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Endoscopic ultrasound-guided biliary drainage:Are we there yet?

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World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 302-318页

作者： rishi Pawa Troy Pleasant Chloe Tom Swati Pawa Department of Internal Medicine Section of Gastroenterology and HepatologyWake Forest Baptist Medical CenterWinston-SalemNC 27157United States Department of Medicine Wake Forest School of MedicineWinston-SalemNC 27101United States

Endoscopic retrograde cholangiopancreatography(ERCP)is the mainstay procedure of choice for management of obstructive biliary *** ERCP is widely performed with high success rates,the procedure is not feasible in every patient such as cases of non-accessible *** the setting of unsuccessful ERCP,endoscopic ultrasound-guided biliary drainage(EUS-BD)has become a promising alternative to surgical bypass and percutaneous biliary drainage(PTBD).A variety of different forms of EUS-BD have been described,allowing for both intrahepatic and extrahepatic *** studies have reported high success rates utilizing EUS-BD for both transpapillary and transluminal drainage,with fewer adverse events when compared to *** in novel technologies designed specifically for EUS-BD have led to increased success rates as well as improved safety profile for the *** techniques of EUS-BD are yet to be fully standardized and are currently performed by highly trained advanced *** aim of our review is to highlight the different EUSguided interventions for achieving biliary drainage and to both assess the progress that has been made in the field as well as consider what the future may hold.

关键词： Endoscopic ultrasound-guided biliary drainage Endoscopic ultrasound-guided rendezvous Endoscopic ultrasound-guided choledochoduodenostomy Endoscopic ultrasound-guided hepaticogastrostomy Endoscopic ultrasound-guided gallbladder drainage Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography

Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal polyps:A meta-analysis and metaregression with single arm analysis

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World Journal of Gastroenterology 2021年第25期27卷 3925-3939页

作者： Xiong Chang Lim Kameswara rishi Yeshayahu Nistala Cheng Han Ng Snow Yunni Lin Darren Jun Hao Tan Khek-Yu Ho Choon-Seng Chong Mark Muthiah Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Medicine National University HospitalSingapore 119074Singapore Department of Surgery National University HospitalSingapore 119074Singapore

BACKGROUND Endoscopic submucosal dissection(ESD)has shown to be effective in management of colorectal neoplasm in the Asian countries,while its implementation in Western countries where endoscopic mucosal resection(EMR)is preferred is still *** To compare the surgical,histological,and oncological outcomes between ESD and EMR in the treatment of colorectal polyps,with subgroup analysis comparing the efficacy of ESD and EMR between Japan and the rest of the *** Embase and Medline databases were searched from inception to October 2020 in accordance with PRISMA guidelines for studies comparing en bloc,complete resection,margin involvement,resection time,need for additional surgery,complications,and recurrence rate of ESD with *** Of 281344 colorectal polyps from 21 studies were *** compared to EMR,the pooled analysis revealed ESD was associated with higher en bloc and complete resection rate,and lower lateral margin involvement and *** led to increased procedural time,need for additional surgery,and perforation *** significant difference in bleeding risk was found between the two ***-regression analysis suggested only right colonic polyps correlated with an increased perforation risk in *** including polyp size and invasion depth did not significantly influence the en bloc and complete resection rate,bleeding risk and *** subgroup analysis,Japan performed better than the rest of the world in both ESD and EMR with perforation risk of 4%and 0.0002%,respectively,as compared to perforation risk of 8%and 1%,respectively,in reports coming from rest of the *** ESD resulted in better resection outcomes and lower recurrence compared to *** appropriate training,ESD is preferred over EMR as the first-line therapy for resection of colorectal polyps,without restricting to lesions greater than 20 mm and those with high suspicion of submucosal invasion.

关键词： Endoscopic mucosal resection Endoscopy Colonic polyps Colorectal neoplasm Colonoscopy

Obstructive Sleep Apnea and Post-Operative Complications: Single Center Data, Review of Literature and Guidelines for Practicing Internists and Surgeons

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Surgical Science 2012年第2期3卷 65-71页

作者： Kenneth M. Nugent Michael Phy rishi Raj Texas Tech University Health Sciences Center Lubbock USA

Obstructive sleep apnea has been linked to higher rates of post-operative complications in some studies. We examined the prevalence of obstructive sleep apnea and its impact on post-operative complications in 125 patients (21 prospective, 104 retrospective) undergoing various elective outpatient surgeries at our institution. Ten percent of these patients had OSA, and half of them were on continuous positive airway pressure therapy (CPAP). Patients who were on CPAP as outpatients received CPAP post-operatively as well. No patients died, and the prevalence of post-operative complications was low. There was no difference in complication rates between patients with and without OSA. We also review the existing literature on this subject and make practical recommendations regarding pre-operative evaluation and post-operative management of these patients for practicing internists and surgeons based on the current literature.

