Thoracolumbar Vertebral Injuries with Neurological Deficit Treated with Posterior Decompression, Short Segment Pedicle Screw Fixation, and Interlaminar Fusion

Sachin Kumar,Satish Kumar,Rajender Kumar Arya,Avinash Kumar 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.6

Study Design: Prospective clinical study. Purpose: The purpose of this study was to evaluate the effect of interlaminar fusion and short segment pedicle screw fixation on thoracolumbar vertebral injuries for preventing pain and post-traumatic kyphosis. Overview of Literature: The treatment of thoracolumbar injuries continues to be one of the most controversial areas in spine care. The main aim of surgical treatment is to decompress the spinal cord or nerve roots, realign the spine, and correct or prevent posttraumatic kyphosis. We evaluated the outcome of interlaminar fusion along with posterior decompression and short segment pedicle screw fixation in patients with thoracolumbar fractures with neurological deficit. Methods: Twenty-two patients with traumatic thoracolumbar vertebral injuries and neurological deficit underwent short segment pedicle screw fixation above and below the fractured vertebrae, posterior decompression, and interlaminar fusion using a bone graft. Results: All patients were followed up for 12 months postoperatively. The average operative time and blood loss was 142 minutes and 214 mL, respectively. Of the 22 patients, 14 recovered completely. Of the nine patients with American Spinal Injury Association (ASIA) grade A disease, two improved by 1 grade, whereas one each improved by grades 2, 3, and 4, and four did not recover. Radiologically, vertebral kyphosis angle improved from 20.91 preoperatively to 15.73 postoperatively, sagittal index improved from 24.77 to 18.73, the sagittal plane kyphosis angle improved from 17.45 to 11.41, regional angle kyphosis improved from 14.73 to 10.14, the superior inferior end plate angle from 16.14 to 13.00, and mean anterior body compression improved from 36.26 to 27.64 postoperatively. No implant failed and no patient had neurological deterioration. Conclusions: Short segment pedicle screw fixation with posterior decompression and interlaminar fusion provided considerable reduction in kyphosis, restored the vertebral height of patients with thoracolumbar vertebral injuries and neurological deficit, and prevented development of delayed kyphotic deformity.

Global Energy, Environment and Transportation Sector : Issues, Challenges and Future Prospects

Arya Kumar 한국유통과학회 2017 KODISA ICBE (International Conference on Business Vol.2017 No.-

Human existence and development have long been mainly dependent on use of energy - for survival growth and development. The prosperity of mankind essentially revolves around their ability to capture, gather, harness and utilize energy for productive purposes in a productive manner. Transportation sector alone consume more than 25% of global energy demand. It is mainly reliant (95%) upon petroleum products with the exception of railways using electrical power. It is estimated that the transport sector is responsible for about 25 percent of emissions of the gases contributing to global warming in industrialized countries, and about one-half this amount in developing countries. A transportation system that needs to be affordable, safe, efficient and environment friendly is a fundamental constituent of sustainable development. Bio-fuels, ethanol, and bio-diesel hold great promise towards a safer and healthy environment by replacing imported oil by indigenously produced fuels. This paper attempts to focus on technological priorities that need to be well defined; especially regarding elimination of lead from gasoline and elimination or cleaning up of high-mileage, heavily polluting vehicles along with appropriate incentive systems to overcome the problem of environmental deterioration.

Morin ameliorates myocardial injury in diabetic rats via modulation of inflammatory pathways

Vipin Kumar Verma,Salma Malik,Ekta Mutneja,Anil Kumar Sahu,Vaishali Prajapati,Prashant Mishra,Jagriti Bhatia,Dharamveer Singh Arya 한국실험동물학회 2024 Laboratory Animal Research Vol.40 No.1

