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Penetrating neck injury： Collaterals for another life after ligation of common carotid artery and subclavian artery

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Chinese Journal of Traumatology 2017年第1期20卷 56-58页

作者： Annu Babu Harshit Garg sushma sagar Amit Gupta Subodh Kumar Department of Surgery JPN Apex Trauma Centre All India Institute of Medical Science New Delhi India

Neck, being not protected by skeleton, is vulnerable to external trauma and injury which involves blood vessels, trachea, esophagus and other endocrine and nervous system organs. Vascular injuries can not only cause potentially, life-threatening hemorrhage but also need profound surgical expertise in man- agement. Development of collateral circulation in neck is well known： however, there is scarcity of literature on the role of collateral formation in neck trauma. Here, we present a unique case of pene- trating gunshot injury to neck with right common carotid and right subclavian artery injury with hemorrhagic shock managed with ligation of these vessels as a life-saving procedure. The patient pre- sented ~ith no neurological or motor de~,cits in immediate postoperative period owing to the collateral circulation between right vertebral artery and right common carotid and right subclavian artery.

关键词： Common carotid artery Collaterals Neck injury Subclavian artery

Comparison of ISS, NISS, and RTS score as predictor of mortality in pediatric fall

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Burns & Trauma 2017年第3期5卷 209-214页

作者： Kapil Dev Soni Santosh Mahindrakar Amit Gupta Subodh Kumar sushma sagar Ashish Jhakal Department of Trauma Surgery and Critical Care Jai Prakash Narayan Trauma Centre AIIMS New Delhi India

Background:Studies to identify an ideal trauma score tool representing prediction of outcomes of the pediatric fall patient remains elusive. Our study was undertaken to identify better predictor of mortality in the pediatric fall patients. Methods:Data was retrieved from prospectively maintained trauma registry project at level 1 trauma center developed as part of Multicentric Project—Towards Improving Trauma Care Outcomes (TITCO) in India. Single center data retrieved from a prospectively maintained trauma registry at a level 1 trauma center, New Delhi, for a period ranging from 1 October 2013 to 17 February 2015 was evaluated. Standard anatomic scores Injury Severity Score (ISS) and New Injury Severity Score (NISS) were compared with physiologic score Revised Trauma Score (RTS) using receiver operating curve (ROC). Results:Heart rate and RTS had a statistical difference among the survivors to nonsurvivors. ISS, NISS, and RTS were having 50, 50, and 86% of area under the curve on ROCs, and RTS was statistically significant among them. Conclusions: Physiologically based trauma score systems (RTS) are much better predictors of inhospital mortality in comparison to anatomical based scoring systems (ISS and NISS) for unintentional pediatric falls.

关键词： Pediatric fall Trauma score system ISS NISS RTS

Are fails more common than road traffic accidents in pediatric trauma？ Experience from a Level 1 trauma centre in New Delhi, India

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Chinese Journal of Traumatology 2016年第2期19卷 75-78页

作者： Annu Babu Amulya Rattan Piyush Ranjan Maneesh Singhal Amit Gupta Subodh Kumar Biplab Mishra sushma sagar JPN Apex Trauma Centre New Delhi 110029 India

Purpose： The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents （RTAs） as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India. Methods： Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21. Results： We had 300 patients over a 33 month period. Among them, 236 （78.6%） were males and 64 （21.3%） females. Overall the predominant cause was RTAs in 132 （43%） patients. On subgroup analysis of up to 12 years age group （n - 147）, the most common cause was found to be RTAs again. However, falls showed an incremental upward trend （36.05% in up to 12 age group versus 27% overall）, catching up with RTAs （44.89%）. Pediatric Trauma Score （PTS） ranged from 0 to 12 with a mean of 8.12 _＋ 2.022. 223 （74.33%） patients experienced trauma limited to one anatomic region only, whereas 77 （25.66%） patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days （range 1-182）. Conclusion： Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs （43%） as compared to falls from height （27%）; however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatri

关键词： Accidental fallsPediatricsAccidents trafficWounds and injuries

Innocuous cardiac gunshot that proved fatal： A bitter lesson learned

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Chinese Journal of Traumatology 2017年第2期20卷 122-124页

作者： Biplab Mishra Mohit Kumar Joshi Subodh Kumar Atin Kumar Amit Gupta Amulya Rattan sushma sagar Maneesh Singhal Mahesh Chandra Misra Department of Surgical Disciplines. JPN Apex Trauma Centre. All India Institute of Medical Sciences New Delhi 110029. India Department of Radiodiagnosis. JPN Apex Trauma Centre. All India Institute of Medical Sciences New Delhi 110029 India

The management of hemodynamically normal patients with retained intra-pericardial foreign body re- mains a matter of conjecture. The available literature supports non-operative management of such innocuous foreign bodies. We report our experience of a hemodynamically normal patient with a retained intra-pericardial pellet from a firearm injury. He initially received successful non-operative management but developed fatal hemopericardium 21 days after injury. In this paper, we discussed the pitfalls in the management of such injuries in light of the available literature and summarized the clinical experience.

