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Epidemiology of pelvic fractures in adults: Our experience at a tertiary hospital

Chinese Journal of Traumatology 2019年第3期22卷 138-141页

作者： Subhajit Ghosh Sameer Aggarwal vishal Kumar Sandeep Patel Prasoon Kumar Department of Orthopedics Post Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

Purpose: Pelvic fractures are severe injuries and are often associated with multiple system injuries, exacerbating the overall outcome. In India, the incidence of pelvic fractures is on a rise due to suboptimal roads and traffics but related literature regarding the overall epidemiology of these injuries is scarce and scanty. Our aim was to study the epidemiology of patients admitted with pelvic fractures at a level 1 trauma centre in India. Methods: A 16-month (between September 2015 and December 2016) prospective observational study was carried out on trauma patients with pelvic fractures at a level 1 trauma centre of a tertiary care hospital. Demography of patients, mechanism of injuries and complications were recorded prospectively. Results: We observed 75 patients who presented with pelvic fractures, where 56 were males and 19 were females. Mean age of the study populationwas 37.57 years. Road traffic accidents were the most common mode of injuries. Lateral compression injuries were the most common pattern. Associated injuries frequently encountered were lower extremities and acetabulum fractures, blunt abdominal trauma, urogenital injuries and head injuries. Out of the 75 patients, 52 were treated surgically and 23 were managed by conservative methods. Associated injuries of the extremities, head, abdomen and urogenital system indicated a longer hospital stay. Conclusion: Pelvic fractures, although belong to a relatively rare trauma subset, cause a high morbidity and mortality with considerable burden on the economy. Proper road safety training and driving etiquettes along with its strict implementation in true sense and spirit are the need of the hour.

关键词： Pelvic fractures Epidemiology Incidence

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Pharmacological properties of Datura stramonium L. as a potential medicinal tree:An overview

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Asian Pacific Journal of Tropical Biomedicine 2012年第12期2卷 1002-1008页

作者： Priyanka Soni Anees Ahmad Siddiqui Jaya Dwivedi vishal Soni Department of Herbal Drug Research B.R.Nahata College of PharmacyResearch Centre Department of Pharmaceutical Chemistry Jamia Hamdard University Deptatment of Chemistry Banasthali Vidyapith Banasthali University

India has a great wealth of various naturally occurring plant drugs which have great potential pharmacological *** stramonium(*** is one of the widely well known folklore medicinal *** troublesome weed,*** is a plant with both poisonous and medicinal preperties and has been proven to have great pharmacological potential with a great utility real usage in folklore *** has been scientifically proven to contain alkaloids,tannins,carbohydrates and *** plant has contributed various pharmacological actions in the scientific field of Indian systems of medicines like analgesic and antiasthmatic *** present paper presents an exclusive review work on the ethnomedical,phytochemical,pharmacological activities of this plant.

关键词： Datura stramonium Jimsonweed Phytochemistry Ethnopharmacology Traditional uses Pharmacology

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Delayed presentation of a loose body in undisplaced paediatric talar neck fracture

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World Journal of Orthopedics 2014年第3期5卷 398-401页

作者： vishal Patel Benjamin Bloch Nicholas Johnson Jitendra Mangwani Department of Trauma and Orthopedics Musculoskeletal DirectorateUniversity Hospitals of Leicester NHS TrustLeicester Royal InfirmaryLeicester LE1 5WW United Kingdom

Fractures of the talus are rare in children.A high index of suspicion is needed to avoid missing such an injury,which is not an uncommon occurrence especially with undisplaced *** present an unusual case of an undisplaced talar neck fracture in a five-year-old child leading to a delayed presentation of a symptomatic osteochondral loose body in the ankle *** our knowledge there are no reports in the literature of osteochondral loose bodies occurring in conjunction with an associated undisplaced talar neck fracture in either children or *** loose body was removed using anterior ankle *** child had an uneventful post operative recovery and regained full range of movement and function of his ankle joint and was discharged at one year *** aim to highlight the need to have a low threshold to further evaluate symptomatic children after fracture healing of an undisplaced talar neck fracture for a possible associated loose bodyin the ankle joint.

关键词： Talus Fracture Loose body Ankle arthroscopy Children

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Patients with culture negative pyogenic liver abscess have the same outcomes compared to those withKlebsiella pneumoniae pyogenic liver abscess

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Hepatobiliary & Pancreatic Diseases International 2016年第5期15卷 504-511页

作者： vishal G Shelat Qiao Wang Clement LK Chia Zhongkai Wang Jee Keem Low Winston WL Woon Department of General Surgery Tan Tock Seng Hospital Singapore 308433 Singapore Ministry of Health Holdings Pte Ltd. Singapore 099253 Singapore

