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Safe laparoscopic cholecystectomy:Adoption of universal culture of safety in cholecystectomy

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World Journal of Gastrointestinal Surgery 2019年第2期11卷 62-84页

作者： vishal Gupta Gaurav Jain Department of Surgical Gastroenterology Shatabdi Hospital Phase 1 King George’s Medical University Transplant and HPB Surgery the Iowa Clinic-Iowa Methodist Hospital

The incidence of biliary injury after laparoscopic cholecystectomy(LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. Major biliary or vasculobiliary injury is associated with significant morbidity. As prevention is the best strategy, the concept of a culture of safe cholecystectomy has been recently introduced to educate surgeons and apprise them of basic tenets of safe performance of LC. Various aspects of safe cholecystectomy include:(1) thorough knowledge of relevant anatomy, various anatomical landmarks, and anatomical variations;(2) an understanding of the mechanisms involved in biliary/vascular injury, the most important being the misidentification injury;(3) identification of various preoperative and intraoperative predictors of difficult cholecystectomy;(4) proper gallbladder retraction;(5) safe use of various energy devices;(6) understanding the critical view of safety, including its doublet view and documentation;(7) awareness of various error traps(e.g., fundus first technique);(8) use of various bailout strategies(e.g., subtotal cholecystectomy) in difficult gallbladder cases;(9) use of intraoperative imaging techniques(e.g., intraoperative cholangiogram) to ascertain correct anatomy; and(10) understanding the concept of *** should be facile with these aspects of this culture of safety in cholecystectomy in an attempt to reduce the incidence of biliary/vascular injury during LC.

关键词： Bile leak Bile duct injury Cholecystectomy Cholelithiasis Cholecystitis

Radiofrequency ablation of pancreatic ductal adenocarcinoma:The past,the present and the future

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World Journal of Gastrointestinal Oncology 2015年第2期7卷 6-11页

作者： Garvi J Pandya vishal G Shelat Medicine Ministry of Health Holdings Pte LtdSingapore 308433 Singapore Division of Hepato-pancreatico-biliary Surgery Tan Tock Seng HospitalSingapore 308433Singapore

Pancreatic ductal adenocarcinoma(PDAC)is one of the most aggressive cancers with a grim overall 5-year survival rate of 5%.Advances in surgical techniques,critical care,molecular diagnosis,diagnostic imaging,endosonology and adjuvant therapy have improved outcomes;but still more needs to be *** is an urgent need to discover new avenues that may impact *** ablation(RFA)has attracted attention as an adjunctive treatment in PDAC.A review of English literature in Pub Med was done using the MESH terms for PDAC and *** the articles were reviewed and core information was tabulated for *** a comprehensive review of all articles the data was evaluated to discover the role of RFA in PDAC ***,contraindications,feasibility,success rate,safety,complications and impact on survival were reviewed and are discussed *** appears to be an attractive option for nonmetastatic locally advanced *** is feasible but has a significant *** the present time the integration of RFA into the management of pancreatic ductal adenocarcinoma is *** should be considered as having a complimentary role to current standard therapy in the multimodal management care *** is likely that indications and patient selection for pancreatic RFA will expand.

关键词： Pancreatic cancer Radiofrequency ablation

Relativistic Self-Focusing of Hermite-cosine-Gaussian Laser Beam in Collisionless Plasma with Exponential Density Transition

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Communications in Theoretical Physics 2019年第6期71卷 736-740页

作者： vishal Thakur Manzoor Ahmad Wani Niti Kant Department of Physics Lovely Professional UniversityPhagwara-144411PunjabIndia Govt.Higher Secondary School Waterhail Budgam-191111J&KIndia

This work reveals an exploration of self-focusing of Hermite-cosine-Gaussian laser beam in a collisionless plasma under relativistic nonlinearity. Self-focusing along with self-trapping of Hermite-cosine-Gaussian laser beam are analyzed for different values of laser intensity, plasma density, and decentered parameters. Mathematical analysis displays that these parameters play a major role in achieving the stronger and earlier self-focusing. Further, a comparative study between self-focusing of Hermite-cosine-Gaussian laser beam with and without exponential density ramp profile is introduced. Plasma density transition with exponential profile is found to be more effective in order to have stronger self-focusing. The present analysis may lead to very useful applications in the field of efficient harmonic generation, laser driven fusion etc.

