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Are fails more common than road traffic accidents in pediatric trauma？ Experience from a Level 1 trauma centre in New Delhi, India

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Chinese Journal of Traumatology 2016年第2期19卷 75-78页

作者： Annu Babu Amulya Rattan piyush ranjan Maneesh Singhal Amit Gupta Subodh Kumar Biplab Mishra Sushma Sagar JPN Apex Trauma Centre New Delhi 110029 India

Purpose： The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents （RTAs） as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India. Methods： Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21. Results： We had 300 patients over a 33 month period. Among them, 236 （78.6%） were males and 64 （21.3%） females. Overall the predominant cause was RTAs in 132 （43%） patients. On subgroup analysis of up to 12 years age group （n - 147）, the most common cause was found to be RTAs again. However, falls showed an incremental upward trend （36.05% in up to 12 age group versus 27% overall）, catching up with RTAs （44.89%）. Pediatric Trauma Score （PTS） ranged from 0 to 12 with a mean of 8.12 _＋ 2.022. 223 （74.33%） patients experienced trauma limited to one anatomic region only, whereas 77 （25.66%） patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days （range 1-182）. Conclusion： Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs （43%） as compared to falls from height （27%）; however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatri

关键词： Accidental fallsPediatricsAccidents trafficWounds and injuries

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MetalloPred: A tool for hierarchical prediction of metal ion binding proteins using cluster of neural networks and sequence derived features

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Journal of Biophysical Chemistry 2011年第2期2卷 112-123页

作者： Pradeep Kumar Naik piyush ranjan Pooja Kesari Sankalp Jain Department of Biotechnology and Bioinformatics Jaypee University of Information Technology Waknaghat Solan- 173215 Hi-machal Pradesh India

Given a protein sequence, how can we identify whether it is a metalloprotein or not? If it is, which main functional class and subclasses it belongs to? This is an important biological question because they are closely related to the biological function of an uncharacterized protein. Particularly, with the avalanche of protein sequences generated in the post genomic era and since conventional techniques are time consuming and expensive, it is highly desirable to develop an automated method by which one can get a fast and accurate answer to these questions. Here, a top-down predictor, called MetalloPred, is developed which consists of 3 level of hierarchical classification using cascade of neural networks from sequence derived features. The 1st layer of the prediction engine is for identifying a query protein as metalloprotein or not;the 2nd layer for the main functional class;and the 3rd layer for the sub-functional class. The overall success rates for all the three layers are higher than 60% that were obtained through rigorous cross-validation tests on the very stringent benchmark datasets in which none of the proteins has 30% sequence identity with any other in the same class or subclass. MetalloPred achieved good prediction accuracies and could nicely complement experimental approaches for identification of metal binding proteins. MetalloPred is freely available to be used in-house as a standalone and is accessible at http://***/assets/Metallopred/.

关键词： Metalloprotein Classification Sequence Derived Parameters Neural Networks

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Blunt traumatic superior gluteal artery pseudoaneurysm presenting as gluteal hematoma without bony injury： A rare case report

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Chinese Journal of Traumatology 2016年第4期19卷 244-246页

作者： Annu Babu Amit Gupta Pawan Sharma piyush ranjan Atin Kumar Department of Surgery Jai Prakash Narayan Apex Trauma Centre All India Institute of Medical Sciences New Delhi India

Blunt traumatic injuries to the superior gluteal artery are rare in clinic. A majority of injuries present as aneurysms following penetrating trauma, fracture pelvis or posterior dislocation of the hip joint. We reported a rare case of superior gluteal artery pseudoaneurysm following blunt trauma presenting as large expanding right gluteal hematoma without any bony injury. The gluteal hematoma was suspected clinically, confirmed by ultrasound and the arterial injury was diagnosed by CT angiography that revealed a large right gluteal hematoma with a focal contrast leakage forming a pseudoaneurysm within the hematoma. Pseudoaneurysm arose from the superior gluteal branch of right internal iliac artery, which was successfully angioembolized. The patient was discharged on day 4 of hospitalization with resolving gluteal hematoma. This report highlighted the importance of considering an arterial injury following blunt trauma to the buttocks with subsequent painful swelling. Acknowledgment of this rare injury pattern was necessary to facilitate rapid diagnosis and appropriate treatment.

