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Clinical Utility of N-13 Ammonia Cardiac PET Perfusion Imaging in the Assessment of Epicardial Coronary Lesions of Intermediate Range

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Open Journal of Medical Imaging 2012年第2期2卷 41-46页

作者： maddury jyotsna Ghanta Somasekhar Vatturi Venkata Satya Prabhaker Rao RNV Kumar E. jyotsna Cardiology Department Nizam’s Institute of Medical Sciences Hyderabad India Nuclear Medicine Department Nizam’s Institute of Medical Sciences Hyderabad India

Objective: To identify the high risk myocardial perfusion defects which prognosticate the future ischemic cardiac events, on Positron emission tomography (PET) myocardial perfusion imaging (MPI) of intermediate coronary stenosis (ICS) on coronary angiogram (CAG) with negative single photon emission computed tomography (SPECT) MPI in chronic stable angina (CSA) patients. Methods: For this study non-infarcted CSA patients of single vessel disease (SVD) on CAG with ICS and normal LV function were selected. In all patients with negative stress SPECT MPI, stress PET MPI was done. In both scans, extent score (ES), severity score (SS), total severity/extent score ratio (TS-ES R) and Left ventricular dilatation (LVD) were noted. Patients with Positive PET MPI were closely followed for 2yrs and PCI was performed depending on symptoms. Results: Out of 47 study group patients, during 2yr follow up period, 11 out of 15 patients with ischemia positive PET MPI underwent percutaneous coronary intervention (PCI). Indication for PCI was rest or persistence or recurrence of angina. Four of 15 patients remained asymptomatic. In medically managed vs. PCI done patients, mean of ES was 1.2 ± 0.5 vs. 2.3 ± 1, SS was 1.2 ± 0.5 vs. 5.3 ± 1.9, TS-ESR was 1 vs. 2.5 ± 0.5 which was statistically significant (p = 0.01). Conclusion: It was inferred that subgroup of PET MPI positive ICS patients with basal PET MPI showing SS > 5 and TS-ES R > 1.5 with LVD during stress required close follow up as they are likely require PCI subsequently. Condensed Abstract: As negative for inducible ischemia by single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) is associated with low cardiac event rate, even though positive imaging by Positron emission tomography myocardial perfusion imaging (PET MPI), in patients with intermediate Coronary stenosis (ICS) may not require immediate percutaneous coronary intervention (PCI). We fol-lowed these patients for two 2yrs and identified tha

关键词： PET MPI SPECT MPI Intermediate Coronary Stenosis Percutaneous Coronary Intervention

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Incense smoke(IS)inhalation exposure system:Physicochemical characterization,IS particle deposition and clearance in human airway using MPPD model

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Particuology 2024年第4期87卷 271-285页

作者： Vyas Kumar Hafsa Hashmi Anshita Nasreen Ghazi Ansari jyotsna Singh Inhalation Toxicology Facility Regulatory Toxicology GroupCSR-Indian Institute of Toxicology ResearchLucknow22001UPIndi Academy of Scientific and Innovative Research(AcsSIR) Ghaziabad201002UPIndia Analytical Chemistry Regulatory Toxicology GroupCSIR-Indian Institute of Toxicology ResearchLucknow226001UPIndia

Incense smoke(IS)is source of indoor air pollution and key risk for diverse human *** in-formation is available regarding controlled IS rodent inhalation exposure system and IS particulate matter(PM)deposition in human *** aimed to demonstrate stable ISPM physicochemical parameters of 10 incense products inside the customized whole body inhalation exposure chamber(without animal)connected to smoke generation unit via aerosol mixing *** analyzed for size segregated PM emission,ISPM in vitro aerodynamics(MMAD and GSD determination),fine and ultrafine particle's SEM,SEM-EDX and PAH *** real life exposure scenario by utilizing MMAD,GSD and PM concentration after Tier 1 exposure assessment as key input parameters,ISPM dosimetry in infant(3 months)and adult(21 years male and female)human airways was calculated using multiple-path particle dosimetry(MPPD 3.04)*** median aerodynamic diameter(MMAD)and geo-metric standard deviation(GSD)ranged between 0.55 and 2.10μm and 1.22 to 1.77(polydisperse)***1.0 and PM0.1 showed multiple morphology and presence of heavy and trace *** like acenaphthylene,anthracene,fluorene,naphthalene and phenanthrene were detected(0.84-143.17μg/g).MPPD results showed higher ISPM deposition in pulmonary region and lowest in trachea bronchial *** deposition in tissue was higher in lower,peripheral lung as compared to upper and central lung *** body inhalation exposure system showed stable IS atmosphere(physi-cochemical parameters)indicating the device suitability in future inhalation *** ISPM deposition fraction and clearance data showed deep lung penetrating and retention behavior with higher risk in infant followed by female and then *** modeled particle deposition and clearance data may be useful in risk assessment analysis of IS.

