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Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery Bypass Grafting: Insights from a Bangladesh-Based Single Center Experience

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World Journal of Cardiovascular Diseases 2024年第4期14卷 252-267页

作者： vivek kumar jha Md Abir Tazim Chowdhury Munama Magdum Manoj Tiwari Md Abul Bashar Maruf Md Saiful Islam Khan Priyanka Sinha Rajesh Naryan Kapar Md. Rezwanul Hoque Department of Cardiothoracic and Vascular Surgery BP Koirala Institute of Health Sciences Dharan Nepal Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Thoracic Surgery BP Koirala Memorial Cancer Hospital Bharatpur Nepal Department of Cardiac Surgery United Hospital Limited Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of Microbiology Kathmandu Medical College Kathmandu Nepal Department of Nephrology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at BSMMU from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium afte

关键词： Coronary Artery Bypass Grafting (CABG) Serum Cortisol Postoperative Delirium Bangladesh

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Using Magnesium Sulfate to Prevent Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery: A Single Centre Experience in Bangladesh

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World Journal of Cardiovascular Diseases 2023年第9期13卷 565-577页

作者： Manoj Tiwari Md. Abir Tazim Chowdhury Hema Poudel Munama Magdum Md. Mostafizur Rahman vivek kumar jha Md. Ahaduzzaman Md. Abul Bashar Maruf Department of Cardiovascular and Thoracic Surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Dermatology and Venerology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Ibn Sina Specialized Hospital Dhaka Bangladesh

Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0th, 1st, 2nd, and 3rd days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a preventa

关键词： Atrial Fibrillation (AF) Coronary Artery Bypass Grafting (CABG) Postopera-tive Atrial Fibrillation (POAF) Magnesium Sulfate Bangladesh.

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Pumpkin seeds as nutraceutical and functional food ingredient for future:A review

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Grain & Oil Science and Technology 2024年第1期7卷 12-29页

作者： Arunima Singh vivek kumar Department of Food Technology Harcourt Butler Technical UniversityKanpur 208002UPIndia

Pumpkin belongs to the family of Cucurbitaceae,which comprises several species that has economical as well as agronomical importance.All parts of pumpkin are edible and laden with beneficial neutraceutical compounds.Pumpkin seeds are valuable source protein which can help in eradicating protein malnutrition and lipids(rich in PUFAs)contains essential as well as non essential fatty acids which prevents from various ailments like cancer and other cardiovascular diseases.Since,seeds of pumpkin are abundant in macro(magnesium,phosphorous,potassium,sodium and calcium)and micro minerals(iron,copper,manganese,zinc and selenium),they can be used as an incredible dietary supplement which in turn helps in curbing various deficiency disorders.This review enlightens the characteristics of pumpkin seeds,process of valorization of pumpkin seeds and the effect of processing on their nutritional composition which have been studied currently with the aim to use this wonder seeds for human wellbeing.Pumpkin seeds possess many bioactive compounds like polyphenols,flavonoids,phytosterols and squalene which makes it a lucrative raw material for pharmacological and food industries.Pumpkin seeds work as anti-depressant and helps majorly in the treatment of benign prostate hyperplasia(BHP).Daily consumption of pumpkin seeds can reduce the chances of Alzheimer's and Parkinson's disease.Pumpkin seeds are rich in tocopherols and can be used for oil extraction for edible purposes and utilized in other food formulations for future use.

关键词： Pumpkin seed Neutraceutical properties Nutritional composition Tocopherols Squalene β-Carotene Waste valorization

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Emergence of taurine as a therapeutic agent for neurological disorders

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Neural Regeneration Research 2024年第1期19卷 62-68页

作者： Ashok Jangra Priyanka Gola Jiten Singh Pooja Gond Swarnabha Ghosh Mahesh Rachamalla Abhijit Dey Danish Iqbal Mehnaz Kamal Punya Sachdeva Saurabh kumar jha Shreesh Ojha Dinesh kumar Niraj kumar jha Hitesh Chopra Shing Cheng Tan Department of Pharmaceutical Sciences Central University of HaryanaMahendergarhHaryanaIndia Department of Biology University of SaskatchewanSaskatoonSKCanada Department of Life Sciences Presidency UniversityKolkataWest BengalIndia Department of Health Information Management College of Applied Medical SciencesBuraydah Private CollegesBuraydahSaudi Arabia Department of Pharmaceutical Chemistry College of PharmacyPrince Sattam Bin Abdulaziz UniversityAl-KharjSaudi Arabia GloNeuro Vishwakarma RoadNoidaIndia Department of Biotechnology School of Engineering&Technology(SET)Sharda UniversityGreater NoidaUttar PradeshIndia Department of Pharmacology and Therapeutics College of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUnited Arab Emirates School of Bioengineering&Biosciences Lovely Professional UniversityPhagwaraIndia Department of Biotechnology School of Applied&Life Sciences(SALS)Uttaranchal UniversityDehradunIndia Chitkara College of Pharmacy Chitkara UniversityPunjabIndia UKM Medical Molecular Biology Institute Universiti Kebangsaan MalaysiaKuala LumpurMalaysia

