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Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease

World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 44-54页

作者： Suprabhat Giri Prajna Anirvan Sumaswi Angadi Ankita Singh Anurag Lavekar Department of Gastroenterology and Hepatology Kalinga Institute of Medical SciencesBhubaneswar 751024OdishaIndia Department of Gastroenterology Kalinga Gastroenterology FoundationCuttack753001OdishaIndia Department of Gastroenterology Nizam’s Institute of Medical SciencesHyderabad 500082TelanganaIndia Department of Gastroenterology Seth GS Medical College and KEM HospitalMumbai 400012MaharashtraIndia Department of Gastroenterology Sagar HospitalBengaluru 560041KarnatakaIndia

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced ***,characterized by decreased muscle strength and mass,shares common pathophysiological traits with *** association exists between sarcopenia and increased NAFLD ***,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain *** To analyze the prevalence and outcomes of sarcopenia in patients with *** We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June *** included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse *** also used the Newcastle-Ottawa scale for quality *** Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for *** was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such *** in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and *** This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD *** variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent *** review demonstrates the multidimension

关键词： Non-alcoholic fatty liver disease Sarcopenia Hepatic fibrosis Low muscle mass Hand grip strength Bioelectric impedance analysis Dual X-ray absorptiometry

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Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 699-715页

作者： Ankit Agarwal Sagnik Biswas Shekhar Swaroop Arnav Aggarwal Ayush Agarwal Gautam Jain Anshuman Elhence Arun Vaidya Amit Gupte Ravi Mohanka Ramesh Kumar Ashwani Kumar Mishra Shivanand Gamanagatti Shashi Bala Paul Subrat Kumar Acharya Akash Shukla Shalimar Department of Gastroenterology and Human Nutrition All India Institute of Medical SciencesNew Delhi 110029DelhiIndia Department of Gastroenterology Seth Gordhandas Sunderdas Medical College and KEM HospitalMumbai 400012MaharashtraIndia Department of Gastroenterology Sir HN Reliance Foundation HospitalMumbai 400004India Department of Liver Transplant and HPB Sir HN Reliance Foundation HospitalMumbai 400004India Department of Gastroenterology All India Institute of Medical SciencesPatna 801507India Professor of Biostatistics National Drug Dependence Treatment Centre(NDDTC)All India Institute of Medical SciencesNew Delhi 110029India Department of Radiodiagnosis All India Institute of Medical SciencesNew Delhi 110029DelhiIndia

BACKGROUND There is scant literature on hepatocellular carcinoma(HCC)in patients with Budd-Chiari syndrome(BCS).AIM To assess the magnitude,clinical characteristics,feasibility,and outcomes of treatment in *** A total of 904 BCS patients from New Delhi,India and 1140 from Mumbai,India were *** prevalence and incidence of HCC were determined,and among patients with BCS-HCC,the viability and outcomes of interventional therapy were *** In the New Delhi cohort of 35 BCS-HCC patients,18 had HCC at index presentation(prevalence 1.99%),and 17 developed HCC over a follow-up of 4601 person-years,[incidence 0.36(0.22-0.57)per 100 person-years].BCS-HCC patients were older when compared to patients with BCS alone(P=0.001)and had a higher proportion of inferior vena cava block,cirrhosis,and long-segment vascular *** median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up(13029 ng/mL vs 500 ng/mL,P=0.01).Of the 35 BCS-HCC,26(74.3%)underwent radiological interventions for BCS,and 22(62.8%)patients underwent treatment for HCC[transarterial chemoembolization in 18(81.8%),oral tyrosine kinase inhibitor in 3(13.6%),and transarterial radioembolization in 1(4.5%)].The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo(P=0.0001).In contrast to the New Delhi cohort,the Mumbai cohort of BCS-HCC patients were predominantly males,presented with a more advanced HCC[Barcelona Clinic Liver Cancer C and D],and 2 patients underwent liver *** HCC is not uncommon in patients with *** interventions and liver transplantation are feasible in select primary BCS-HCC patients and may improve outcomes.

