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Cardiopulmonary Bypass for Tracheal Resection and Repair—A Safe Alternative

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World Journal of Cardiovascular Surgery 2018年第11期8卷 197-203页

作者： akshay Chauhan Satish Kumar Aggarwal Vishnu Dutt Saket Agarwal M. A. Geelani Department of Cardiothoracic and Vascular Surgery G B Pant Hospital New Delhi India Department of Pediatric Surgery Maulana Azad Medical College New Delhi India Department of Pediatric Surgery Sir Ganga Ram Hospital New Delhi India Department of Anaesthesia G B Pant Hospital New Delhi India

Airway management during tracheal surgery is always challenging for the anaesthesia team. Cardiopulmonary bypass (CPB) is generally not required during tracheal surgery on the cervical trachea. However, for tracheal surgeries CPB may be advantageous and give the surgeon more freedom to work. We report three cases of post-intubation tracheal stenosis successfully managed with tracheal resection and reconstruction performed under cardiopulmonary bypass.

关键词： Cardiopulmonary Bypass Tracheal Stenosis

An Experience on Normothermic Beating Heart Pulmonary Thromboendarterectomy

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World Journal of Cardiovascular Surgery 2019年第1期9卷 1-13页

作者： akshay Kumar Bisoi Pradeep Ramakrishnan Sandeep Chauhan Manoj Kumar Sahu Naveen Chander Chandrasekharan Department of CTVS C N Centre All India Institute of Medical Sciences New Delhi India Department of Cardiac Anaesthesiology C N Centre All India Institute of Medical Sciences New Delhi India

Objective: To study the outcome of normothermic beating heart pulmonary thromboendarterectomy (PTE) performed in patients with chronic pulmonary thromboembolism. Methodology: A retrospective analysis of 15 patients who underwent PTE under normothermic beating heart cardio-pulmonary bypass from July 2009 to September 2018 was done. The patients were followed up with clinical assessment, transthoracic echocardiography and computerized tomographicangiography (CTA) for 1 month to 82 months. Results: Data were analysed for 15 consecutive patients. Mean age of the patients was 35.28 years and 10 patients were male. Pre-operatively 6 (40%) patients presented with New York Heart Association (NYHA) class II dyspnoea on exertion symptomatology, 7 (47%) were in NHYA class III, and 2 (13%) were in NYHA class IV. The preoperative and postoperative mean pulmonary artery pressures (mPAP) (mmHg) were 36.50 ± 11.3 and 20.21 ± 7.19, the systolic PAPs (mmHg) were 73.35 ± 14.12 and 35.21 ± 7.89 and the diastolic PAPs (mmHg) were 19.28 ± 8.60 and 12.85 ± 7.26 respectively. 2 (13%) patients had Jamieson’s type I and 12 (87%) had Jamieson type II disease. One patient (7%) expired on 9th postoperative day. All the patients had improved pulmonary gas exchange and did not require oxygen supplementation from 5th postoperative day;symptoms improved to NYHA class I & II in 12 (80%) & 3 (20%) of patients respectively. There was no reperfusion pulmonary edema or any neurologic complications. Postoperative echocardiogram showed improved right ventricular function and Computerised Tomographic Angiogram showed completeness of the procedure. Conclusion: Pulmonary thromboendarterectomy under normothermic beating heart cardiopulmonary bypass has good immediate postoperative results with significant progressive improvement in hemodynamics and quality of life during the course of follow-up. The results were not only comparable to those of the procedure done under deep hypothermic circulatory arrest by ot

关键词： Pulmonary Thromboendarterectomy Normothermic Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Beating Heart

Fresh Pericardial Valved Conduit for Reconstruction of Right Ventricular Outflow Tract in Tetralogy of Fallot with Pulmonary Stenosis or Pulmonary Atresia—Early Results

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World Journal of Cardiovascular Surgery 2017年第2期7卷 16-25页

作者： Anurag Agarwal akshay Chauhan Nayem Raja Chirantan Mangukia Saket Aggarwal Deepak Kumar Satsangi Department of CTVS Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (Gipmer) New Delhi India