BACKGROUND: Etiologic organism is not frequently isolated despite multiple blood and lfuid cultures during management of pyogenic liver abscess (PLA). Such culture negative pyogen-ic liver abscess (CNPLA) is routinely managed by antibiotics targeted toKlebsiella pneumoniae. In this study, we evaluated the outcomes of such clinical practice. METHODS: All the patients with CNPLA andKlebsiella pneu-moniaePLA (KPPLA) admitted from January 2003 to Decem-ber 2011 were included in the study. A retrospective review of medical records was performed and demographic, clinical and outcome data were collected. RESULTS: A total of 528 patients were treated as CNPLA or KPPLA over the study period. CNPLA presented more com-monly with abdominal pain (P=0.024). KPPLA was more com-mon in older age (P=0.029) and was associated with thrombo-cytopenia (P=0.001), elevated creatinine (P=0.002), bilirubin (P=0.001), alanine aminotransferase (P=0.006) and C-reactive protein level (P=0.036). CNPLA patients tend to have anemia (P=0.015) and smaller abscess (P=0.008). There was no differ-ence in hospital stay (15.7 vs 16.8 days) or mortality (14.0% vs 11.0%). No patients required surgical drainage after initiation of medical therapy. CONCLUSION: Despite demographic and clinical differences between CNPLA and KPPLA, overall outcomes are not different.

关键词： culture negative Klebsiella pneumoniae pyogenic liver abscess

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An Acoustic Analysis of Fluctuations for Inter-and Intra-Speaker Variability in Speech Sounds

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Journal of Forensic Science and Medicine 2023年第1期9卷 38-43页

作者： Jasdeep Kaur Kailash Chandra Juglan Kush Sharma vishal Sharma Department of Physics School of Chemical Engineering and Physical Sciences Lovely Professional UniversityPhagwaraPunjab Data Manager School of Community Medicine and Public HealthPostgraduate Institute of Medical Education and ResearchChandigarh Institute of Forensic Science and Criminology Panjab UniversityChandigarhIndia

Background:Variation in the speech of speakers is a crucial issue for the forensic *** main reason behind incorrect speaker identification is greater intra-speaker *** the forensic state of play,a lot of research has been carried out on speaker *** inter variations and intra fluctuations in speakers for the Punjabi language is still a grey *** and Objectives:Our aim is to study acoustic analysis of fluctuations for inter and intra speaker variability in speech *** our study,we will consider Punjabi vowel with *** Statistical methods will be applied to analyze the data;firstly,the Shapiro-Wilk test will be checked for normality and then Levene’s Test to assess the equality of *** and Method:Five vowels were selected with different *** were combined to make meaningful *** these meaningful words were embedded in *** speakers participated *** are students of A.S College at Khanna in *** individuals were aged between 20-22 years with no hearing or speech *** voice samples were recorded with help of good quality microphone and by Goldwave software in the sound proof *** were introduced directly into PRAAT software by the use of a Sony microphone and with sampling rate of 44100 Hz *** Analysis has been done with help of Goldwave software in form of *** and Conclusion:Each formant shows a different value for inter variations and inter speaker fluctuations.F1 and F2 shows lesser speaker variation than the high-frequency region in F3 and F4,so we can say that in comparison with the lower part,high-frequency regions are more *** assumptions for TWO-WAY ANOVA is violated and hence,we have used the non-parametric Friedman Test and performed its Post hoc *** Posthoc analysis,we can say that F1 and F2(p>0.05)and F2 and F3(p>0.05)gave the same type of ***,from the results of these st

关键词： Forensic voice identification Friedman test intervariations and intrafluctuations Punjabi

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Sex differences in SARS-CoV-2 infections,anti-viral immunity and vaccine responses

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Asian Pacific Journal of Tropical Medicine 2022年第3期15卷 97-105页

作者： Abhishek Mohanty Aanchal Sawhney Shefali Gupta vishal Rao Periyasamy Govindaraj Sambit Mohanty Vandana Jain Rajiv Gandhi Cancer Institute and Research Centre New DelhiIndia HCG Cancer Hospitals BangaloreIndia All India Institute of Medical Sciences Rae BareliIndia Centre for DNA Finger Printing and Diagnostics HyderabadIndia CORE Diagnostics GurgaonHaryanaIndia

The COVID-19 pandemic has revealed sex-based differences in anti-viral responses,with a higher rate of SARS-CoV-2 infections as well as a higher rate of morbidity and mortality in men than in *** and females also show disparate immune responses to COVID-19 infection,which may be important contributors to lower rates of infection,disease severity and deaths in women than in ***,the authors review sex differences in SARS-CoV-2 infections,anti-viral immunity and vaccine responses,putting forth the importance of sex,the underappreciated variables in vaccine response and disease infectivity.

