of Fallot Right Ventricular Outflow Tract Patch Material

Extent of Degenerative Changes in Ascending Aorta of Patients with Bicuspid Aortic Valve (BAV)—A Histopathological Study

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World Journal of Cardiovascular Surgery 2012年第4期2卷 66-72页

作者： Mukesh Kumawat shiv kumar choudhary Sachin Talwar Velayoudam Devagourou Millind Hotte Neeti Makhija Ruma Ray All India Institute of Medical Sciences New Delhi India

Objective: To find out, whether the degenerative process of ascending aorta is limited to the aortic sinuses only or is extending to mid and distal ascending aorta of Bicuspid Aortic Valve patients. Method: A prospective consecutive study on 25 patients of BAV (undergoing aortic valve with ± ascending aortic surgeries) was conducted from 1st Jan 2010 to 30th Dec 2011. Morphological and anatomical data of root and ascending aorta were recorded from echocardiography and computed tomography angiography. Intra-operatively, aortic tissue biopsy taken from three sites: sinus, mid, and distal ascending aorta. Histological evaluation of the aortic wall was based on criteria adapted from Schlatmann and Becker and from de Sa et al. The presence and degree of the 5 variables of degeneration were studied: Linear regression and correlation were used to get relationship between histopathological scoring (HPE-T) and aortic diameter for each site of ascending aorta. Results: Significant linear relation was found between aortic sinus diameter and HPE T score with R value = 0.590 (p value 0.001) and variance of 37.5%. Analysis suggests that HPE T Score = -5.139 + (0.188 x Ao. Sinus Diameter in mm). No significant linear relation could be established between mid and distal ascending aorta diameter and HPE T scoring. Conclusion: In BAV patient’s, a definite relationship between degenerative changes of aortic media and aortic diameter was found and was limited up to the sinus level only. Thus, the study reinforces the thought of replacing aortic sinus too while dealing with aortic valve, even without significant dilatation. By this aggressive management of aortic root, progression of aortic dilatation or dissection can be prevented in bicuspid aortic valve patients.

关键词： Bicuspid Aortic Valve Ascending Aorta Degenerative Changes

Optimization of variables and assessment of in-vitro and in-vivo antihyperlipidemic activity of Eudragit RS nanoparticles containing simvastatin

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Particuology 2024年第7期90卷 189-198页

作者： Bina Gidwani Vishal Jain Veenu Joshi Ravindra kumar Pandey shiv Shankar Shukla Amber Vyas Columbia Institute of Pharmacy Raipur(C.G.)India University Institute of Pharmacy Pt Ravishankar Shukla UniversityRaipur(C.G.)India Center for Basic Science and Research Pt Ravishankar Shukla UniversityRaipur(C.G.)India

Simvastatin, a BCS class II drug, is associated with poor aqueous solubility, first-pass metabolism and short half-life. In the present work, nanoparticles were prepared and evaluated. Optimization of formulation and process parameters was done through the use of independent and dependent variables. Preliminary studies were done to determine suitable range of the concentration of Eudragit polymer (10%–30%) and the ratio of drug to polymer (1:1 to 1:5) for the formation of nanoparticles by emulsification and a solvent evaporation technique. Results revealed that the mean size of nanoparticles was affected by stirring speed from 5000 RPM, 8000 RPM, and 12000 RPM. The results of increase in association efficiency and percent yield with increase in amount of drug from 100 mg, 150 mg, and 200 mg in selected range were observed. In-vitro release studies showed that two formulations possess highest initial burst and slow sustained drug release. There was 2.93-fold decrease in total cholesterol and 3.27-fold increases in triglyceride level during in-vivo study.