Taurine is a sulfur-containing,semi-essential amino acid that occurs naturally in the body.It alternates between inflammation and oxidative stress-mediated injury in various disease models.As part of its limiting functions,taurine also modulates endoplasmic reticulum stress,Ca^(2+)homeostasis,and neuronal activity at the molecular level.Taurine effectively protects against a number of neurological disorders,including stro ke,epilepsy,cerebral ischemia,memory dysfunction,and spinal cord injury.Although various therapies are available,effective management of these disorders remains a global challenge.Approximately 30 million people are affected worldwide.The design of taurine fo rmation co uld lead to potential drugs/supplements for the health maintenance and treatment of central nervous system disorders.The general neuroprotective effects of taurine and the various possible underlying mechanisms are discussed in this review.This article is a good resource for understanding the general effects of taurine on various diseases.Given the strong evidence for the neuropharmacological efficacy of taurine in various experimental paradigms,it is concluded that this molecule should be considered and further investigated as a potential candidate for neurotherapeutics,with emphasis on mechanism and clinical studies to determine efficacy.

关键词： antioxidant epilepsy γ-amino butyric acid neurodegenerative disorders neuroprotection oxidative stress spinal cord injury taurine

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Transcranial direct current stimulation as early augmentation in adolescent obsessive compulsive disorder:A pilot proof-of-concept randomized control trial

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World Journal of Clinical Pediatrics 2024年第2期13卷 161-170页

作者： Aditya Agrawal vivek Agarwal Sujita kumar Kar Amit Arya Department of Psychiatry King George Medical UniversityUttar PradeshLucknow 226003India

BACKGROUND Transcranial direct current stimulation(tDCS)is proven to be safe in treating various neurological conditions in children and adolescents.It is also an effective method in the treatment of OCD in adults.AIM To assess the safety and efficacy of tDCS as an add-on therapy in drug-naive adolescents with OCD.METHODS We studied drug-naïve adolescents with OCD,using a Children’s Yale-Brown obsessive-compulsive scale(CY-BOCS)scale to assess their condition.Both active and sham groups were given fluoxetine,and we applied cathode and anode over the supplementary motor area and deltoid for 20 min in 10 sessions.Reassessment occurred at 2,6,and 12 wk using CY-BOCS.RESULTS Eighteen adolescents completed the study(10-active,8-sham group).CY-BOCS scores from baseline to 12 wk reduced significantly in both groups but change at baseline to 2 wk was significant in the active group only.The mean change at 2 wk was more in the active group(11.8±7.77 vs 5.25±2.22,P=0.056).Adverse effects between the groups were comparable.CONCLUSION tDCS is safe and well tolerated for the treatment of OCD in adolescents.However,there is a need for further studies with a larger sample population to confirm the effectiveness of tDCS as early augmentation in OCD in this population.

关键词： Adolescents Early augmentation Obsessive compulsive disorder Safety Transcranial direct current stimulation

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Helicobacter pylori isolated from gastric juice have higher pathogenic potential than biopsy isolates

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Genes & Diseases 2024年第1期11卷 34-37页

作者： Budhadev Baral Dharmendra Kashyap Nidhi Varshney Tarun Prakash Verma Ajay kumar Jain Debi Chatterji Vinod kumar Amit Mishra Awanish kumar Hem Chandra jha Infection Bioengineering Group Department of Biosciences and Biomedical EngineeringIndian Institute of Technology IndoreSimrolIndoreMadhya Pradesh 453552India Choithram Hospital and Research Center IndoreMadhya Pradesh452014India Department of Metallurgy Engineering and Materials Science Indian Institute of Technology IndoreSimrolIndoreMadhya Pradesh 453552India Department of Bioscience&Bioengineering Indian Institute of Technology JodhpurNH 65 Nagaur RoadJodhpur DistrictKarwarRajasthan 342037India Department of Biotechnology National Institute of Technology RaipurGE RoadRaipurChhattisgarh 492010India

Persistent gastritis induced by Helicobacter pylori(H.pylori)is the strongest known risk factor for gastric cancer(GC).H.pylori is prevalent in about 50%world's population,while it causes cancer in less than 2%of exposed individuals.1 Our studies found that H.pylori infection can induce oncogenic properties in AGS cells by deregulating multiple factors associated with the cell cycle,apoptosis,and other important events associated with cancer progression.