关键词： SARS-CoV-2 Antiviral immunity Sex based mitochondrial differences Vaccine responses Innate immunity Sex differences COVID-19 pandemic

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On-table hepatopancreatobiliary surgical consults for difficult cholecystectomies:A 7-year audit

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Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 273-278页

作者： Kai Siang Chan Elizabeth Hwang JeeKeem Low SameerP Junnarkar Cheong Wei Terence Huey vishal G Shelat Department of General Surgery Tan Tock Seng Hospital308433Singapore

Background: Cholecystectomy is considered a general surgical operation. However, general surgeons are not trained to manage severe complications such as bile duct injury(BDI) and should refer to hepatopancreatobiliary(HPB) surgeons when difficulty arises. This study aimed to investigate the outcomes of patients who had on-table HPB consults during cholecystectomy. Methods: This is an audit of 50 patients who required on-table HPB consult during cholecystectomy from 2011 to 2017. Consultations were classified as “proactive” and “reactive”, where consults were made before or after surgical incision, respectively. Patient demographics and perioperative details were collected. Results: The median age of the patients was 62.5 years [interquartile range(IQR) 50.8–71.3 years]. Eight(16%) patients had underlying HPB co-morbidity. Gallbladder wall was thickened in all patients(median 5 mm, IQR 4–7 mm), and common bile duct was of normal caliber in all patients(median 5 mm, IQR 4–6 mm). Median length of operation and length of stay were 165 min(IQR 124–209 min) and five days(IQR 3–7 days), respectively. Subtotal cholecystectomy was performed in 18(36%) patients. Forty-eight patients were initially managed by laparoscopic approach, 15(31%) required open conversion;majority(9/15, 60%) were initiated before on-table consult. Majority of referrals(98%) were reactive. Common reasons for referral included unclear anatomy or anatomical variations(30%), presence of dense adhesions and/or contracted gallbladder(18%) and impacted stones in Hartmann’s pouch(16%). Three(6%) patients were referred for BDI(2 Strasberg D and 1 Strasberg E1), and two(4%) were referred for torrential bleeding from arterial injury(1 cystic artery and 1 right hepatic artery). Any morbidity and 30-day readmission were 22% and 6%, respectively. There was no 90-day mortality. Conclusions: Calling for help in BDI is obligatory, but in other instances is a personal choice. Calling for help prior to open conversion i

关键词： Bile duct injury Cholecystectomy Cholecystitis On-table consult Quality indicators Hepatopancreatobiliary surgery

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An infrequent cause of neonatal upper airway obstruction:Congenital nasal pyriform aperture stenosis presenting to a remote facility

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Pediatric Investigation 2021年第3期5卷 244-246页

作者： Tahne Joseph Lahiff Viliame Sotutu Smrdhi Sarachandran Lucas Speed vishal Saddi James Cook University School of Medicine and DentistryDouglas QLD 4811Australia North West Hospital and Health Service Paediatric DepartmentMount IsaQLDAustralia Sydney Children’s Hospital Randwick Department of Sleep MedicineSydneyNSWAustralia

Introduction:Congenital nasal pyriform aperture stenosis(CNPAS)is a rare congenital condition of structural nasal *** distress,stertor,and poor feeding are often presenting *** Presentation:We report a case of a newborn diagnosed with CNPAS at 3 weeks of *** diagnosis was missed on a nasoendoscopy at day 3 of life but was realised following a facial CT when the infant presented with ongoing symptoms of upper airway *** dilation was performed ***:CNPAS should be considered in any neonate with upper airway obstruction.A normal nasoendoscopy does not exclude the diagnosis.

关键词： Nasal obstruction Constriction Pathologic Congenital abnormalities

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Double segmental tibial fractures-- an unusual fracture pattern

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Chinese Journal of Traumatology 2011年第4期14卷 247-249页

作者： Kamal Baili vishal Kumar Sandeep Patel Sameer Aggarwal Department of Orthopaedics Postgraduate Institute ofMedical Education and Research Sector 12 Chandigarh160012 India

A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibia and multisegmental fractures of the fibula. Review of the literature revealed that this fracture pattern was unique and only a single case was reported so far. Moreover, we discussed the possible mechanisms which can lead to such an injury. We also discussed the management of segmental tibial fracture and the difficulties encountered with them. This case was managed by modern osteosynthesis technique with a pleasing outcome.

关键词： Fracture, bone Tibia Fibula Nails

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Withania somnifera (Ashwagandha):a Novel Source of L-asparaginase

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Journal of Integrative Plant Biology 2009年第2期51卷 201-206页

作者： vishal P.Oza Shraddha D.Trivedi Pritesh P.Parmar R.B.Subramanian B.R.D.School of Biosciences Sardar Patel UniversityV.V.Nagar 388 120 (Gujarat)India B.R.D.School of Biosciences Sardar Patel UniversityV.V.Nagar 388120 (Gujarat)India

Different parts of plant species belonging to Solanaceae and Fabaceae families were screened for L-asparaginase enzyme （E.C.3.***.1.1.）. Among 34 plant species screened for L-asparaginase enzyme. Withania somnifera L. was identified as a potential source of the enzyme on the basis of high specific activity of the enzyme. The enzyme was purified and characterized from W. somnifera, a popular medicinal plant in South East Asia and Southern Europe. Purification was carried out by a combination of protein precipitation with ammonium sulfate as well as Sephadex-gel filtration. The purified enzyme is a homodimer, with a molecular mass of 72 ± 0.5 kDa as estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresisand size exclusion chromatography. The enzyme has a pH optimum of 8.5 and an optimum temperature of 37 ℃. The Km value for the enzyme is 6.1 × 10^-2 mmol/L. This is the first report for L-asparaginase from W. somnifera, a traditionally used Indian medicinal plant.

关键词： Fabaceae L-asparaginase purification Sotanaceae Withania somnifera.

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