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Importance of reporting segmental bowel preparation scores during colonoscopy in clinical practice

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World Journal of Gastroenterology 2015年第13期21卷 3994-3999页

作者： Deepanshu Jain Mojdeh Momeni Mahesh Krishnaiah sury anand Shashideep Singhal Internal Medicine Department Albert Einstein Medical CentrePh 19141United States Division of Gastroenterology Department of Internal MedicineThe Brooklyn hospital CentreBrooklynNY 11205United States Division of Gastroenterology hepatology and NutritionUniversity of Texas health Science Centre at houstonhoustonTX 77030United States

AIM: To evaluate the impact of reporting bowel preparation using Boston Bowel Preparation Scale(BBPS) in clinical ***: The study was a prospective observational cohort study which enrolled subjects reporting for screening colonoscopy. All subjects received a gallon of polyethylene glycol as bowel preparation regimen. After colonoscopy the endoscopists determined quality of bowel preparation using BBPS. Segmental scores were combined to calculate composite BBPS. Site and size of the polyps detected was recorded. Pathology reports were reviewed to determine advanced adenoma detection rates(AADR). Segmental AADR's were calculated and categorized based on the segmental BBPS to determine the differential impact of bowel prep on AADR. RESULTS: Three hundred and sixty subjects were enrolled in the study with a mean age of 59.2 years, 36.3% males and 63.8% females. Four subjects with incomplete colonoscopy due BBPS of 0 in any segment were excluded. Based on composite BBPS subjects were divided into 3 groups; Group-0(poor bowel prep, BBPS 0-3) n = 26(7.3%), Group-1(Suboptimal bowel prep, BBPS 4-6) n = 121(34%) and Group-2(Adequate bowel prep, BBPS 7-9) n = 209(58.7%). AADR showed a linear trend through Group-1 to 3; with an AADR of 3.8%, 14.8% and 16.7% respectively. Also seen was a linear increasing trend in segmental AADR with improvement in segmental BBPS. There was statistical significant difference between AADR among Group 0 and 2(3.8% vs 16.7%, P < 0.05), Group 1 and 2(14.8% vs 16.7%, P < 0.05) and Group 0 and 1(3.8% vs 14.8%, P < 0.05). χ2 method was used to compute P value for determining statistical ***: Segmental AADRs correlate with segmental BBPS. It is thus valuable to report segmental BBPS in colonoscopy reports in clinical practice.

关键词： Colorectal cancer screening Adenomas Polyps Boston

Role of over the scope clips in the management of iatrogenic gastrointestinal perforations

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World Journal of Gastroenterology 2014年第32期20卷 11460-11462页

作者： Kinesh Changela Muhhamad A Virk Niravkumar Patel Sushil Duddempudi Mahesh Krishnaiah sury anand Division of Gastroenterology The Brooklyn Hospital Center New York Presbyterian Healthcare System Brooklyn NY 11201 United States

Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of gastroenterology, the promising use of an over the scope clips(OTSC) has fulfilled the unmet need for a reliable endoscopic devise in approximation of gastrointestinal perforation. This novel approach has raised the level of confidence in endoscopist in dealing with this serious complication during endoscopy. Here we have shared our experience with OTSC to evaluate its efficacy and safety in managing iatrogenic gastrointestinal perforations during endoscopy.

关键词： Gastrointestinal perforation Over-the-scope clip Over the scope clip system Endoscopic adverse events

Review of efficacy and safety of laxatives use in geriatrics

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第2期7卷 334-342页

作者： Manhal Izzy Anju Malieckal Erin Little sury anand Division of Gastroenterology and Liver Diseases Montefiore Medical Center Albert Einstein College of Medicine Division of Gastroenterology the Brooklyn Hospital Center Division of Gastroenterology NYU-Lutheran Medical Center

AIM:To study the efficacy and safety of pharmacolo-gical treatment of constipation in ***:Pub Med,MEDLINE,google scholar,and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation,which were conducted between January1990 and January 2013 using the specified *** studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were *** were excluded from this review if they were non-controlled trials,case series,or case ***:Out of twenty three studies we initially retrieved in our search,only nine studies met the eligibility criteria of being controlled trials within *** laxatives examined in the nine studies were senna,lactulose,sorbital,polyethylene glycol(PEG),lubiprostone,linaclotide,and *** those studies,senna combinations had a higher efficacy than sorbitol or lactulose as well as,a very good adverse effect *** was also shown to be safe and effective in geriatric ***,it has been shown that PEG is as safe in geriatrics as in general *** agents like lubiprostone and prucalopride show promising results but the data about these agents in geriatrics are still limited which warrant further ***:Senna combinations and PEG appear to have a more favorable profile over the other traditionally used laxatives in elderly patients with constipation.