关键词： Budd chiari syndrome Cancer Cirrhosis Thrombosis Liver Varices Transarterial chemoembolization Hepatic venous outflow tract obstruction

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Pathology of atherosclerotic coronary artery disease in the young Indian population

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Forensic Sciences Research 2019年第3期4卷 241-246页

作者： Pradeep Vaideeswar Shashank Tyagi Saranya Singaravel Department of Pathology(Cardiovascular&Thoracic Division) Seth GS Medical College&KEM HospitalMumbaiIndia Department of Forensic Medicine&Toxicology Seth GS Medical College&KEM HospitalMumbaiIndia

Atherosclerotic coronary artery disease (CAD) is of great concern in young adults because of its potential to cause great *** arena of cardiology has gained importance in South Asian countries,particularly India due to increased prevalence that is related to traditional risk factors,altered life styles and inherent risk *** this study,we sought to evaluate,at autopsy,the pathology of atherosclerotic CAD in young patients with ischemic heart disease (IHD).A 10-year retrospective autopsy-based study was carried out in a large tertiary-care centre and patients aged ≤45 years with IHD were *** of 545 autopsied cases of IHD,95 patients (17.4%) were *** these 95 patients,84 (88.4%) had IHD related to atherosclerotic CAD;the youngest patient was 18years *** there was sole involvement of left anterior descending artery and the presence of fibrous *** of the plaque morphology,the commonest complication was thrombosis produced by plaque erosion seen in 36.9% of *** coronary insufficiency was noted in 52 patients (61.9%),while healed infarctions were surprisingly noted in 28 patients (33.3%).Screening for IHD in the young population may help to improve prognosis by detecting subclinical disease,although more studies are necessary to establish reference limits for this young *** research must also focus on treatment concerns that are specific to young patients.

关键词： Forensic sciences forensic pathology ischemic heart disease coronary atherosclerosis young adults sudden cardiac death

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Bone mineral density and disorders of mineral metabolism in chronic liver disease

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World Journal of Gastroenterology 2009年第28期15卷 3516-3522页

作者： Joe George Hosahithlu K Ganesh Shrikrishna Acharya Tushar R Bandgar Vyankatesh Shivane Anjana Karvat Shobna J Bhatia Samir Shah Padmavathy S Menon Nalini Shah Department of Endocrinology Seth G.S. Medical College and KEM Hospital Department of Gastroenterology Seth G.S Medical College and KEM Hospital Department of Gastroenterology Jaslok Hospital

AIM： To estimate the prevalence and identify the risk factors for metabolic bone disease in patients with cirrhosis. METHODS： The study was performed on 72 Indian patients with cirrhosis （63 male, 9 female; aged 〈 50 years）. Etiology of cirrhosis was alcoholism （n = 37）, hepatitis B （n = 25） and hepatitis C （n = 10）. Twenty-three patients belonged to Child class A, while 39 were in class B and 10 in class C. Secondary causes for metabolic bone disease and osteoporosis were ruled out. Sunlight exposure, physical activity and dietary constituents were calculated. Complete metabolic profiles were derived, and bone mineral density （BMD） was measured using dual energy X ray absorptiometry. Low BMD was defined as a Z score below -2. RESULTS： Low BMD was found in 68% of patients. Lumbar spine was the most frequently and severely affected site. Risk factors for low BMD included low physical activity, decreased sunlight exposure, and low lean body mass. Calcium intake was adequate, with unfavorable calcium： protein ratio and calcium： phosphorus ratio. Vitamin D deficiency was highly prevalent （92%）. There was a high incidence of hypogonadism （41%）. Serum estradiol level was elevated significantly in patients with normal BMD. Insulin-like growth factor （IGF） 1 and IGF binding protein 3 levels were below the age-related normal range in both groups. IGF-1 was significantly lower in patients with low BMD. Serum osteocalcin level was low （68%） and urinary deoxypyridinoline to creatinine ratio was high （79%）, which demonstrated low bone formation with high resorption. CONCLUSION： Patients with cirrhosis have low BMD. Contributory factors are reduced physical activity, low lean body mass, vitamin D deficiency and hypogonadism and low IGF-1 level.

