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Stroke:Evolution of newer treatment modalities for acute ischemic stroke

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World Journal of Clinical Cases 2024年第28期12卷 6137-6147页

作者： Deb Sanjay Nag Amlan Swain Seelora Sahu Biswajit Sen vatsala Sadiya Parween Department of Anaesthesiology Tata Main HospitalJamshedpur 831001India Department of Anaesthesiology Manipal Tata Medical CollegeJamshedpur 831017India

Acute ischemic stroke is one of the leading causes of morbidity and mortality *** of cerebral blood flow to affected ischemic areas has been the cornerstone of therapy for patients for eligible patients as early diagnosis and treatment have shown improved ***,there has been a paradigm shift in the management approach over the last decade,and with the emphasis currently directed toward including newer modalities such as neuroprotection,stem cell treatment,magnetic stimulation,anti-apoptotic drugs,delayed recanali-zation,and utilization of artificial intelligence for early diagnosis and suggesting algorithm-based management protocols.

关键词： Acute ischemic stroke Neuroprotection Treatment Neurocritical care Thrombolytic therapy Reperfusion injury Oxidative stress

Endoscopic management of a new entity-plastobezoar:A case report and review of literature

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World Journal of Gastroenterology 2006年第41期12卷 6730-6733页

作者： SP Misra Manisha Dwivedi vatsala Misra Department of Gastroenterology and Pathology Motilal Nehru Medical College Allahabad 211 001India

Foreign bodies and bezoars are commonly encountered in children. We describe a child aged 11 years who ingested large amounts of plastic material used for knitting chairs and charpoys. The conglomerate of plastic threads, entrapped food material and other debris, formed a huge mass occupying the whole stomach. Chronic irritation of the gastric antral mucosa led to ulceration and formation of hyperplastic polyps. We labeled this new entity as a “plastobezoar”. The entire bezoar could be removed endoscopically.

关键词： Bezoar Stomach Gastric Endoscopy Foreign body Gastric polyps Plastic

Ileoscopy in patients with ileocolonic tuberculosis

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World Journal of Gastroenterology 2007年第11期13卷 1723-1727页

作者： SP Misra vatsala Misra Manisha Dwivedi Department of Gastroenterology and Pathology Moti Lal Nehru Medical College University of Allahabad Allahabad 211 001 India

AIM: To study the role of retrograde terminal ileoscopy in patients suspected to have ileocolonic tuberculosis. METHODS: A retrospective analysis was performed for patients undergoing colonoscopy for suspected ileocolonic tuberculosis between January 2000 and June 2004, in whom retrograde ileoscopy had been performed. Only patients diagnosed with tuberculosis on the basis of histological findings of either a caseating granuloma or those having non-caseating granuloma or a collection of epithelioid cells at a minimum of one endoscopic lesion (either in the colon or the terminal ileum) on histology with good responses to conventional anti-tuberculous drugs were enrolled for the study. RESULTS: Fifty-three patients were included. The terminal ileum was involved in only 11 patients. Eight of these patients had involvement of the cecum too. Two patients had ileal lesions without cecal involvement; however, lesions were noted in the ascending colon. In one patient the whole colon was normal and only the terminal ileum showed nodularity and ulceration. Histological examination of the ileal biopsies obtained from the ileal lesions showed noncaseating granulomas in five, collection of epithelioid cells in four and nonspecific histology in two patients. Mucosal biopsies obtained from the lesion in the terminal ileum, in the patient in whom mucosal abnormality was observed to be confined to the ileum, showed noncaseating granulomas. In two other patients the ileal biopsies alone showed histological evidence of tuberculosis with biopsies from the colonic lesions showing non-specific inflammatory changes only. CONCLUSION: Retrograde ileoscopy should be performed in all patients undergoing colonoscopy for suspected ileocolonic tuberculosis. In some patients only the terminal ileum may be involved and histological examination may reveal evidence of tuberculosis only from the lesions in the terminal ileum. This approach would lead to additional lesions being picked up andincreasing

关键词： Tuberculosis Ileoscopy Colonoscopy

Ileocecal masses in patients with amebic liver abscess:Etiology and management

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World Journal of Gastroenterology 2006年第12期12卷 1933-1936页