关键词： Angioembolization Gluteal hematoma Pseudoaneurysm Superior gluteal artery

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预防和治疗乙型肝炎病毒感染

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继续医学教育 2007年第8期21卷 13-18页

作者： Rakesh AgRarwal piyush ranjan 印度勒克瑙医学科学研究院消化科

乙型肝炎（简称乙肝）病毒感染是全球性的公共卫生问题，总共约有4亿慢性感染者，全球每年死于乙肝者超过50万人。急性乙肝病毒感染后，大多出现无症状的亚临床感染（70％）及急性肝炎（30％），亦有暴发性肝功能衰竭（占0．1％-0．5％... 详细信息

乙型肝炎（简称乙肝）病毒感染是全球性的公共卫生问题，总共约有4亿慢性感染者，全球每年死于乙肝者超过50万人。急性乙肝病毒感染后，大多出现无症状的亚临床感染（70％）及急性肝炎（30％），亦有暴发性肝功能衰竭（占0．1％-0．5％）。感染持续6个月则为慢性感染，成人中占5％～10％，在新生儿和儿童中的比例远高于这个数字。慢性乙肝病毒感染的疾病谱范围从无症状的病毒携带状态，到慢性乙型肝炎、肝硬化甚至肝细胞癌，其病程复杂且受多种因素影响。总体来说，有15％～40％的慢性感染患者进展到终末期肝病．

关键词：乙型肝炎病毒感染暴发性肝功能衰竭慢性乙肝病毒感染治疗预防公共卫生问题急性乙肝慢性感染

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All ileo-cecal ulcers are not Crohn's:Changing perspectives of symptomatic ileocecal ulcers

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World Journal of Gastrointestinal Endoscopy 2017年第7期9卷 327-333页

作者： Jay Toshniwal Romesh Chawlani Amit Thawrani Rajesh Sharma Anil Arora Hardik L Kotecha Mohan Goyal Vijendra Kirnake Pankaj Jain Pankaj Tyagi Naresh Bansal Munish Sachdeva piyush ranjan Mandhir Kumar Praveen Sharma Vikas Singla Rinkesh Bansal Vineet Shah Sunita Bhalla Ashish Kumar Department of Gastroenterology Dr.Toshniwal’s Gastro-Liver Care Department of Gastroenterology Sir Gangaram Hospital Department of Histo-pathology Sir Gangaram Hospital

To investigated clinical, endoscopic and histopathological parameters of the patients presenting with ileocecal ulcers on colonoscopy. METHODSConsecutive symptomatic patients undergoing colonoscopy, and diagnosed to have ulcerations in the ileocecal (I/C) region, were enrolled. Biopsy was obtained and their clinical presentation and outcome were recorded. RESULTSOut of 1632 colonoscopies, 104 patients had ulcerations in the I/C region and were included in the study. Their median age was 44.5 years and 59% were males. The predominant presentation was lower GI bleed (55, 53%), pain abdomen ± diarrhea (36, 35%), fever (32, 31%), and diarrhea alone (9, 9%). On colonoscopy, terminal ileum was entered in 96 (92%) cases. The distribution of ulcers was as follows: Ileum alone 40% (38/96), cecum alone 33% (32/96), and both ileum plus cecum 27% (26/96). The ulcers were multiple in 98% and in 34% there were additional ulcers elsewhere in colon. Based on clinical presentation and investigations, the etiology of ulcers was classified into infective causes (43%) and non-infective causes (57%). Fourteen patients (13%) were diagnosed to have Crohn’s disease (CD). CONCLUSIONNon-specific ileocecal ulcers are most common ulcers seen in ileo-cecal region. And if all infections are clubbed together then infection is the most common (> 40%) cause of ulcerations of the I/C region. Cecal involvement and fever are important clues to infective cause. On the contrary CD account for only 13% cases as a cause of ileo-cecalulcers. So all symptomatic patients with I/C ulcers on colonoscopy are not Crohn’s.

关键词： Ileocecal Crohn’s disease Diffuse large B-cell non-hodgkin’s lymphoma

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