Background: High blood glucose levels in diabetes lead to vascular inflammation which accelerates atherosclerosis. Herein, Morin was orally administered in male Wistar rats, at the dose of 40 mg/kg for 28 days, and on the 27th and 28th day, ISO was administered to designate groups at the dose of 85 mg/kg s.c., to induce myocardial infarction. Results: Free radical generation, including ROS, in diabetes following ISO administration, leads to the activation of both intrinsic and extrinsic pathways of apoptosis. Morin significantly (p ≤ 0.05) reduced oxidative stress (GSH, MDA, SOD), cardiac injury markers (CK-MB, LDH), inflammation (TNF, IL-6), and apoptosis (Bax, BCl2, Caspase-3). In addition, it also reduced insulin and blood glucose levels. Akt/eNOS, Nrf2/HO-1, MAPK signaling pathways, and Insulin signal transduction pathways were positively modulated by morin pre-treatment. Conclusions: Morin attenuated oxidative stress and inflammation and also modified the activity of various molecular pathways to mitigate cardiomyocyte damage during ISO-induced MI in diabetic rats.

Weekly cisplatin or gemcitabine concomitant with radiation in the management of locally advanced carcinoma cervix: results from an observational study

Arun K Verma,Ashok Kumar Arya,Milind Kumar,Anuj Kumar,Sweety Gupta,DN Sharma,GK Rath 대한부인종양학회 2009 Journal of Gynecologic Oncology Vol.20 No.4

Objective: The use of non-platinum drugs in concurrent chemoradiation in carcinoma cervix has not been well explored and hence a two arm study was planned to compare the outcome of concomitant cisplatin or gemcitabine in locally advanced carcinoma cervix. Methods: Thirty six patients were evaluated in this study for response rates and complications. These patients were divided into two arms, sixteen patients in the cisplatin arm and twenty patients in the gemcitabine arm. Cisplatin and gemcitabine were given as i.v. infusion at doses of 40 mg/㎡ and 150 mg/㎡ respectively for five weeks concomitant with radiotherapy. All patients had received pelvic radiotherapy to a dose of 50 Gy/25 fraction/5 weeks by four field box technique followed by high-dose-rate brachytherapy (3 sessions, each of 7.5 Gy to point A). Results: Median follow up was of 10.4 months (range, 3 to 36 months) and 10.9 months (range, 2 to 49 months) in the cisplatin and gemcitabine arms, respectively. At first follow up, 68.8% in the cisplatin arm and 70% in the gemcitabine arm had achieved complete response (p=0.93). Similar response rates were noted in different stages in both arms. None of the patients except one developed grade 4 toxicity. Similar toxicity profiles were observed in both arms. Local disease control, distant disease free survival and overall survival was 68.8% vs. 70%, 93.8% vs. 85%, 68.8% vs. 60% in the cisplatin and gemcitabine arms, respectively. Conclusion: Weekly gemcitabine had similar disease control and tolerable toxicity profile with cisplatin. Gemcitabine may be used as an alternative to cisplatin in patients with compromised renal function. Objective: The use of non-platinum drugs in concurrent chemoradiation in carcinoma cervix has not been well explored and hence a two arm study was planned to compare the outcome of concomitant cisplatin or gemcitabine in locally advanced carcinoma cervix. Methods: Thirty six patients were evaluated in this study for response rates and complications. These patients were divided into two arms, sixteen patients in the cisplatin arm and twenty patients in the gemcitabine arm. Cisplatin and gemcitabine were given as i.v. infusion at doses of 40 mg/㎡ and 150 mg/㎡ respectively for five weeks concomitant with radiotherapy. All patients had received pelvic radiotherapy to a dose of 50 Gy/25 fraction/5 weeks by four field box technique followed by high-dose-rate brachytherapy (3 sessions, each of 7.5 Gy to point A). Results: Median follow up was of 10.4 months (range, 3 to 36 months) and 10.9 months (range, 2 to 49 months) in the cisplatin and gemcitabine arms, respectively. At first follow up, 68.8% in the cisplatin arm and 70% in the gemcitabine arm had achieved complete response (p=0.93). Similar response rates were noted in different stages in both arms. None of the patients except one developed grade 4 toxicity. Similar toxicity profiles were observed in both arms. Local disease control, distant disease free survival and overall survival was 68.8% vs. 70%, 93.8% vs. 85%, 68.8% vs. 60% in the cisplatin and gemcitabine arms, respectively. Conclusion: Weekly gemcitabine had similar disease control and tolerable toxicity profile with cisplatin. Gemcitabine may be used as an alternative to cisplatin in patients with compromised renal function.