关键词： Bone mineral density Liver disease Chronic disease Cirrhosis Bone mineral metabolism Hepatic osteodystrophy

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Early Infant Diagnosis (EID) of HIV: An Experience at a Tertiary Care hospital in India

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World Journal of AIDS 2012年第1期2卷 1-5页

作者： Supriya M. Paranjpe Rajkunwar S. Phakade Nayana A. Ingole Preeti R. Mehta Department of Microbiology Seth GS Medical College & KEM Hospital Mumbai India

Introduction: Early infant diagnosis (EID) confers substantial benefit to HIV infected and HIV uninfected infants and to programmes providing prevention of mother to child transmission (MTCT), but has been challenging to implement in resource limited settings. Objectives: To find out the rate of perinatal transmission in infants born to HIV positive mothers, to study the effect of various predisposing factors on HIV transmission and to evaluate the utility of dried blood spot (DBS) specimen for EID of HIV. Methods: Infants born to HIV positive mothers were tested according to National AIDS Control Organization (NACO) guidelines. Infants of 6 weeks to 6 months of age (n = 84) were diagnosed by DBS PCR;DBS positive results were confirmed by whole blood PCR. Infants 6 - 18 months (n = 47) were subjected to antibody test and if positive were confirmed by DNA PCR. Detailed history including type of delivery, single dose nevirapine (SDN) and breast feeding was taken. Results: The HIV transmission rate was 10.69%. In children ≤ 6 months, who did not receive SDN the positivity was 44.44% (4/9) whereas in those who received SDN it was 6.66% (5/75), (P = 0.0063). In children > 6 months the positivity rate was significantly higher in breast fed 42.85% (3/7) as compared to non breast fed 5% (2/40) children (P = 0.0187). There was 100% concordance between DBS and whole blood PCR. Conclusions: In resource limited settings, though HAART should be considered to further reduce MTCT during pregnancy and to prevent the emergence of resistance, SDN should be kept as an option for mothers coming directly in labour. Also, extended ART should be provided to mothers who want to breast feed their children. Early infant diagnosis using DBS specimens will further reduce the morbidity and mortality in these children.

关键词： Early Infant Diagnosis (EID) Dried Blood Spot (DBS) Single Dose Nevirapine (SDN) Mother to Child Transmission of HIV (MTCT)

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Management of Aluminium Phosphide Poisoning with a Holistic Approach at NHL Municipal medical college and hospital,Ahmedabad

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Journal of Forensic Science and Medicine 2022年第1期8卷 6-10页

作者： Dheeraj B.More Mahendra N.Wankhede Harshad Malve Department of Cardiology Seth GS Medical College and KEM HospitalMumbaiMaharashtraIndia Department of Forensic Medicine HBT Medical College and Cooper HospitalMumbaiMaharashtraIndia Department of Pharmacology Vedanta Institute of Medical SciencesDahanuMaharashtraIndia

Background:Aluminium phosphide is a usual ingredient of rodenticide and its poisoning is a common cause of suicide in *** and symptoms of its toxicity are *** toxic effects are mainly due to liberation of phosphine gas which causes cell hypoxia due to inhibition of oxidative phosphorylation and results in circulatory *** and Objectives:Mortality with aluminium phosphide is high as there is no specific antidote available *** hence we need to explore holistic treatment approach to improve patient outcomes in aluminium phosphide *** and Methods:Present study discusses a holistic treatment approach to aluminium phosphide poisoning in this retrospective analysis of 100 cases from a tertiary care hospital in this ***:Around 65%patients survived due to the holistic treatment approach and correct treatment protocol with supportive ***:The aggressive and appropriate management with continuous hemodynamic monitoring and holistic treatment approach can reduce the mortality significantly in aluminium phosphide poisoning.

