Alcohol and Tobacco Consumption among Indian Women

Rishi Kumar,Risheek Sood 숙명여자대학교 아시아여성연구원 2020 Asian Women Vol.36 No.2

Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops

( Rishi Dhillan ),( Alok Bhalla ),( Sushil Kumar Jha ),( Hakam Singh ),( Aman Arora ) 대한외상학회 2019 大韓外傷學會誌 Vol.32 No.2

Purpose: Penetrating vascular trauma though less common poses a challenge to all Surgeons. This study was designed to analyse the profile, management modalities of vascular trauma and the outcomes thereof at a Trauma Care Centre in a Tertiary care setting in hostile environment in India. Methods: A prospective review of all patients with arterial and venous injuries being transferred to the Trauma Center at out Tertiary Care Center between June 2015 and May 2018 was done. Demographics, admission data, treatment, and complications were reviewed. Results: There were a total of 46 patients with 65 vascular injuries, 39 arterial injuries and 26 venous injuries. The age range was 21 to 47 years. Nineteen patients had both arterial and venous injuries. A total of 42 cases presented within 12 hours of injury and complete arterial transections were found in 33 cases (80.49%). There were three mortalities (6.52%) and three amputations (8.33%). The overall limb salvage rate was 91.67% with popliteal artery being the commonest injured artery. Poor prognosticators for limb salvage were increasing time to present to the trauma centre, hypovolemic shock, multi-organ trauma and associated venous injuries. Conclusions: Penetrating missile trauma leading to vascular injuries has not been widely reported. Attempting limb salvage even in cases with delayed presentation should be weighed with the threat to life before revascularisation and should preferably be done at a centre with vascular expertise. A team approach with vascular, orthopaedic, general surgeons, and critical care anaesthesiologists all aboard improve the outcomes manifold. Use of tourniquets and early fasciotomies have been emphasized as is the use of native veins as the bypass conduit. This is probably the largest study on penetrating Vascular trauma in anti-terrorism ops from the Indian subcontinent. It highlights the significance of prompt recognition and availability of vascular expertise in optimally managing cases of vascular trauma.

Irreducible Atlanto-Axial Dislocation in Neglected Odontoid Fracture Treated with Single Stage Anterior Release and Posterior Instrumented Fusion

Rishi Anil Aggarwal,Ashok Keshav Rathod,Kshitij Subhash Chaudhary 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.2

It is a well-know fact that type 2 odontoid fractures frequently go into nonunion. If left untreated, patients may develop irreducible atlantoaxial dislocation (AAD). We describe the surgical management of two patients with neglected odontoid fractures and irreducible AAD treated with single stage anterior release followed by posterior instrumented fusion. Both patients presented with history of neglected trauma and progressive myelopathy. Traction under anesthesia failed to achieve reduction of AAD. Anterior release was done by trans-oral approach in one patient and retrophayngeal approach in the other. Posterior fixation was performed with transarticular screws in both the patients. Both patients had full neurological recovery and demonstrated fusion at follow-up. Anterior release followed by posterior instrumented correction may be an effective alternative to the traditional means of treating irreducible dislocations associated with neglected odontoid fractures.

Biomechanical Comparison of an Intramedullary and Extramedullary Free-Tissue Graft Reconstruction of the Acromioclavicular Joint Complex

Rishi Garg,Gregory J. Adamson,Pooya Javidan,Thay Q. Lee 대한정형외과학회 2013 Clinics in Orthopedic Surgery Vol.5 No.4

