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Shifting paradigm in brain abscess management at tertiary care centre in Nepal

Neuroimmunology and Neuroinflammation 2018年第6期5卷 10-17页

作者： Prakash Kafle Mohan Raj Sharma sushil krishna shilpakar Gopal Sedain Amit Pradhanang Ram Kumar Shrestha Binod Raj Bhandari Christine Groves Department of Neurosurgery Nobel Medical College Teaching HospitalBiratnagar56613Nepal Department of Neurosurgery Tribhuvan University Teaching HospitalKathmandu44613Nepal Department of Physical Medicine and Rehabilitation Indiana University School of MedicineIndianapolisIN46202USA

Aim: Brain abscess is a challenging clinical entity with substantial high case fatality rates despite significant advances in imaging techniques,laboratory modalities,surgical interventions,and antimicrobial treatment.Otogenic and cardiogenic sources are among the most common.Classic clinical presentation is seen in very few cases only.Burr hole with aspiration works well with good clinical outcomes.Control of primary source in cases of ear infection in the single setting results in good outcomes,reduces for additional surgery,and decreases the duration of hospital stay.Methods: This is prospective observational study conducted at Institute of Medicine,Tribhuvan University Teaching Hospital,Kathmandu,Nepal over the period of two and a half years(from September 2014 to March 2017).We analyzed the demographic profile,management strategies and outcome of these cases diagnosed with brain abscess using Microsoft Excel 2007.Results: A total of 51 cases were undertaken for surgical management.There were 35 males and 16 females with the male to female ratio of 2.18:1.The mean age of the study population was 16.76 years with age range from 4 months to 60 years.Otogenic source was the most common.Temporal lobe was the most common abscess location.Headache was the most common clinical presentation and was seen in 86.27%of the study population.All cases were initially managed with burrhole and aspiration of the abscess.Only 3.92%(n = 2)of cases subsequently required surgical excision of the abscess wall.Only 11.76%(n = 6)of the cases required multiple aspiration.Only 19.61%(n = 10)showed positive culture.Pseudomonas aeruginosa and E.coli were the most common organisms grown.Mortality rate among the study group was 3.92%.Conclusion: With the advent of modern technology in neuroimaging,mortality due to brain abscess has significantly decreased.Joint involvement of the otorhinolaryngology team and efforts in addressing the primary source have further helped in improving outcomes in cases of otogenic brain abscess.Hence,source c

关键词： Abscess otogenic brain abscess tubercular abscess

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Outcome of patients with traumatic cranial nerve palsy admitted to a university hospital in Nepal

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中华神经外科杂志(英文) 2024年第2期10卷 1-7页

作者： Kumari Khusbu Gautam Naveen Parajuli Monika Singh Shreejana Pradhananga Amit Sedai Gopal shilpakar sushil Sharma Mohan Raj Maharajgunj Medical Campus Institute of Medicine Tribhuvan University Maharajgunj Kathmandu Nepal Department of Research Institute of Medicine Maharajgunj Kathmandu Nepal Department of Neurosurgery Tribhuvan University Teaching Hospital Maharajgunj Kathmandu Nepal

Background Cranial nerve palsy (CNP) is a common complication of traumatic brain injury (TBI). Despite a high incidence of TBI in Nepal (382 per 100,000), literature on the specific management and outcome of CNP is lacking. This study aimed to examine the outcomes of TBI patients involving single versus multiple CNP.Methods A retrospective chart review of 170 consecutive TBI patients admitted to the tertiary neurosurgical center in Nepal between April 2020 and April 2022 was conducted. Demographic, clinical, and etiological characteristics; imaging findings; and management strategies were recorded, compared, and analyzed using descriptive statistics. The Glasgow Outcome Scale Extended (GOSE) was used to measure the outcomes in two groups of patients (single and multiple CNP) at 3 months.Results Out of 250 eligible patients, 80 were excluded and CNP was noted in 29 (17.1%) of the remaining 170. The median age was 34.9 years, and falls (60.6%) were the most common cause of trauma. TBI severity was categorized based on GCS: mild (82.4%), moderate (15.9%), and severe (1.8%). Cranial nerve involvement was seen in 29 (17.05%) patients: single cranial nerve involvement in 26 (89.65%) and multiple nerve involvement in 3 (10.34%). The most common isolated cranial nerve involved was the oculomotor nerve (37.9%). CT findings revealed a maximum of skull fractures with no significant association between CNP and CT findings.Conclusions CNP is a common consequence of TBI with the most common etiology being falls followed by RTA. Single CNP was more common than multiple CNP with no significant difference in the outcome in the 3-month GOSE score. Further research is needed to determine the burden of traumatic CNP and establish specific management guidelines for different types of CNP.

