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Reinforced tissue matrix to strengthen the abdominal wall following reversal of temporary ostomies or to treat incisional hernias

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 823-832页

作者： Spencer P Lake Corey R Deeken amit k agarwal Mechanical Engineering&Materials Science Washington University in St.LouisSt.LouisMO 63130United States Covalent Bio LLCSt.LouisMO 63025United States Department of Surgery McGovern Medical School at UTHealthHoustonTX 77026United States

BACkGROUND Abdominal wall deficiencies or weakness are a common complication of tem-porary ostomies,and incisional hernias frequently develop after colostomy or ileostomy *** use of synthetic meshes to reinforce the abdominal wall has reduced hernia *** meshes have also been used to enhance healing,particularly in contaminated *** tissue matrices(R-TMs),which include a biologic scaffold of native extracellular matrix and a syn-thetic component for added strength/durability,are designed to take advantage of aspects of both synthetic and biologic *** date,RTMs have not been reported to reinforce the abdominal wall following stoma *** Twenty-eight patients were selected with a parastomal and/or incisional hernia who had received a temporary ileostomy or colostomy for fecal diversion after rectal cancer treatment or *** hernia repair and proximal stoma closure,RTM(OviTex®1S permanent or OviTex®LPR)was placed to reinforce the abdominal wall using a laparoscopic,robotic,or open surgical ***-operative follow-up was performed at 1 month and 1 *** recurrence was determined by physical examination and,when necessary,via computed tomo-graphy *** endpoints included length of hospital stay,time to return to work,and hospital *** complications of the wound/repair site included presence of surgical site infection,seroma,hematoma,wound dehiscence,or fistula *** The observational study cohort included 16 male and 12 female patients with average age of 58.5 years±16.3 years and average body mass index of 26.2 kg/m^(2)±4.1 kg/m^(2).Patients presented with a parastomal hernia(75.0%),in-cisional hernia(14.3%),or combined parastomal/incisional hernia(10.7%).Using a laparoscopic(53.6%),robotic(35.7%),or open(10.7%)technique,RTMs(OviTex®LPR:82.1%,OviTex®1S:17.9%)were placed using sublay(82.1%)or intraperitoneal onlay(IPOM;17.9%)mesh *** 1-mo

关键词： Reinforced tissue matrix Reinforced forestomach matrix Ileostomy Colostomy Ostomy takedown Incisional hernia Abdominal wall

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Multiple floating metatarsals： a unique injury

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Chinese Journal of Traumatology 2013年第2期16卷 110-112页

作者： Vivek Trikha Tarun Goyal amit k. agarwal Department of Orthopaedics Jai Prakash Narayan Apex Trauma Centre All India Institute of Medical Sciences New Delhi 110029 India

tarsometatarsal 的伴随物脱臼和脚的 metatarsophalangeal 关节是极其稀罕的损害。在一个单身者或邻近的双光线介绍的如此的损害以前在很少情况中被描述了。我们描述如此的损害在邻近一个 polytrauma 病人的三 metatarsals。这些损害... 详细信息

tarsometatarsal 的伴随物脱臼和脚的 metatarsophalangeal 关节是极其稀罕的损害。在一个单身者或邻近的双光线介绍的如此的损害以前在很少情况中被描述了。我们描述如此的损害在邻近一个 polytrauma 病人的三 metatarsals。这些损害是可能的在对一个 polytrauma 病人的起始的评价被错过。这些病人在俯看的诊断的风险，但是错过这类损害的后果可能是相当严重的。鉴于它的唯一，这个盒子与损害的可能的机制一起被介绍，减小和后续的顺序。

关键词：受伤浮动可能机制伤害患者

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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 *** is also an effective method in the treatment of OCD in *** To assess the safety and efficacy of tDCS as an add-on therapy in drug-naive adolescents with *** We studied drug-naïve adolescents with OCD,using a Children’s Yale-Brown obsessive-compulsive scale(CY-BOCS)scale to assess their *** 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 *** occurred at 2,6,and 12 wk using *** 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 *** 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 *** tDCS is safe and well tolerated for the treatment of OCD in ***,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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Novel technique for anastomotic salvage using transanal minimally invasive surgery:A case report

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World Journal of Gastrointestinal Surgery 2019年第5期11卷 271-278页

作者： Oscar A Olavarria Robert L kress Shinil k Shah amit k agarwal Center for Surgical Trials and Evidence-Based Practice McGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTX 77033United States Department of Surgery McGovern Medical School at the University of Texas Health Science Center HoustonHoustonTX 77033United States