关键词： Obstructive Sleep Apnea Postoperative Complications Pre-Operative Evaluation

Single CDBA Based Voltage Mode Bistable Multivibrator and Its Applications

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Circuits and Systems 2015年第11期6卷 237-251页

作者： rishi Pal Rajeshwari Pandey Neeta Pandey Ramesh Chandra Tiwari Department of Electronics and Communication Engineering Delhi Technological University Delhi India Department of Physics Mizoram University Aizawl India Department of Electronics and Communication Engineering Delhi Technological University Delhi India

In this paper, current differencing buffered amplifier (CDBA) based bistable multivibrators are introduced. Each presented circuit is constructed using single CDBA as the basic active building block and three resistors. Two applications namely an astable and a monostable multivibrator are also realized to demonstrate the usefulness of the proposed bistable multivibrators. The presented circuits are simulated using PSPICE from Cadence Orcad16.2 to verify their functionality. Simulation results agree well with the theoretical analysis.

关键词： Schmitt Trigger Bistable Multivibrator CDBA Monostable Multivibrator

A scientific perspective of how and why Omicron is less severe than SARS-CoV-2

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Emergency and Critical Care Medicine 2023年第3期3卷 115-121页

作者： Rachel Parise Sindhu Ramesh Jun Ren Manoj Y.Govindarajulu rishi M.Nadar Suhrud Pathak Timothy Moore Muralikrishnana Dhanasekaran Department of Drug Discovery and Development Harrison College of PharmacyAuburn UniversityAuburnALUSA Department of Cardiology Zhongshan Hospital Fudan UniversityShanghaiChina Department of Laboratory Medicine and Pathology University of WashingtonSeattleWAUSA

Omicron is currently the dominant variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the coronavirus responsible for the coronavirus disease 2019(COVID-19)*** is associated with mild symptoms,although it can cause harmful effects in high-risk patient *** and COVID-19 affect multiple organ systems,including the respiratory system,gastrointestinal tract,cardiovascular system,central nervous system,ophthalmic system,genitourinary tract,and musculoskeletal ***-19 infects additional organ systems,including the hematological system,hepatobiliary system,renal system,and dermatologic *** viral-induced complications were compared to discuss the effects of Omicron versus the authentic SARS-CoV-2 virus,revealing less detrimental outcomes for ***,COVID-19 is more likely to infect older adults,males,and obesity with mild to severe *** causes mild symptoms in younger populations and overweight *** were acquired using PubMed,Centers for Disease Prevention and Control,and the World Health ***-19 and Omicron mechanisms causing organ system-related complications are likely because of the natural immune response to the active infection,the uncontrollable release of cytokines causing cytokine release syndrome,and direct viral damage through angiotensin-converting enzyme 2/transmembrane serine protease 2 receptor binding and entrance to the host cell for infection.

关键词： Complications Infection Inflammation Omicron SARS-CoV-2

Pituitary apoplexy secondary to dengue fever-induced-thrombocytopenia:A case report and review of literature

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Journal of Acute Disease 2023年第1期12卷 39-42页

作者： rishi Agarwal Hardeva Ram Nehara Babulal Meena RP Agrawal Departments of Medicine SP Medical CollegeBikanerRajasthanIndia Endocrinology SP Medical CollegeBikanerRajasthanIndia

Rationale:Pituitary apoplexy(PA)is a rare endocrine emergency that requires prompt diagnosis and *** fever-induced-thrombocytopenia may rarely predispose to ***’s Concern:A 58-year-old male patient having known pituitary macroadenoma presented to the emergency department with fever,a sudden onset severe headache,and altered ***:Pituitary apoplexy caused by dengue ***:Conservative management with fluids,mannitol,dexamethasone and symptomatic ***:The patient responded well to the treatment and was discharged ***:Although dengue hemorrhagic fever is a rare cause of pituitary apoplexy,it should be considered if a patient presents with headache and altered sensorium,and prompt initiation of treatment is crucial to prevent fatality and neuro-ophthalmic deficits.