关键词： self-focusing collisionless plasma exponential plasma density ramp Hermite-cosine-Gaussian laser beam

Prednisolone induced pneumatosis coli and pneumoperitoneum

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World Journal of Gastroenterology 2022年第28期28卷 3739-3742页

作者： Serene S N Goh vishal Shelat Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

Pneumatosis intestinalis(PI)is defined as the presence of gas within the submucosal or subserosal layer of the gastrointestinal *** is a radiologic sign suspicious for bowel ischemia,hence non-viable bowel must be ruled out in patients with ***,up to 15%of cases with PI are not associated with bowel ischemia or acute *** described an asymptomatic patient with prednisolone-induced PI and modified the Naranjo score to aid in a surgeon’s decision-making for emergency laparotomy vs non-operative management with serial assessment in patients who are immunocompromised due to long-term steroid use.

关键词： Benign pneumatosis Pneumatosis coli Pneumatosis intestinalis Prednisolone

Si–Ge based vertical tunnel field-effect transistor of junction-less structure with improved sensitivity using dielectric modulation for biosensing applications

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Chinese Physics B 2023年第12期32卷 644-651页

作者： Lucky Agarwal Varun Mishra Ravi Prakash Dwivedi vishal Goyal Shweta Tripathi School of Electronics Engineering Vellore Institute of TechnologyChennai 600127India Department of Electronics and Communication Engineering Graphic Era(deemed to be University) DehradunUttarakhand 248002India Department of Electronics and Communication Engineering GLA UniversityMathura 281406India Department of Electronics and Communication Engineering Motilal Nehru National Institute of TechnologyAllahabad 211004India

A dielectric modulation strategy for gate oxide material that enhances the sensing performance of biosensors in junction-less vertical tunnel field effect transistors(TFETs)is *** junction-less technique,in which metals with specific work functions are deposited on the source region to modulate the channel conductivity,is used to provide the necessary doping for the proper functioning of the *** simulation studies of the proposed structure and junction structure have been compared,and showed an enhanced rectification of 10^(4) *** proposed structure is designed to have a nanocavity of length 10 nm on the left-and right-hand sides of the fixed gate dielectric,which improves the biosensor capture area,and hence the *** considering neutral and charged biomolecules with different dielectric constants,TCAD simulation studies were compared for their *** off-state current IOFFcan be used as a suitable sensing parameter because it has been observed that the proposed sensor exhibits a significant variation in drain ***,it has been investigated how positively and negatively charged biomolecules affect the drain current and threshold *** explore the device performance when the nanogaps are fully filled,half filled and unevenly filled,extensive TCAD simulations have been *** proposed TFET structure is further benchmarked to other structures to show its better sensing capabilities.

关键词： biomolecules high-k dielectric junction-less vertical tunnel field effect transistor(TFET)

Leidenfrost drops on micro/nanostructured surfaces

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Frontiers in Energy 2018年第1期12卷 22-42页

作者： vishal TALARI Prakhar BEHAR Yi LU Evan HARYADI Dong LIU Department of Mechanical Engineering University of HoustonHouston TX 77204-4006 USA

In the Leidenfrost state, the liquid drop is levitated above a hot solid surface by a vapor layer generated via evaporation from the drop. The vapor layer thermally insulates the drop from the heating surface, causing deteriorated heat transfer in a myriad of important engineering applications. Thus, it is highly desirable to suppress the Leidenfrost effect and elevate the Leidenfrost temperature. This paper presents a comprehensive review of recent literature concerning the Leidenfrost drops on micro/nanostructured surfaces with an emphasis on the enhancement of the Leidenfrost temperature. The basic physical processes of the Leidenfrost effect and the key characteristics of the Leidenfrost drops were first intro- duced. Then, the major findings of the influence of various micro/nanoscale surface structures on the Leidenfrost temperature were presented in detail, and the underlying enhancement mechanism for each specific surface topology was also discussed. It was concluded that multiscale hierarchical surfaces hold the best promise to significantly boost the Leidenfrost temperature by combin- ing the advantages of both micro- and nanoscale structures.

