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Open Journal of Obstetrics and Gynecology 2020年第11期10卷 1590-1608页

作者： divyesh V. shukla[divyeshshukla@***] Shilpi d. shukla Amit Shah Sangita Patel Salome shukla Isha Hospital Sarabhai Campus Vadodara India

Unicentric Castleman’s disease (UCd) is localized lymphoproliferative disease and has favourable prognosis. Surgery offers complete cure of unicentric Castleman disease. Radiotherapy offers either complete response or variable clinical response and cure in selected patients. The present case report is of a young unmarried obese girl presented with pain in right iliac fossa for 2 months. On pelvic ultrasound and MRI performed for diagnosis only single enlarged right external iliac lymph node was the positive finding. The CT scan guided biopsy was performed and the histopathological finding was lymphoid lesion-reactive lymphoid hyperplasia is favoured over Hodgkin’s lymphoma. Successful laparoscopic complete excisional surgery was performed for this single enlarged external iliac lymph node. The final histopathological report of the lymph node removed was unicentric Castleman’s disease, hyaline vascular type. This is the 16th such reported case of pelvic retroperitoneal UCD of hyaline vascular type treated by surgical excision, and 3rd case treated by Laparoscopic excisional surgery. By now at the time of reporting this case 4 months of follow up has been completed and patient does not have any symptom nor not show any sign of residual disease locally on transabdominal ultrasound examination and whole-body PET CT scan is also normal.

关键词： Laparoscopic Surgery Unicentric Castleman’s disease Adnexal Mass

Malate and Lactate dehydrogenases of a Freshwater Catfish: Impact of Endosulfan

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Biomedical and Environmental Sciences 1990年第1期3卷 52-64页

作者： G. TRIPATHI S. P. shukla department of Zoology Banaras Hindu University Varanasi 221005 India

A sublethal concentration of technical grade endosulfan (ENd) inhibited 35 to 55% of the activities of cytoplasmic malate dehydrogenase (cMdH), mitochondrial malate dehydrogenase (mMdH), and lactate dehydrogenase (LdH) in the liver and the skeletal muscle of a freshwater catfish, Clarias halrachus, after 7 days of exposure. The activity remained in the inhibited state up to 28 days. The withdrawal of ENd from the medium after 1 week of exposure gradually restored the activities to control levels within 21 days in the skeletal muscle and 28 days in the liver. The administration of actinomycin d or cycloheximide between the 14th and the 21st day of the withdrawal of ENd almost completely inhibited the withdrawal-dependent recovery in the activities of all the three enzymes. This indicates de novo synthesis of the enzymes during the recovery period. A conjoint treatment of ENd and triiodothyronine (T_3) raised the activities of cMdH, mMdH, and LdH in the liver and the skeletal muscle up to the control levels. This shows that the inhibitory effect of ENd may be relieved in presence of T_3. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed few changes in the pattern of cytoplasmic proteins of the liver and the skeletal muscle in response to exposure to ENd. 1990 Academic Press. Inc.

关键词： Nd Impact of Endosulfan Malate and Lactate dehydrogenases of a Freshwater Catfish

Changing Trends in Rate of Cervical dilation in First Stage of Labor: Prospective Longitudinal Study

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1176-1186页

作者： divyesh V. shukla Shilpi d. shukla Sangita Patel Amit Shah Isha Hospital Vadodara India department of PSM Medical College Baroda Vadodara India

Introduction: Knowledge of change in the duration of stages of labour would be an essential step to reduce the increasing rates of cesarean section reported worldwide. Objective: To study the rate of cervical dilation in the 1st stage of labour in spontaneous and induced labour and in primigravida and multigravida with singleton pregnancy. Methods: A prospective observational study conducted at a multispeciality hospital was carried out for a period of 3 years from Jan 2017 to Dec 2019. A total of 640 patients who were admitted with spontaneous and induced labour having singleton pregnancy with cephalic presentation and intact membranes after 34 weeks who delivered vaginally were included for analysis. Progression of labor in the 1st stage of labour was measured by the dana;">rate of cervical dilation as noted by serial per vaginal examination and findings were plotted in part

关键词： Cervical dilatation Spontaneous Labour Induced Labour Active Phase of Labour

Prospective Assessment of direction of Cervical Canal in Routine Hysteroscopy

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 660-673页

作者： divyesh V. shukla Shilpi d. shukla Sangita Patel Amit Shah department of Obg/Gyn and Minimal Access Surgery Isha Hospital Sarabhai Campus Opposite Atlantis Mall Vadodara India department of PSM Govt Medical College Baroda Vadodara India Isha Hospital Vadodara India

Introduction: If the direction of the cervical canal is known, the commonly performed procedures as sono salpingography, embryo transfer, IUd insertion, cervical dilation etc. will be easier. The reported resultant tr... 详细信息