Aedes aegypti container preference for oviposition and its possible implications for dengue vector surveillance in Delhi, India

Pooja Prasad,Suman Lata,Sanjeev Kumar Gupta,Pawan Kumar,Rekha Saxena,Deepak Kumar Arya,Himmat Singh 한국역학회 2023 Epidemiology and Health Vol.45 No.-

OBJECTIVES: Dengue is a mosquito-borne viral disease globally transmitted by Aedes aegypti. The most effective method to prevent the transmission of the disease is proficient vector control. Understanding the breeding behaviour of the responsible vectors is very pertinent in this regard; therefore, the present study was conducted to understand Ae. aegypti behaviour regarding the selection of containers for oviposition in the megacity of Delhi. METHODS: A household survey in different localities within Delhi was carried out during 2018-2019. All available containers were inspected for the presence of immature Ae. aegypti. In entomological surveillance, the ovipositional preference of Aedes was computed using the breeding preference ratio, container index in the field, and laboratory settings, and associations of dengue cases with monthly variation in environmental factors and container type were also calculated. RESULTS: The household larval survey in 40 localities showed that 40% of 27,776 water-holding containers in 3,400 houses were plastic, followed by overhead tanks (26.2%), and coolers (12.1%). The most preferred breeding habitat was clay pots (9.3%), followed by metallic containers (8.5%) and solid waste (7.1%). A laboratory-based study showed that Aedes preferred clay containers (81.8%) over 4 other types of containers (plastic, paper, metal, and glass). CONCLUSIONS: The present study provides a rationale for using clay containers as a possible surveillance tool (ovitraps) or as a vector control tool. This information might aid researchers in developing novel traps and targeting preferred containers for larval control activities during transmission and non-transmission seasons.

Management of patients with allergy to local anesthetics: two case reports

Arya, Varun,Arora, Geetanjali,Kumar, Sanjeev,Kaur, Amrita,Mishra, Santosh The Korean Dental Society of Anesthsiology 2021 Journal of Dental Anesthesia and Pain Medicine Vol.21 No.6

Lidocaine is the most commonly used local anesthetic (LA) agent in various dental as well as oral and maxillofacial procedures. Although rare, adverse effects and allergic reactions to lidocaine have been reported. In patients with suspected allergy to LA or a history of such reaction, careful history-taking and allergy testing should be performed to choose an alternative LA agent to avoid any adverse effects. Here, we present two cases of delayed hypersensitivity reaction to lidocaine, wherein the patients presented with erythema, edema, and itching. Intradermal testing confirmed allergic reaction to lidocaine, and the patients underwent successful dental treatment using an alternative LA agent. This report highlights the importance of allergy testing prior to LA use considering the serious consequences of allergy to these agents and describes the management of such patients using an alternative LA agent.

Digital Controlled Oscillator Design with Novel 3 Transistors XOR Gate

Manoj Kumar,Sandeep K. Arya,Sujata Pandey 보안공학연구지원센터 2012 International Journal of Smart Home Vol.6 No.1

Design and Realization of Fractional Low-Pass Filter of 1.5 Order Using a Single Operational Transresistance Amplifier

Piyush Kumar Tewari,Rachana Arya 보안공학연구지원센터 2016 International Journal of Signal Processing, Image Vol.9 No.9

Design of fractional order analog filter, using a single Operational Transresistance Amplifier (OTRA) as an active current mode building block, is presented. The order of the proposed filter is 1.5. The theoretical results have been verified with PSPICE simulation. Obtained filter was realized using OTRA using the RC-RC decomposition technique. Frequency response for the presented filter is shown in the paper. The proposed filter offers some important features: employing single operational transresistance amplifier as an active element, lower sensitivity, insensitive to stray capacitances and parasitic resistances due to internally grounded input terminals of OTRA. Simulation results agree well with the theoretical values.

