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Patients with Cirrhosis of Liver Operated for Non-transplant Surgery: A Retrospective Analysis

Journal of Clinical and Translational Hepatology 2019年第1期7卷 9-14页

作者： Kishore Kumar Kuduva Subramanian Manish Tandon chandra kant pandey Priyanka Jain Department of Anaesthesiology Institute of Liver and Biliary SciencesNew DelhiIndia Department of Research Institute of Liver&Biliary Sciences(ILBS)New DelhiIndia

Background and Aims:Patients with cirrhosis of the liver have high mortality after *** investigated the mortality in patients with cirrhosis of the liver who underwent surgery other than liver transplant and applied the Mayo clinic model to predict mortality and compare with the observed *** also studied the association of the observed mortality with the Child-Turcotte-Pugh(CTP)class and the model for end-stage liver disease(MELD)and model for end-stage liver disease-sodium(MELD-Na)***:The electronic records database of our hospital was accessed to analyze the data of 133 cirrhotic patients who underwent various surgeries under general anesthesia from October 2009 to June *** Mayo risk score was applied to each and used to calculate predicted mortality;the MELD and MELD-Na scores were also *** interview was performed with the patients and or their relative to ascertain survival or time of death after surgery,when the information was not available from the hospital ***:The all-cause observed mortality rates at postoperative days 30 and 90 and at 1 year were 12%,20.3%and 26.3%*** area under the receiver operating characteristic curve values for the Mayo model as a predictor of 30-day,90-day and 1-year mortality were 0.836,0.828 and 0.744 *** correlation was seen for observed mortality with CTP class and with MELD and MELD-Na ***:The Mayo model for predicting postoperative mortality in patients with cirrhosis of the liver demonstrated good correlation in this *** strength of prediction of mortality by Mayo risk score calculation was similar at postoperative days 30 and 90 but decreased at 1-year after the *** correlation was seen for the observed mortality with MELD,MELD-Na and CTP scores.

关键词： Cirrhosis of the liver Mayo risk model CTP score MELD score

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Diagnostic and therapeutic challenge of heart failure after liver transplant:Case series

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World Journal of Hepatology 2017年第33期9卷 1253-1260页

作者： Manish Tandon Sunaina Tejpal Karna chandra kant pandey Ravindra Chaturvedi Institute of Liver and Biliary Sciences New Delhi 110070India

Heart failure(HF) following liver transplant(LT) surgery is a distinct clinical entity with high mortality. It is known to occur in absence of obvious risk factors. No preoperative workup including electrocardiogram, echocardiography at rest and on stress, reasonably prognosticates the risk. In patients of chronic liver disease, cirrhotic cardiomyopathy, alcoholic cardiomyopathy, and stress induced cardiomyopathy have each been implicated as a cause for HF after LT. However distinguishing one etiology from another not only is difficult, several etiologies may possibly coexist in a given patient. Diagnostic dilemma is further compounded by the fact that presentation and management of HF irrespective of the possible underlying cause, remains the same. In this case series, 6 cases are presented and in the light of existing literature modification in the preoperative workup are suggested.

关键词： Liver transplant Heart failure Cirrhotic cardiomyopathy Stress cardiomyopathy Alcohol cardiomyopathy

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Perioperative risk factors in patients with liver disease undergoing non-hepatic surgery

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World Journal of Gastrointestinal Surgery 2012年第12期4卷 267-274页

作者： chandra kant pandey Sunaina Tejpal Karna Vijay kant pandey Manish Tandon Amit Singhal Vivek Mangla Department of Anaesthesiology Institute of Liver and Biliary Sciences Vasant Kunj New Delhi 110070 India Department of HPB Surgery Institute of Liver and Biliary Sciences Vasant Kunj New Delhi 110070 India

The patients with liver disease present for various surgical interventions. Surgery may lead to complications in a significant proportion of these patients. These complications may result in considerable morbidity and mortality. Preoperative assessment can predict survival to some extent in patients with liver disease undergoing surgical procedures. A review of literature suggests nature and the type of surgery in these patients determines the peri-operative morbidity and mortality. Optimization of premorbid factors may help to reduce perioperative mortality and morbidity. The purpose of this review is to discuss the effect of liver disease on perioperative outcome; to understand various risk scoring systems and their prognostic significance; to delineate different preoperative variables implicated in postoperative complications and morbidity; to establish the effect of nature and type of surgery on postoperative outcome in patients with liver disease and to discuss optimal anaesthesia strategy in patients with liver disease.