Objective: To study early results of hand made fresh (autologous/homologous) pericardial valved conduit in achieving right ventricle to pulmonary artery continuity. Method: Between November 2014 and September 2015, 19 cases, with diagnosis of Tetralogy of Fallot with Pulmonary stenosis (PS) or Pulmonary atresia (PA) underwent intracardiac repair and Right Ventricular Outflow Tract (RVOT) reconstruction with hand made fresh [autologous (n = 2)/ homologous (n = 17)] pericardial valved conduit. Mean age of the patients at time of surgery was 6.37 years (range 3 months to 18 years), mean weight was 18.52 kilograms (range 6 kg to 40 kg) and mean size of the conduit was 20.7 mm (range 16 mm to 24 mm). Results: All patients had a smooth post-operative course, with mean ICU (Intensive Care Unit) stay of 3.6 days (range 3 days to 6 days) and mean post-operative hospital stay 8.5 days (range 7 days to 16 days). Intra-operative and Post-operative echocardiography revealed moderate Pulmonary regurgitation (PR) in one patient, mild PR in 5 patients and no or trace PR in 13 patients. No patient has developed conduit stenosis or calcification till now. Conclusion: Autologous or homologous pericardial valved conduit provides good early results and is especially suitable for developing world because of zero cost. Long term usefulness of such option remains to be confirmed in terms of dilation, calcification and freedom from intervention.

关键词： RV-PA (Right Ventricle-Pulmonary Artery) Continuity Tetralogy of Fallot Pericardial Valved Conduit

Comparison of Parasternal Intercostal Block Using Ropivacaine or bupivacaine for Postoperative Analgesia in Patients Undergoing Cardiac Surgery

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World Journal of Cardiovascular Surgery 2015年第6期5卷 49-57页

作者： Kulbhushan Saini Sandeep Chauhan Usha Kiran akshay Kumar Bisoi Minati Choudhury Suruchi Hasija Department of Cardiothoracic and Vascular Anaesthesia CN Centre All India Institute of Medical Science New Delhi India M.CH Cardiothoracic and Vascular Surgery All India Institute of Medical Science New Delhi India

Objective: The objective of this study was to compare the efficacy of 0.5% ropivacaine and 0.25% bupivacaine for parasternal intercostal block for postoperative analgesia in children undergoing cardiac surgery. Design: A randomized, controlled, prospective, double blind study. Setting: A tertiary care teaching hospital. Participants: One Hundred children scheduled for cardiac surgery through a median sternotomy were divided into 3 groups of at least 33 children each, receiving either ropivacaine, bupivacaine or saline (control). Interventions: A bilateral parasternal block performed either with 0.5% ropivacaine or 0.25% bupiacaine or 0.9% saline with 5 doses of 0.5 mL on each side in the 2nd to 6th parasternal intercostal spaces 1 to 1.5 cm lateral to the sternal edge, before sternal wound closure. Measurements and Main Results: The time to extubation was significantly less in children administered the parasternal blocks with ropivacaine or bupivacaine compared to the saline (control) group. The pain scores were lower and comparable in the ropivacaine and bupivacaine groups compared to the saline group. The cumulative fentanyl dose requirement over a 24-hour period was higher in the saline group than the ropivacaine (p < 0.001) and bupivacaine group. No side effects were observed in any of the children. Conclusions: Parasternal blocks either with ropivacaine or bupivacaine appear to be a simple, safe, and useful technique for supplementation of postoperative analgesia in children undergoing cardiac surgery with a median sternotomy.

关键词： Pediatric Cardiac Patients Parasternal Intercostalblock Sternotomy Ropivacaine Bupivacaine Postoperative Pain

Assessment of Groundwater Potential Zones across Katrol Hill Fault, Kachchh, Western India: A Remote Sensing and GIS Approach

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Open Journal of Geology 2022年第2期12卷 111-135页

作者： Hemashri Thacker Yash Shah akshay Jyoti Borah Yogendrasinh Jadeja Mahesh Thakkar Sazina Bhimani Gaurav Chauhan Department of Earth and Environmental Science KSKV Kachchh University Bhuj India Arid Communities and Technologies (ACT) Bhuj India Geo Science Services (GSS) Bhuj India

The present study focuses on the use of remote sensing and geographical information system tools for morphometric and geomorphic analysis of major river basins across the Katrol Hill Fault, which makes drainage divide. It aims to find groundwater potential for the management and planning of groundwater resources. The study area consists of 6 major watersheds of major river systems namely Bhurud, Khari, and Pat flowing north of the major divide, while Rukmawati, Nagavanti, and Bhukhi are southerly flowing rivers. Based on linear, areal, and geomorphic aspects, a watershed with excellent groundwater potential was found. The highest order in the area is the 5th order stream. Appropriate drainage network characteristics, elongated shape, and permeable lithological formation with low relief among all the watersheds made WS3 be excellent potential for groundwater. The statistical analysis, where Cp value was computed, showed the potential groundwater zone to be in WS3 followed by WS2 and WS5. These results were even verified with field data, collected from well-inventory and that too favored WS3 as an excellent groundwater potential.