关键词： PericardiumHeartWoundsGunshotFirearms

Varied presentations, magnitude, and outcome of traumatic neck injuries at a level I trauma center

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Emergency and Critical Care Medicine 2022年第2期2卷 45-49页

作者： Parvez Mohi Ud Din Dar Jogendra Boddeda Supreet Kaur Pratyusha Priyadarshini Abhinav Kumar Dinesh Bagaria Narendra Choudhary Junaid Alam sushma sagar Subodh Kumar Amit Gupta Biplab Mishra Division of Trauma Surgery and Critical Care Jai Prakash Narayan Apex Trauma CentreAll India Institute of Medical Sciences(AIIMS)New DelhiIndia Department of General Surgery All India Institute of Medical Sciences(AIIMS)JodhpurRajasthanIndia

Introduction:Traumatic neck injuries(TNIs)constitute 5%–10%of all trauma *** injuries can be caused by either penetrating or blunt *** can have a varied presentation like cut injury over the neck,bleeding,neck swelling,breathing difficulty,dysphagia,***:This was a retrospective observational study conducted at a level I trauma center in India from January 2016 to March *** hundred thirty patients who required admission and intervention due to TNIs were included in this ***:One hundred thirty patients with neck injuries were included in this *** were predominant(91.5%)with the age ranging from 10 to *** most common mechanism of injury was physical assault(40.7%),followed by road traffic injury(23.8%)and self-inflicted injuries(18.4%).Penetrating trauma was *** neck wound with bleeding was the most common presenting *** II injuries were more common(83.8%)followed by zone I(12.3%)and zone III(3.8%).Soft tissue injury including skin,platysma breach,and strap muscle injury was present in 46.9% of *** injury was present in 13.8%,tracheal injury in 28.5%,vascular injury in 13.8%,and esophageal injury in 4.6% of ***:Penetrating neck trauma is more common than blunt in developing countries like *** Trauma Life Support(ATLS)protocol guides the initial *** definitive management depends on the type and mechanism of injury,anatomical level,severity,and the organ injured.

关键词： Bleeding Neck trauma Resuscitation Trachea Vascular injury

Management and outcome of pancreatic trauma:a 6-year experience at a level I trauma center

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Emergency and Critical Care Medicine 2023年第1期3卷 6-11页

作者： Abhinav Anand Parvez Mohi Ud Din Dar Preksha Rani Supreet Kaur Joses Dany James Junaid Alam Pratyusha Priyadarshini Abhinav Kumar Dinesh Bagaria Narendra Choudhary Subodh Kumar Amit Gupta sushma sagar Biplab Mishra Division of Trauma Surgery and Critical Care Jai Prakash Narayan Apex Trauma CentreAll India Institute of Medical Sciences(AIIMS)New DelhiIndia Department of Trauma and Emergency Medicine All India Institute of Medical Science(AIIMS)VijaypurJammuJammu and KashmirIndia Department of General Surgery All India Institute of Medical Science(AIIMS)JodhpurRajasthanIndia

Background: Pancreatic trauma (PT) accounts for less than 1% of all trauma admissions. Occasionally, PT is undetected during theprimary survey and becomes apparent only when complications arise. It occurs in up to 5% of blunt abdominal trauma cases and 12%of individuals with penetrating abdominal injuries. Management is determined by the status of the main pancreatic duct and ***: This was an ambispective study conducted at the Jai Prakash Narayan Apex Trauma Center, All India Institute ofMedical Sciences,New Delhi, from January 2015 to December 2017 (retrospective), and January 2019 to December 2020 (prospective). In total, 113patients with PT were included in this ***:We analyzed the data of 113 patients with PT included in this study, of whichmales predominated (93.7%). Blunt PT was presentin 101 patients (89.4%) and penetrating PT in 12 patients (10.6%). Half of the patients (51.3%) had the American Association for theSurgery of Trauma grade III PT, followed by grade II (18.6%), and grade I (15%). Of the total 113 patients, 68 (60.2%) were treated withoperative management, and 45 (39.8%) with nonoperative management. Distal pancreatectomy, with or without splenectomy, was themost common procedure performed in our study, followed by drainage. There were 27 mortalities (23.8%) during the study period, ofwhich 7 were directly related to PT and 20 were due to other organ-related sepsis and hemorrhagic ***: Pancreatic trauma is rare but challenging for trauma surgeons, with persistent management controversies. Early diagnosisis important for favorable results;however, a delay in diagnosis has been associated with higher morbidity and mortality. Low-grade pancreaticinjuries can be successfully managed nonoperatively, whereas high-grade pancreatic injuries require surgical intervention.

