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Seasonal, Age &Gender Variation of Guillain Barre Syndrome in a Tertiary Referral Center in India

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Neuroscience & Medicine 2013年第1期4卷 23-28页

作者： Geetanjali Sharma Sushma Sood sudhir Sharma Department of Medicine University of Health Sciences Rohtak India. Department of Physiology University of Health Sciences Rohtak India

Background: Seasonal variation & gender preponderance have not been adequately studied in Guillain Barre Syndrome (GBS). University of Health Sciences, Rohtak is the tertiary referral facility for a large part of North West India. We conducted a prospective study to investigate differences in GBS incidence between males and females & across different seasons of the year. Methods:65 clinically diagnosed GBS patients, aged 5 - 70 years, referred for nerve conduction, Fwave & EMG studies for 3 years. Results: 64.61% were males while 35.38% were females. Maximum patients were in the age group 5 - 20 years (46.15%). The highest incidence of GBS (41.53%) were seen in the summer months;19 (29.23%) in the spring season, 11 (16.92%) in winter season and 8 (12.30%) in rainy season. 5 patients had diarrhoea while 12 patients had flu like syndrome 1 - 2 weeks before the onset of GBS. Conclusion: The peak seasonal clustering noted by us in the summer months was consistent significantly with other Asian studies. The age and sex distribution of GBS in our series, which showed children & minor preponderance with peak incidence in 5 - 20 years age followed by another in the age group 21 - 40 years, is different from most studies which report a second peak after 50 years of age.

关键词： EMG Epidemiology Guillain-Barre Syndrome Neuroepidemiology

Synthesis and Characterization of Advanced Red Mud and MWCNTs Based EMI Shielding Material via Ceramic Processing

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Materials Sciences and Applications 2016年第4期7卷 192-201页

作者： Sarika Verma sudhir Sitaram Amritphale Satyabrata Das Council of Scientific and Industrial Research-Advanced Materials and Processes Research Institute Bhopal India

For the first time in the world advanced multi layered Red Mud and MWCNTs (ARMC) based EMI shielding material has been developed at CSIR-AMPRI, Bhopal. Red mud provides oxides of titanium and iron as precursor and the MWCNTs provides electrical conductivity characteristics necessary for making desired EMI shielding materials. The novel process involves unique designing of chemical compositions and mineralogical phases of red mud, MWCNTs together with appropriate additive and solvent which results in the simultaneous and synergistic chemical reactions among various constituents thereby forming tailored precursor powder. Further, the ceramic processing of tailored precursor powder in appropriate environment enables formation of advanced ARMC shielding material having a variety of ceramic phases with multi elemental compositions and multi layered crystal structures. The synthesized material was characterized by various techniques namely XRD, PL, FESEM, EDXA. The reflection loss (R. L.) of the sample was calculated based on the measured complex permittivity and permeability. The advanced ARMC material with thickness t = 1.5 mm showed a minimum R. L. of -35.5 Db at 14.0 GHz with a response band width of 1.8 GHz. Thus, the developed advanced ARMC material acts as a good EMI wave absorber.

关键词： Red Mud MWCNTs EMI Shielding Ceramic Processing Multilayered Structure

Do Continuous Flow LVADS Improve Diastolic Dysfunction?

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Open Journal of Organ Transplant Surgery 2014年第3期4卷 23-28页

作者： Nandini Nair sudhir Thotakura Enrique Gongora Memorial Cardiac and Vascular Institute Hollywood FL USA Scott and White Memorial Hospital and TAMHCS College of Medicine Temple TX USA