关键词： Cirrhosis Liver disease Perioperative risk

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Intraoperative blood loss in orthotopic liver transplantation:The predictive factors

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World Journal of Gastrointestinal Surgery 2015年第6期7卷 86-93页

作者： chandra kant pandey Anshuman Singh Kamal Kajal Mandeep Dhankhar Manish Tandon Vijay kant pandey Sunaina Tejpal Karna Department of Anaesthesiology Institute of Liver and Biliary Sciences

Liver transplantation has been associated with massive blood loss and considerable transfusion requirements. Bleeding in orthotopic liver transplantation is multifactorial. Technical difficulties inherent to this complex surgical procedure and pre operative derangements of the primary and secondary coagulation system are thought to be the principal causes of perioperative hemorrhage. Intraoperative practices such as massive fluid resuscitation and resulting hypothermia and hypocalcemia secondary to citrate toxicity further aggravate the preexisting coagulopathy and worsen the perioperative bleeding. Excessive blood loss and transfusion during orthotopic liver transplant are correlated with diminished graft survival and increased septic episodes and prolonged ICU stay. With improvements in surgical skills, anesthetic technique, graft preservation, use of intraoperative cell savers and overall perioperative management, orthotopic liver transplant is now associated with decreased intra operative blood losses. The purpose of this review is to discuss the risk factors predictive of increased intra operative bleeding in patients undergoing orthotopic liver transplant.

关键词： Liver transplantation Intraoperative bloodloss Liver disease

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Tongue thickness in health vs cirrhosis of the liver:Prospective observational study

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2020年第3期11卷 59-68页

作者： Manish Tandon Harshita Singh Nishant Singla Priyanka Jain chandra kant pandey Department of Anesthesia Institute of Liver and Biliary SciencesNew Delhi 110070India Department of Intervention Radiology Institute of Liver and Biliary SciencesNew Delhi 110070India Department of Research Institute of Liver and Biliary SciencesNew Delhi 110070India

BACKGROUNDMalnutrition affects 40%-90% of patients with cirrhosis of the liver. L3 skeletalmuscle index (L3SMI) is presently accepted as the most objective and quantitativemeasure available for sarcopenia, a surrogate marker of malnutrition. L3SMIapplication is, however, limited by non-availability of computed tomographyscanning in remote areas, cost, need for extensive training, and the risk ofexposure to radiation. Therefore, an alternative dependable measure with wideravailability is needed. Malnutrition causes sarcopenia not only in skeletal musclesbut also in other muscular structures such as the psoas muscle, diaphragm andtongue. We therefore hypothesised that the tongue, being easily accessible forinspection and for measurement of thickness using ultrasonography, may be usedto document *** measure and compare tongue thickness in healthy individuals and in patientswith cirrhosis of the liver and to study its correlation with conventionalprognostic scores for patients with cirrhosis of the *** thickness was measured using ultrasonography. One hundred twentysubjects of either gender aged 18 to 65 years were studied, with 30 subjects in eachgroup. The tongue thickness was compared between groups based on “ChildTurcotte Pugh” (CTP) scores. The correlations between measured tonguethickness and “Model for end stage liver disease” (MELD) score and between age and measured tongue thickness were also *** tongue thickness (mean ± SD) in patients with CTP class A, B and C was4.39 ± 0.39 cm, 4.19 ± 0.53 cm, and 3.87 ± 0.42, respectively, and was 4.33 ± 0.49 cmin normal healthy individuals. Significant differences were seen in tonguethickness between patients with CTP class C and those with CTP class A and B (P< 0.05). Patients with CTP class C also had a significantly reduced tonguethickness than normal individuals (P < 0.05). However, no significant differencewas seen in tongue thickness between patients with CTP class A and

