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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 *** of>10 mm size are associated with increased embolic events and poor *** is a paucity of literature on the association of multiple vegetations with *** To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple *** 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 *** demographic,clinical,laboratory,and ECHO parameters were *** that were studied included recurrent admission,embolic phenomenon,and *** Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were *** mean age of these patients was ***(35%)had a prior episode of *** 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 *** these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically *** 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 *** This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple *** features of moderate to severe regurgitation,presence of pacemaker lead,impai

关键词： Endocarditis Echocardiography Vegetations Predictors Outcome

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Paradigm shift in transfusion practices during early COVID-19 pandemic:A single center retrospective study

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World Journal of Virology 2024年第2期13卷 78-86页

作者： Sumukh Arun kumar Sushmita Prabhu Ankushi Sanghvi Maya Gogtay Mithil Gowda Suresh Harshit Khosla Yuvaraj Singh ajay kumar mishra Susan George Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Hematology and Oncology University of Nebraska Medical CenterOmahaNE 68198United States Hospice and Palliative Care UTHSC and McGovern School of MedicineTexasTX 77030United States Department of Gastroenterology and Hepatology UMass Chan Medical SchoolWorcesterMA 01655United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a *** the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical *** COVID era and pre-COVID *** We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community *** was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional ***-square was applied to test the statistical association between qualitative *** t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative *** A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID *** leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.

关键词： Blood transfusion Restrictive transfusion COVID-19 Pre-COVID-19 Blood shortage Pandemic

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Photocatalytic degradation of the diazo dye naphthol blue black in water using MWCNT/Gd,N,S-TiO_2 nanocomposites under simulated solar light

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Journal of Environmental Sciences 2015年第7期27卷 219-228页

作者： Gcina Mamba Xavier Yangkou Mbianda ajay kumar mishra Department of Applied Chemistry University of Johannesburg Faculty of Science DST-NRF Centre of Excellence in Strong Materials School of Physics University of the Witwatersrand Nanotechnology and Water Sustainability Unit College of Engineering Science and Technology University of South Africa Florida Campus

A simple sol-gel method was employed to prepare gadolinium, nitrogen and sulphur tridoped titania decorated on oxidised multiwalled carbon nanotubes（MWCNT/Gd,N,S-Ti O2）, using titanium（IV） butoxide and thiourea as titanium and nitrogen and sulphur source, respectively. Samples of varying gadolinium loadings（0.2%, 0.6%, 1.0% and3.0% Gd3＋） relative to titania were prepared to investigate the effect of gadolinium loading and the amounts of carbon nanotubes, nitrogen and sulphur were kept constant for all the samples. Furthermore, the prepared nanocomposites were evaluated for the degradation of naphthol blue black（NBB） in water under simulated solar light irradiation. Higher degradation efficiency（95.7%） was recorded for the MWCNT/Gd,N,S-Ti O2（0.6% Gd）nanocomposites. The higher photocatalytic activity is attributed to the combined effect of improved visible light absorption and charge separation due to the synergistic effect of Gd,MWCNTs, N, S and Ti O2. Total organic carbon（TOC） analysis revealed a higher degree of complete mineralisation of naphthol blue black（78.0% TOC removal） which minimises the possible formation of toxic degradation by-products such as the aromatic amines. The MWCNT/Gd,N,S-Ti O2（0.6% Gd） was fairly stable and could be re-used for five times,reaching a maximum degradation efficiency of 91.8% after the five cycles.

关键词： Gadolinium MWCNTs NBB Simulated solar light Tridoped titania

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Clinical considerations for critically ill COVID-19 cancer patients:A systematic review

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World Journal of Clinical Cases 2021年第28期9卷 8441-8452页

作者： Chidambaram Ramasamy ajay kumar mishra Kevin John John Amos Lal Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Bangalore Baptist HospitalBangalore 578954India Department of Medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55902United States

