Replacement of hazard lubricants by green coolant in machining of Ti6Al4V: A 3D FEM approach

Ankit Jain,Sanu Kumar,Vivek Bajpai,Hyung Wook Park 한국정밀공학회 2019 International Journal of Precision Engineering and Vol.20 No.6

Metalworking fluids (MWF’s) are frequently used for cooling and lubrication during machining processes in manufacturing industries. MWF’s such as soluble straight oils, synthetic oils, solid lubricants, bio lubricants contain a mix of water and mineral oil with some percentage of vegetable oils and petroleum. These MWF’s are hazardous for the environment and for human health. After using, the lubricants are disposed into the environment by burning or by dumping on the ground or in the sea water. Burning the lubricant creates pollution and airborne disease. To avoid these harmful effects of the lubricants sustainable machining technique is implemented in machining processes. In the present study, liquid nitrogen (green coolant) is used as a sustainable machining technique for cooling and lubrication. Finite element modeling is used to simulate the micro-end milling at different conditions of the workpiece (cryogenic plus preheated and cryogenic). The analysis of chip morphology and cutting forces measurement were done by applying these conditions. The predicted model is validated with the experimental results. It was observed that cryogenic with preheated workpiece (473 K) is the optimum condition with the application of green coolant. This study will clarify the behavior of cryogenic on the machining conditions and will solve the environmental problems.

Analysis and Review the Data Using Big Data Hadoop

Ankit Jain,Subbulakshmi T. 보안공학연구지원센터 2016 International Journal of Database Theory and Appli Vol.9 No.5

Big information is pool of huge and complicated information sets so it becomes tough to method information exploitation management tools. The term ‘Big Data’ illustrates innovative method and knowledge to capture, store, distribute, handle and evaluate petabyte or larger-sized datasets with high-speed and totally different structures. Huge knowledge may be structured, unstructured or semi-structured, leading to incapability of standard knowledge management ways. With the quick evolution of information, information storage and networking assortment capability, massive information area unit quickly growing altogether science and engineering domains. Knowledge is generated from numerous totally different sources and might arrive within the system at numerous rates. So as to method these giant amounts of information in a cheap and economical approach, similarity are employed. Huge knowledge may be knowledge whose scale, diversity, and quality need new design, techniques, algorithms, and analytics to manage it and extract price and hidden information from it. The analysis of huge information typically tough because it often involves assortment of mixed information supported completely different patterns or rules. The challenges embrace capture, storage, search, sharing, analysis, and visualization. The trend to massive information sets is owing to the additional info drawn from analysis of one large set of connected information, compared to separate smaller sets with constant total quantity of information. Massive data processing is that the ability of extracting helpful info from streams of information or datasets, that owing to its rate, variability and volume. This paper argues applications of huge processing model and conjointly massive data processing. Hadoop is that the core platform for structuring huge knowledge, and solves the matter of constructing it helpful for analytics functions. Hadoop is Associate in nursing open supply software system project that permits the distributed process of huge knowledge sets across clusters of goods servers. It’s designed to rescale from one server to thousands of machines, with a awfully high degree of fault tolerance.

Sphingolipids as Potential Biomarkers to Direct Acting Antiviral Therapy in Chronic Hepatitis C Virus Infection

( Ankit Jain ),( Dk Singh ),( Ar Rao ) 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1

Contrast Enhanced Harmonic Endoscopic Ultrasound: A Novel Approach for Diagnosis and Management of Gastrointestinal Stromal Tumors

Ankit Chhoda,Deepanshu Jain,Venkateswar R Surabhi,Shashideep Singhal 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.3

The histologic analysis of gastrointestinal stromal tumors (GISTs) is a common method to detect the mitotic activity and to subsequentlydetermine the risk of GISTs for malignancy. The potential false negative error due to inadequate yield of specimens and actualdetermination of malignancy risk requires analysis of the whole tumor. We aimed to assess the role of contrast enhanced endoscopicultrasound (CE-EUS) in the management of GISTs. Two authors individually did review of English literatures to identify nine peerreviewedoriginal articles using keywords- contrast endoscopic ultrasound, GIST and submucosal tumor. Studies were heterogeneousin their aims looking either at differentiating submucosal lesions from GISTs, estimating malignant potential of GISTs with histologiccorrelation or studying the role of angiogenesis in malignant risk stratification. CE-EUS had moderate to high efficacy in differentiatingGISTs from alternative submucosal tumors. CE-EUS had a higher sensitivity than EUS-guided fine needle aspiration, contrast computedtomography and Doppler EUS for detection of neo-vascularity within the GISTs. However, the evidence of abnormal angiogenesiswithin GIST as a prognostic factor needs further validation. CE-EUS is a non-invasive modality, which can help differentiate GISTs andprovide valuable assessment of their perfusion patterns to allow better prediction of their malignant potential but more experience isneeded.