Background: Several different surgical techniques have been described to address the coracoclavicular (CC) ligaments in acromioclavicular (AC) joint injuries. However, very few techniques focus on reconstructing the AC ligaments, despite its importance in providing stability. The purpose of our study was to compare the biomechanical properties of two free-tissue graft techniques that reconstruct both the AC and CC ligaments in cadaveric shoulders, one with an extramedullary AC reconstruction and the other with an intramedullary AC reconstruction. We hypothesized intramedullary AC reconstruction will provide greater anteroposterior translational stability and improved load to failure characteristics than an extramedullary technique. Methods: Six matched cadaveric shoulders underwent translational testing at 10 N and 15 N in the anteroposterior and superoinferior directions, under AC joint compression loads of 10 N, 20 N, and 30 N. After the AC and CC ligaments were transected, one of the specimens was randomly assigned the intramedullary free-tissue graft reconstruction while its matched pair received the extramedullary graft reconstruction. Both reconstructed specimens then underwent repeat translational testing, followed by load to failure testing, via superior clavicle distraction, at a rate of 50 mm/min. Results: Intramedullary reconstruction provided significantly greater translational stability in the anteroposterior direction than the extramedullary technique for four of six loading conditions (p < 0.05). There were no significant differences in translational stability in the superoinferior direction for any loading condition. The intramedullary reconstructed specimens demonstrated improved load to failure characteristics with the intramedullary reconstruction having a lower deformation at yield and a higher ultimate load than the extramedullary reconstruction (p < 0.05). Conclusions: Intramedullary reconstruction of the AC joint provides greater stability in the anteroposterior direction and improved load to failure characteristics than an extramedullary technique. Reconstruction of the injured AC joint with an intramedullary free tissue graft may provide greater strength and stability than other currently used techniques, allowing patients to have improved clinical outcomes.

A Comparison of Deep Reinforcement Learning and Deep learning for Complex Image Analysis

Rishi Khajuria,Abdul Quyoom,Abid Sarwar 한국멀티미디어학회 2020 The journal of multimedia information system Vol. No.

The image analysis is an important and predominant task for classifying the different parts of the image. The analysis of complex image analysis like histopathological define a crucial factor in oncology due to its ability to help pathologists for interpretation of images and therefore various feature extraction techniques have been evolved from time to time for such analysis. Although deep reinforcement learning is a new and emerging technique but very less effort has been made to compare the deep learning and deep reinforcement learning for image analysis. The paper highlights how both techniques differ in feature extraction from complex images and discusses the potential pros and cons. The use of Convolution Neural Network (CNN) in image segmentation, detection and diagnosis of tumour, feature extraction is important but there are several challenges that need to be overcome before Deep Learning can be applied to digital pathology. The one being is the availability of sufficient training examples for medical image datasets, feature extraction from whole area of the image, ground truth localized annotations, adversarial effects of input representations and extremely large size of the digital pathological slides (in gigabytes).Even though formulating Histopathological Image Analysis (HIA) as Multi Instance Learning (MIL) problem is a remarkable step where histopathological image is divided into high resolution patches to make predictions for the patch and then combining them for overall slide predictions but it suffers from loss of contextual and spatial information. In such cases the deep reinforcement learning techniques can be used to learn feature from the limited data without losing contextual and spatial information.

Combined Antiangiogenic and Mammalian Target of Rapamycin Inhibitor Targeted Therapy in Metaplastic Breast Cancer Harboring a PIK3CA Mutation

Rishi Agarwal,Kimberly Koenig,Eric Rohren,Vivek Subbiah 한국유방암학회 2014 Journal of breast cancer Vol.17 No.3

Metaplastic breast cancer (MpBC) is an extremely rare breastcancer subtype, characterized by a heterogeneous phenotype. MpBC aggressive biology is attributed to its stem cell-like characteristics. Since these tumors are largely chemoresistant, noveltargeted therapies should be explored. Herein, we report theclinical course of a 59-year-old African American woman withMpBC with a PIK3CA mutation in codon 545, exon 10 (GAG toAAG; p.Glu545Lys) and a TP53 mutation in codon 286, exon 8(GAA to AAA; p.Glu286Lys). The same mutations were observedin the primary and secondary sites. The patient wastreated with a molecularly matched therapy using a combinedantiangiogenic and mammalian target of rapamycin kinase inhibitorstrategy that included liposomal doxorubicin, bevacizumab,and temsirolimus. Partial remission was achieved. Inthis report, the scientific rationale underlying the activity of thiscombination was explored. In conclusion, patients may benefitfrom being offered molecular profiling early during the course ofthe disease to receive a therapy guided accordingly.