Anastomotic leak(AL)after low anterior resection(LAR)can be a highly morbid *** incidence of AL ranges from 5%to 20%depending on patient characteristics and the distance of the anastomosis from the anal *** anastomoses and leaks pose technical challenges for endoscopic *** aim of this report was to describe the use of a commercially available laparoscopic energy device through a transanal minimally invasive surgery(TAMIS)port for the management of a symptomatic leak not requiring relaparotomy(grade B)after a LAR with diverting loop *** SUMMARY A TAMIS GelPOINT Path port was inserted into the anus to access the distal *** was achieved with AirSeal insufflation and a 30 degree laparoscope was introduced through a trocar.A LigaSureTM Retractable L-Hook device was then used to perform a septotomy of the chronic sinus tract identified posterior to the *** procedure was then repeated twice in three weeks intervals with ultimate resolution of the chronic leak *** months after serial TAMIS septotomies,barium enema demonstrated a patent anastomosis with no evidence of persistent leak or *** patient subsequently underwent ileostomy reversal and has had no significant postoperative *** TAMIS septotomy with the LigaSureTM Retractable L-Hook is a feasible and effective,minimally invasive salvage technique for the treatment of grade B *** studies are needed to assess the generalizability and long-term results of this technique.

关键词： Transanal minimally invasive surgery Ligasure hook Anastomotic leak Low anterior resection Septotomy Case report

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Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 699-715页

作者： Ankit agarwal Sagnik Biswas Shekhar Swaroop Arnav Aggarwal Ayush agarwal Gautam Jain Anshuman Elhence Arun Vaidya amit Gupte Ravi Mohanka Ramesh kumar Ashwani kumar Mishra Shivanand Gamanagatti Shashi Bala Paul Subrat kumar Acharya Akash Shukla Shalimar Department of Gastroenterology and Human Nutrition All India Institute of Medical SciencesNew Delhi 110029DelhiIndia Department of Gastroenterology Seth Gordhandas Sunderdas Medical College and KEM HospitalMumbai 400012MaharashtraIndia Department of Gastroenterology Sir HN Reliance Foundation HospitalMumbai 400004India Department of Liver Transplant and HPB Sir HN Reliance Foundation HospitalMumbai 400004India Department of Gastroenterology All India Institute of Medical SciencesPatna 801507India Professor of Biostatistics National Drug Dependence Treatment Centre(NDDTC)All India Institute of Medical SciencesNew Delhi 110029India Department of Radiodiagnosis All India Institute of Medical SciencesNew Delhi 110029DelhiIndia

BACkGROUND There is scant literature on hepatocellular carcinoma(HCC)in patients with Budd-Chiari syndrome(BCS).AIM To assess the magnitude,clinical characteristics,feasibility,and outcomes of treatment in *** A total of 904 BCS patients from New Delhi,India and 1140 from Mumbai,India were *** prevalence and incidence of HCC were determined,and among patients with BCS-HCC,the viability and outcomes of interventional therapy were *** In the New Delhi cohort of 35 BCS-HCC patients,18 had HCC at index presentation(prevalence 1.99%),and 17 developed HCC over a follow-up of 4601 person-years,[incidence 0.36(0.22-0.57)per 100 person-years].BCS-HCC patients were older when compared to patients with BCS alone(P=0.001)and had a higher proportion of inferior vena cava block,cirrhosis,and long-segment vascular *** median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up(13029 ng/mL vs 500 ng/mL,P=0.01).Of the 35 BCS-HCC,26(74.3%)underwent radiological interventions for BCS,and 22(62.8%)patients underwent treatment for HCC[transarterial chemoembolization in 18(81.8%),oral tyrosine kinase inhibitor in 3(13.6%),and transarterial radioembolization in 1(4.5%)].The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo(P=0.0001).In contrast to the New Delhi cohort,the Mumbai cohort of BCS-HCC patients were predominantly males,presented with a more advanced HCC[Barcelona Clinic Liver Cancer C and D],and 2 patients underwent liver *** HCC is not uncommon in patients with *** interventions and liver transplantation are feasible in select primary BCS-HCC patients and may improve outcomes.

