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Spectrum of cardiac manifestations and its relationship to outcomes in patients admitted with scrub typhus infection

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World Journal of Critical Care Medicine 2018年第1期7卷 16-23页

作者： Gunasekaran Karthik thomas isaiah sudarsan John Victor Peter Thambu sudarsanam George M Varghese Paul Kundavaram Sowmya Sathyendra Ramya Iyyadurai Kishore Pichamuthu Department of Medicine Christian Medical College Medical Intensive Care Unit Christian Medical College Department of Infectious Diseases Christian Medical College

AIM To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to *** Demographic data, electrocardiographic(ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio(OR) with 95%*** The cohort(n = 81; 35 males) aged 49.4 ± 16.1 years(mean, SD) presented 8.1 ± 3.1 d after symptom onset. The APACHE-Ⅱ score was 15.7 ± 7.0. Fortyeight (59%) patients were ventilated, and 46 (56%) required vasoactive agents. Mortality was 9.9%. ECG changes were non-specific; sinus tachycardia was the most common finding. Myocardial injury was evident in 61.7% of patients and LV systolic dysfunction in 30.9%. A diagnosis of myocarditis was made in 12.3%. In addition, seven patients with regional wall motion abnormalities had LV systolic dysfunction and elevated cardiac enzymes. Mild diastolic dysfunction was observed in 18 (22%) patients. Mild to moderate pericardial effusion was seen in 51%. On multivariate logistic regression analysis, patients with myocarditis tended to be older (OR = 1.04, 95%CI: 0.99-1.09), had shorter symptom duration (OR = 0.69, 95%CI: 0.49-0.98), and tended to stay longer in hospital(OR = 1.17, 95%CI: 0.98-1.40). Myocarditis was not associated with increased *** In scrub typhus infection, cardiac manifestations are frequent and associated with increased morbidity but not mortality.

关键词： Scrub typhus Myocarditis Outcome

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Mid-term follow-up of superior pubic ramus osteotomy in locked symphysis pubis with urethral injury:A case report

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Chinese Journal of Traumatology 2023年第4期26卷 244-248页

作者： Anindansu Basu Navin Shukla Sandeep Velagada sudarsan Behera Department of Orthopaedics Fortis HospitalKolkata700107India Department of Orthopaedics Sahid Laxman Nayak Medical CollegeKoraput7642020India Department of Orthopaedics Institute of Medical Sciences and Sum HospitalBhubaneswar751003India

A locked pubic ramus body is an unusual variant of lateral compression *** date,there have been only 25 cases reported in the published *** herein described a case where the right pubic ramus was entrapped within the opposite obturator foramen with an overlap of greater than 4 cm,with associated urethral *** all maneuvers of closed and instrumented reduction failed,we per-formed a superior pubic ramus osteotomy on the left side and unlocked the incarcerated right pubic *** osteotomy site was stabilized with a 6-hole recon *** patient underwent delayed urethral repair 10 weeks after the index *** 3-year follow-up,the patient has sexual dysfunction especially difficulty in maintaining erection,secondary urethral stricture,heterotopic ossification,and breakage of implants.

关键词： Pubic symphysis Urethral injury Superior pubic osteotomy

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Groundwater solute chemistry,hydrogeochemical processes and fluoride contamination in phreatic aquifer of Odisha,India

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Geoscience Frontiers 2021年第3期12卷 234-248页

作者： sudarsan Sahu Utpal Gogoi N.C.Nayak Central Ground Water Board SERBhujal BhawanBhubaneswarOdishaIndia

The work investigates the major solute chemistry of groundwater and fluoride enrichment(F^(-))in the shallow phreatic aquifer of *** study also interprets the hydrogeochemical processes of solute acquisition and the genetic behavior of groundwater F^(-)contamination.A total of 1105 groundwater samples collected from across the state from different hydro-geomorphic settings have been analyzed for the major solutes and F^(-) *** is alkaline in nature(range of pH:6.6-8.7;ave.:7.9)predominated by moderately hard to very hard *** cation and anion chemistry stand in the orders of Ca^(2+)>Na^(+)>Mg^(2+)>K^(+) and HCO_(3)^(-)>Cl^(-)>SO_(4)^(2-)>CO_(3)^(2-) *** average mineralization is low(319 mg/L).The primary water types are Ca-Mg-HCO_(3) and Ca-Mg-Cl^(-)HCO_(3),followed by Na-Cl,Ca-Mg-Cl,and Na-Ca-Mg-HCO_(3)^(-)***-halite dissolution and reverse ion exchange are the significant processes of solute *** the geogenic as well as the anthropogenic sources contribute to the groundwater fluoride contamination,*** ratio of Na^(+)/Ca^(2+)>1.0 comprises Na-HCO_(3)(Cl)water types with F^(-)>1.0 mg/L(range 1.0-3.5 mg/L)where the F^(-)bears geogenic *** relations exist between F^(-)and pH,Na^(+),TDS,and HCO_(3)^(-).It also reflects a perfect Na-TDS correlation(0.85).The ratio of Na^(+)/Ca^(2+)<1.0 segregates the sample population(F^(-)range:1.0-4.0 mg/L)with the F derived from anthropogenic *** water types include Ca-Mg-HCO_(3)(Cl)varieties which are recently recharged meteoritic water *** F^(-) levels exhibit poor and negative correlations with the solutes in *** Na-TDS relation remains poor(0.12).In contrast,the TDS levels show strong correlations with Ca^(2+)(0.91),Mg^(2+)(0.80)and even Cl^(-)(0.91).The majority of the monitoring points with the anthropogenic sources of groundwater F^(-) are clustered in the Hirakud Canal Command area in the western parts of the state,indi