Introduction: If the direction of the cervical canal is known, the commonly performed procedures as sono salpingography, embryo transfer, IUD insertion, cervical dilation etc. will be easier. The reported resultant trauma to the cervical canal and uterus during these procedures also can be avoided. As we know the cervical canal is tortuous in majority of cases, but the exact course is not yet reported or known. Objective: The objective of the present study was to try to identify the various directions of cervical canal while performing routine hysteroscopic surgeries. Methods:dana;">dana;">dana;"> Four-point cervical canal direction was assessed while performing routine hysteroscopic procedures using 5fr Bettocchi operative assembly with 2.9 mm 12-degree telescope (Karl-Storz). The study group was patients with infertility who required

关键词： Cervical Canal direction 5 fr Bettocchi Hysteroscope down Right Up Straight

Can Incarceration of Uterus between 14 - 17 Wks. Be Managed by General Anaesthesia Only? A Second Reported Case

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Open Journal of Obstetrics and Gynecology 2018年第8期8卷 720-727页

作者： divyesh V. shukla Shilpi d. shukla Amit Shah Yesha Choksi Isha Hospital Sarabhai Campus Vadodara India

This is a case of primigravida of 35 years of age having spontaneous conception & 14.5 wks. pregnancy with retention of urine and pain in lower abdomen for 5 days. There was history of unsuccessful attempt of correction of retroversion one day prior. Transabdominal USG (ultrasonography) confirmed 14.5 wks. live pregnancy with incarceration of uterus. In this case, only GA (general anaesthesia) corrected retroversion & incarceration.

关键词： Incarceration USG GA Retention of Urine 14 - 20 Wks. Pregnancy

An integrated theoretical and experimental investigation of insensitive munition compounds adsorption on cellulose,cellulose triacetate, chitin and chitosan surfaces

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Journal of Environmental Sciences 2018年第2期30卷 174-180页

作者： Luke A.Gurtowski Chris S.Griggs Veera G.Gude Manoj K.shukla Environmental Laboratory Engineer Research and Development Center department of Civil and Environmental Engineering Mississippi State University

This manuscript reports results of combined computational chemistry and batch adsorption investigation of insensitive munition compounds, 2,4-dinitroanisole（dNAN）, triaminotrinitrobenzene（TATB）, 1,1-diamino-2,2-dinitroethene（FOX-7） and nitroguanidine（NQ）, and traditional munition compound 2,4,6-trinitrotoluene（TNT） on the surfaces of cellulose, cellulose triacetate, chitin and chitosan biopolymers. Cellulose,cellulose triacetate, chitin and chitosan were modeled as trimeric form of the linear chain of4 C1 chair conformation of β-d-glucopyranos, its triacetate form, β-N-acetylglucosamine and d-glucosamine, respectively, in the 1 ？ 4 linkage. Geometries were optimized at the M062 X functional level of the density functional theory（dFT） using the 6-31 G（d,p） basis set in the gas phase and in the bulk water solution using the conductor-like polarizable continuum model（CPCM） approach. The nature of potential energy surfaces of the optimized geometries were ascertained through the harmonic vibrational frequency analysis. The basis set superposition error（BSSE） corrected interaction energies were obtained using the 6-311 G（d,p）basis set at the same theoretical level. The computed BSSE in the gas phase was used to correct interaction energy in the bulk water solution. Computed and experimental results regarding the ability of considered surfaces in adsorbing the insensitive munitions compounds are discussed.

关键词： Cellulose Cellulose triacetate Chitin Chitosan 2,4-dinitroanisole(dNAN) Triaminotrinitrobenzene(TATB) 1,1-diamino-2,2-dinitroethene(FOX-7) Nitroguanidine(NQ)

Prospective Interventional Study to Quantify Barbed Suture Exposure at Vaginal Vault and Assess Post-Operative Risk

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Open Journal of Obstetrics and Gynecology 2020年第7期10卷 855-865页

作者： divyesh V. shukla Shilpi d. shukla Amit Shah Sangita Patel Vaidehi Nene Isha Hospital Vadodara India department of PSM Medical College Baroda Vadodara India