关键词： Cranial nerve palsy Nepal Outcome Traumatic brain injury

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Surveying the genomic landscape of silage-quality traits in maize(Zea mays L.)

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The Crop Journal 2023年第6期11卷 1893-1901页

作者： Jatin Sharma Shubham Sharma krishna Sai Karnatam Om Prakash Raigar Chayanika Lahkar Dinesh Kumar Saini sushil Kumar Alla Singh Abhijit Kumar Das Priti Sharma Ramesh Kumar Department of Plant Breeding and Genetics Punjab Agricultural UniversityLudhianaPunjab 141004India School of Agricultural Biotechnology Punjab Agricultural UniversityLudhianaPunjab 141004India ICAR-Indian Institute of Maize Research LudhianaPunjab 141004India Department of Plant and Soil Science Texas Tech UniversityLubbockTX 79409-2122USA

Despite the longstanding importance of silage as a critical feed source for ruminants,its quality improvement has been largely overlooked.Although numerous quantitative trait loci(QTL)and genes affecting silage quality in maize have been reported,only a few have been effectively incorporated into breeding programs.Addressing this gap,the present study undertook a comprehensive meta-QTL(MQTL)analysis involving 523 QTL associated with silage-quality traits collected from 14 published studies.Of the 523 QTL,405 were projected onto a consensus map comprising 62,424 genetic markers,resulting in the identification of 60 MQTL and eight singletons.The average confidence interval(CI)of the MQTL was 3.9-fold smaller than that of the source QTL.Nine of the 60 identified MQTL were classified as breeder’s MQTL owing to their small CIs,involvement of more QTL,and large contribution to phenotypic variation.One-third of the MQTL co-localized with DNA marker-trait associations identified in previous genomewide association mapping studies.A set of 78 high-confidence candidate genes influencing silage quality were identified in the MQTL regions.These genes and associated markers may advance marker-assisted breeding for maize silage quality.

关键词： Meta-QTL Silage quality Maize GWAS Candidate genes

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并行和分布式计算本科核心课程(英文)

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计算机教育 2012年第11期 76-89页

作者： sushil K.Prasad Anshul Gupta krishna Kant Andrew Lumsdaine David Padua Yves Robert Arnold Rosenberg Alan Sussman Charles Weems Georgia State University AtlantaGA 30302USA IBM T.J.Watson Research Center Yorktown HeightsNY 10598USA Intel and George Mason University ArlingtonVA 22230USA Indiana University BloomingtonIN 47405USA University of Illinois at Urbana-Champaign UrbanaIL 61801USA INRIA Lyon 69364France Northeastern University Colorado State University BostonMA 02115USA University of Maryland College ParkMD 20742USA University of Massachusetts AmherstMA 01003USA

The penetration of parallel and distributed computer（PDC） technology into the daily lives of users via their wireless networks,smartphones,social networking sites and more,has made it imperative that computer scientists and engineers provide rapidly changing,yet effective,efficient,and reliable technology to consumers.This highlights the urgent need for imparting a broad-based skill set in PDC technology at various levels in the educational fabric.However,the rapid changes in computing technology and advances in research challenge educators＇ abilities to know what to teach in any given semester.Other stakeholders in the push to cope with fast-changing PDC technology,including employers,face similar challenges in identifying basic expertise.