关键词： Sarcopenia Malnutrition Cirrhosis of the liver Child Turcotte Pugh class Model for end stage liver disease score Ultrasonography

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ON APPROXIMATE EFFICIENCY FOR NONSMOOTH ROBUST VECTOR OPTIMIZATION PROBLEMS

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Acta Mathematica Scientia 2020年第3期40卷 887-902页

作者： Tadeusz ANTCZAK Yogendra pandey Vinay SINGH Shashi kant MISHRA Faculty of Mathematics and Computer Science University of LódźBanacha 2290-238 LódźPoland Department of Mathematics Satish Chandra CollegeBallia 277001India Department of Mathematics National Institute of TechnologyAizawl-796012MizoramIndia Department of Mathematics Banaras Hindu UniversityVaranasi-221005India

In this article,we use the robust optimization approach(also called the worst-case approach)for findingε-efficient solutions of the robust multiobjective optimization problem defined as a robust(worst-case)counterpart for the considered nonsmooth multiobjective programming problem with the uncertainty in both the objective and constraint ***,we establish both necessary and sufficient optimality conditions for a feasible solution to be anε-efficient solution(an approximate efficient solution)of the considered robust multiobjective optimization *** also use a scalarizing method in proving these optimality conditions.

关键词： Robust optimization approach robust multiobjective optimization ε-efficient solution ε-optimality conditions scalarization

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Remote Sensing approach to evaluate anthropogenic influences on Forest Cover of Palamau Tiger Reserve,Eastern India

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Ecological Processes 2020年第1期9卷 185-195页

作者： Binita Kumari Arvind chandra pandey Amit Kumar Department of Geoinformatics Central University of JharkhandRanchiJharkhand 835205India

Background:Tropical forests have been experiencing remarkable rates of transformation over the past century as they are getting degraded or decimated to a great extent by anthropogenic *** study aims at investigating the long-term forest cover transformation in Palamau Tiger Reserve(PTR),Jharkhand,India,using Landsat TM,ETM+,and OLI satellite images during *** forest cover was delineated utilizing various keys of visual interpretation ***:The forest cover was primarily decreased in the north-eastern and north-western parts in *** order to identify the anthropogenic disturbance in the forest reserve,human settlement density was mapped using highresolution Google Earth *** results showed a positive correlation between human population density and settlement *** major affected sites with an outer buffer of 2 km were demarcated in order to deduce the anthropogenic influences in major non-forested sites in *** was observed that the forest change was maximum at site 3(Ranidah,area 61.06 km^(2),−6.47%change)followed by site 2(Saidup,area 124.38 km^(2),−7.65%change),where settlement units were also high(2638 and 2621 settlement units,respectively).At site 1(Barkheta,area 81.59 km^(2)),−1.99%change was observed,and at site 4(Samadh Tola,area 9.15 km^(2)),1.03% change was observed having moderate settlement units(2422 and 1892 settlement units,respectively).Areas with the low level of human settlements(1038 settlement units)observed the least change,i.e.,at site 5(Netarhat,area 48.52 km^(2)),0.58%change was observed mainly during the ***:The forest cover exhibited an overall decrease of 14.55 km^(2)(−1.34%change)with episodic variation during 1975-2015 in PTR,Eastern India.A significant forest disturbance occurred primarily in the north-eastern and north-western parts of PTR along the forest fringe due to the high population and settlement *** study highlighted the potential use of freely availa

关键词： Population density Settlement density Remote sensing and GIS Palamau Tiger Reserve