关键词： Aluminum phosphide toxicity holistic treatment rodenticide poisoning

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Management of complications of Medpor implants in rhinoplasty

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Plastic and Aesthetic Research 2017年第3期4卷 54-56页

作者： Kapil Agrawal Raghav Shrotriya Department of Plastic and Reconstructive Surgery Seth GS Medical College and KEM HospitalMumbai 400012India

Sir, Implants are widely used currently in aesthetic surgery to provide augmentation or support. To provide better stability, alloplastic materials such as porous high-density polyethylene (Medpor?) implants have been... 详细信息

关键词： Management complications of Medpor rhinoplasty

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HIV Diagnosis in Resource Constrained Setting: How Good Is the Current Algorithm?

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World Journal of AIDS 2014年第1期4卷 45-51页

作者： Nayana Ingole Purva Sarkate Supriya Paranjpe Rahul Sarode Sameer Shinde Preeti Mehta Department of Microbiology Seth G S Medical College and KEM Hospital Parel Mumbai India

Background: The conventional HIV testing algorithm in most of the developed countries consists of two tests: an HIV enzyme immunoassay capable of identifying HIV-1 and HIV-2 antibodies and a confirmatory HIV-1 Western blot or immunofluorescence assay. However, the current algorithm for HIV diagnosis in India uses three sequential antibody assays. There has always been doubt regarding the benefits of this algorithm. Objective: To determine the utility of the current diagnostic algorithm and to find out the proportion of indeterminate or discrepant results. Methods: Retrospective analysis of HIV antibody testing data was carried out over a period of five years after institutional ethics committee approval. The specimens positive with the screening test and negative with both the supplemental tests were labeled as discrepant. Specimens positive with any of the two tests (screening and one of the supplemental tests) and negative with the remaining supplemental test were labeled as indeterminate. These indeterminate specimens were confirmed by immunoblotting. Results: A total of 141,296 samples were tested. Of these, 71 (0.05%) samples were indeterminate and 292 (0.21%) were discrepant. Western blot was done on 60 indeterminate samples of which 10 (16.67%) were positive for HIV 1 antibodies, 14 (23.33%) were negative for HIV antibodies and 36 (60%) had indeterminate result. Conclusion: In view of the low numbers of indeterminate and discrepant results, the current algorithm appears to be appropriate in our resource constrained setting. However, the algorithm for HIV testing should also include DNA PCR testing facility to resolve western blot indeterminate results.

关键词： HIV Indeterminate Discrepant Rapid Tests Western Blot Algorithm

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Assessment of the histological state of the healing wound

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Plastic and Aesthetic Research 2015年第1期2卷 239-242页

作者： Akriti Gupta Pramod Kumar Department of Pathology Seth GS Medical College and KEM HospitalMumbai 400012MaharashtraIndia Department of Plastic Surgery King Abdulaziz Specialist HospitalSakaka 42421Al-JoufSaudi Arabia

The dynamic process of wound healing has various phases,and the knowledge of which is essential for identification of the pathology involved in a chronic intractable *** instruments for the assessment of wound healing have been described,primarily for clinical assessment of the ***,very few instruments are currently available for histological grading of the *** aim of this article is to review all available literature from 1993 to 2014 on the objective histological scoring of the state of wound *** review article emphasizes the importance of histological grading of wounds based on the different parameters from each phase of wound healing and the need for an ideal grading system in order to help assessment of wound *** parameter chosen in an experimental model should be defined by the scientific question,the underlying hypothesis and the pathogenesis of the disease.

关键词： Experimental wound assessment grading of wound histopathologic grading wound assessment wound grading wound healing wound histology

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Review of surgical strategies in gastric cancer

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Oncology and Translational Medicine 2023年第5期9卷 199-205页

作者： Soumil Vyas Avinash Supe H.N.Reliance hospital MumbaiIndia seth G.S.medical college and kem hospital ParelMumbaiIndia

Successful and effective management of gastric cancer involves a multidisciplinary *** and appropriate staging of gastric cancer is mandatory to define the optimum treatment *** surgery achieving R0 resection is considered potentially *** remains the cornerstone of multimodal *** is a well-defined role for neoadjuvant and adjuvant chemotherapy *** and chemotherapy combinations have improved tumor response rates,which have translated into more effective surgery and reduced local recurrences and improved long-term survivals.

关键词： Gastric cancer Lymphadenectomy Surgical treatment

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