关键词： H.pylori pylori Helicobacter

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Efficacy of stromal vascular fraction for knee osteoarthritis:A prospective,single-centre,non-randomized study with 2 years follow-up

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World Journal of Orthopedics 2024年第5期15卷 457-468页

作者： Madhan Jeyaraman Naveen Jeyaraman Tarun Jayakumar Swaminathan Ramasubramanian Rajni Ranjan Saurabh kumar jha Ashim Gupta Department of Orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennaiTamil Nadu 600077India Department of Biotechnology School of Engineering and TechnologySharda UniversityGreater NoidaUttar Pradesh 201310India Department of Orthopaedics and Regenerative Medicine South Texas Orthopaedic Research InstituteLaredoTX 78045United States Department of Orthopaedics KIMS-Sunshine HospitalHyderabadTelangana 500032India Department of Orthopaedics Government Medical CollegeOmandurar Government EstateChennaiTamil Nadu 600002India Department of Orthopaedics School of Medical Sciences and ResearchSharda UniversityGreater NoidaUttar Pradesh 201306India Department of Zoology Kalindi CollegeUniversity of DelhiNew Delhi 110008India Department of Orthopaedics and Regenerative Medicine Regenerative OrthopaedicsNoida 201301Uttar PradeshIndia Department of Orthopaedics and Regenerative Medicine Future BiologicsLawrencevilleGA 30043United States Department of Orthopaedics and Regenerative Medicine BioIntegrateLawrencevilleGA 30043United States

BACKGROUND Current osteoarthritis(OA)treatments focus on symptom relief without addressing the underlying disease process.In regenerative medicine,current treatments have limitations.In regenerative medicine,more research is needed for intra-articular stromal vascular fraction(SVF)injections in OA,including dosage optimization,long-term efficacy,safety,comparisons with other treatments,and mechanism exploration.AIM To compare the efficacy of intra-articular SVF with corticosteroid(ICS)injections in patients with primary knee OA.METHODS The study included 50 patients with Kellgren-Lawrence grades II and III OA.Patients were randomly assigned(1:1)to receive either a single intra-articular SVF injection(group A)or a single intra-articular ICS(triamcinolone)(group B)injection.Patients were followed up at 1,3,6,12,and 24 months.Visual analog score(VAS)and International Knee Documentation Committee(IKDC)scores were administered before the procedure and at all followups.The safety of SVF in terms of adverse and severe adverse events was recorded.Statistical analysis was performed with SPSS Version 26.0,IBM Corp,Chicago,IL,United States.RESULTS Both groups had similar demographics and baseline clinical characteristics.Follow-up showed minor patient loss,resulting in 23 and 24 in groups A and B respectively.Group A experienced a notable reduction in pain,with VAS scores decreasing from 7.7 to 2.4 over 24 months,compared to a minor reduction from 7.8 to 6.2 in Group B.This difference in pain reduction in group A was statistically significant from the third month onwards.Additionally,Group A showed significant improvements in knee functionality,with IKDC scores rising from 33.4 to 83.10,whereas Group B saw a modest increase from 36.7 to 45.16.The improvement in Group A was statistically significant from 6 months and maintained through 24 months.CONCLUSION Our study demonstrated that intra-articular administration of SVF can lead to reduced pain and improved knee function in patients with primary knee OA.More adequately powe

关键词： Knee osteoarthritis Adipose tissue Stromal vascular fraction Regenerative medicine Orthobiologics

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Cloud‐based video streaming services:Trends,challenges,and opportunities

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CAAI Transactions on Intelligence Technology 2024年第2期9卷 265-285页

作者： Tajinder kumar Purushottam Sharma Jaswinder Tanwar Hisham Alsghier Shashi Bhushan Hesham Alhumyani vivek Sharma Ahmed I.Alutaibi CSE Department JMIETIYamunanagarHaryanaIndia Department of Information Technology ASETAmity University Uttar PradeshNoidaIndia Tata Communications Limited New DelhiIndia Department of Information Technology College of Computer and Information SciencesMajmaah UniversityMajmaahSaudi Arabia Amity School of Engineering and Technology Amity UniversityPatnaBiharIndia Department of Computer Engineering College of Computers and Information TechnologyTaif UniversityTaifSaudi Arabia Department of Computer Engineering College of Computer and Information SciencesMajmaah UniversityMajmaahSaudi Arabia