Ethnopharmacological survey of indigenous medicinal plants of Palampur, Himachal Pradesh in north-western Himalaya, India

Atul Arya,Suresh Kumar,Rajinder Paul,Amrita Suryavanshi,Dolly Kain,Rudra Narayan Sahoo 경희대학교 융합한의과학연구소 2023 Oriental Pharmacy and Experimental Medicine Vol.23 No.1

The ethnopharmacological investigation was done to study the traditional usage of indigenous medicinal plants of Palampur, Himachal Pradesh. Therefore, an extensive ethnopharmacological survey was conducted to document the traditional knowledge of ethnomedicinal plants. Direct interviews of 77 informants were conducted with the help of a questionnaire. Three quantitative factors (use value, factor informant consensus and fidelity level) were used for the analysis of generated data. A total of 102 species, belonging to 90 genera and 30 families were identified and collected with the help of traditional healers and local informants from different locations of the study area. Total 19 medicinal plants species were reported for new or less known ethnomedicinal uses. Also, 3 threatened wild plants species were collected from the study area. The maximum number of species belongs to the family Lamiaceae (7), Fabaceae (7), Asteraceae (6), Moraceae (4 species), Apocyanaceae (4 species) and Euphorbiaceae (3 species). Different plant parts were used by local informants such as leaves, galls, fruits, seeds, latex, stem, root, flowers, bark, and rhizomes. It was also observed that maximum numbers of plant species were used to cure gastro-intestinal disorders (48 species), skin disorders (34 species) and respiratory disorders (25 species). Ethnopharmacological data depict that medicinal plants were extensively used by local people to cure gastrointestinal, dermatological disorders and skeletomuscular disorders. Traditionally used medicinal plants have enormous potential to provide the raw material for the discovery of new bioactive compounds and drugs.

Intrinsic Vertebral Markers for Spinal Level Localization in Anterior Cervical Spine Surgery: A Preliminary Report

Deepak Kumar Jha,Anil Thakur,Mukul Jain,Arvind Arya,Chandrabhushan Tripathi,Rima Kumari,Suman Kushwaha 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.6

Study Design: Prospective clinical study. Purpose: To observe the usefulness of anterior cervical osteophytes as intrinsic markers for spinal level localization (SLL) during sub-axial cervical spinal surgery via the anterior approach. Overview of Literature: Various landmarks, such as the mandibular angle, hyoid bone, thyroid cartilage, first cricoid ring, and C6 carotid tubercle, are used for gross cervical SLL; however, none are used during cervical spinal surgery via the anterior approach. We present our preliminary assessment of SLL over anterior vertebral surfaces (i.e., intrinsic markers) in 48 consecutive cases of anterior cervical spinal surgeries for the disc-osteophyte complex (DOC) in degenerative diseases and granulation or tumor tissue associated with infectious or neoplastic diseases, respectively, at an ill-equipped center. Methods: This prospective study on patients undergoing anterior cervical surgery for various sub-axial cervical spinal pathologies aimed to evaluate the feasibility and accuracy of SLL via intraoperative palpation of disease-related morphological changes on anterior vertebral surfaces visible on preoperative midline sagittal T1/2-weighted magnetic resonance images. Results: During a 3-year period, 48 patients (38 males,10 females; average age, 43.58 years) who underwent surgery via the anterior approach for various sub-axial cervical spinal pathologies, including degenerative disease (n= 42), tubercular infection (Pott’s disease; n=3), traumatic prolapsed disc (n=2), and a metastatic lesion from thyroid carcinoma (n=1), comprised the study group. Intrinsic marker palpation yielded accurate SLL in 79% of patients (n=38). Among those with degenerative diseases (n=42), intrinsic marker palpation yielded accurate SLL in 76% of patients (n=32). Conclusions: Intrinsic marker palpation is an attractive potential adjunct for SLL during cervical spinal surgeries via the anterior approach in well-selected patients at ill-equipped centers (e.g., those found in developing countries). This technique may prove helpful when radiographic visualization is occasionally inadequate.