关键词： Inhalation Incense smoke Multiple-path particle dosimetry(MPPD) Particle deposition Particulate matter(PM) Mass median aerodynamic diameter (MMAD) Human airway

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Safety and Efficacy of Ultra-Thin, Biodegradable Polymer Coated Sirolimus-Eluting Supralimus-Core Stents in Real-World Patients: Outcomes at 24-Month Follow-Up

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World Journal of Cardiovascular Diseases 2018年第11期8卷 523-532页

作者： Kala Jeethender Kumar Jain Subash Dasarapu Sai Satish Oruganti jyotsna maddury Srinivas Bhyravavajhala Rama Kumari Nuthalapati Vanaparthi Satya Bharathi Lakshmi Rajender Betham Anil Kumar Enikapalli Nizam’s Institute of Medical Sciences Hyderabad Telangana India

Aim: The purpose of this registry was to establish long-term safety and efficacy through implantation of Supralimus-Core sirolimus-eluting stents (SES) in real-world patients with coronary artery disease (CAD). Methods:The present registry was a retrospective, singe-arm, single-centre, investigator-initiated registry. A total of 372 consecutive patients were implanted with Supralimus-Core SES between January 2015 and November 2016. The primary endpoints were major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and target vessel revascularization (TVR) at 24 months. The secondary endpoints were all-cause death and all separate components of the primary endpoint. Additional endpoints included events of stent thrombosis classified as definite, probable, and possible stent thrombosis. Follow-ups were conducted at 30-days, 6-months, 12-months and 24-months after the index procedure. Results: The mean age of the registry population was 56.3 ± 11.1 years. Males constituted 276 (74.2%) patients. Hypertensives, diabetics, alcoholics, tobacco chewers and smokers comprised 198 (53.2%), 160 (43.0%), 93 (25.0%), 91 (24.5%) and 88 (23.7%) of the registry population, respectively. The mean length and diameter of stents implanted was 19.3 ± 8.8 mm and 2.9 ± 0.3 mm, respectively. At the 24-month follow-up, MACE was reported in 14 (3.8%) patients. Cardiac death, MI, TLR and TVR was reported in 7 (1.9%), 4 (1.1%), 3 (0.8%) and 4 (1.1%) patients, respectively. Overall stent thrombosis occurred in 4 (1.1%) patients. Conclusions: The low MACE rate of 3.8% at the 24-month follow-up indicates favorable long-term results after implantation of the ultra-thin strut Supralimus-Core SES in all-comer, real-world patients.

关键词： Biodegradable Polymer Cobalt-Chromium Coronary Artery Disease Drug Eluting Stents Percutaneous Coronary Intervention Sirolimus-Eluting Stent

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Effect of process parameter on the flowability of nanocrystalline CoNiCrAlY powder synthesized by mechanical milling

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Particuology 2024年第9期92卷 210-223页

作者： Annadaa Shankara Dash Indranil Manna Deepa Devapal Sharad Chandra Sharma jyotsna Dutta Majumdar School of Nanoscience and Technology IIT KharagpurWest BengalIndia BIT Mesra RanchiJharkhandIndia Department of Metallurgical and Materials Engineering IIT KharagpurWest BengalIndia Vikram Sarabhai Space Centre ThiruvanthapuramKeralaIndia