关键词： Abdominal trauma Distal pancreatectomy Management Pancreatic trauma

Nanozyme‑Engineered Hydrogels for Anti‑Inflammation and Skin Regeneration

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Nano-Micro Letters 2024年第6期16卷 127-179页

作者： Amal George Kurian Rajendra K.Singh Varsha sagar Jung‑Hwan Lee Hae‑Won Kim Institute of Tissue Regeneration Engineering(ITREN) Dankook UniversityCheonan 31116Republic of Korea Department of Nanobiomedical Science&BK21 NBM Global Research Center for Regenerative Medicine Dankook UniversityCheonan 31116Republic of Korea Department of Biomaterials Science School of DentistryDankook UniversityCheonan 31116Republic of Korea UCL Eastman‑Korea Dental Medicine Innovation Centre Dankook UniversityCheonan 31116Republic of Korea Cell and Matter Institute Dankook UniversityCheonan 31116Republic of Korea Mechanobiology Dental Medicine Research Center Dankook UniversityCheonan 31116Republic of Korea

Inflammatory skin disorders can cause chronic scarring and functional impairments,posing a significant burden on patients and the healthcare *** therapies,such as corticosteroids and nonsteroidal anti-inflammatory drugs,are limited in efficacy and associated with adverse ***,nanozyme(NZ)-based hydrogels have shown great promise in addressing these ***-based hydrogels possess unique therapeutic abilities by combining the therapeutic benefits of redox nanomaterials with enzymatic activity and the water-retaining capacity of *** multifaceted therapeutic effects of these hydrogels include scavenging reactive oxygen species and other inflammatory mediators modulating immune responses toward a pro-regenerative environment and enhancing regenerative potential by triggering cell migration and *** review highlights the current state of the art in NZ-engineered hydrogels(NZ@hydrogels)for anti-inflammatory and skin regeneration *** also discusses the underlying chemo-mechano-biological mechanisms behind their ***,the challenges and future directions in this ground,particularly their clinical translation,are *** insights provided in this review can aid in the design and engineering of novel NZ-based hydrogels,offering new possibilities for targeted and personalized skin-care therapies.

关键词： Nanozymes Hydrogels ROS scavenging Anti-inflammation Skin regeneration

A case report on a rare case of primary tuberculous otitis media

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Journal of Otology 2024年第1期19卷 40-45页

作者： Dr Yadav sagar Shyamlal Dr Shikha Gianchand Dr Rahul Kurkure Dept of ENT and Head Neck Surgery 5 Air Force HospitalJorhatAssam785005India Dept of ENT and Head Neck Surgery Armed Forces Medical CollegePuneMaharashtra411040India

Although tuberculosis has become more common in recent years, it still accounts for just a small percentage of cases of chronic otitis media. Common symptoms of tuberculous otitis media(TOM) include otorrhoea, hearing loss, and multiple tympanic membrane perforations. Due to its rarity, the illness is frequently misdiagnosed. When a patient does not improve with standard antibacterial and antifungal treatment, this may be a possible diagnosis to explore. Complete healing is possible if the illness is diagnosed and treated timely to prevent consequences.

关键词： otitis healing diagnosis

A Harmonic Approach to Handwriting Style Synthesis Using Deep Learning

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Computers, Materials & Continua 2024年第6期79卷 4063-4080页

作者： Mahatir Ahmed Tusher Saket Choudary Kongara sagar Dhanraj Pande Seong Ki Kim Salil Bharany School of Computer Science and Engineering VIT-AP UniversityAmaravatiAndhra Pradesh522237India School of Engineering&Technology Pimpri Chinchwad UniversityPuneMaharashtra412106India Department of Computer Engineering Chosun UniversityGwangju61452Republic of Korea Independent Researcher AmritsarPunjab143001India

The challenging task of handwriting style synthesis requires capturing the individuality and diversity of human *** majority of currently available methods use either a generative adversarial network(GAN)or a recurrent neural network(RNN)to generate new handwriting *** is why these techniques frequently fall short of producing diverse and realistic text pictures,particularly for terms that are not commonly *** resolve that,this research proposes a novel deep learning model that consists of a style encoder and a text generator to synthesize different handwriting *** network excels in generating conditional text by extracting style vectors from a series of style *** model performs admirably on a range of handwriting synthesis tasks,including the production of text that is *** works more effectively than previous approaches by displaying lower values on key Generative Adversarial Network evaluation metrics,such Geometric Score(GS)(3.21×10^(-5))and Fréchet Inception Distance(FID)(8.75),as well as text recognition metrics,like Character Error Rate(CER)and Word Error Rate(WER).A thorough component analysis revealed the steady improvement in image production quality,highlighting the importance of specific handwriting *** fields include digital forensics,creative writing,and document security.

关键词： Recurrent neural network generative adversarial network style encoder fréchet inception distance geometric score character error rate mixture density network word error rate