关键词： Chronic constipation Laxatives Elderly Lubiprostone Linaclotide Prucalopride

Peroral endoscopic reduction of dilated gastrojejunal anastomosis after bariatric surgery: Techniques and efficacy

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World Journal of Gastrointestinal Endoscopy 2016年第4期8卷 239-243页

作者： Kinesh Changela Emmanuel Ofori Sushil Duddempudi sury anand Shashideep Singhal Division of Gastroenterology the Brooklyn Hospital Center-Clinical Affiliate of Mount Sinai Hospital Division of Gastroenterology Hepatology and Nutrition University of Texas Health Science Center at Houston

AIM: To investigate the techniques and efficacy of peroral endoscopic reduction of dilated gastrojejunal anastomosis after bariatric ***: An extensive English language literature search was conducted using Pub Med, MEDLINE, Medscape and Google to identify peer-reviewed original and review articles using the keywords "bariatric endoscopic suturing", "overstitch bariatric surgery", "endoscopic anastomotic reduction", "bariatric surgery", "gastric bypass", "obesity", "weight loss". We identified articles describing technical feasibility, safety, efficacy, and adverse outcomes of overstitch endoscopic suturing system for transoral outlet reduction in patients with weight regain following Roux-en-Y gastric bypass(RYGB). All studies that contained material applicable to the topic were considered. Retrieved peer-reviewed original and review articles were reviewed by the authors and the data extracted using a standardized collection tool. Data were analyzed using statistical analysis as percentages of the event. RESULTS: Four original published articles which met our search criteria were pooled. The total number cases were fifty-nine with a mean age of 46.75 years(34-63 years). Eight of the patients included in those studies were males(13.6%) and fifty-one were females(86.4%). The mean time elapsed since the primary bypass surgery was 5.75 years. The average pre-endoscopic procedure body mass index(BMI) was 38.68(27.5-48.5). Mean body weight regained post-RYGB surgery was 13.4 kg from their post-RYGB nadir. The average pouch length at the initial upper endoscopy was 5.75 cm(2-14 cm). The pre-intervention anastomotic diameter was averaged at 24.85 mm(8-40 mm). Average procedure time was 74 min(50-164 min). Mean post endoscopic intervention anastomotic diameter was 8 mm(3-15 mm). Weight reduction at 3 to 4 mo post revision noted to be anaverage of 10.1 kg. Average overall post revision BMI was recorded at 37.7. The combined technical and clinical success rate was

关键词： Endoscopic anastomosis reduction Bariatricsurgery Endoscopic suturing EndoCinch Overstitchbariatric surgery

Accuracy of endoscopists' estimate of polyp size: A continuous dilemma

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World Journal of Gastrointestinal Endoscopy 2015年第8期7卷 824-829页

作者： Manhal Izzy Muhammad Asif Virk Avi Saund Juan Tejada Faraj Kargoli sury anand Division of Gastroenterology the Brooklyn Hospital Center/New York Presbyterian Health Care System Division of Gastroenterology and Liver Diseases Montefiore Medical Center

AIM: To examine the discrepancy, if any, between the endoscopist's estimate and pathologist's measurement of colonic polyp size. METHODS: We retrospectively studied 88 patients who underwent colonoscopy with a clear unequivocal documentation of polyp size by both the endoscopist and pathologist. Endoscopist measurements were based on the visual estimate of polyp size seen on high definition screens. The measurement was done by our pathologists after formalin fixation. We compared the endoscopist estimate of the polyp size to the pathologist measurement in order to explore the discordance between the two readings. Data regarding demographics and method of polypectomy(snare polypectomy vs excisional biopsy) was collected, as well. Statistical analysis software statistical software was used to analyze the data. RESULTS: Our cohort included 88 patients from which 111 polyps were removed. Fifty-two(46.8%) of the 111 polyps were excised using biopsy forceps and fiftynine(53.2%) were removed by snare. In the biopsy forceps group, the mean polyp size documented by the pathologist was 0.38 ± 0.19 cm and the mean polyp size documented by the endoscopist was 0.54 ± 0.16cm. The mean difference was 0.15 cm(P < 0.001). In the snare group, the mean polyp size documented by the pathologist was 0.54 ± 0.24 cm and the mean polyp size documented by the endoscopist 0.97 ± 0.34 cm. The mean difference was 0.42 cm(P < 0.001). Combining both groups, the mean size documented by pathologist was 0.46 ± 0.23 cm compared to 0.76 ± 0.35 cm documented by the endoscopist. The mean difference was 0.3 cm(95%CI: 0.23-0.36).CONCLUSION: Post polypectomy measurement by the pathologist are generally smaller than the endoscopist's estimate.