关键词： Leidenfrost drop Leidenfrost temperature,heat transfer enhancement miero/nanostructured surfaces

Pulse Slippage of Resonant Third Harmonic Generation in Electron-Hole Plasma

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Communications in Theoretical Physics 2018年第9期69卷 311-316页

作者： vishal Thakur Prabhdeep Kaur Amanpreet Kaur Niti Kant Department of Physics Lovely Professional UniversityG.T.RoadPhagwara-144411PunjabIndia Department of Applied Sciences Chandigarh Engineering College LandranMohali 140307PunjabIndia

Effect of pulse slippage on resonant third harmonic generation of a short pulse laser in electron-hole plasma in the presence of wiggler magnetic field has been *** group velocity mismatch of the third harmonic pulse and the fundamental pulse is significant in electron hole *** the third harmonic pulse has higher group velocity than that of fundamental pulse,therefore,it moves faster than the fundamental *** gets slipped out of the domain of fundamental pulse and its amplitude *** matching condition is satisfied by applying wiggler magnetic field,which provides additional angular momentum to the third harmonic photon to make the process *** in the efficiency of third harmonic generation of an intense short pulse laser in electron-hole plasma embedded with a magnetic wiggler is seen.

关键词： Wiggler magnetic field pulse slippage electron-hole plasma third harmonic generation laser

Simplified pupilloplasty technique through a corneal paracentesis to manage small iris coloboma or traumatic iris defect

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Annals of Eye Science 2017年第1期2卷 140-145页

作者： Yong Yao vishal Jhanji Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong Shantou 515041China Department of Ophthalmology and Visual Sciences The Chinese University of Hong KongHong Kong

Background:To report a new simplified surgical technique to manage small iris coloboma or traumatic iris ***:A new surgical technique in which simplified pupilloplasty technique through only a clear corneal paracentesis to manage the iris coloboma or traumatic iris defect within the 120°range was designed.A retrospective revision of the medical records of patients treated with this technique between the years 2013 and 2016 was *** eyes of six patients with iris coloboma or traumatic iris defect treated with this new technique were ***:All the operated eyes quickly recovered with central round pupil,negligible complications,inessential symptoms of photophobia and glare,and mild inflammation after a median follow-up time of 22 months(range:6-34 months).Conclusions:The simplified pupilloplasty technique presented here could be a good alternative for the management of small iris coloboma or traumatic iris defect.

关键词： Iris pupilloplasty iris defect coloboma trauma

Conjunctival flap cover surgery:10-year review

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Annals of Eye Science 2017年第1期2卷 97-103页

作者： Yong Yao vishal Jhanji Joint International Eye Center ShanTou University and The Chinese University of Hong KongShantou 515041China Department of Ophthalmology and Visual Sciences The Chinese University of Hong KongHong KongChina

Background:To evaluate the conjunctival flap cover surgery for the treatment of ocular surface ***:Retrospective uncontrolled study was performed.A total of 253 eyes of 253 patients who had received conjunctival flap cover surgery during a 10-year period were *** indications,symptoms and complications experienced by patients undergoing partial or total conjunctival flap cover surgery were ***:In all of these cases,satisfactory anatomic and functional outcomes were *** BCVA of 224 eyes out of 253 patients(88.5%)were no worse than that of preoperative and the BCVA of 29 eyes out of 253 patients(11.5%)decreased *** eye pain,foreign body sensation and other discomforts presented in the last *** surgical indications was therapeutic for 138 out of 253 patients(54.5%),aesthetic for 63 eyes out of 253 patients(24.9%),tectonic for 45 eyes out of 253 patients(17.8%),and analgesic for 7 eyes out of 253 patients(2.8%).The primary diagnose of therapeutic indications is refractory corneal ulcer for 135 eyes out of 253 patients(53.4%).The main diagnose of aesthetic indications is atrophy of eyeball for 45 eyes out of 253 patients(17.8%)and corneal leukoma for 18 eyes out of 253 patients(7.1%).The principal diagnose of tectonic indications is corneal perforation for 43 eyes out of 253 patients(17%).The main intraoperative complications is buttonhole formation for 8 eyes out of 253 patients(3.2%),which can be handled by simple *** most severe complications postoperatively was conjunctival flaps dissolving and corneal perforation for 3 eyes out of 253 patients(1.2%),and corneal transplantation had to be performed to avoid *** addition,4 eyes out of 253 patients(1.6%)presented cystic flap and two of them received surgical ***:Conjunctival flap cover surgery is an underused *** primary indication is refractory corneal ulcer and corneal perforation,and its second indication is

关键词： Cornea conjunctiva conjunctival flap ocular surface