BACKGROUND The World Health Organization(WHO)on March 11,2020,had declared the novel coronavirus disease 2019(COVID-19)outbreak a global *** COVID-19 infection continues to be a pandemic and is currently causing overwhelming challenges to healthcare across the *** patients represent a unique population vulnerable to COVID-19 infection due to their advanced age,intrinsic frailty,medical comorbidities,immunosuppression,and frequent health care visits for their underlying *** analysis of COVID-19 infection among cancer patients is crucial to aid in the optimal management of these *** To identify contributors of worse outcomes in patients with malignancy and COVID-19 and to describe the role of critical *** In this review,we summarized the information from seminal articles on the presentation and management of patients with COVID-19 and malignancy that were published before December 10,*** searched the Pub Med and Medline database for“COVID-19”and“Cancer”,“Malignancy”.Studies published in English,including adults with malignancy and COVID-19 infection,were eligible to be included in this *** on patients that provided details on malignancy,clinical presentation,management,and outcome were *** details of malignancy that were included are the site of cancer,histopathological type,stage,chemotherapy,and *** of COVID-19 infection that were obtained are clinical presentation,the modality of testing,imaging,management,and *** care details that were obtained were the type of the organ dysfunction and the requirement of organ support measures,requirement of noninvasive,invasive ventilation,management of vasopressor support,and *** that did not have patient details,opinions,letters,and articles not published in English were *** articles were reviewed by 2 independent *** were screened for the above terminologies by independent clinician

关键词： COVID-19 Cancer Critical care Mortality Pandemic

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Cocaine-induced methemoglobinemia

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World Journal of Emergency Medicine 2021年第1期12卷 81-82页

作者： Kamal Kant Sahu ajay kumar mishra Amos Lal Ahmad Daniyal Siddiqui Susan VGeorge MD Medicine Saint Vincent HospitalWorcester 10608USA MD Medicine Mayo ClinicRochester 55905USA

Dear editor,We congratulate Chowdhury et al[1] for their excellentreport and successful management of a young ladysuffering from cocaine-induced *** this letter, we aim to address some additionalconcerns, which would ... 详细信息

关键词： editor letter caine

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Case-control analysis of venous thromboembolism risk in nonalcoholic steatohepatitis diagnosed by transient elastography

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World Journal of Clinical Cases 2023年第34期11卷 8126-8138页

作者： Mithil Gowda Suresh Maya Gogtay Yuvaraj Singh Lekha Yadukumar ajay kumar mishra George M Abraham Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Hematology and Oncology University of Nebraska Medical CenterOmahaNE 68198United States Department of Gastroenterology and Hepatology University of MassachusettsWorcesterMA 01605United States Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18505United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the most common cause of chronic liver disease *** have shown a strong association between nonalcoholic steatohepatitis(NASH)cirrhosis and portal vein ***,there is paucity of data on the association of NASH and venous thromboembolism(VTE),with one such study predicting a 2.5-fold increased risk for VTE compared to other liver diseases in hospitalized *** mechanism is believed to be a hepatocellular injury,which causes a chronic inflammatory state leading to the unregulated activation of procoagulant *** has been no prior analysis of the degree of steatosis and fibrosis(measured using transient elastography,commonly known as FibroScan)in NASH and its association with *** To examine the association between the degree of hepatic steatosis and fibrosis,quantified by transient elastography,and the incidence of VTE in patients with *** In our case-control study,we included patients with a documented diagnosis of *** excluded patients with inherited thrombophilia,hemoglobinopathy,malignancy,alcohol use disorder,autoimmune hepatitis,and primary biliary *** collected data included age,demographics,tobacco use,recreational drug use,medical history,and vibration controlled transient elastography ***-specific data included the location,type of anticoagulant,need for hospital stay,and history of VTE *** was categorized as S0-S1(mild)and S2-S3(moderate to severe)based on the controlled attenuation parameter *** was classified based on the kilopascal score and graded as F0-F1(Metavir stage),F2,F3,and F4(cirrhosis).χ^(2) and Mann-Whitney U tests were used for the qualitative and quantitative variable analyses,***,we performed a logistic regression using VTE as the dependent *** A total of 415 patients were analyzed,and 386 met the inclusion criteria.51 and 335 patients were included

关键词： Nonalcoholic fatty liver disease Venous thromboembolism Non-alcoholic steatohepatitis Diabetes mellitus Liver fibrosis Steatosis Deep vein thrombosis Anticoagulation management

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Detection of colorectal adenomas using artificial intelligence models in patients with chronic hepatitis C

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World Journal of Hepatology 2023年第1期15卷 107-115页