De-novo Gastrointestinal Anastomosis With Lumen Apposing Metal Stent

Deepanshu Jain,Ankit Chhoda,Abhinav Sharma,Shashideep Singhal 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.5

Gastric outlet obstruction, afferent or efferent limb obstruction, and biliary obstruction among patients with altered anatomy oftenrequire surgical intervention which is associated with significant morbidity and mortality. Endoscopic dilation for benign etiologiesrequires multiple sessions, whereas self-expandable metal stents used for malignant etiologies often fail due to tumor in-growth. Lumenapposing metal stents, placed endoscopically with the intent of creating a de-novo gastrointestinal anastomosis bypassing the site ofobstruction, can potentially achieve similar effcacy, with a much lower complication rate. In our study cohort (n=79), the compositetechnical success rate and clinical success rate was 91.1% (72/79) and 97.2% (70/72), respectively. Five different techniques were used:43% (34/79) underwent the balloon-assisted method, 27.9% (22/79) underwent endoscopic ultrasound-guided balloon occludedgastro-jejunostomy bypass, 20.3% (16/79) underwent the direct technique, 6.3% (5/79) underwent the hybrid rendezvous technique,and 2.5% (2/79) underwent natural orifice transluminal endoscopic surgery (NOTES)-assisted procedure. All techniques required anechoendoscope except NOTES. In all, 53.2% (42/79) had non-cautery enhanced Axios stent, 44.3% (35/79) had hot Axios stent, and2.5% (2/79) had Niti-S spaxus stent. Symptom-recurrence was seen in 2.8%, and 6.3% had a complication (bleeding, abdominal pain orperitonitis). All procedures were performed by experts at centers of excellence with adequate surgical back up.

Endoscopic Sleeve Gastroplasty - A New Tool to Manage Obesity

Deepanshu Jain,Bharat Singh Bhandari,Ankit Arora,Shashideep Singhal 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.6

Obesity is a growing pandemic across the world. Dietary restrictions and behavior modifications alone have a limited benefit. Bariatric surgery, despite being the current gold standard, has limited acceptance by patients due to cost and associated morbidity. In our review, we have discussed nine original studies describing endoscopic sleeve gastroplasty (ESG). A total of 172 subjects successfully underwent ESG. Of 65 subjects with follow up data, 95.4% (62/65) had intact gastric sleeve confirmed via esophagogastroduodenoscopy or oral contrast study at the end of study specific follow up interval (the longest being 6 months). Individual studies reported a technical success rate for intact gastric sleeve from as low as 50% to as high as 100%. A statistically significant (p<0.05) weight loss was reported in seven of the eight studies with available data. None of the patients experienced any intra-procedure complications, and approximately 2.3% (4/172) of patients experienced major post-procedure complications; however, no mortality was reported. Majority of the studies reported relatively high incidence of minor post-procedure complications, which improved with symptomatic treatment alone. Good patient tolerance with comparable clinical efficacy in achieving and sustaining desired weight loss makes ESG an attractive option to consider among other bariatric therapies.

Alcohol associated liver cirrhotics have higher mortality after index hospitalization: Long-term data of 5,138 patients

( Priyanka Jain ),( Saggere Muralikrishna Shasthry ),( Ashok Kumar Choudhury ),( Rakhi Maiwall ),( Guresh Kumar ),( Ankit Bharadwaj ),( Vinod Arora ),( Rajan Vijayaraghavan ),( Ankur Jindal ),( Manoj 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1

Background/Aims: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC. Methods: Cirrhosis patients at index hospitalisation (from January 2010 to June 2017), with ≥1 year follow-up were included. Results: Five thousand and one hundred thirty-eight cirrhosis patients (age, 49.8±14.6 years; male, 79.5%; alcohol, 39.5%; Child-A:B:C, 11.7%:41.6%:46.8%) from their index hospitalization were analysed. The median time from diagnosis of cirrhosis to index hospitalization was 2 years (0.2-10). One thousand and seven hundred seven patients (33.2%) died within a year; 1,248 (24.3%) during index hospitalization. 59.5% (2,316/3,890) of the survivors, required at least one readmission, with additional mortality of 19.8% (459/2,316). ALC compared to non-ALC were more often (P<0.001) male (97.7% vs. 67.7%), younger (40-50 group, 36.2% vs. 20.2%; P<0.001) with higher liver related complications at baseline, (P<0.001 for each), sepsis: 20.3% vs. 14.9%; ascites: 82.2% vs. 65.9%; spontaneous bacterial peritonitis: 21.8% vs. 15.7%; hepatic encephalopathy: 41.0% vs. 25.0%; acute variceal bleeding: 32.0% vs. 23.7%; and acute kidney injury 30.5% vs. 19.6%. ALC patients had higher Child-Pugh (10.6±2.0 vs. 9.0±2.3), model for end-stage liver-disease scores (21.49±8.47 vs. 16.85±7.79), and higher mortality (42.3% vs. 27.3%, P<0.001) compared to non-ALC. Conclusions: One-third of cirrhosis patients die in index hospitalization. 60% of the survivors require at least one rehospitalization within a year. ALC patients present with higher morbidity and mortality and at a younger age. (Clin Mol Hepatol 2021;27:175-185)