Theoretical study of temperature dependent lattice anharmonicity in TlCl and TlBr

Rishi Pal Singh,Rajendra Kumar Singh 한국물리학회 2010 Current Applied Physics Vol.10 No.4

Effect of temperature on ultrasonic attenuation in BCC structured (CsCl-type) thallium halides (TlCl and TlBr) have been investigated in a wide temperature range 50–500 K for longitudinal and shear modes along [1 0 0], [1 1 0] and [1 1 1] directions of propagation. Starting with nearest neighbour distance and repulsive parameter and taking interactions up to next nearest neighbours, second and third order elastic moduli have been evaluated, which in turn have been used for evaluating thermal relaxation time,Gruneisen numbers, acoustic coupling constants, ultrasonic velocity and ultrasonic attenuation. Ultrasonic attenuation in these bcc structured crystalline materials has been found less than the fcc crystalline materials. The results have been discussed and compared with available data.

Actinomyces: a deceptive infection of oral cavity

Rishi Thukral,Kirti Shrivastav,Vidhi Mathur,Animesh Barodiya,Saurabh Shrivastav 대한구강악안면외과학회 2017 대한구강악안면외과학회지 Vol.43 No.4

Actinomycosis is an infrequent chronic infection regarded as the most misdiagnosed disease by experienced clinicians. The Office of Rare Diseases at the National Institute of Health has also listed this disease as a “rare disease.” This article presents a case report of actinomycosis of the alveolus with unusual clinical features but a successful resolution. It also states the importance of biopsy of deceptive inflammatory lesions that do not respond or recur after conventional treatment modalities.

Prevalence, Patterns, and Genetic Association Analysis of Modic Vertebral Endplate Changes

Rishi Mugesh Kanna,Rajasekaran Shanmuganathan,Veera Ranjani Rajagopalan,Senthil Natesan,Raveendran Muthuraja,Kenneth Man Chee Cheung,Danny Chan,Patrick Yu Ping Kao,Anita Yee,Ajoy Prasad Shetty 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.4

Study Design: A prospective genetic association study. Purpose: The etiology of Modic changes (MCs) is unclear. Recently, the role of genetic factors in the etiology of MCs has been evaluated. However, studies with a larger patient subset are lacking, and candidate genes involved in other disc degeneration phenotypes have not been evaluated. We studied the prevalence of MCs and genetic association of 41 candidate genes in a large Indian cohort. Overview of Literature: MCs are vertebral endplate signal changes predominantly observed in the lumbar spine. A significant association between MCs and lumbar disc degeneration and nonspecific low back pain has been described, with the etiopathogenesis implicating various mechanical, infective, and biochemical factors. Methods: We studied 809 patients using 1.5-T magnetic resonance imaging to determine the prevalence, patterns, distribution, and type of lumbar MCs. Genetic association analysis of 71 single nucleotide polymorphisms (SNPs) of 41 candidate genes was performed based on the presence or absence of MCs. SNPs were genotyped using the Sequenome platform, and an association test was performed using PLINK software. Results: The mean age of the study population (n=809) was 36.7±10.8 years. Based on the presence of MCs, the cohort was divided into 702 controls and 107 cases (prevalence, 13%). MCs were more commonly present in the lower (149/251, 59.4%) than in the upper (102/251, 40.6%) endplates. L4–5 endplates were the most commonly affected levels (30.7%). Type 2 MCs were the most commonly observed pattern (n=206, 82%). The rs2228570 SNP of VDR (p =0.02) and rs17099008 SNP of MMP20 (p =0.03) were significantly associated with MCs. Conclusions: Genetic polymorphisms of SNPs of VDR and MMP20 were significantly associated with MCs. Understanding the etiopathogenetic mechanisms of MCs is important for planning preventive and therapeutic strategies.

Cancer Growth Prediction via Artificial Neural Networks

Rishi Pal,Pardeep Garg,Rajiv Chechi,Sandeep Kumar,Naresh Kumar 보안공학연구지원센터 2010 International Journal of Bio-Science and Bio-Techn Vol.2 No.2