作者： Yuvaraj Singh Maya Gogtay Anuroop Yekula Aakriti Soni ajay kumar mishra Kartikeya Tripathi GM Abraham Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Hospice and Palliative Medicine University of Texas Health-San AntonioSan AntonioTX 78201United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Division of Gastroenterology and Hepatology UMass Chan School-Baystate Medical CenterSpringfieldMA 01199United States Division of Infectious Disease Chief of MedicineSaint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Hepatitis C virus is known for its oncogenic potential,especially in hepatocellular carcinoma and non-Hodgkin *** studies have shown that chronic hepatitis C(CHC)has an increased risk of the development of colorectal cancer(CRC).AIM To analyze this positive relationship and develop an artificial intelligence(AI)-based tool using machine learning(ML)algorithms to stratify these patient populations into risk groups for CRC/adenoma *** To develop the AI automated calculator,we applied ML to train models to predict the probability and the number of adenomas detected on *** sets were split into 70:30 ratios for training and internal *** Scikit-learn standard scaler was used to scale values of continuous *** findings were used as the gold standard and deep learning architecture was used to train six ML models for prediction.A Flask(customizable Python framework)application programming interface(API)was used to deploy the trained ML model with the highest accuracy as a web ***,Heroku was used for the deployment of the web-based API to https://*** Of 415 patients,206 had colonoscopy *** internal validation,the Bernoulli naive Bayes model predicted the probability of adenoma detection with the highest accuracy of 56%,precision of 55%,recall of 55%,and F1 measure of 54%.Support vector regressor predicted the number of adenomas with the least mean absolute error of *** Our AI-based tool can help providers stratify patients with CHC for early referral for screening *** with providing a numerical percentage,the calculator can also comment on the number of adenomatous polyps a gastroenterologist can expect,prompting a higher adenoma detection rate.

关键词： Machine learning Calculator Artificial intelligence Hepatitis C Screening

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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(***)is the strongest known risk factor for gastric cancer(GC).*** is prevalent in about 50%world's population,while it causes cancer in less than 2%of exposed individuals.1 Our studies found that *** 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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Update on retroperitoneal hematoma in children

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World Journal of Emergency Medicine 2020年第1期11卷 64-64页

作者： Kamal Kant Sahu ajay kumar mishra Amos Lal Department of Internal Medicine Saint Vincent HospitalWorcester

Dear editor,We read with great interest the recent article by Badheka et al[1]published in your esteemed *** we would like to address few additional points related to childhood retroperitoneal hematoma(RPH).RPH can be broadly divided into two categories,trauma/procedure related or spontaneous ***,there may be one or more predisposing factors contributing for RPH:chronic liver disease,chronic kidney disease,bleeding disorders,blood thinner,interventions and so on.

关键词： hematoma bleeding RPH

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Geochemistry and mineral chemistry of the armoor granitoids,eastern dharwar craton: implications for the redox conditions and tectono-magmatic environment

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Acta Geochimica 2024年第1期43卷 110-133页

作者： A.ajay kumar Ch.Ashok Department of Geology Osmania UniversityHyderabad 500007India CSIR-National Geophysical Research Institute UppalHyderabad 500007India

The mineralogical and geochemical characteristics of the K-rich granites from the Armoor granitic rocks in the northeastern portion of the Eastern Dharwar Craton(EDC) are *** order to understand its physicochemical conditions,the petrogenesis of the granitoid was explained from biotite chemistry and geochemical *** of mineral chemistry expose that compositionally,K-feldspar and plagioclase in Armoor granite rocks range from An0,Ab_(3-5.9),Or_(94-96.9) and An_(5-29,-Ab71.9-94.9),Or_(0-1.5),*** mineral chemistry of biotite crystals exhibits composition that varies from primary to re-equilibrated primary *** biotites from the Armoor granites generally exhibit an I-type trend,with calc-alkaline parental magma in a subduction *** chemistry of granites displays magnetite(oxidized)series nature,which has oxygen fugacity(fO_(2))=-15.1 to-16.7(log_(10) bar),under high oxidizing *** and pressure estimates for the crystallization of Armoor granites based on biotite composition are T=612-716 ℃ and 1.0-0.4 kbar,***,these rocks are metaluminous to slightly peraluminous and magnesian,with calc-alkaline potassiumrich *** the chondrite normalized REE diagram,the granites have positive europium anomalies;rich Sr/Y,(Dy/Yb)_(N) ratios and reduced Mg#,Rb/Sr,Rb,Sr indicate that the melting of earlier rocks,crystal accumulation and residual garnet source formed at high *** examined granites show that they are produced from the melting of crustal ***,the extensive analyses of the described Armoor granite suggest that they were produced by crust sources and developed under oxidizing conditions in subduction setting.

关键词： Armoor granites Oxygen fugacity Crystal accumulation Remelting Subduction

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