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Important Newborn Cardiac Diagnostic Dilemmas for the Neonatologist and Cardiologist-A Clinical Perspective

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Congenital Heart Disease 2021年第2期16卷 189-196页

作者： Samuel Menahem Arvind sehgal Department of Paediatrics University of MelbourneMelbourneAustralia School of Clinical Sciences Monash UniversityMelbourneAustralia Monash Newborn Cardiovascular ResearchMonash Children’s HospitalMelbourneAustralia Department of Paediatrics Monash UniversityMelbourneAustralia

Most congenital heart disease(CHD)is readily recognisable in the *** by previous fetal scanning,the presence of a murmur,tachypnoea,cyanosis and/or differential pulses and saturations all point to a cardiac *** serious heart disease may be missed on a fetal *** may be no murmur or clinical cyanosis,and tachypneoa may be attributed to non-cardiac *** on day 1 is usually non-cardiac except arising from ventricular failure or a large systemic arteriovenous fistula.A patent ductus arteriosus(PDA)may support either pulmonary or systemic duct dependent *** initially high pulmonary vascular resistance(PVR)limits shunts so that murmurs even from large communications between the systemic and pulmonary circulations take days/weeks to *** times despite expert input,serious CHD maybe difficult to diagnose and warrants close interaction between the neonatologist and cardiologist to reach a timely *** conditions include obstructed total anomalous pulmonary venous connections(TAPVC)and the need to distinguish it from persistent pulmonary hypertension in the newborn(PPHN)–the treatment of the former is surgical the latter medical.A large duct shunting right to left may overshadow a suspected hypoplastic aortic isthmus and/or *** the right to left shunting because of severe aortic obstruction or resulting from a high PVR with little *** diagnosis of pulmonary vein stenosis(PVS)remains problematic often developing in premature infants with ongoing bronchopulmonary dysplasia(BPD),still being cared for by the *** there are other diagnostic dilemmas including deciding the contribution of a recognised CHD in a sick neonate,this paper will focus on the above-mentioned conditions with suggestions on what may be done to arrive at a timely diagnosis to achieve optimal outcomes.

关键词： Obstructed pulmonary veins persistent pulmonary hypertension aortic coarctation pulmonary vein stenosis newborn

Optimization of friction and wear characteristics of varied cryogenically treated hot die steel grade AISI-H13 under dry condition

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Friction 2017年第1期5卷 66-86页

作者： Sanjeev KATOCH Rakesh sehgal Vishal SINGH Centre for Materials Science and Engineering National Institute of Technology Hamirpur(HP)177005 IndiaInstitute for Auto Parts & Hand Tools Technology A-9 Phase V Focal Point Ludhiana(Punjab)141010 India Department of Mechanical Engineering National Institute of Technology Hamirpur(HP)177005 India Centre for Materials Science and Engineering National Institute of Technology Hamirpur(HP)177005 India

Cryogenic treatment (CT) is a relatively new field,which has emerged during the last three decades of the twentieth ***,its impact on material shaping and making tool life,and enhancement of their mechanical properties are quite *** selection of appropriate process parameters for CT is essential for cost reduction and optimum *** study focuses on the influence of key parameters of CT cycles (i.e.,soaking temperature and duration) on the friction and wear behavior of AISI H13 hot die steel under dry sliding conditions against hardened and tempered AISI D3 cold work tool steel (counter face) at varying sliding speeds and *** models have been developed for wear rate,the average coefficient of friction,and maximum contact temperature using the Box-Cox *** developed mathematical models have been validated by comparing with the experimental ***,the optimum values of the process parameter have been employed to maximize the output and validate the same by confirmation of the *** the best of our knowledge,this is the first study that demonstrates the modeling and optimization of sliding friction and wear characteristics of AISI H13 under varied CT cycles.

关键词： cryogenics treatment hot die steel friction wear modeling Box-Cox method optimization

Size of atrial septal defect after balloon atrial septostomy does not correlate with immediate improvement in oxygenation

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World Journal of Pediatric Surgery 2021年第1期4卷 21-24页

作者： Kartik sehgal Kunal sehgal Suraj Varma Monash University MelbourneVictoriaAustralia Monash University ClaytonVictoriaAustralia Monash Heart Monash HealthClaytonVictoriaAustralia

Objective Transposition of great arteries is a common cyanotic heart *** atrial septostomy aims to improve circulatory mixing and *** studies have combined infants with intact ventricular septum and those with ventricular septal ***,the septostomy was performed much later after *** objectives were to ascertain any correlation between the atrial septal defect size and oxygenation,before and after septostomy,as well the change in parameters pre-post *** We performed an audit of the last 10 years of clinical and echocardiographic data(2010-2020)for infants with transposition of great arteries with intact ventricular septum.A pediatric cardiologist,masked to clinical data,reviewed the *** Our study of 25 infants with transposition of great arteries with intact ventricular septum noted that the procedure was performed at a median[interquartile range(IQR)]of 3(2,4)hours after *** was administered to the majority of infants[20/25(80%)].While significant increases in partial pressure of oxygen(24±5 vs 40±6 mmHg,p<0.001)and preductal oxygen saturations(67%±18%vs 81%±11%,p=0.003)were noted,and while the atrial septal defect increased in size from 1.8±0.6 vs 4.8±0.7 mm(p<0.001),no correlation was noted between atrial septal defect size and oxygen *** In our study of infants with transposition of great arteries and intact ventricular septum managed with balloon atrial septostomy,no correlation was noted between the atrial septal defect size and oxygen *** vascular resistance and pulmonary blood flow may be important physiological variables determining oxygenation.

