Cyclic Vomiting Syndrome: A Functional Disorder

Kaul, Ajay,Kaul, Kanwar K. The Korean Society of Pediatric Gastroenterology 2015 Pediatric gastroenterology, hepatology & nutrition Vol.18 No.4

Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asymptomatic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started ('abortive treatment') includes keeping the patient in a dark and quiet room, intravenous hydration, ondansetron, sumatriptan, clonidine, and benzodiazepines. Prophylactic treatment includes cyproheptadine, propranolol and amitriptyline. No mortality has been reported as a direct result of CVS and many children outgrow it over time. A subset may develop other functional disorders like irritable bowel syndrome and migraine headaches.

Cyclic Vomiting Syndrome: A Functional Disorder

Ajay Kaul,Kanwar K. Kaul 대한소아소화기영양학회 2015 Pediatric gastroenterology, hepatology & nutrition Vol.18 No.4

Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asympto-matic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started (‘abortivetreatment’) includes keeping the patient in a dark and quiet room, intravenous hydration, ondansetron, sumatriptan, clonidine, and benzodiazepines. Prophylactic treatment includes cyproheptadine, propranolol and amitriptyline. No mortality has been reported as a direct result of CVS and many children outgrow it over time. A subset may develop other functional disorders like irritable bowel syndrome and migraine headaches.

Green Stink Bug (Hemiptera: Pentatomidae) Recorded as a New Pest of Olive in India

Kaul, V.,Tiku, A.K.,Shankar, Uma,Monobrullah, Md. Korean Society of Applied Entomology 2007 Journal of Asia-Pacific Entomology Vol.10 No.1

During the survey of olive orchards in Jammu and Kashmir, various insect pests were recorded infesting olive which include, olive psylla, olive black scale, scarab beetle and green stink bug. Among these green stink bug, Nezara virudula (L.) [Hemiptera: Pentatomidae] has been recorded for the first time in India.

A Computed Tomography-Based Assessment of the Anatomical Parameters Concerning S2-Alar Iliac Screw Insertion Using “Safe Trajectory Method” in Indian Population

Kaul Rahul,Goswami Bharat,Kumar Khemendra,Jeyaraman Madhan,Sangondimath Gururaj,Chhabra HS 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.1

Study Design: A retrospective computed tomography (CT)-based radiological analysis.Purpose: To obtain CT-based morphometric data for the S2 alar iliac (S2AI) screw in the Indian population presenting to School of Medical Sciences and Research, Greater Noida, we used the concept of “safe trajectory” by Pontes and his colleagues in a recent study.Overview of Literature: Although previous CT-based morphometric studies on the S2AI screw have been published for a variety of ethnic groups, morphometric data specifically for the Indian population are scarce.Methods: We used the three-dimensional multiplanar reformatting software to conduct a retrospective CT analysis of 112 consecutive patients who met our exclusion criteria for various abdominal and pelvic pathologies. CT imaging planes were rotated between the S1 and S2 foramen until they matched the ideal S2AI screw trajectory, which was represented by the longest and widest iliac osseous channel observed in the axial CT section. Following the concept of a safe trajectory, S2AI screw morphometric parameters were measured on both sides of the pelvis using corresponding axial and sagittal CT images.Results: In the sagittal and transverse planes on both sides of the pelvis, females had significantly higher screw trajectory angulation than males (<i>p</i><0.001). On both sides of the pelvis, males had significantly greater iliac width, maximum screw trajectory length, and intrascrotal length than females (<i>p</i><0.001). On both sides of the pelvis, the S2AI screw entry point in females was significantly deeper than in males from the skin margin (<i>p</i><0.001).Conclusions: Based on our methodology, we discovered that the S2AI screw trajectory is significantly more caudal and lateral in females, the maximum screw length is sufficient for use in clinical practice regardless of gender, and that 8.5 mm or even larger screw diameters are feasible in the majority of the Indian population.