Background: Ventricular assist devices are now used as a bridge to recovery/decision/transplant or as destination therapy in end-stage heart failure. Continued improvements in technology and pump design have made implantation an easier process with reduced operative risks and pump-related adverse events. Considering the beneficial effects of these devices in the clinical setting, it seemed logical to address the long-term effect of the continuous flow pumps on diastolic dysfunction. Methods: This study addresses the effect of HeartMate IITM(HMII) support for 284+/-97 days on echocardiographic parameters of diastolic function. Data from fifteen patients was retrospectively studied status post left ventricular assist device (LVAD) implantation. The data at approximately 1-year post implantation was compared with that obtained prior to implantation. Statistical analyses were performed using the Microsoft Excel Program/MSExcel Stats. Echocardiographic measurements were carried out in accordance with the American Society of Echocardiography guidelines. Results: Of all the echocardiographic parameters assessed only E/Ea and calculated left atrial pressure (LAP) showed a statistically significant decrease. Two parameters that showed a trend towards significance are Ea (septal) and global functional index (p = 0.05). Conclusions: Continuous Flow LVAD support appears to improve diastolic dysfunction. This study has limitations in that we used a single type of continuous flow device (HeartMate IITM) and was conducted as a retrospective analysis. Further studies with larger populations and longer support are required to validate this finding.

关键词： Continuous Flow Device Diastolic Function HeartMate IITM Left Ventricular Assist Devise

尼泊尔及南侧邻区元古宙以来的构造-沉积演化

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地球科学 2022年第2期47卷 405-417页

作者：王正和谭富文 sudhir R. Ganesh N.T. 杜佰伟杨平中国地质调查局成都地质调查中心四川成都610081 自然资源部沉积盆地与油气资源重点实验室四川成都610081 Department of Mines and Geology KathmanduNepal

迄今,尼泊尔及其南侧邻区元古宙以来的构造-沉积演化尚缺乏系统性研究.为了促进区域地质认识,结合前人研究成果及新的研究发现,对尼泊尔低喜马拉雅带及以南的构造-沉积演化首次进行系统性总结与讨论.结果表明:尼泊尔低喜马拉雅带及以南... 详细信息

迄今,尼泊尔及其南侧邻区元古宙以来的构造-沉积演化尚缺乏系统性研究.为了促进区域地质认识,结合前人研究成果及新的研究发现,对尼泊尔低喜马拉雅带及以南的构造-沉积演化首次进行系统性总结与讨论.结果表明:尼泊尔低喜马拉雅带及以南与印度地盾北缘在地质历史中的构造-沉积演化息息相关,且自元古宙以来,发育了被动大陆边缘→陆内裂谷→被动大陆边缘→前陆盆地等不同构造演化阶段的沉积响应;尼泊尔西部的Dailekh群属于~1.8 Ga以前或前哥伦比亚超大陆之前的被动大陆边缘沉积;Vindhyan超群为下断上坳的陆内裂谷沉积,尼泊尔境内的Lakharpata群相当于下Vindhyan群;Gondwana超大陆裂解导致由北往南形成一系列初始发育时间越来越晚的裂谷盆地;Surkhet群至Siwalik群为被动大陆边缘至前陆盆地沉积,其中,Surkhet群Swat/Subathu组是喜马拉雅南侧地质历史上最后一套海相沉积地层,也是被动大陆边缘向前陆盆地转换期的沉积响应;Siwalik群大规模的磨拉石建造标志着喜马拉雅快速和大幅度隆升,该群沉积成岩后,印度-欧亚板块进一步的挤压作用导致了地质历史上迄今为止最后一次强烈的构造运动,形成MFT与Siwalik褶皱带,并奠定了喜马拉雅带现今构造格局.

关键词：喜马拉雅印度地盾尼泊尔构造-沉积演化大陆裂解构造地质

Compensated liver cirrhosis:Natural course and disease-modifying strategies

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World Journal of Methodology 2023年第4期13卷 179-193页

作者： Ramesh Kumar sudhir Kumar Sabbu Surya Prakash Department of Gastroenterology All India Institute of Medical SciencesPatna 801507India