关键词： Budd chiari syndrome Cancer Cirrhosis Thrombosis Liver Varices Transarterial chemoembolization Hepatic venous outflow tract obstruction

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Advancements in nanotechnology for the delivery of phytochemicals

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Journal of Integrative Medicine 2024年第4期22卷 385-398页

作者： Divya Chauhan Pavan k.Yadav Nazneen Sultana Arun agarwal Saurabh Verma Manish k.Chourasia Jiaur R.Gayen Division of Pharmaceutics and Pharmacokinetics Central Drug Research InstituteCouncil of Scientific and Industrial ResearchLucknow 226031Uttar PradeshIndia Academy of Scientific and Innovative Research Ghaziabad 201002Uttar PradeshIndia

Phytosomes(phytophospholipid complex) are dosage forms that have recently been introduced to increase the stability and therapeutic effect of herbal medicine. Currently, bioactive herbs and the phytochemicals they contain are considered to be the best remedies for chronic diseases. One promising approach to increase the efficacy of plant-based therapies is to improve the stability and bioavailability of their bio-active ingredients. Phytosomes employ phospholipids as their active ingredients, and use their amphiphilic properties to solubilize and protect herbal extracts. The unique properties of phospholipids in drug delivery and their use in herbal medicines to improve bioavailability results in significantly enhanced health benefits. The introduction of phytosome nanotechnology can alter and revolutionize the current state of drug delivery. The goal of this review is to explain the application of phytosomes, their future prospects in drug delivery, and their advantages over conventional formulations.

关键词： Phytochemical Bioavailability Drug delivery system Phytosome Plant extracts

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Routine colonic endoscopic evaluation following resolution of acute diverticulitis:Is it necessary?

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World Journal of Gastroenterology 2014年第35期20卷 12509-12516页

作者： amit k agarwal Burzeen E karanjawala Justin A Maykel Eric k Johnson Scott R Steele Department of Surgery University of Texas Health Science Center-Houston Department of Surgery University of Texas Health Science Center-Houston and Lyndon B.Johnson General Hospital University of Massachusetts Memorial Medical Center Colon Rectal Surgery Department of SurgeryMadigan Army Medical Center

Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations,low fiber diets,and in younger and obese ***-five percent of patients with diverticulosis will develop acute *** imposes a significant burden on healthcare systems,resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion *** computed tomography(CT) is the diagnostic study of choice,with a sensitivity and specificity greater than 95%.Unfortunately,similar CT findings can be present in colonic neoplasia,especially when perforated or *** prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out ***,the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated *** any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation,in the era of widespread use of high-resolution computed tomography,routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs,comes with inherent risks,and may require further *** this manuscript,we review the current data related to this recommendation.

关键词： Colonic evaluation Colonoscopy Diverticulitis Acut

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Computerized tomography based “patient specific blocks” improve postoperative mechanical alignment in primary total knee arthroplasty

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World Journal of Orthopedics 2016年第7期7卷 426-433页

作者： Raju Vaishya Vipul Vijay Vikas P Birla amit k agarwal Department of Orthopaedics Joint Replacement and ArthroscopyIndraprastha Apollo Hospital

AIM: To compare the postoperative mechanical alignment achieved after total knee arthroplasty(TkA) using computer tomography(CT) based patient specific blocks(PSB) to conventional instruments(CI).METHODS: Total 80 knees were included in the study, with 40 knees in both the groups operated using PSB and CI. All the knees were performed by a single surgeon using the same cruciate sacrificing implants. In our study we used CT based PSB to compare with CI. Postoperative mechanical femoro-tibial angle(MFT angle) was measured on long leg x-rays using picture archiving and communication system(PACS). We compared mechanical alignment achieved using PSB and CI in TkA using statistical ***: The PSB group(group 1) included 17 females and seven males while in CI group(group 2) there were 15 females and eight males. The mean age of patients in group 1 was 60.5 years and in group 2 it was 60.2 years. The mean postoperative MFT angle measured on long-leg radiographs in group 1 was 178.23°(SD = 2.67°, range: 171.9° to 182.5°) while in group 2, the mean MFT angle was 175.73°(SD = 3.62°, range: 166.0° to 179.8°). There was significant improvement in postoperative mechanical alignment(P value = 0.001), in PSB group compared to CI. Number of outliers were also found to be less in group operated with PSB(7 knee) compared to those operated with CI(17 knee).CONCLUSION: PSB improve mechanical alignment after total knee arthroplasty, compared to CI. This may lead to lower rates of revision in the PSB based TkA as compared to the conventional instrumentation.