Background: The use of barbed suture in laparoscopic surgery is increasing ever since 2008. Published reports of use of unidirectional barbed suture for vaginal vault closure following total laparoscopic hysterectomy (TLH), indicates it is safe. Despite of this many reports of adhesions and bowel obstruction are reported. This complication was never assessed in relation to amount of suture exposure at vaginal vault. We thought of quantifying the barbed suture exposure at vaginal vault and assess the risk of post-operative complications. Objective: The objective was to quantify the exposure of barbed suture at vaginal vault by adopting a uniform technique of vault suturing and assessing postoperative risk related to adhesions at vaginal vault. Method: In 30 patients who underwent TLH, a uniform new technique of vaginal vault closure using barbed suture was used and the portion of suture exposed at vaginal vault was quantified. The patients were followed up for a period of 6 months to assess post-operative risk of adhesions at vault and sequalae. Result: Mean length of suture exposed was 2.64 ± 1.65 mm only. Suture exposure at vaginal vault was seen in 23 (76.67%) out of 30 patients. The suture was exposed on average at 1.57 ± 1.20 places at vaginal vault. Conclusion and Recommendations:

关键词： Barbed Suture dS Suturing Technique Suture Exposure TLH Vaginal Vault Closure

Spontaneous Resolution of Traumatic AV Malformation of the Uterus Following Hysteroscopic Cold Knife Evacuation of Retained Products of Conception

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Open Journal of Obstetrics and Gynecology 2020年第6期10卷 790-801页

作者： divyesh V. shukla Shilpi d. shukla Amit Shah Sangita Patel Vaidehi Nene Isha Hospital Sarabhai Campus Vadodara India

Uterine myometrial arteriovenous malformations (AVM) are reported on color doppler ultrasonography as mosaic pattern of blood flow with different peak systolic velocities (PSV) at different places. High PSV within the AVM may require arterial embolization as treatment. However, we present a case of traumatic AVM with incomplete abortion managed by hysteroscopic cold knife evacuation. This case report is of a young patient with off and on vaginal bleeding for 3 1/2 months following 2nd trimester spontaneous abortion. She had undergone dilation and evacuation (D & E) for incomplete abortion. Now the bleeding was heavy and intermittent not responding to medications. The subsequent TVS examination shows incomplete abortion with myometrial AVM with high PSV. Hysteroscopic cold knife removal of products of conception resulted in immediate resolution of Uterine AVM.

关键词： AVM Color doppler Cold Knife Evacuation d & E Hysteroscopy Retained Products Uterus PSV

Rh Isoimmunized Pregnancy—do Maternal Antibody Titre Always Correlate with the Fetal Affection? A Non-Invasive Management

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Open Journal of Obstetrics and Gynecology 2018年第3期8卷 170-174页

作者： divyesh V. shukla Shilpi d. shukla Ajay Valia Yesha Chokshi Isha Hospital Sarabhai Campus Vadodara India

This case is of Rh -ve 2nd gravida having antibody titre detected 1:2 at 8 weeks of 2nd pregnancy. Serial antibody titre carried out along with clinical examination. Fetal monitoring was done by assessing MCA-PSV (Middle cerebral artery peak systolic velocity) and CTG (Cardiotocograph) when required. Pregnancy was terminated when the titre reached 1:512 at 34 wks of pregnancy with abnormal MCA-PSV values. Neonate just had begun to show sign of anaemia & haemolysis at birth.

关键词： Rh -Ve Rh +Ve MCA-PSV CTG Rh Isoimmunization Rh Antibody Titre

diagnosis and detection of Alzheimer’s disease Using Learning Algorithm

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Big data Mining and Analytics 2023年第4期6卷 504-512页

作者： Gargi Pant shukla Santosh Kumar Saroj Kumar Pandey Rohit Agarwal Neeraj Varshney Ankit Kumar the department of Management Doon Business SchoolDehradun 248001India. Jaipuria Institute of Management Jaipur 302033India department of Computer Engineering and Apllications GLA UniversityMathura 281406India.

In Computer-Aided detection(CAd)brain disease classification is a vital ***’s disease(Ad)and brain tumors are the primary reasons of *** studies of these diseases are carried out by Magnetic Resonance Imaging(MRI),Positron Emission Tomography(PET),and Computed Tomography(CT)scans which require expertise to understand the *** disease is the most prevalent in the elderly and can be fatal in its later *** result can be determined by calculating the mini-mental state exam score,following which the MRI scan of the brain is *** from that,various classification algorithms,such as machine learning and deep learning,are useful for diagnosing MRI ***,they do have some limitations in terms of *** paper proposes some insightful pre-processing methods that significantly improve the classification performance of these MRI ***,it reduced the time it took to train the model of various pre-existing learning algorithms.A dataset was obtained from Alzheimer’s disease Neurological Initiative(AdNI)and converted from a 4d format to a 2d *** clipping,grayscale image conversion,and histogram equalization techniques were used to pre-process the *** pre-processing,we proposed three learning algorithms for Ad classification,that is random forest,XGBoost,and Convolution Neural Networks(CNN).Results are computed on dataset and show that it outperformed with exiting work in terms of accuracy is 97.57%and sensitivity is 97.60%.

关键词： alzheimer’s disease deep learning random forest XGBoost