Compensated liver cirrhosis(CLC)is defined as cirrhosis with one or more decompensating events,such as ascites,variceal haemorrhage,or hepatic *** with CLC are largely asymptomatic with preserved hepatic *** transition from CLC to decompensated cirrhosis occurs as a result of a complex interaction between multiple predisposing and precipitating *** first decompensation event in CLC patients is considered a significant turning point in the progression of cirrhosis,as it signals a drastic decline in median survival rates from 10-12 years to only 1-2 ***,early cirrhosis has the potential to regress as liver fibrosis is a dynamic *** the advent of effective non-invasive tools for detecting hepatic fibrosis,more and more patients with CLC are currently being *** offers clinicians a unique opportunity to properly manage such patients in order to achieve cirrhosis regression or,at the very least,prevent its *** are numerous emerging approaches for preventing or delaying decompensation in CLC patients.A growing body of evidence indicates that treating the underlying cause can lead to cirrhosis regression,and the use of non-selective beta-blockers can prevent decompensation by lowering portal ***,address-ing various cofactors(such as obesity,diabetes,dyslipidaemia,and alcoholism)and precipitating factors(such as infection,viral hepatitis,and hepatotoxic drugs)that have a detrimental impact on the natural course of cirrhosis may benefit patients with ***,high-quality data must be generated through well-designed and adequately powered randomised clinical trials to validate these diseasemodifying techniques for CLC *** article discussed the natural history of CLC,risk factors for its progression,and therapeutic approaches that could alter the trajectory of CLC evolution and improve outcomes.

关键词： Compensated cirrhosis Compensated advanced chronic liver disease Clinical decompensation Cirrhosis reversal Disease-modifying agents Acute-on-chronic liver failure

Giant Angiomyolipoma Masquerading as Perinephric Abscess: A Diagnostic Conundrum

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Open Journal of Urology 2021年第10期11卷 351-357页

作者： sudhir Jain Adiba Nizam Tariq Hameed Astha Nayyar Department of Surgery Maulana Azad Medical College and Associated Lok Nayak Hospital New Delhi India

Renal angiomyolipomas are the most common benign tumours of the kidney accounting for up to 1% of all renal masses. Giant angiomyolipomas which have a size greater than 10 centimetres are rare entities with few cases reported in literature. Small angiomyolipomas are usually a symptomatic and increasing size correlates with symptomatology. These are usually incidentally detected or when symptomatic may present with an abdominal lump, flank pain or hemorrhage. Herein, we report a rare case of 45-year-old lady with giant angiomyolipoma with clinical presentation indistinguishable from perinephric abscess. The case is rare with regards to the large size of tumour and the discordant presentation unusual for an angiomyolipoma.

关键词： Angiomyolipoma Giant Angiomyolipoma Perinephric Abscess

Role of Cardiac CT to Assess the Left Atrial Appendage for the Management of Atrial Fibrillation and Concomitant Cardioembolic Stroke

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Role of Cardiac CT to Assess the Left Atrial Appendage for t...

作者： sudhir Prasad Deo 重庆医科大学

学位级别：硕士

Atrial fibrillation(AF)and concomitant cardioembolic stroke are the most common problems stumble upon in clinical *** recent past,there has been significant progress in techniques and diagnostic tools aidingthe diagnosis and treatment of AF and concomitant cardioembolic *** ablation has gradually come out as the therapy of choice for symptomatic,recurrent,drug refractory *** techniques in catheter ablation of AF have led to the extension of the knowledge of left atrium *** left atrial appendage(LAA)is understood to be the key location of thrombus formation,mostly in patients with nonvalvular *** diagnosis of LAA thrombus is essential because the existence of thrombus is an absolute contraindication for ablation procedures in patients with AF due to the concomitant risk of thromboembolic *** echocardiogram(TEE)is regarded the gold standard modality in detecting LAA ***,this is a semi-invasive procedure with rare but potential life-threatening *** Computed Tomography(CCT)is an explicit,noninvasive substitute to TEE for the detection of LAA thrombi,mainly when delayed imaging acquisition protocols are *** the past decade,CCT has been tested for the detection of LAA thrombi using several imaging protocols and results are *** is also of primary significance during setting of LAA closure devices and several electrophysiological ***,CCT also have some ***,multicenter studies are neededto further clear up the role of CCT in assessment of *** focus should be given in reducing radiation dose and use of iodinated *** purpose of this article is to explore the potential use of CCT and highlight the data which are indicative of their efficacy assessing the *** will also shed light on anatomical,physiological and the pathophysiological aspect of *** will also compare CCT with other imaging modalities used for asse