Cloud computing has drastically changed the delivery and consumption of live streaming content.The designs,challenges,and possible uses of cloud computing for live streaming are studied.A comprehensive overview of the technical and business issues surrounding cloudbased live streaming is provided,including the benefits of cloud computing,the various live streaming architectures,and the challenges that live streaming service providers face in delivering high‐quality,real‐time services.The different techniques used to improve the performance of video streaming,such as adaptive bit‐rate streaming,multicast distribution,and edge computing are discussed and the necessity of low‐latency and high‐quality video transmission in cloud‐based live streaming is underlined.Issues such as improving user experience and live streaming service performance using cutting‐edge technology,like artificial intelligence and machine learning are discussed.In addition,the legal and regulatory implications of cloud‐based live streaming,including issues with network neutrality,data privacy,and content moderation are addressed.The future of cloud computing for live streaming is examined in the section that follows,and it looks at the most likely new developments in terms of trends and technology.For technology vendors,live streaming service providers,and regulators,the findings have major policy‐relevant implications.Suggestions on how stakeholders should address these concerns and take advantage of the potential presented by this rapidly evolving sector,as well as insights into the key challenges and opportunities associated with cloud‐based live streaming are provided.

关键词： cloud computing video analysis video coding

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Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study

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World Journal of Cardiology 2024年第6期16卷 318-328页

作者： Ajay kumar Mishra Kannu Bansal Ibragim Al-Seykal Pradnya B Bhattad Anu Anna George Anil jha Nitish Sharma Jennifer Sargent Mark J Kranis Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Division of CardiologySaint Vincent HospitalWorcesterMA 01608United States Division of Cardiovascular Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of patients.Vegetations of>10 mm size are associated with increased embolic events and poor prognosis.There is a paucity of literature on the association of multiple vegetations with outcome.AIM To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple vegetations.METHODS In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from June 2017 to June 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were identified.Baseline demographic,clinical,laboratory,and ECHO parameters were reviewed.Outcomes that were studied included recurrent admission,embolic phenomenon,and mortality.RESULTS Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were female.The mean age of these patients was 50.Eight(35%)had a prior episode of IE.ECHO features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple vegetations.Of these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically significant.These patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically significant.CONCLUSION This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple vegetations.ECHO features of moderate to severe regurgitation,presence of pacemaker lead,impaired LV relaxation,and elevated PASP and outcomes

关键词： Endocarditis Echocardiography Vegetations Predictors Outcome

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Determining the Checkpoint of Transition from Thin to Thick Periodontal Phenotypes in the Maxillary and Mandibular Anterior Regions of South Indian Population

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Journal of Forensic Science and Medicine 2024年第1期10卷 55-61页

作者： Mohan kumar Pasupuleti Rasagna Chowdary G Gautami SPenmetsa vivek Bypalli Ramesh S.V.Konathala Sruthima N.V.S.Gottumukkala Department of Periodontics and Implantology Vishnu Dental CollegeBhimavaramAndhra PradeshIndia2Vishnu Dental CollegeBhimavaramAndhra PradeshIndia

Aim:The aim of this study was to compare and investigate the tissue thickness at the maxillary and mandibular central incisors utilizing the probe visibility method and traditional way of measuring gingival thickness(GT)by endodontic files.Methodology:In 200 selected patients,the GT was measured at both the maxillary and mandibular anterior using an endodontic file after local infiltration at the mid-distance from the gingival margin to the mucogingival junction.The checkpoint of transition from thin to thick periodontal phenotype was determined by probe visibility method in the following age groups:Group A:21-30 years;Group B:31-40 years;Group C:41-50 years;and Group D:51-60 years.Results:GT varied from 0.3 to 1.9 mm.Gingival translucency was observed up to the thickness of 0.7 mm.At 0.8 mm of GT,there was no probe visibility.Conclusion:According to the present research,the gingiva appears transparent up to a thickness of around 0.7 mm.The checkpoint of transition between thin and thick periodontal phenotypes at both the maxillary and mandibular anterior was associated with a GT of 0.8 mm.

关键词： Gingiva periodontal phenotype probe visibility

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