作者： Sri Prakash Misra vatsala Misra Marisha Dwivedi Department of Gastroenterology and Pathology Moti Lal Nehru Medical CollegeAllahabad 211001India

AIM. To assess the causes of ileocecal mass in patients with amebic liver abscess. METHODS： Patients with amebic liver abscess and ileocecal mass were carefully examined and investigated by contrast-enhanced CT scan followed by colonoscopy and histological examination of biopsy materials from lesions during colonoscopy. RESULTS： Ileocecal masses were found in seventeen patients with amebic liver abscess. The cause of the mass was ameboma in 14 patients, cecal tuberculosis in 2 patients and adenocarcinoma of the cecum in 1 patient. Colonic ulcers were noted in five of the six （83%） patients with active diarrhea at presentation. The ileocecal mass in all these patients was ameboma. Ulcers were seen in only one of the 11 （9%） patients without diarrhea. The difference was statistically significant from the group with diarrhea （P〈 0.005）. CONCLUSION： Ileocecal mass is not an uncommon finding in patients with amebic liver abscess. Although, the ileocecal mass is due to ameboma formation in most cases, it should not be assumed that this is the case in all patients. Colonoscopy and histological examination of the target biopsies are mandatory to avoid missing a more sinister lesion.

关键词： Amebiasis Ameboma Colon Colonoscopy Diagnosis

Helicobacter pylori and gastric cancer: Indian enigma

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World Journal of Gastroenterology 2014年第6期20卷 1503-1509页

作者： vatsala Misra Renu Pandey Sri Prakash Misra Manisha Dwivedi Department of Pathology Moti Lal Nehru Medical College Pandey Research 3312 Jackson Blvd Department of Gastroenterology and Hepatology MLN Medical College

Helicobacter pylori (H. pylori) is a gram negative microaerophilic bacterium which resides in the mucous linings of the stomach. It has been implicated in the causation of various gastric disorders including gastric cancer. The geographical distribution and etiology of gastric cancer differ widely in different geographical regions and H. pylori, despite being labeled as a grade I carcinogen, has not been found to be associated with gastric cancer in many areas. Studies in Asian countries such as Thailand, India, Bangladesh, Pakistan, Iran, Saudi Arabian countries, Israel and Malaysia, have reported a high frequency of H. pylori infection co-existing with a low incidence of gastric cancer. In India, a difference in the prevalence of H. pylori infection and gastric cancer has been noted even in different regions of the country leading to a puzzle when attempting to find the causes of these variations. This puzzle of H. pylori distribution and gastric cancer epidemiology is known as the Indian enigma. In this review we have attempted to explain the Indian enigma using evidence from various Indian studies and from around the globe. This review covers aspects of epidemiology, the various biological strains present in different parts of the country and within individuals, the status of different H. pylori-related diseases and the molecular pathogenesis of the bacterium.

关键词： Gastric cancer Gastric diseases Helicobacter pylori p53 mutation Carcinogen

Characterization and validation of a chronic retinal neovascularization rabbit model by evaluating the efficacy of anti-angiogenic and anti-inflammatory drugs

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International Journal of Ophthalmology(English edition) 2022年第1期15卷 15-22页

作者： Sandeep Kumar John Quach Nicholas Cook Glenwood Gum vatsala Naageshwaran Department of Ophthalmology Absorption Systems:a Pharmaron company7901 Vickers StSan DiegoCA 92111USA