关键词： balloon atrial septal

Traditional Indian religious streets： A spatial study of the streets of Mathura

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Frontiers of Architectural Research 2017年第4期6卷 469-479页

作者： Meeta Tandon Vandana sehgal Faculty of Architecture Dr. A.P.J. Abdul Kalam Technical University Lucknow India

Streets determine the spatial characteristics of a city and are its most important element. They retain their unique identity by depicting their own sense of place and provide psychological and functional meaning to people＇s lives. Traditional streets, located in the heart of a city and where religious buildings are situated, are visited by numerous pilgrims daily and should be assessed for their physical features and spatial qualities. This study aims to investigate the character of one of such streets, Yishram Bazaar Street, which is a commercial street where the famous Dwarkadhish temple of Mathura is located. This study, therefore, aspires to uncover the spatial qualities of the street in terms of its physical characteristics based on the tool given by Reid Ewing, Clemente, and Handy, which includes imageability, enclosure, human scale, transparency, and complexity, and to establish the relevance of these qualities in Indian religious streets. The methods used for data collection are literature reviews, on-site documentation （field notes, photographs, and videos）, visual assessment, and questionnaire surveys.

关键词： Street Spatiat quatities Religious precincts Physical characteristics

Inversion of radiative transfer model for retrieval of wheat biophysical parameters from broadband reflectance measurements

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Information Processing in Agriculture 2016年第2期3卷 107-118页

作者： Vinay Kumar sehgal Debasish Chakraborty Rabi Narayan Sahoo Division of Agricultural Physics Indian Agricultural Research InstituteNew Delhi 110012India

This study describes the retrieval of wheat biophysical variables of leaf chlorophyll(Cab),leaf area index(LAI),canopy chlorophyll(CCC),and leaf wetness(Cw)from broadband reflectance data corresponding to IRS LISS-3(Linear Imaging Self Scanner)sensor by inversion of PROSAIL5B canopy radiative transfer *** data of wheat crop,grown under different treatments,were measured by hand-held spectroradiometer and later integrated to LISS-3 reflectance using its band-wise relative spectral response *** inversion techniques were used and their performance was compared using different statistical parameters and target *** inversion techniques tried were:a look up table with best solution(LUT-I),a look up table with mean of best 10%solutions(LUT-II)and an artificial neural network(ANN).All the techniques could estimate the biophysical variables by capturing variability in their observed values,though accuracy of estimation varied among the three *** diagram clearly depicted the superiority of LUT-II over the other two approaches indicating that a mean of best 10%solutions is a better strategy while ANN was worst performer showing highest bias for all the *** all the three inversion techniques,the general order of retrieval accuracy was LAI>Cab>CCC>*** range of Cw was very narrow and none of the techniques could estimate variations in *** most of the cases,the parameters were underestimated by model *** best identified LUT-II technique was then applied to retrieve wheat LAI from IRS LISS-3 satellite image of 5-Feb-2012 in Sheopur *** comparison with ground observations showed that the RMSE of LAI retrieval was about 0.56,similar to that observed in ground *** findings of this study may help in refining the protocol for generating operational crop biophysical products from IRS LISS-3 or similar sensors.

关键词： PROSAIL Look up table Neural network Leaf area index Chlorophyll content Target diagram IRS LISS-3

Acute motor axonal neuropathy following anti-rabies human diploid cell vaccine:A rare case and review

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Asian Pacific Journal of Tropical Medicine 2022年第9期15卷 425-426页

作者： Tanushree Chawla Jyoti sehgal Surekha Dabla Vinay Goyal Department of Neurology Institute of Neurosciences Medantathe Medicity GurugramHaryanaIndia Department of Neurology Pt BD Sharma Post Graduate Institute of Medical SciencesRohtakHaryanaIndia

Rationale:Guillain Barre syndrome(GBS)is an acute neurological illness leading to quadriparesis with respiratory *** can be triggered by infections,vaccinations,surgery,trauma,transplantation and ***-rabies cell culture vaccines introduced to overcome the high rate of neurological complications associated with tissue based rabies vaccine,can be very rarely associated with *** concerns:A 50-year-old female presented with acute severe upper back pain evolving into pure motor quadriparesis following administration of human diploid cell vaccine for ***:Acute motor axonal neuropathy variant of GBS following anti-rabies human diploid cell ***:Intravenous high dose ***:Patient recovered completely within 1 ***:Although anti-rabies cell culture vaccines are highly immunogenic and safe,they are rarely associated with *** should be aware of this link because prompt diagnosis and treatment can result in complete recovery and avoid complications.