Functional Outcomes of Subaxial Spine Injuries Managed With 2-Level Anterior Cervical Corpectomy and Fusion: A Prospective Study

Vaibhav Jain,Ankit Madan,Manoj Thakur,Amit Thakur 대한척추신경외과학회 2018 Neurospine Vol.15 No.4

Objective: To evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone–filled titanium mesh cage. Methods: This study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure. Results: According to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12–48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate. Conclusion: Two-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

Complete Bony Segment Flap Failure without Skin Paddle Compromise in Fibular Free Flap: A Case Report of a Rare Early Complication

Singh Hardeep,Jain Ankit,Jain Rahul,Mahendru Sanjay,Khazanchi Rakesh Kumar 대한창상학회 2023 Journal of Wound Management and Research Vol.19 No.1

The free fibula flap is sometimes associated with partial flap loss. A 62-year-old man with squamous carcinoma of the lower alveolus underwent anterior arch resection and reconstruction with a fibula osteocutaneous flap containing three bony segments. There were two perforators in the skin flap; the first perforator was proximal to the bony segments and the other perforator was at the level of the middle segment. Atherosclerosis was observed in the anastomotic vessels. During surgery, thrombosis occurred in the arterial anastomosis, but was revised before the operation was over. The patient’s early postoperative course was uneventful. In the second week, purulent discharge was observed from the drains. Flap exploration showed devascularization of bony segments and periosteum, but the skin paddle was viable. The peroneal vessel had thrombosed distal to the takeoff of the proximal perforator and the viable skin paddle perfused by proximal perforators falsely indicated the well-being of underlying bones. The de-vascularized bones and sloughed periosteum were removed at the time of exploration, after which the skin paddle was reoriented for coverage of the defect. The patient completed chemoradiation without any bony reconstruction afterwards. This is the only reported case of early total bony flap portion loss with a viable skin paddle in free fibula flap transfer.

Effectiveness of four ultrasonographic parameters as predictors of difficult intubation in patients without anticipated difficult airway

Agarwal Rishabh,Jain Gaurav,Agarwal Ankit,Govil Nishith 대한마취통증의학회 2021 Korean Journal of Anesthesiology Vol.74 No.2

Background: Predicting difficult intubation (DI) is a key challenge, as no single clinical predictor is sufficiently valid to predict the outcome. We evaluated the effectiveness of four upper airway ultrasonographic parameters in predicting DI. The validity of the models using combinations of ultrasonography-based parameters was also investigated.Methods: This prospective, observational, double-blinded cohort trial enrolled 1,043 surgical patients classified as American Society of Anesthesiologists physical status I–III without anticipated difficult airway. Preoperatively, their tongue thickness (TT), invisibility of hyoid bone (VH), and anterior neck soft tissue thickness from the skin to thyrohyoid membrane (ST) and hyoid bone (SH) were measured by sublingual and submandibular ultrasonography. The logistic regression, Youden index, and receiver operator characteristic analysis results were reported.Results: Overall, 58 (5.6%) patients were classified as DI. The TT, SH, ST, and VH had accuracies of 78.4%, 85.0%, 84.7%, and 84.9%, respectively. The optimal values of TT, SH, and ST for predicting DI were > 5.8 cm (sensitivity, 84.5%; specificity; 78.1%; AUC, 0.880), > 1.4 cm (sensitivity, 81%; specificity, 85.2%; AUC, 0.898), and > 2.4 cm (sensitivity, 75.9%; specificity, 85.2%; AUC, 0.885), respectively. VH had a sensitivity and specificity of 72.4% and 85.6% (AUC, 0.790. The AUC values of the five models (with combinations of three or four parameters) ranged from 0.975–0.992. ST and VH had a significant impact on the individual models.Conclusions: SH had the best accuracy. Individual parameters showed limited validity. The model including all four parameters offered the best diagnostic value.