AIM:To establish a rabbit model with chronic condition of retinal neovascularization(RNV)induced by intravitreal(IVT)injection of DL-2-aminoadipic acid(DL-AAA),a retinal glial(Mül er)cell toxin,extensive characterization of DL-AAA induced angiographic features and the suitability of the model to evaluate anti-angiogenic and anti-inflammatory therapies for ocular vascular ***:DL-AAA(80 mmol/L)was administered IVT into both eyes of Dutch Belted *** DL-AAA delivery,clinical ophthalmic examinations were performed weekly following modified Mc Donald-Shadduck Scoring *** fundus photography,fluorescein angiography(FA),and optical coherence tomography(OCT)procedures were performed every 2 or 4 wk until stable retinal vascular leakage was *** stable retinal leakage(12 wk post DL-AAA administration)was established,anti-vascular endothelial growth factor(VEGF)(bevacizumab,ranibizumab and aflibercept)and anti-inflammatory(triamcinolone,TAA)drugs were tested for their efficacy after IVT *** angiograms were scored before and after treatment following a novel grading system,developed for the DL-AAA rabbit ***:Post DL-AAA administration,eyes were presented with moderate to severe retinal/choroidal inflammation which was accompanied by intense vitreous flare and presence of inflammatory cells in the vitreous *** hemorrhage was restricted to the tips of neo-retinal *** revealed maximum retinal vascular leakage at 2 wk after DL-AAA injection and then persisted as evidenced by stable mean FA scores in weeks 8 and *** vascular angiographic and tomographic features were stable and consistent up to 36 mo among two different staggers induced for RNV at two different *** 7,mean FA scores showed that 1μg/eye of bevacizumab,ranibizumab,aflibercept and 2μg/eye of TAA suppress 65%,90%,100%and 50%retinal vascular leakage,*** 30,bevacizumab and TAA continued to show 66%and 44%su

关键词： DL-2-aminoadipic acid chronic wet agerelated macular degeneration retinal neovascularization animal model anti-vascular endothelial growth factor drugs fluorescein angiography

Deep Learning Based Automated Diagnosis of Skin Diseases Using Dermoscopy

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Computers, Materials & Continua 2022年第5期71卷 3145-3160页

作者： vatsala Anand Sheifali Gupta Deepika Koundal Shubham Mahajan Amit Kant Pandit Atef Zaguia Chitkara University Institute of Engineering and Technology Chitkara UniversityPunjabIndia Department of Systemics School of Computer ScienceUniversity of Petroleum&Energy StudiesDehradunUttrakhandIndia School of Electronics&Communication Shri Mata Vaishno Devi UniversityKatra182320India Department of Computer Science College of Computers and Information TechnologyTaif UniversityTaif21944Saudi Arabia

Biomedical image analysis has been exploited considerably by recent technology involvements,carrying about a pattern shift towards‘automation’and‘error free diagnosis’classification methods with markedly improved accurate diagnosis productivity and cost *** paper proposes an automated deep learning model to diagnose skin disease at an early stage by using Dermoscopy *** proposed model has four convolutional layers,two maxpool layers,one fully connected layer and three dense *** the convolutional layers are using the kernel size of 3∗3 whereas the maxpool layer is using the kernel size of 2∗*** dermoscopy images are taken from the HAM10000 *** proposed model is compared with the three different models of ResNet that are ResNet18,ResNet50 and *** models are simulated with 32 batch size and Adadelta *** proposed model has obtained the best accuracy value of 0.96 whereas the ResNet101 model has obtained 0.90,the ResNet50 has obtained 0.89 and the ResNet18 model has obtained value as ***,features obtained from the proposed model are more capable for improving the classification performance of multiple skin disease *** model can be used for early diagnosis of skin disease and can also act as a second opinion tool for dermatologists.

关键词： Dermoscopy images CNN deep learning classification optimizer ResNet diagnosis skin disease

Carcinogenic Helicobacter pylori in gastric pre-cancer and cancer lesions: Association with tobacco-chewing

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World Journal of Gastroenterology 2014年第22期20卷 6860-6868页

作者： Arvind Pandey Satyendra Chandra Tripathi Sutapa Mahata Kanchan Vishnoi Shirish Shukla Sri Prakash Misra vatsala Misra Suresh Hedau Ravi Mehrotra Manisha DwivediZ Alok C Bharti Divisionof Molecular Oncology Institute of Cytology and Preventive Oncology (ICMR)Noida 201301India Center for Biotechnology University of AllahabadAllahabad 211002India Clinical Cancer Prevention-Research UT MD Anderson Cancer CenterHoustonTX 77030United States Department of Gastroenterology MLN Medical CollegeAllahabad 211002India Department of Pathology MLN Medical CollegeAllahabad 211002India

AIM: To investigate the low gastric cancer incidence rate relative to the highly prevalent Helicobacter pylori (H. pylori) infection; data relevant to H. pylori infection during gastric carcinogenesis in Indian patien... 详细信息

关键词： UreC CagA Dysplasia Intestinal metaplasia Gastric adenocarcinoma Tobacco chewing