关键词： Simvastatin Eudragit RS 100 Nanoparticles Hyperlipidemia

Testing the LCC hypothesis by considering environmental sustainability and economic development:Role of green energy and resource management

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Geoscience Frontiers 2024年第3期15卷 419-430页

作者： Sunil Tiwari Syed Ali Raza shiv kumar Gupta Irum Shahzadi Mahendra Babu Kuruva Department of Tourism Studies School of Business StudiesCentral University of KeralaIndia Department of Business Administration IQRA UniversityKarachi 75300Pakistan Centre for Mountain Tourism and Hospitality Studies HNB Garhwal Central UniversitySrinagarUttarakhand 246174India Department of Production Engineering São Paulo State University(UNESP)BauruBrazil Department of Business Administration IQRA University Karachi-75300Pakistan Department of Business Management HNB Garhwal Central UniversitySrinagar GarhwalUttarakhand 246174India

This study aims to demystify the role of green energy and green technology in establishing the nexus between behavioural intentions of tourists,technologies,and digital payments by using Perceived value(PV),Compatibility(CO),Perceived Enjoyment(PE),and Social Influence(SI)as a predictor variables,Trust(TR)and Satisfaction(SA)as a mediating variables and Behavioural Intentions(BI)as an outcome *** the empirical estimation,we employ smart PLS-SEM,TAM(Technology Acceptance Model)and SPSS and Tested the LCC *** findings suggest that green energy and perceived value have the highest positive impact on tourists’trust towards digital payments followed by compatibility,social influence and perceived ***,tourists’satisfaction and green technology is one of the important determinants of choosing any digital mode of payment,is mostly influence by perceived value,perceived enjoyment,compatibility and social ***,if we choose between trust and satisfaction,trust plays a significant role in exploring the behavioural intentions of tourists about green energy and green technology followed by tourists’*** addition,Tourists’trust and satisfaction are highly correlated and influence each *** study offers novel policy implications in terms of use of green technology and green energy in enhancing trust and satisfaction of tourists in order to deeper understanding of different dimensions of digital payments and M-wallets,and allowing them to explore the long-term value inherent of digital payments and M-wallets.

关键词： Digital payment Green technology Green energy Tourism LCC hypothesis

用冷模拟研究和热力学分析评价转炉炼钢底吹搅拌系统

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现代冶金（内蒙古） 2008年第1期 26-31页

作者： shiv kumar choudhary[印度] 张怀军(译) 兰岳光(校)

为了优化新转炉底枪布置形式，在试验模型尺寸与实际炼钢转炉尺寸几何相似比为1：6的条件下，完成了底枪布置水模试验。通过测量电导率方法测量了10种不同底枪布置条件下的混合时间，结果表明：在几种不同底枪布置形式中，以8支底枪对... 详细信息

为了优化新转炉底枪布置形式，在试验模型尺寸与实际炼钢转炉尺寸几何相似比为1：6的条件下，完成了底枪布置水模试验。通过测量电导率方法测量了10种不同底枪布置条件下的混合时间，结果表明：在几种不同底枪布置形式中，以8支底枪对称非等角布置方式搅拌效果最佳。与先前的底枪布置形式相比（6支底枪），在新转炉中采用相同的底枪布置形式时（底枪数为八支），溶池内的混合效果可提高40％。根据水模试验确定了最佳底枪布置形式后，将其应用于塔塔钢厂LDI车间转炉实际生产操作中，磷的平均分配比提高10％-12％，转炉渣中的TFe％平均值降低了1％-2％。采用新的底枪布置形式后，转炉第一个炉役炉龄大于2000炉。此外，本文利用现场实际生产操作数据，评价了塔塔钢厂在过去几年中，使用不同底吹搅拌系统时，转炉炼钢过程中脱磷热力学的情况。从中可以发现：由于提高了底吹搅拌系统，改善了炼钢过程脱磷效果，并使脱磷反应逐渐达到平衡条件。

关键词：碱性氧气转炉炼钢底吹搅拌水模混合时间脱磷

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低碳盘条Mn—Si镇静钢可浇铸性的研究

现代冶金（内蒙古） 2008年第2期 27-30页

作者： shiv kumar choudhary[印度] 张怀军(译) 李德奎(校)

1引言在小方坯铸机生产中，采取合理的钢包二次精炼技术可有效地控制钢水脱氧产物和夹杂物。为了使钢水顺利通过尺寸较小的耐火材料水口（直径15—18mm，小方坯铸机中典型的水口直径），前提条件之一是保证钢水中的夹杂物为液态。钢水... 详细信息

