1.Relevance of intra-abdominal pressure monitoring in non-operative management of patients with blunt liver and splenic injuries.
Vivek KUMAR ; Ramesh VAIDYANATHAN ; Dinesh BAGARIA ; Pratyusha PRIYADARSHINI ; Abhinav KUMAR ; Narendra CHOUDHARY ; Sushma SAGAR ; Amit GUPTA ; Biplab MISHRA ; Mohit JOSHI ; Kapil Dev SONI ; Richa AGGARWAL ; Subodh KUMAR
Chinese Journal of Traumatology 2025;28(4):307-312
PURPOSE:
Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury.
METHOD:
A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries. Hemodynamically unstable patients or those on ventilators were excluded, as well as patients who suffered significant head, spinal cord, and/or bladder injuries. The study predominantly included males (83.9%) with a mean age of 32.5 years. IAP was monitored continuously and the relation of IAP with various parameters, interventions, and outcomes were measured. Data were summarized as frequency (percentage) or mean ± SD or median (Q1, Q3) as indicated. χ2 or Fisher's exact test was used for categorical variables, while for continuous variables parametric (independent t-test) or nonparametric tests (Wilcoxon rank sum test) were used as appropriate. Clinical and laboratory correlates of IAP < 12 with p < 0.200 in the univariable logistic regression analysis were included in the multivariable analysis. A p < 0.05 was used to indicate statistical significance.
RESULTS:
Intra-abdominal hypertension (IAH) was seen in 19.0% of the study population. IAH was strongly associated with a high injury severity score (p < 0.001), and other physiological parameters like respiratory rate (p < 0.001), change in abdominal girth (AG) (p < 0.001), and serum creatinine (p < 0.001). IAH along with the number of solid organs involved, respiratory rate, change in AG, and serum creatinine was associated with the intervention, either operative or non-operative (p = 0.001, p = 0.002, p < 0.001, p < 0.001, p = 0.013, respectively). On multivariable analysis, IAP (p = 0.006) and the mean change of AG (p = 0.004) were significantly associated with the need for intervention.
CONCLUSION
As a part of NOM, IAP should be monitored as a continuous vital. However, the decision for any intervention, either operative or non-operative cannot be guided by IAP values alone.
Humans
;
Male
;
Adult
;
Female
;
Wounds, Nonpenetrating/physiopathology*
;
Spleen/injuries*
;
Prospective Studies
;
Cross-Sectional Studies
;
Liver/injuries*
;
Middle Aged
;
Monitoring, Physiologic/methods*
;
Pressure
;
Abdominal Injuries/physiopathology*
;
Intra-Abdominal Hypertension
;
Young Adult
2.Polygenic Risk Score for Cardiovascular Diseases in Artificial Intelligence Paradigm: A Review
Narendra N KHANNA ; Manasvi SINGH ; Mahesh MAINDARKAR ; Ashish KUMAR ; Amer M. JOHRI ; Laura MENTELLA ; John R LAIRD ; Kosmas I. PARASKEVAS ; Zoltan RUZSA ; Narpinder SINGH ; Mannudeep K. KALRA ; Jose Fernandes E. FERNANDES ; Seemant CHATURVEDI ; Andrew NICOLAIDES ; Vijay RATHORE ; Inder SINGH ; Jagjit S. TEJI ; Mostafa AL-MAINI ; Esma R. ISENOVIC ; Vijay VISWANATHAN ; Puneet KHANNA ; Mostafa M. FOUDA ; Luca SABA ; Jasjit S. SURI
Journal of Korean Medical Science 2023;38(46):e395-
Cardiovascular disease (CVD) related mortality and morbidity heavily strain society. The relationship between external risk factors and our genetics have not been well established.It is widely acknowledged that environmental influence and individual behaviours play a significant role in CVD vulnerability, leading to the development of polygenic risk scores (PRS). We employed the PRISMA search method to locate pertinent research and literature to extensively review artificial intelligence (AI)-based PRS models for CVD risk prediction.Furthermore, we analyzed and compared conventional vs. AI-based solutions for PRS. We summarized the recent advances in our understanding of the use of AI-based PRS for risk prediction of CVD. Our study proposes three hypotheses: i) Multiple genetic variations and risk factors can be incorporated into AI-based PRS to improve the accuracy of CVD risk predicting. ii) AI-based PRS for CVD circumvents the drawbacks of conventional PRS calculators by incorporating a larger variety of genetic and non-genetic components, allowing for more precise and individualised risk estimations. iii) Using AI approaches, it is possible to significantly reduce the dimensionality of huge genomic datasets, resulting in more accurate and effective disease risk prediction models. Our study highlighted that the AI-PRS model outperformed traditional PRS calculators in predicting CVD risk. Furthermore, using AI-based methods to calculate PRS may increase the precision of risk predictions for CVD and have significant ramifications for individualized prevention and treatment plans.