关键词： Immunization Rabies Guillain Barre syndrome Human diploid cell vaccine Acute motor axonal neuropathy

Monitoring of lithium-ion cells using a microcontroller

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Clean Energy 2022年第1期6卷 89-96页

作者： Gaurav Pratap Singh Yash Lehri Lakshay Bhatia Yogesh sehgal Department of Electrical and Electronics Department Bharati Vidyapeeth’s College of EngineeringNew DelhiIndia

Safe and efficient operation of batteries is always desired but batteries with a high energy density pose a threat to the system causing thermal breakdown,reduced performance and rapid *** reduce such vulnerabilities,an optimum environment with controlled parameters is *** parameters have been considered for analysis,*** of charge,current,voltage and *** module makes a detailed analysis of the above-mentioned parameters and suggests a microcontroller-based prototype that is capable of monitoring the external factors in real time and generating relevant warnings.

关键词： lithium ion battery-management system thermal runaway battery temperature battery current battery voltage microcontrollers

Historical development of mesenteric anatomy provides a universally applicable anatomic paradigm for complete/total mesocolic excision

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Gastroenterology Report 2014年第4期2卷 245-250页

作者： Rishabh sehgal J.Calvin Coffey Centre for Interventions in Infection Inflammation and Immunity(4i)Graduate Entry Medical SchoolUniversity of LimerickIreland Department of Surgery University Hospitals Group LimerickLimerickIreland

Although total mesorectal excision has now become the‘gold standard’for the surgical management of rectal cancer,this is not so for colon *** data,provided by Hohenberger and West et *** others,have demonstrated excellent oncological outcomes when mesenterectomy is extensive(as is implicit in the concept of a‘high tie’)and the mesenteric package not *** studies highlight the importance of understanding the basics of the mesenteric organ(including the small intestinal mesentery,mesocolon,mesosigmoid and mesorectum)and of abiding to principles of planar *** this review,we first offer classic descriptions of the mesocolon and then detail contemporary *** so doing,we provide an anatomical basis for safe and effective complete mesocolic excision(CME)in the management of colon *** we list opportunities associated with the new anatomical paradigm,demonstrating benefits across multiple *** most importantly,we feel that a crystallized view of mesenteric anatomy will overcome factors that have hindered the general uptake of CME.

关键词： mesocolon mesenteric excision complete mesocolic excision Toldt’s fascia

Inhibition of hepatitis B virus DNA replicative intermediate forms by recombinant interferon-γ

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World Journal of Gastroenterology 2006年第19期12卷 3006-3014页

作者： Mohammad Khalid Parvez Deepak sehgal Shiv Kumar Sarin Seemi Farhat Basir Shahid Jameel Department of Biosciences Jamia Millia Islamia New DelhiVirology GroupInternational Centre for Genetic Engineering and BiotechnologyNew DelhiDepartment of GastroenterologyG.B.Pant HospitalNew DelhiIndia Virology Group International Centre for Genetic Engineering and Biotechnology New DelhiIndia Department of Gastroenterology G.B.Pant Hospital New DelhiIndia Department of Biosciences Jamia Millia Islamia New DelhiIndia

AIM: To evaluate the in vitro anti-HBV activity of recombinant human IFN-γ, alone and in combination with lamivudine. METHODS: A recombinant baculovirus-HBV/HepG2 culture system was developed which could support productive HBV infection in vitro. Expression of HBsAg and HBeAg in infected HepG2 culture medium was detected by commercial enzyme immunoassays. HBV DNA replication intermediates were detected in infected cells by Southern hybridization and viral DNA load was determined by dot hybridization. RESULTS: IFN-γat 0.1 to 5μg/L efficiently down regulated HBsAg expression in transduced HepG2 cells. At 5μg/L, IFN-γalso suppressed HBV DNA replication in these cells. While treatment with a combination of lamivudine and IFN-γshowed no additive effect, sequential treatment first with lamivudine and then IFN-γwas found to be promising. In this culture system the best HBV suppression was observed with a pulse of 2μmol/L lamivudine for two days, followed by 1μg/L IFN-γfor another four days. Compared to treatment with lamivudine alone, the sequential use of 0.2μmol/L lamivudine for two days, followed by 5μg/L IFN-γfor six days showed a 72% reduction in HBV cccDNA pool. CONCLUSION: This in vitro study warrants further evaluation of a combination of IFN-γand lamivudine, especially in IFN-αnon-responder chronic hepatitis B patients. A reduced duration of lamivudine treatment would also restrict the emergence of drug-resistant HBV mutants.

关键词： Hepatitis B virus (HBV) Lamivudine Interferon-γ Replicative intermediates cccDNA