1引言在小方坯铸机生产中，采取合理的钢包二次精炼技术可有效地控制钢水脱氧产物和夹杂物。为了使钢水顺利通过尺寸较小的耐火材料水口（直径15—18mm，小方坯铸机中典型的水口直径），前提条件之一是保证钢水中的夹杂物为液态。钢水的可浇性主要受钢水中固态微型夹杂物（氧化铝富集）以及钢水中夹杂物的浓度影响。因此，防止水口絮死的有效措施是：通过采取有效的脱氧方法，清洁钢水，减少钢水中总的夹杂物通量。

关键词：镇静钢钢水脱氧浇铸 Si Mn 盘条低碳方坯铸机

Development and validation of multicentre study on novel Artificial Intelligence-based Cardiovascular Risk Score(AICVD)

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Family Medicine and Community Health 2024年第S1期12卷 20-33页

作者： shiv kumar Jalepalli Prashant Gupta Andre L A J Dekker Inigo Bermejo Sujoy Kar Apollo Hospitals HyderabadTelanganaIndia Azure Microsoft Research IndiaBengaluruIndia Department of Radiation Oncology(Maastro) Maastricht UniversityMaastrichtNetherlands

Objective Cardiovascular diseases(CVD)are one of the most prevalent diseases in India amounting for nearly 30%of total deaths.A dearth of research on CVD risk scores in Indian population,limited performance of conventional risk scores and inability to reproduce the initial accuracies in randomised clinical trials has led to this study on large-scale patient *** objective is to develop an Artificial Intelligence-based Risk Score(AICVD)to predict CVD event(eg,acute myocardial infarction/acute coronary syndrome)in the next 10 years and compare the model with the Framingham Heart Risk Score(FHRS)and *** Our study included 31599 participants aged 18–91 years from 2009 to 2018 in six Apollo Hospitals in India.A multistep risk factors selection process using Spearman correlation coefficient and propensity score matching yielded 21 risk factors.A deep learning hazards model was built on risk factors to predict event occurrence(classification)and time to event(hazards model)using multilayered neural ***,the model was validated with independent retrospective cohorts of participants from India and the Netherlands and compared with FHRS and *** The deep learning hazards model had a good performance(area under the curve(AUC)0.853).Validation and comparative results showed AUCs between 0.84 and 0.92 with better positive likelihood ratio(AICVD−6.16 to FHRS−2.24 and QRisk3−1.16)and accuracy(AICVD−80.15%to FHRS 59.71%and QRisk351.57%).In the Netherlands cohort,AICVD also outperformed the Framingham Heart Risk Model(AUC−0.737 vs 0.707).Conclusions This study concludes that the novel AI-based CVD Risk Score has a higher predictive performance for cardiac events than conventional risk scores in Indian population.

关键词： AICVD Cardiovascular acute

New treatment options for alcoholic hepatitis

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World Journal of Gastroenterology 2016年第15期22卷 3892-3906页

作者： Saggere Muralikrishna Shasthry shiv kumar Sarin Depart-ment of Hepatology Institute of Liver and Biliary Sciences

The burden of alcoholic liver disease has rapidly grown in the past two decades and is expected to increase further in the coming years. Alcoholic hepatitis, the most florid presentation of alcoholic liver disease, continues to have high morbidity and mortality, with significant financial and healthcare burden with limited treatment options. Steroids remain the current standard of care in severe alcoholic hepatitis in carefully selected patients. No specific treatments are available for those patients who are steroid ineligible, intolerant or unresponsive. Liver transplant has shown good short-term outcome; however, feasibility, ethical and economic concerns remain. Modification of gut microbiota composition and their products, such as lipopolysaccharide, nutritional interventions, immune modulation, increasing steroid sensitivity, genetic polymorphism and epigenetic modification of alcohol induced liver damage, augmenting hepatic regeneration using GCSF are potential therapeutic avenues in steroid non-responsive/ineligible patients. With better understanding of the pathophysiology, using “Omics” platforms, newer options for patients with alcoholic hepatitis are expected soon.

关键词： Alcoholic liver disease Alcoholic steatosis Alcoholic hepatitis Gut microbiota Lipopolysaccharide Steroid non-response

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