The present study concerns understanding the effect of process parameters on the characteristics and flowability of nanocrystalline CoNiCrAlY powder synthesized by mechanical *** milling has been conducted in a planetary ball mill with tungsten carbide(WC)ball,with ball to powder ratio of 10:1 at 300 rpm speed,using 1%stearic acid and toluene as process control agent(PCA)with time varying from 10 h to 36 *** synthesized nanocrystalline powder were characterized by Scanning Electron Microscopy,X-ray Diffraction technique,X-ray Photoelectron Spectroscopy,and Differential Scanning ***,flowability in terms of Hausner ratio was assessed by Tap Density *** particle size of the powder was found to decrease from 33μm to 22μm after 10 h of milling and further increases to 43μm and 38μm after 25 and 36 h of milling,respectively,in stearic acid ***,in toluene medium particle size continuously decreases from 33μm to 9.7μm with increasing milling *** particle morphology changes from spherical to platelet shape at low milling hours in both of the *** 25 h of milling,the shape of the particles is nearly spherical for stearic acid and irregular for toluene used as a *** size was found to decrease with increasing milling time from 147 nm to 7.7 nm and to 6.4 nm in stearic acid and toluene media,*** was presence ofγ,γʹ,β,hcp-Co,Al_(2)O_(3)and AlOOH phases on the powder particles milled in both the *** measured Hausner ratio of the powders was found to vary from 1.18 to 1.32 in stearic acid medium,and was found to increase with increasing milling *** the other hand,in toluene media flowability decreases(Hausner ratio increases from 1.33 to 1.44)with increasing milling time.

关键词： Mechanical milling Microstructure Process control agent(PCA) CoNiCrAIY Toluene Stearic acid Flowability

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Evaluation of thyroid profile among children aged 1-15 years with nephrotic syndrome:An observation study

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World Journal of Clinical Pediatrics 2024年第3期13卷 34-39页

作者： Priyanka Kumari Amit Agrawal jyotsna Shrivastava Department of Pediatrics Gandhi Medical CollegeBhopal 462030India Department of Pediatrics Gandhi Medical CollegeHamidia Hospital CampusBhopal 462022India

BACKGROUND The interaction between the kidney and the thyroid is important for normal function of both *** nephrotic syndrome,proteinuria leads to loss of several proteins,which in turn causes *** To assess the thyroid function in children with nephrotic *** This cross-sectional study was conducted in a tertiary center,Bhopal,from February 2020 to January *** children aged 1-15 years admitted with nephrotic syndrome(first-time diagnosed and all relapse cases)were included in the study.A thyroid profile was sent along with routine investigations,and thyroid hormone status was assessed in nephrotic syndrome *** Of the 70 patients,39(55.7%)showed abnormal thyroid profiles;19(27.1%)had overt hypothyroidism,and 20(28.6%)had subclinical *** hypothyroidism was seen in 16.1%of newly diagnosed cases,40%of second relapses,and 2.7%of frequently relapsed cases(P<0.001).The mean serum free T3 and free T4 levels in frequent relapses were 2.50±0.39 ng/dL and 0.78±0.12 ng/dL,respectively,which were significantly lower than in newly diagnosed cases(2.77±0.37 ng/dL and 0.91±0.19 ng/dL,respectively).The mean thyroidstimulating hormone(TSH)level was significantly higher in frequent relapses (5.86±1.56μIU/mL)and second relapse(5.81±1.78μIU/mL)than in newly diagnosed cases(4.83±0.76μIU/mL)and first relapse cases(4.74±1.17μIU/mL),(P<0.01).CONCLUSION An abnormal thyroid profile was commonly observed in children with nephrotic syndrome,and overt hypothyroidism was more common in frequent relapse ***,thyroid screening should be a part of the management of nephrotic syndrome so that hypothyroidism can be detected and managed at an early stage.