关键词： Dengue hemorrhagic fever Pituitary adenoma Apoplexy Thrombocytopenia Endocrine emergency

Assessing the academic achievement of United States orthopaedic departments

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World Journal of Orthopedics 2022年第2期13卷 201-211页

作者： rishi Trikha Thomas E Olson Ameen Chaudry Chad R Ishmael Cristina Villalpando Clark J Chen Kellyn R Hori Nicholas M Bernthal Department of Orthopaedic Surgery University of CaliforniaLos AngelesCA 90404United States Department of Orthopaedic Surgery David Geffen School of Medicine at UCLALos AngelesCA 90095United States

BACKGROUND Assessing academic productivity allows academic departments to identify the strengths of their scholarly contribution and provides an opportunity to evaluate areas for *** To provide objective benchmarks for departments seeking to enhance academic productivity and identify those with significant improvement in recent *** Our study retrospectively analyzed a cohort of orthopaedic faculty at United States-based academic orthopaedic programs.5502 full-time orthopaedic faculty representing 178 programs were included in *** included for analysis were National Institutes of Health funding(2014-2018),leadership positions in orthopaedic societies(2018),editorial board positions of top orthopaedic journals(2018),total number of publications and Hirsch-index.A weighted algorithm was used to calculate a cumulative score for each academic *** study was performed at a large,United States medical *** All 178 programs included in analysis were evaluated using the comprehensive weighted *** five institutions with the highest cumulative score,in decreasing order,were:Washington University in ***,the Hospital for Special Surgery,Sidney Kimmel Medical College(SKMC)at Thomas Jefferson University,the University of California,San Francisco(UCSF)and Massachusetts General Hospital(MGH)/Brigham and Women’s/*** five institutions with the highest score per capita,in decreasing order,were:Mayo Clinic(Rochester),Washington University in ***,Rush University,Virginia Commonwealth University(VCU)and MGH/Brigham and Women’s/*** five academic programs that had the largest improvement in cumulative score from 2013 to 2018,in decreasing order,were:VCU,SKMC at Thomas Jefferson University,UCSF,MGH/Brigham and Women’s/Harvard,and Brown *** This algorithm can provide orthopaedic departments a means to assess academic productivity,monitor progress,and identify areas for improvement as th

关键词： Bibliometrics Academic achievement Number of publications National Institutes of Health funding Hirsch-index

Duality for a Control Problem Involving Support Functions

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Applied Mathematics 2014年第21期5卷 3525-3535页

作者： I. Husain Abdul Raoof Shah rishi K. Pandey Department of Mathematics Jaypee University of Engineering and Technology Guna India Department of Statistics University of Kashmir Srinagar India

Mond-Weir type duality for control problem with support functions is investigated under generalized convexity conditions. Special cases are derived. A relationship between our results and those of nonlinear programmin... 详细信息

关键词： Control Problem Support Function Generalize Convexity Converse Duality Nonlinear Programming

Refinement of total 12-lead QRS voltage criteria for diagnosing left ventricular hypertrophy

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World Journal of Cardiovascular Diseases 2013年第2期3卷 210-214页

作者： Deepti Kumar rishi Bajaj Lovely Chhabra David H. Spodick Department of Cardiovascular Medicine Saint Vincent Hospital University of Massachusetts Medical School Worcester USA Department of Internal Medicine Saint Vincent Hospital University of Massachusetts Medical School Worcester USA

Objective: We sought to test the hypothesis that the total QRS voltage without either set of the limb leads (I, II, III) or (R, L, F) may be a better indicator of LVH as compared to the total QRS voltage. Background: The total 12 lead QRS voltage has been a validated electrocardiographic criterion for left ventricular hypertrophy (LVH), with an upper limit of175 mm. However, there is some redundancy in this measurement as the output of the limb leads is repeated because leads I, II, III, and R, L, F use the same three electrodes. Methods: 43 unselected, consecutive echocardiograms were examined for evidence of LVH by wall thickness. Electrocardiogram (ECG) of these patients within a week of the echocardiogram were then examined for the total 12 leads QRS voltage, minus I, II, III and total minus R, L, F voltages. ECG findings were then compared with corresponding echocardiographic dimensions. Results: A total QRS voltage of123 mmon ECG yielded a sensitivity of 73% and specificity of 67% for diagnosing LVH with 95% CI = 0.59 - 0.89, p = 0.007. Total minus (R, L and F) value of110 mmon ECG appears to give the best sensitivity (73%), specificity (72%), and accuracy (64% negative predictive value and 82% positive predictive value) for LVH. Conclusion: It appears that total QRS voltage minus either set of the limb leads, especially the total minus R, L and F is a better criterion, with110 mmbeing the best specific, sensitive and accurate index for diagnosing LVH.

关键词： ECG QRS Voltage Left Ventricular Hypertrophy Echocardiography Interventricular Septum