关键词： knee Replacement Arthroplasty Patient specific jigs Conventional jigs

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Identifying the stability of housekeeping genes to be used for the quantitative real-time PCR normalization in retinal tissue of streptozotocin-induced diabetic rats

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 794-805页

作者： Muhammad Zulfiqah Sadikan Nurul Alimah Abdul Nasir Mohammad Johari Ibahim Igor Iezhitsa Renu agarwal Department of Pharmacology Faculty of MedicineManipal University College Malaysia(MUCM)Bukit BaruMelaka 75150Malaysia Centre for Neuroscience Research(NeuRon) Faculty of MedicineUniversiti Teknologi MARASungai Buloh CampusSungai BulohSelangor 47000Malaysia Department of Medical Education Faculty of MedicineUniversiti Teknologi MARASungai Buloh CampusSungai BulohSelangor 47000Malaysia Department of Biochemistry and Molecular Medicine Faculty of MedicineUniversiti Teknologi MARASungai Buloh CampusSungai BulohSelangor 47000Malaysia School of Medicine International Medical UniversityBukit JalilKuala Lumpur 57000Malaysia Department of Pharmacology and Bioinformatics Volgograd State Medical UniversityVolgograd 400131Russia

AIM:To investigate the stability of the seven housekeeping genes:beta-actin(ActB),glyceraldehyde-3-phosphate dehydrogenase(GAPDH),18s ribosomal unit 5(18s),cyclophilin A(CycA),hypoxanthine-guanine phosphoribosyl transferase(HPRT),ribosomal protein large P0(36B4)and terminal uridylyl transferase 1(U6)in the diabetic retinal tissue of rat ***:The expression of these seven genes in rat retinal tissues was determined using real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR)in two groups;normal control rats and streptozotocininduced diabetic *** stability analysis of gene expression was investigated using geNorm,NormFinder,Bestkeeper,and comparative delta-Ct(ΔCt)***:The 36B4 gene was stably expressed in the retinal tissues of normal control animals;however,it was less stable in diabetic *** 18s gene was expressed consistently in both normal control and diabetic rats’retinal *** this gene was the best reference for data normalisation in RT-qPCR studies that used the retinal tissue of streptozotocin-induced diabetic ***,there was no ideal gene stably expressed for use in all experimental ***:Identifying relevant genes is a need for achieving RT-qPCR validity and reliability and must be appropriately achieved based on a specific experimental setting.

关键词： housekeeping genes stability real-time reverse transcription polymerase chain reaction retinal tissue streptozotocin-induced diabetic rats

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Effect of inlet elbow on rotation stall in waterjet ppropulsionpump

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Fundamental Research 2024年第4期4卷 898-906页

作者： Wei Li Shuo Li Leilei Ji Enda Li Weidong Shi Ramesh agarwal Muhammad Awais National Research Center of Pumps Jiangsu UniversityZhenjiang 212013China Institute of Fluid Engineering Equipment Technology Jiangsu UniversityZhenjiang 212009China College of Mechanical Engineering Nantong UniversityNantong 226019China departmentof Mechanical Engineering&Materials Science Washington University in StLouisSt.LouisMO6330US.

To study the influence of an elbow inlet on the rotating stall characteristics of a waterjet propulsion pump(WJPP),a three-dimensional internal flow field in a WJPP under a straight-pipe inlet and elbow inlet is numerically *** comparing the hydraulic performance of WJPP under the two inlet conditions,the internal relationship between the inlet mode and the flow pattern in the pump is *** on unsteady pressure fluctuation characteristics and wavelet analysis,the influence of the inlet mode on the rotating stall is revealed,and the stall transient propagation characteristics under critical stall conditions are *** disturbance effects of the inlet channel geometry disappear under low flow rate conditions,the main disturbance is induced by the highspeed countercurrent,and the flow pattern under the elbow inlet is better than that under the straight-pipe *** the straight-pipe inlet,the single-stall nucleus in the WJPP temporarily experiences a low-frequency and high-amplitude disturbance,which subsequently transforms into a mode of multi-stall nuclei with high-frequency circumferential *** the elbow inlet,the rotating stall always maintains a mode of high-amplitude and low-frequency disturbance,which represents the transient characteristics of a single stall core propagating in the circumferential direction inside the *** results of this study have a reference value for structural design optimization in a WJPP.

关键词： Waterjet propulsion pump Inlet condition Rotation stall Flow structure Pressurefluctuation

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