关键词：计算机教育并行和分布式计算本科英文课程

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Efficacy and Safety of Tinefcon^® Tablets in Subjects with Plaque Psoriasis: An Open Label, Non-Comparative, Multicenter, Phase IV Trial

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Journal of Cosmetics, Dermatological Sciences and Applications 2016年第2期6卷 55-66页

作者： Somesh Sharma Kailash Bhatia Meetesh Agarwal Sandesh Gupta Leelavathi Budamakuntla Sudhakar Grandhi Vinod Titarmare sushil Pande Ranjan Rawal Aruna Samarth Rizwan Haq Vikrant Saoji D. V. S. Pratap L. M. Kansal D. G. Saple Shatrughan Sahay Parag Kalyani Puneet Goyal Sharmila Patil A. J. Kanwar Bhavesh Swarnakar Sujay Kulkarni Abhijeet Morde Hitesh Khandagale Yogesh Dound Nitin Jadhav Sanjeev Hegde Murlidhara Padigaru Ashish C. Suthar Piramal Enterprises Limited Mumbai India Bhatia Skin Center Bima Nagar Indore India Agrawal Path LAB Vijaynagar Indore India Skin & Laser Center Krishna Nagar New Delhi India Diabetes and Shirdi Skin Care Centre Karnataka India Medipoint Hospitals Pvt. Ltd. Pentagon Research Pvt. Ltd. Pune India Skin Care Clinic Nagpur India NKP Salve Institute and Lata Mangeshkar Hospital Nagpur India Department of Dermatology Sheth VS General Hospital Ahmedabad India Sai Skin Care Clinic Hyderabad India Radiance Skin Care Clinic Nagpur India Dr. Vikrant Saoji’s Clinic Ramdaspeth Nagpur India Durgabai Deshmukh Hospital & Research Center Hyderabad India Kansal Cosmetic & Skin Care Clinic Jaipur India Dr. Saple’s Clinic Dadar (East) Mumbai India Sri Skin Care & Laser Clinic Lucknow UP India Ruby Hall Clinic Pune India Renova Skin & Laser Clinic Sector-9 Mansarovar Jaipur India Dr. D. Y. Patil Medical College and Hospital Nerul Navi Mumbai India Department of Dermatology Venerology & Leprology Postgraduate Institute of Medical Education and Research Chandigarh India Swarnakar Superspeciality Centre Indore India Clinical Research and Development Piramal Enterprises Limited Mumbai India

Importance: This post-marketing surveillance study was conducted to evaluate real-world information about the efficacy and safety of oral Tinefcon? tablets (Sphaeranthus indicus based) in plaque psoriasis patients. Materials and Methods: Patients aged at least 18 years and older with clinical diagnosis of plaque psoriasis, were enrolled in this open label, non-comparative, multicenter trial. All eligible subjects received four 700 mg Tinefcon? tablets/day for 12 weeks. The primary outcome measure was percent change in Psoriasis Area Severity Index (PASI) score from baseline to week 12. The secondary outcome measures were Physician Global Assessment (PGA), Nail Psoriasis Severity Index (NAPSI), Psoriatic Arthritis Evaluation and Gene Expression Profiling and Immunohistochemistry. Results: After completion of Tinefcon? treatment at 12 weeks, more than half of subjects (52%) achieved PASI 50 response;PASI 75 response was attained in 68 (23%) subjects and PASI 90 response in 22 (7%) subjects. Five subjects with severe psoriasis achieved PASI 90 without receiving any concomitant medication. Reduction in severity as assessed by PGA was observed in more than half of patients with moderate disease. Histopathological evaluation revealed that epidermal thickness was considerably reduced in 66% of subjects. The expression of inflammatory marker S100A9 protein was(meaningfully reduced in 60% patients with non-significant reduction of Keratin 10 protein expression. Gene expression analysis showed increase down regulation of SERPINB4;PI3 and KRT16 genes after a 12-week treatment period in subjects with higher PASI scores. Conclusion: Oral Tinefcon? tablets showed good efficacy and had a favorable safety profile in plaque psoriasis patients.

关键词： Psoriasis Tinefcon® Tablet Sphaeranthus indicus

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