关键词： Katrol Hill Fault Kachchh Groundwater Potential Statistical Analysis Groundwater Resources

Identification of Multiple Alleles at the Wx Locus and Development of Single Segment Substitution Lines for the Alleles in Rice

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Rice science 2006年第1期13卷 9-14页

作者： akshay TALUKDAR Guangdong Provincial Key Laboratory of Plant Molecular Breeding South China Agricultural University Guangzhou 510642 China

The microsatellite markers 484/485 and 484/W2R were used to identify the multiple alleles at the Wx locus in rice germplasm. Fifteen alleles were identified in 278 accessions by using microsatellite class and G-T polymorphism. Among these alleles, （CT）12-G, （CT）15-G, （CT）16-G, （CT）17-G, （CT）18-G and （CT）21-G have not been reported. Seventy-two single-segment substitution lines （SSSLs） carrying different alleles at the Wx locus were developed by using Huajingxian 74 with the （CT）11-G allele as a recipient and 20 accessions containing 12 different alleles at the Wx locus as donors. The estimated length of the substituted segments ranged from 2.2 to 77.3 cM with an average of 17.4 cM.

关键词： rice waxy gene single segment substitution line allelic variation molecular marker-assisted selection

Molecular-Targeted Antitumor Agents:Discovery of Natural Product-Based PPAR-gamma Activators

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Molecular-Targeted Antitumor Agents:Discovery of Natural Pro...

第十五届国际药理学大会

作者： Nagle Dale Mora Flor Desai Prashant Patny akshay Avery Mitchell Pharmacognosy Dept Pharmacognosy Dept Medicinal Chemistry Dept. U.Mississippi University MS38677 USA. Medicinal Chemistry Dept Medicinal Chemistry Dept

＜正＞ Peroxisome proliferate - activated receptors （PPARs） are ligand- activated transcription *** of PPAR - gamma have been shown to inhibit growth, promote terminal differentiation, and induce apoptosis in human breast tumor cells.A MCF7 cell - based reporter assay was developed to examine extracts of terrestrial andmarine organisms for the ability to activate PPAR - *** of active extracts from the marine sponge Pseudoceratina rhax and a member of the tomato family Physalis angulata yielded the histone deacetylase （HDAC） inhibitor psammaplin A and a group of highly oxygenated secosteroidsknown as physalins,*** A and physalins were shown to activate PPAR - g and induce apoptosis in MCF-7 breast tumor cells. Molecular modeling studies suggest that psammaplin A and physalins may interact with binding sites within the PPAR - g ligand - binding pocket and activation of PPAR - g - regulated gene expression may play a role in the ability of these natural products to induce apoptosis in tumor cells.

关键词： PPAR- gamma breast cancer drug discovery molecular target

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单片IC产生精密三角波

电子产品世界 2010年第12期17卷 35-36页

作者： akshay Bhat Maxim

本文介绍如何用MAX9000配合几个无源器件实现单电源供电的三角波发生器。实现这一电路所需的有源器件包括:一个运放、一个比较器和一个电压基准,MAX9000刚好集成了这三个器件。

关键词：运算放大器比较器三角波发生器电压基准

Study of Common Urinary Problems of Females at a Government Hospital in Central India

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Surgical Science 2012年第6期3卷 339-343页

作者： Roma Pradhan Raj Kumar Mathur Poonam Mathur Fareed Khan akshay Gupta Mansi Chowhan Department of obstetrics and gynaecology Mahatma Gandhi Memorial Medical College Indore India Department of surgery Mahatma Gandhi Memorial Medical College Indore India

Aim: The aim of this study is to identify the common urinary problems in Indian females, their etiology and symtomatology. Material and Methods: This is a prospective epidemiological study of 703 female patients with urinary problems, who attended the surgery and gynecology OPD (outpatient department) in our institution which is a tertiary referral centre in central India. Result: 58% of patients were middle age (31 - 55) yrs. Burning micturition was the most common urinary complain (607 patients) followed by increased frequency of micturition (309 patients). 68% females took months or even years to take first consultation after appearance of their symptoms. 14% percent of patients suffered from urinary incontinence (stress, urge and mixed). 86% of women had education level below fifth standard. About 58% of females gave birth to 3 or more than 3 issues. About 254 (36%) patients had one or more unassisted delivery at home. Thirty eight percent of patients still remained undiagnosed. More than 50% of undiagnosed females lie in middle age group. 68% of undiagnosed patients took consultation months or years after their symptoms first appeared. Irritative symptoms are the most common presenting complains of these undiagnosed patients followed by pain in abdomen. Around 60% of patients had history of either mental distress, domestic violence or any neuropschiatric disease. This study only gives us an idea about the urinary problems faced by females and their probable causative factors. Many more studies need to be done involving multidisciplinary approach in order to benefit this section of our society.

关键词： Common Urinary Problems Undiagnosed