3.Clinical behaviour and outcome in pediatric glioblastoma: current scenario
Aditya Kumar SINGLA ; Renu MADAN ; Kirti GUPTA ; Shikha GOYAL ; Narendra KUMAR ; Sushant Kumar SAHOO ; Deepak K. UPPAL ; Chirag K. AHUJA
Radiation Oncology Journal 2021;39(1):72-77
Pediatric glioblastoma (pGBM) is a rare entity accounting for only approximately 3% of all childhood brain tumors. Treatment guidelines for pGBM have been extrapolated from those in adult glioblastoma. Rarity of pGBM and underrepresentation of pediatric population in major studies precludes from defining the ideal treatment protocol for these patients. Maximum safe resection is performed in most of the cases followed by postoperative radiotherapy in children over 3 years of age. Benefit of temozolomide is unclear in these patients. Here, we present the clinicopathological details and outcome of six pGBM patients treated at our institute in 2018–2019.
4.Clinical behaviour and outcome in pediatric glioblastoma: current scenario
Aditya Kumar SINGLA ; Renu MADAN ; Kirti GUPTA ; Shikha GOYAL ; Narendra KUMAR ; Sushant Kumar SAHOO ; Deepak K. UPPAL ; Chirag K. AHUJA
Radiation Oncology Journal 2021;39(1):72-77
Pediatric glioblastoma (pGBM) is a rare entity accounting for only approximately 3% of all childhood brain tumors. Treatment guidelines for pGBM have been extrapolated from those in adult glioblastoma. Rarity of pGBM and underrepresentation of pediatric population in major studies precludes from defining the ideal treatment protocol for these patients. Maximum safe resection is performed in most of the cases followed by postoperative radiotherapy in children over 3 years of age. Benefit of temozolomide is unclear in these patients. Here, we present the clinicopathological details and outcome of six pGBM patients treated at our institute in 2018–2019.
5. One-pot synthesis of silver nanocomposites from Achyranthes aspera: An eco-friendly larvicide against Aedes aegypti L.
Aarti SHARMA ; Pushplata TRIPATHI ; Sarita KUMAR
Asian Pacific Journal of Tropical Biomedicine 2020;10(2):54-64
Objective: To formulate silver nanocomposites from Achyranthes aspera leaf extracts and evaluate its larvicidal activity against Aedes aegypti. Methods: The silver nanocomposites were synthesized from Achyranthes aspera leaf extracts. The process was optimized and traced through UV-visible and photon correlation spectroscopy. The larvicidal potential of silver nanocomposites of Achyranthes aspera leaf extracts was assessed against the early fourth instars of Aedes aegypti and three non-target organisms. Furthermore, the most effective and eco-safe nanocomposite was characterized by different biophysical techniques including scanning electron microscopy (SEM), energy dispersive X-ray (EDX) spectroscopy, transmission electron microscopy (TEM), X-ray diffraction (XRD) and Fourier transform-infrared spectroscopy (FT-IR). Results: The formulated silver nanocomposites exhibited efficient larvicidal efficacy against Aedes aegypti. Bioassay with silver nanocomposites formulated using different AgNO 3 concentrations (3, 4, and 5 mM) revealed respective LC
6.Solitary osteochondroma in the body of the pubic bone: a cadaveric case report.
Satheesha B. NAYAK ; Naveen KUMAR ; Srinivasa Rao SIRASANAGANDLA ; Srilatha Parampalli SRINIVAS ; Narendra PAMIDI ; Surekha D. SHETTY
Anatomy & Cell Biology 2018;51(2):136-138
Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.
Cadaver*
;
Diagnosis
;
Facial Bones
;
Osteochondroma*
;
Periosteum
;
Pubic Bone*
;
Skeleton
;
Skull
7.Empirical model for estimating dengue incidence using temperature, rainfall, and relative humidity: a 19-year retrospective analysis in East Delhi.