关键词： Left Atrial Appendage Cardiac Computed Tomography Left Atrial Appendage Thrombus Transesophageal echocardiogram Atrial Fibrillation

Assessment of Day Time Anthesis Warming on Rice Cultivars under Varying Textured Sites of South-Western Punjab, India

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Agricultural Sciences 2021年第2期12卷 112-127页

作者： Navjot Kaur Dhillon sudhir Kumar Mishra Harinder Singh Directorate of Extension Education PAU Ludhiana India Punjab Agricultural University Regional Research Station (RRS) Faridkot India Punjab Agricultural University Farm Advisory Service Scheme (FASS) Faridkot India

Rice production is highly influenced by the prevailing weather conditions, physico-chemical properties of the soil, the yielding potential of cultivars besides, several crop management practices and inputs. To understand the performance of the tiller production of various paddy cultivars under varying soil texture sites of the south-western Punjab, four rice cultivars viz., PR121 (V1), PAU201 (V2), PR128 (V3) and PR129 (V4) were grown at three different locations having soil texture from light to heavy. Sowing of nursery was completed between May 15, 2019 and May 23, 2019 however, seedlings were transplanted in the well prepared field during 05-20 June, 2019. Results of the present study clearly depicted the role of weather parameters on plant height, effective tillers, grain yield and spikelet sterility in the rice crop. High temperatures have detrimental effects on fertility of rice varieties, regardless the transplanting time. Among different rice cultivars, sterility was the lowest (17.8%) in PR121 and the highest 42.6% in PR129. Apart from the varietal differences, the lowest sterility 28.4% recorded in medium textured soil was lowered by 21.5% and 27.8% than light and high textured soils. Cultivar PR121 produced 3.9%, 7.7% and 15% higher grain yield than PR128, PAU201 and PR129, respectively. The response of anthesis period thermal stress on spikelet sterility should be considered to develop the temperature tolerant varieties for addressing the climate change issues.

关键词： Rice Soil Texture Spikelet Sterility Thermal Stress

Successful minimal approach transcatheter aortic valve replacement in an allograft heart recipient 19 years post transplantation for severe aortic stenosis: A case report

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World Journal of Cardiology 2019年第8期11卷 209-212页

作者： Sravani Avula sudhir Mungee Marco A Barzallo Department of Cardiovascular Medicine University of Illinois College of Medicine at PeoriaPeoriaIL 61637United States Key Clinal Faculty Department of Cardiovascular MedicineUniversity of Illinois College of Medicine at PeoriaPeoriaIL 61637United States

BACKGROUND Aortic stenosis is one of the rare valvular complications in a transplanted *** the past 8 years,transcatheter approach for aortic valve replacement(TAVR)has been slowly evolving to be the preferred approach in these patient population when compared to the surgical *** report a second case in the United States with successful transfemoral minimal approach with minimal sedation for TAVR in a heart transplant recipient 19 years post transplantation for severe symptomatic calcified aortic *** SUMMARY We present a case of 73-year-old male who has undergone successful minimal approach transcatheter aortic valve replacement in an allograft *** had received orthotopic heart transplantation 19 years ago for non-ischemic *** up transthoracic echocardiograms as per routine protocol did not show any aortic valve disease until 15 years post *** valve was noted to be mildly sclerotic at that time and gradually progressed to severe symptomatic aortic stenosis over the next 4 *** had complaints of worsening shortness of breath that limited his functional *** his post heart transplantation period has been mostly uneventful except for allograft non occlusive vasculopathy and aortic *** Society of Thoracic Surgery risk score was 12.205%and he was considered to be a high-risk surgical candidate by *** was made to undergo transcatheter aortic valve *** With the improved survival of these patients,we think it is time to look intopathophysiology of valvular disease in transplant heart *** other unanswered questions include,underlying donor and recipient risk factors for valvular diseases in heart transplant recipients.

关键词： Transcatheter aortic valve replacement Heart transplant Minimal approach valve replacement Severe aortic stenosis Case report