关键词： Nephrotic syndrome Hypothyroidism Proteinuria Children Steroid-sensitive nephrotic syndrome Steroidresistant nephrotic syndrome

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A Study to Observe Pulse Pressure Variation after Induction with Propofol for General Anesthesia

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World Journal of Cardiovascular Diseases 2024年第5期14卷 343-350页

作者： Kunal Tewari Vibhu Raghuvanshi Deepak Mishra Nitin Pahuja Maj jyotsna Om Bahadur Thapa Department of Anaesthesiology and Critical Care Armed Forces Medical College Pune India Chauhan Medicity and Trauma Centre Pathankot India Department of Anaesthesiology and Critical Care Command Hospital (Southern Command) Pune India

Background and Aims: Pulse pressure variation (PPV) is a reliable and predictive dynamic parameter presently being utilized for fluid responsiveness. In the operating room, fluid administration based on PPV monitoring helps the physician in deciding whether to volume resuscitate or use interventions in patients undergoing surgery. Propofol is an intravenous induction agent which lowers blood pressure. There are multiple causes such as depression in cardiac output, and peripheral vasodilatation for hypotension. We undertook this study to observe the utility of PPV as a guide to fluid therapy after propofol induction. Primary outcome of our study was to monitor PPV as a marker of fluid responsiveness for the hypotension caused by propofol induction. Secondary outcome included the correlation of PPV with other hemodynamic parameters like heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP);after induction with propofol at regular interval of time. Methods: A total number of 90 patients were recruited. Either of the radial artery was then cannulated under local anaesthesia with 20G VygonLeadercath arterial cannula and invasive monitoring transduced. A baseline recording of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and PPV was then recorded. Patients were then induced with predetermined doses of propofol (2 mg/kg) and recordings of HR, SBP, DBP, and PPV were taken at 5, 10 and 15 minutes. Results: Intraoperatively, PPV was significantly higher at 5 minutes and significantly lower at 15 minutes after induction. It was observed that there were no statistically significant correlations between PPV and SBP or DBP. PPV was strongly and directly associated with HR. Conclusion: We were able to establish that PPV predicts fluid responsiveness in hypotension caused by propofol induction;and can be used to administer fluid therapy in managing such hypotension. However, PPV was not directly correlated with hypotensi

关键词： Pulse Pressure Variation (PPV) Propofol Fluid Responsiveness

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A Comparative Study between Landmark Based and Real Time Ultrasound Guided Sub Arachnoid Block

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Open Journal of Anesthesiology 2024年第4期14卷 118-125页

作者： Kunal Tewari Om Bahadur Thapa Deepak Mishra Manjot Multani jyotsna Sharma Akash Ray Mohapatra Sandhya Khwaunju Department of Anesthesiology and Critical Care Armed Forces Medical College Pune India Department of Anesthesiology and Critical Care AFMC Pune India

Background: Sub arachnoid block (SAB) performed by traditional landmark palpation technique can be inaccurate. This problem is exacerbated by altered patient anatomy due to obesity and age-related changes. A pre-procedural ultrasound scan of the lumbar spine has been shown to be of benefit in guiding lumbar epidural insertion in obstetric patients. Information on the use of real-time ultrasound (RUS) guided SAB, to date, been limited. This study compared RUS guided SAB to traditional landmark guided technique in patients undergoing spinal anesthesia for different surgical procedures. Methods: This was a prospective, single center, comparative observational study conducted in the department of anesthesiology at our center. 560 patients who underwent spinal anesthesia either by landmark based technique or real-time ultrasound-guided methods. The primary outcome was the first attempt success rate of dural puncture when employing the two methods. Results: Baseline characteristics were similar in the two study groups. The first attempt success rate of dural puncture in landmark guided group was 64.3% compared to 72.6% in the ultrasound guided group. This difference was not statistically significant. The procedure performance time was significantly shorter with landmark palpation compared to use of real-time ultrasound guided method. Conclusion: Use of RUS-guided technique does not significantly improve the first attempt success rate of SAB dural puncture during spinal anesthesia compared to the traditional landmark-guided technique.

关键词： Sub Arachnoid Block (SAB) Real Time Ultrasound (RUS)

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Comparison of efficacy of lung ultrasound and chest X-ray in diagnosing pulmonary edema and pleural effusion in ICU patients: A single centre, prospective, observational study

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Open Journal of Anesthesiology 2024年第3期14卷 41-50页

作者： Kunal Tewari Sumanth Pelluru Deepak Mishra Nitin Pahuja Akash Ray Mohapatra jyotsna Sharma Om Bahadur Thapa Manjot Multani Department of Anesthesiology and Critical Care Armed Forces Medical College Pune India Department of Anesthesiology and Critical Care Military Hospital Bhopal India

Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.