Vishnampettai G RAMACHANDRAN ; Priyamvada ROY ; Shukla DAS ; Narendra Singh MOGHA ; Ajay Kumar BANSAL
Epidemiology and Health 2016;38(1):e2016052-
OBJECTIVES: Aedes mosquitoes are responsible for transmitting the dengue virus. The mosquito lifecycle is known to be influenced by temperature, rainfall, and relative humidity. This retrospective study was planned to investigate whether climatic factors could be used to predict the occurrence of dengue in East Delhi. METHODS: The number of monthly dengue cases reported over 19 years was obtained from the laboratory records of our institution. Monthly data of rainfall, temperature, and humidity collected from a local weather station were correlated with the number of monthly reported dengue cases. One-way analysis of variance was used to analyse whether the climatic parameters differed significantly among seasons. Four models were developed using negative binomial generalized linear model analysis. Monthly rainfall, temperature, humidity, were used as independent variables, and the number of dengue cases reported monthly was used as the dependent variable. The first model considered data from the same month, while the other three models involved incorporating data with a lag phase of 1, 2, and 3 months, respectively. RESULTS: The greatest number of cases was reported during the post-monsoon period each year. Temperature, rainfall, and humidity varied significantly across the pre-monsoon, monsoon, and post-monsoon periods. The best correlation between these three climatic factors and dengue occurrence was at a time lag of 2 months. CONCLUSIONS: This study found that temperature, rainfall, and relative humidity significantly affected dengue occurrence in East Delhi. This weather-based dengue empirical model can forecast potential outbreaks 2-month in advance, providing an early warning system for intensifying dengue control measures.
Aedes
;
Culicidae
;
Dengue Virus
;
Dengue*
;
Disease Outbreaks
;
Humidity*
;
Incidence*
;
Linear Models
;
Retrospective Studies*
;
Seasons
;
Weather
8.A bony foreign body found in a patient with no bony injury: a case report.
Devwart KAUSHIK ; Narendra JOSHI ; Rakesh KUMAR ; Shiv Kumar GOYAL ; Kamlesh KUMAR ; Sahil GABA
Chinese Journal of Traumatology 2014;17(6):367-369
Open fractures with bone loss are a common occurrence following high energy trauma. But usually the bone fragments are lost on the roadside and are not usable. We report a patient who was involved in a head-on collision between two wheelers and presented with a bone fragment embedded in his thigh. Radiological survey revealed no bony injury in that patient. Another patient, who presented at the same time, sustained a segmental fracture of shaft femur and was found to have lost a bone fragment that was similar to the one found in previous patient. CT scan with 3D reconstruction revealed this missing fragment to be the same as that found in previous patient. Both patients had a history of head-on collision while travelling on a two-wheeler. Present case report throws some highlights on the probable mechanism of injury.
Accidents, Traffic
;
Bone and Bones
;
injuries
;
Foreign Bodies
;
Thigh
;
injuries
9.A bony foreign body found in a patient with no bony injury:a case report
Kaushik DEVWART ; Joshi NARENDRA ; Kumar RAKESH ; Goyal Kumar SHIV ; Kumar KAMLESH ; Gaba SAHIL
Chinese Journal of Traumatology 2014;(6):367-369
Open fractures with bone loss are a common occurrence following high energy trauma. But usually the bone fragments are lost on the roadside and are not usable. We report a patient who was involved in a head-on collision between two wheelers and presented with a bone fragment embedded in his thigh. Radiological survey revealed no bony injury in that patient. Another patient, who presented at the same time, sustained a segmental fracture of shaft femur and was found to have lost a bone fragment that was similar to the one found in previous patient. CT scan with 3D reconstruction revealed this missing fragment to be the same as that found in previous patient. Both patients had a history of head-on collision while travelling on a two-wheeler. Present case report throws some highlights on the probable mechanism of injury.
10.Ethnopharmacology, phytochemistry and pharmacology of Tephrosia purpurea.
Satadru PALBAG ; Bijay Kr DEY ; Narendra Kumar SINGH
Chinese Journal of Natural Medicines (English Ed.) 2014;12(1):1-7
Tephrosia purpurea (L.) Pers. is popularly known as 'Sarapunkha' in classical Ayurvedic texts. It is a perennial plant belonging to the family Fabaceae, and occurs throughout the Indian subcontinent. T. purpurea is traditionally used to treat splenomegaly, cirrhosis, cough and cold, abdominal swelling and as an antidote in the Ayurvedic system of medicine. Phytochemical investigations indicate the presence of semiglabrin, pongamole, lanceolatins A and B, rutin, lupeol, and β-sitosterol. Flavonoids including (+)-tephrorin A and B, (+)-tephrosone, an isoflavone, 7, 4'-dihydroxy-3', 5'-dimethoxyisoflavone and a chalcone, (+)-tephropurpurin were isolated from the whole plant. Pharmacological activities of different parts of the plant reported include anti-inflammatory, antiulcer, antimicrobial, antioxidant, antiallergic, antidiabetic, hepatoprotective, antitumor and insect repellent activity. In the present review, the literature on the phytochemical and pharmacological investigations of Tephrosia purpurea (L.) Pers. are summarized to August, 2012.
Animals
;
Humans
;
India
;
Medicine, Ayurvedic
;
Plant Extracts
;
chemistry
;
pharmacology
;
Tephrosia
;
chemistry

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