关键词： Polyp size estimate Colonic polyps Endoscopistestimate

Geomorphometric Analysis of the Kshetrapal Landslide in Chamoli, Uttarakhand, India Using the White Box Tool (WBT) and QGIS by Comparing various DEMs Obtained from UAV and TLS

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International Journal of Geosciences 2025年第1期16卷 31-60页

作者： Ashok anand Geomatics Engineering Group Department of Civil Engineering Indian Institute of Technology Roorkee Uttarakhand India

Utilizing multispectral satellite data and digital elevation models (DEMs) has emerged as the primary approach for cartographically representing landforms. By using high-resolution satellite photos that capture spatial, temporal, spectral, and radiometric data, one may get a fresh comprehension of the geomorphology of a particular area by recognizing its landforms. In addition, a synergistic method is used by using data produced from digital elevation models (DEMs) such as Slope, Aspect, Hillshade, Curvature, Contour Patterns, and 3-D Flythrough Visuals. The increasing use of UAV (drone) technology for obtaining high-resolution digital images and elevation models has become an essential element in developing complete topographic models in landslide scars that are very unstable and prone to erosion. Comparison (differences in values) of seven (7) different DEMs between two algorithms used, i.e., QGIS and White Box Tool (WBT), were successfully attempted in the present research. The TLS, UAV and Satellite data of the study area—Kshetrapal Landslide, Chamoli (District), Uttarakhand (State), India was subjected to two different algorithms (QGIS and WBT) to evaluate and differentiate seven different DEMs (CARTOSAT, ASTER, SRTM, Alos 3D, TanDEM, MERIT, and FabDEM/FATHOM) taking into consideration various parameters viz. Aspect, Hillshade, Slope, Mean Curvature, Plan Curvature, Profile Curvature and Total Curvature. The different values of aforesaid parameters of various DEMs evaluated (using algorithms QIGS and WBT) reveal that only three parameters, i.e., Aspect, Hillshade, and Slope, show results. In contrast, the remaining ones do not show any meaningful results, and therefore, the comparison was possible only with regard to these three parameters. The comparison is drawn by comparing minimum, maximum, and elevation values (by subtracting WBT values from QGIS values) regarding Aspect, Hillshade, and Slope, arranging the differences in values as per their importance. (I

关键词： Landslide Morphometric Analysis Digital Elevation Models (DEMs) TLS UAV (Drone) QGIS WBT

Comparative efficacy of hyperbaric bupivacaine vs hyperbaric ropivacaine in spinal anesthesia for cesarean section:A metaanalysis

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World Journal of Methodology 2025年第2期15卷 154-165页

作者： Rishi anand Deb Sanjay Nag Roushan Patel Prashant Sharma Vamsi Krishna Uppalapati Umesh Kumar Singh Department of Anaesthesiology Tata Main HospitalJamshedpur 831001JhārkhandIndia

BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential *** meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean *** To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in *** A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during ***,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion *** were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect *** standardized mean difference with 95%CI was used for continuous *** variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds *** Total 8 RCTs were selected from a pool of 119 search results for *** meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the *** primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local *** analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine ***,the duration of the first analgesic

关键词： Ropivacaine Bupivacaine Anesthesia Spinal Cesarean section Meta-analysis

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重塑当代女性的轮廓孟买NEZO零售店

室内设计与装修 2025年第1期 74-77页

作者：无 Pankaj anand(摄影) 西溪(编译) Sanjay Puri Architects 不详

NEZO创始人发现,印度市场缺乏具有西式风格样式的服装,于是决定创建这个独特的品牌,旨在汇聚来自全国的设计师,展示设计的多元化。她深信,印度的设计师代表着时尚的未来。基于这一信念,她邀请Sanjay Puri Architects建筑师事务所打造了... 详细信息

NEZO创始人发现,印度市场缺乏具有西式风格样式的服装,于是决定创建这个独特的品牌,旨在汇聚来自全国的设计师,展示设计的多元化。她深信,印度的设计师代表着时尚的未来。基于这一信念,她邀请Sanjay Puri Architects建筑师事务所打造了一个充满活力、具有前瞻性和现代感的空间。

关键词：建筑师事务所当代女性现代感展示设计多元化前瞻性

Seismic bearing capacity of strip footing on partially saturated soil using modal response analysis

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Earthquake Engineering and Engineering Vibration 2022年第3期21卷 641-662页

作者： Abhijit anand Rajib Sarkar Department of Civil Engineering IIT(ISM)DhanbadDhanbad 826004India

The present study proposes a novel and simplified methodology to assess the seismic bearing capacity(SBC) of a shallow strip footing by incorporating strength non-linearity arising due to partial saturation of a soil matrix. Furthermore, developed methodology incorporates the modal response analysis of soil layers to assess SBC. A constant matric suction distribution profile has been considered throughout the depth of the soil. The Van Genuchten equation and corresponding fitting parameters have been considered to quantify matric suction in the analysis. SBC has been obtained for three different geomaterials;viz. sand, fly ash and clay, based on their predominant grain size and diverse soil water characteristics curve(SWCC) attributes. Variation of SBC with different modes of vibration and damping ratio are reported for ranges of matric suction pertinent to the geomaterials considered in the study. The relative significance of matric suction on SBC has been reported for suction values within the transition zone of each geomaterial. It is observed that the SBC of sand is drastically reduced, with matric suction reaching beyond the residual suction value. The SBC of fly ash remains constant beyond the residual suction value, whereas the SBC of clay shows an increasing trend toward the practical range of matric suction values.

关键词： seismic bearing capacity modal analysis matric suction