关键词： Chest X ray (CXR) Consolidation Pulmonary edema Pleural effusion Lung ultrasound (LUS) Pneumothorax

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Recurrent stroke admissions with vs without COVID-19 and associated in-hospital mortality: A United States nationwide analysis, 2020

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World Journal of Virology 2024年第3期13卷 98-106页

作者： Rupak Desai Sai Priyanka Mellacheruvu Sai Anusha Akella Adil Sarvar Mohammed Mushfequa Hussain Abdul Aziz Mohammed Pakhal Saketha Praveena Sunkara jyotsna Gummadi Paritharsh Ghantasala Outcomes Research Independent ResearcherAtlantaGA 30033United States Department of Public Health University of MassachusettsLowellMA 01854United States Department of Internal Medicine One Brooklyn Health-Interfaith Medical CenterBrooklynNY 11213United States Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48602United States Department of Internal Medicine Kamineni Institute of Medical SciencesNarketpally 508254India Department of Internal Medicine Bhaskar Medical CollegeMoinabad 500075HyderabadIndia Department of Internal Medicine MedStar Medical GroupCharlotte HallMD 20622United States Department of Medicine Medstar Franklin Square Medical CenterBaltimoreMD 21237United States

BACKGROUND Coronavirus disease 2019(COVID-19)has been shown to increase the risk of ***,the prevalence and risk of recurrent stroke in COVID-19 patients with prior stroke/transient ischemic attack(TIA),as well as its impact on mor-tality,are not *** To evaluate the impact of COVID-19 on in-hospital mortality,length of stay,and healthcare costs in patients with recurrent *** We identified admissions of recurrent stroke(current acute ischemic stroke admissions with at least one prior TIA or stroke)in patients with and without COVID-19 using ICD-10-CM codes using the National Inpatient Sample(2020).We analyzed the impact of COVID-19 on mortality following recurrent stroke admissions by *** Of 97455 admissions with recurrent stroke,2140(2.2%)belonged to the COVID-19-positive *** COVID-19-positive group had a higher prevalence of diabetes and chronic kidney disease vs the COVID-19 negative group(P65 years,patients aged 45–64 years,Asians,Hispanics,whites,and blacks in the COVID-19 positive group had higher rates of all-cause mortality than the COVID-19 negative group(P65(OR:7.04,95%CI:5.24-9.44),males(OR:7.82,95%CI:5.38-11.35)compared to females(OR:6.15,95%CI:4.12-9.18),and in Hispanics(OR:15.47,95%CI:7.61-31.44)and Asians/Pacific Islanders(OR:14.93,95%CI:7.22-30.87)compared to blacks(OR:5.73,95%CI:3.08-10.68),and whites(OR:5.54,95%CI:3.79-8.09).CONCLUSION The study highlights the increased risk of all-cause in-hospital mortality in recurrent stroke patients with COVID-19,with a more pronounced increase in middle-aged patients,males,Hispanics,or Asians.

关键词： COVID-19 SARS-CoV-2 Recurrent stroke Mortality Hospitalization Comorbidities Acute ischemic stroke

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Assessment of High-Frequency Performance Limits of Graphene Field-Effect Transistors

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Nano Research 2011年第6期4卷 571-579页

作者： jyotsna Chauhan Jing Guo Department of Electrical and Computer Engineering University of Florida Gainesville FL 32611-6130 USA

High frequency performance limits of graphene field-effect transistors （FETs） down to a channel length of 20 nm have been examined by using self-consistent quantum simulations. The results indicate that although Klein band-to-band tunneling is significant for sub-100 nm graphene FETs, it is possible to achieve a good transconductance and ballistic on-off ratio larger than 3 even at a channel length of 20 nm. At a channel length of 20 nm, the intrinsic cut-off frequency remains at a few THz for various gate insulator thickness values, but a thin gate insulator is necessary for a good transconductance and smaller degradation of cut-off frequency in the presence of parasitic capacitance. The intrinsic cut-off frequency is close to the LC characteristic frequency set by graphene kinetic inductance （L） and quantum capacitance （C）, which is about 100 GHz-um divided by the gate length.

关键词： Field effect transistor (FET) radio frequency (RF) carbon nanotube (CNT) intrinsic cut-off frequency transconductance

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