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On Semi-infinite Mathematical Programming Problems with Equilibrium Constraints Using Generalized Convexity

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Journal of the Operations Research Society of China 2020年第4期8卷 619-636页

作者： Bhuwan chandra Joshi Shashi kant Mishra Pankaj Kumar Centre for Interdisciplinary Mathematical Sciences Department of Science&TechnologyInstitute of ScienceBanaras Hindu UniversityVaranasi 221005India Department of Mathematics Institute of ScienceBanaras Hindu UniversityVaranasi 221005India Mahila Maha Vidyalaya Banaras Hindu UniversityVaranasi 221005India

In this paper,we consider semi-infinite mathematical programming problems with equilibrium constraints(SIMPPEC).By using the notion of convexificators,we establish sufficient optimality conditions for the *** formulate Wolfe and Mond–Weir-type dual models for the SIMPPEC under the invexity and generalized invexity *** and strong duality theorems are established to relate the SIMPPEC and two dual programs in the framework of convexificators.

关键词： Duality Convexificators Generalized invexity Constraint qualification

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A multiwavelength view of a classical T Tauri star CV Cha

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Research in Astronomy and Astrophysics 2019年第1期19卷 75-86页

作者： Jeewan chandra pandey Subhajeet Karmakar Arti Joshi Saurabh Sharma Shashi Bhushan pandey Anil Kumar pandey Aryabhatta Research Institute of Observational Sciences (ARIES)

Using long-term optical, ultraviolet(UV) and X-ray data, we present a study of a classical T Tauri star CV Cha. The V-band light curve obtained from the All Sky Automated Survey(ASAS) shows short as well as long-term variability. The short-term variability could be due to rotational modulation of CV Cha. We derive the rotational period of 3.714 ± 0.001 d for CV Cha. UV light curves obtained from Swift also show the variations. X-ray light curves from XMM-Newton and Swift do not show any significant short as well as long-term variability. However, the light curve from chandra appears to be variable, which could be due to the emergence of flaring activities. X-ray spectra from all observations are explained well by the single temperature plasma of 0.95 keV with X-ray luminosity of 1030.4erg s-1in the 0.5–7.5 keV energy band. It appears that variability in optical and UV bands could be due to the presence of both hot and cool spots on the surface, while X-ray emission is dominated by magnetic processes.

关键词： stars:activity stars:individual(CV Cha) stars:pre-main sequence stars:variable:T Tauri X-ray:stars

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Arbuscular Mycorrhizal (AM) Diversity in Prosopis cineraria (L.) Druce Under Arid Agroecosystems

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Agricultural Sciences in China 2008年第6期7卷 754-761页

作者： Neelam Verma Jagadish chandra Tarafdar Krishna kant Srivastava Jitendra Panwar Arid Forest Research Institute Jodhpur 342 005 Rajasthan India Central Arid Zone Research Institute Biological Sciences Group Birla Institute of Technology & Science

Arbuscular mycorrhizal （AM） fungi associated with Prosopis cineraria （Khejri） were assessed for their qualitative and quantitative distribution from eight districts of Rajasthan. A total of three species of Acaulospora, one species of Entrophospora, two species of Gigaspora, twenty-one species of Glomus, seven species of Sclerocystis and three species of Scutellospora were recorded. A high diversity of AM fungi was observed and it varied at different study sites. Among these six genera, Glomus occurred most frequently. Glomus fasciculatum, Glomus aggregatum, and Glomus mosseae were found to be the most predominant AM fungi in infecting Prosopis cineraria. Acaulospora, G. fasciculatum, Sclerocystis was found in all the fields studied, while Scutellospora species were found only in few sites. A maximum of thirty-six AM fungal species were isolated and identified from Jodhpur, whereas only thirteen species were found from Jaisalmer. Spores of Glomusfasciculatum were found to be most abundant under Prosopis cineraria.

关键词： arbuscular mycorrhizae arid agroecosystems diversity Prosopis cineraria

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