关键词： Groundwater Phreatic Aquifer Quality Odisha India

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A novel OFS–TLBO–SVR hybrid model for optimal budget allocation of government schemes to maximize GVA at factor cost

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Journal of Management Analytics 2018年第1期5卷 32-53页

作者： Sabyasachi Mohanty sudarsan Padhy Department of Computer Science&Engineering Centurion University of Technology&ManagementBhubaneswarIndia Department of Computer Science&Engineering Silicon Institute of TechnologyBhubaneswarIndia

Support Vector Regression (SVR) has already been proved to be one of the mostreferred and used machine learning technique in various fields. In this study, wehave addressed a predictive-cum-prescriptive analysis for finalizing fundallocations by the Government at center to the schemes under Central Plan andto the schemes under States and Union Territories Plan, with a goal to maximizeGross Value Added (GVA) at factor cost. Here, we have proposed a hybridmachine learning model comprising of OFS (Orthogonal Forward Selection),TLBO (Teaching Learning Based Optimization) and SVR for the prediction ofGVA at factor cost. In this model, referred as OFS–TLBO–SVR hybrid model,SVR is at the core of prediction mechanism, OFS is for identifying the relevantfeatures, and TLBO is to support in optimizing the free parameters of SVR andagain TLBO is used for optimizing the governable attributes of data.

关键词： Support Vector Regression(SVR) Teaching Learning Based Optimization(TLBO) Orthogonal Forward Selection(OFS) Gross Value Added(GVA)at factor cost

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用机械阻尼研究方法定量评价填料在不相容橡胶共混体中的分布

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橡胶参考资料 1993年第2期23卷 43-48页

作者： sudarsan Maiti S.K.De Anil K.Bhowmick 秦琪

1 前言共混体中的填料分布在控制橡胶制品物理性能方面很重要。测量填料在橡胶共混体中分布的方法包括:结合橡胶法、热解法、气相色谱法以及显微镜研究方法。Callan。

关键词：填料橡胶共混机械阻尼

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Severe scrub typhus infection: Clinical features, diagnostic challenges and management

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World Journal of Critical Care Medicine 2015年第3期4卷 244-250页

作者： John Victor Peter thomas I sudarsan John Anthony J Prakash George M Varghese Medical Intensive Care Unit Christian Medical College Department of Microbiology Christian Medical College Department of Infectious Diseases Christian Medical College

Scrub typhus infection is an important cause of acute undifferentiated fever in South East Asia. The clinical picture is characterized by sudden onset fever with chills and non-specific symptoms that include headache, myalgia, sweating and vomiting. The presence of an eschar, in about half the patients with proven scrub typhus infection and usually seen in the axilla, groin or inguinal region, is characteristic of scrub typhus. Common laboratory findings are elevated liver transaminases, thrombocytopenia and leukocytosis. About a third of patients admitted to hospital with scrub typhus infection have evidence of organ dysfunction that may include respiratory failure, circulatory shock, mild renal or hepatic dysfunction, central nervous system involvement or hematological abnormalities. Since the symptoms and signs are non-specific and resemble other tropical infections like malaria, enteric fever, dengue or leptospirosis, appropriate laboratory tests are necessary to confirm diagnosis. Serological assays are the mainstay of diagnosis as they are easy to perform; the reference test is the indirect immunofluorescence assay(IFA) for the detection of Ig M antibodies. However in clinical practice, the enzyme-linked immuno-sorbent assay is done due to the ease of performing this test and a good sensitivity and sensitivity when compared with the IFA. Paired samples, obtained at least two weeks apart, demonstrating a ≥ 4 fold rise in titre, is necessary for confirmation of serologic diagnosis. The mainstay of treatment is the tetracycline group of antibiotics or chloramphenicol although macrolides are used alternatively. In mild cases, recovery is complete. In severe cases with multi-organ failure, mortality may be as high as 24%.

关键词： Rickettsia Diagnosis Management Outcome Multi-organ failure

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Hemp Concrete: A Sustainable Green Material for Conventional Concrete

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Journal of Building Material Science 2021年第2期3卷 1-7页

作者： Sudarshan D.Kore J.S.sudarsan School of Construction Management National Institute of Construction Management and Research(NICMAR)PuneIndia

Concrete is one of the most important building material and day by day the utilization of concrete is increasing to meet the infrastructure development *** one hand it is unavoidable but some alternative to be explored to reduce the global environmental impact caused by the *** overcome this from the last decade the world is looking towards the fact of sustainability due to rapid *** growth in the construction industry increased the demand of concrete as construction *** concrete produces significant amount of greenhouse emission in the *** is a need to find an alternative solution to minimize the greenhouse emission emitted from the concrete manufacturing *** is a building material prepared from hemp yarns,lime and *** composite material has several beneficial properties like low in cost,easily available,thermal and acoustic insulation,low density and sustainable cause of no adverse impact of carbon footprint on *** this study the properties and several benefits of the hempcrete were discussed in detail.

关键词： Hemp Hempshiv Concrete Sustainability

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