Lens Design of the Eyepiece Combined with the Accommodation-dependent Navarro Eye at an On-axis Point

KaUl Choi,Seok Ho Song,Sang Gee Kim 한국광학회 2010 Current Optics and Photonics Vol.14 No.1

We introduce a new method for lens design that combines an eyepiece with the finite model eye, to make a corrected version of the accommodation-dependent Navarro eye. The optical system that we designed, which includes a human eye, takes into account the aberration of the eye and increases the performance of the image in the retina. In the design results, for the optimized eyepiece combined with the corrected Navarro eye, visual acuity is 1.40. Compared with the existing method of eyepiece design using inverse ray tracing with the corrected Navarro eye, MTF value was recorded as 0.079 to 0.283 at 160 lp/mm and visual performance was improved.

Ultra deformable vesicles for boosting transdermal delivery of 2-arylpropionic acid class drug for management of musculoskeletal pain

Kaul Shreya,Jain Neha,Nagaich Upendra 한국약제학회 2022 Journal of Pharmaceutical Investigation Vol.52 No.2

Purpose The aim of this investigation was to formulate and evaluate naproxen transethosomal gel for sustained transdermal delivery for the management of musculoskeletal pain. Methods In this examination naproxen sodium-loaded transethosomes were developed by ethanol injection method. A 9 run, 2-factor, 3-level factorial design was used to optimize naproxen-transethosomes. Transethosomal formulations were then incorporated into hydrogel made of gelling agent carbopol 940. The formulated transethosomes were characterized for particle size, entrapment efficiency, zeta potential, in-vitro release, ex-vivo drug permeation study, drug deposition study, and in-vivo anti-inflammatory study. Results The results exhibited that the particle size were in the range of 56.94 ± 0.12 nm to 291.7 ± 0.09 nm. The transethosomes had higher entrapment efficiency in between 66.23 ± 1.52 and 93.11 ± 0.96% and exhibited a spherical morphology when examined by TEM analysis. The in-vitro skin permeation study carried out on rat skin exhibited enhanced skin deposition with lesser systemic absorption. The in-vivo studies carried out on rats showed the superiority of naproxen transethosomal gel in reducing the edema rate. Conclusion The results obtained all together demonstrated that the formulated transethosomal gel possessed a smaller particle size, high entrapment efficiency along higher skin deposition rate which is required in getting relief from musculoskeletal pain. The developed formulation could be regarded as an ideal substitute for the conventional gel for the management of musculoskeletal pain.

Everyday Lives, Everyday Histories: Beyond the Kings and Brahmanas of ‘Ancient’ India

Shonaleeka KAUL 이화여자대학교 아시아여성학센터 2007 Asian Journal of Women's Studies(AJWS) Vol.13 No.3

Green Stink Bug (Hemiptera: Pentatomidae) Recorded as a New Pest of Olive in India

V. Kaul,A.K. Tiku,Uma Shankar,Md. Monobrullah 한국응용곤충학회 2007 Journal of Asia-Pacific Entomology Vol.10 No.1

During the survey of olive orchards in Jammu and Kashmir, various insect pests were recorded infesting olive which include, olive psylla, olive black scale, scarab beetle and green stink bug. Among these green stink bug, Nezara virudula (L.) [Hemiptera: Pentatomidae] has been recorded for the first time in India.

Chemical Control : Incidence and Management of Lepidopteran Fruit Borers of Guava (Psidium guajava L.) in Jammu, India

( Virender Kaul ),( Yogesh K. Kesar ) 한국응용곤충학회 2003 Journal of Asia-Pacific Entomology Vol.6 No.2

Assessment of Myocardial Collateral Blood Flow with Contrast Echocardiography

Sanjiv Kaul 대한심장학회 2015 Korean Circulation Journal Vol.45 No.5

Humans have pre-formed collateral vessels that enlarge with ischemia. In addition, new vessels can be formed within ischemic zones from pre-formed endocardial arcades of vessels providing rich collateral flow. Collateral flow under resting conditions (if >25% of normal) is enough to maintain myocardial viability, but may be insufficient to prevent myocardial ischemia under stress. Coronary angiography is a poor tool for collateral flow assessment. Myocardial contrast echocardiography is arguably the gold standard for experimental and clinical measurement of collateral flow. This review describes several experimental and clinical studies that highlight the importance of the collateral circulation in coronary artery disease.