Prospective comparison of suture ligation and electrothermal sealing for the control of perivascular lymphatics in kidney transplant recipients

Ketan Mehra,Kushal Kapashi,Sajni Khemchandani,Pranjal Ramanlal Modi,Syed Jamal Rizvi 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.4

Background: The use of sutures as ligatures has proven to be safe and reliable for the control of lymphatic vessels. The electrothermal bipolar vessel sealer (EBVS) is a relatively new type of device that can be used to seal lymphatics. We conducted a study to evaluate the safety and efficacy of EBVS for preparation of the recipient vessel during renal transplantation. Methods: In this prospective randomized controlled study, EBVS (Medtronic) was compared with conventional ligature for the control of perivascular lymphatics in kidney transplant recipients. A total of 52 kidney transplant recipients were randomly assigned to two groups. In group 1, EBVS was used to control perivascular lymphatics, while conventional silk ligatures were used in group 2. Demographic characteristics, as well as preoperative, perioperative, and postoperative variables, were noted and compared between the groups. Results: The mean recipient vessel preparation time was 8.3±1.9 minutes in group 1 and 14.5±4 minutes in group 2 (P<0.001). The mean anastomosis time was 28.2±5.4 minutes in group 1 and 28.2±4.2 minutes in group 2 (P=1.000). The mean estimated blood loss was 101.54±44.60 mL in group 1 and 125.19±74.17 mL in group 2 (P=0.270), and the mean drain output was 51.42 mL per day and 57.50 mL per day in groups 1 and 2, respectively (P=0.590). Conclusions: EBVS can be employed safely and effectively for recipient iliac lymphatic vessel dissection and sealing. EBVS is a fast, secure, and effective choice to permanently fuse the vessels and is a good option to avoid posttransplant lymphatic complications.

Demographics of Thoracolumbar Fracture in Indian Population Presenting to a Tertiary Level Trauma Centre

Ketan Khurjekar,Shailesh Hadgaonkar,Ajay Kothari,Rishikesh Raut,Vibhu Krishnan,Ashok Shyam,Parag Sancheti 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.3

Study Design: Prospective, cross-sectional, observational study. Purpose: Spine traumata are devastating injuries, which may result in serious disabilities and dire consequences. The current study involves a detailed analysis and description of patients, who were operated at a tertiary care, urban level 1 Spine Centre in India. Overview of Literature: Various studies in literature have discussed the epidemiology and patterns of these injuries in trauma patients. However, literature describing the demographic profile and distribution of these traumata in the Indian population is scarce. Methods: The current study was conducted as a prospective trial involving patients, who were treated at our Spine Centre in India between July 2009 to December 2012. We studied 92 patients with thoraco-lumbar spine fracture, who were operated with short or long segment posterior stabilization. Epidemiological details, pre- and post-hospitalisation care received and other injury pattern factors were studied. Results: Fall from height (46 patients, 50%) was the most common mechanism observed in the patients. Sixty-three percent injuries belonged to AO type A fractures, while 16.2% and 19.4% of the patients had suffered from AO types B and C injuries, respectively. Conclusions: We identified interesting epidemiological data and prevailing inadequacies in Emergency Spine care management in the study patients. These observations could facilitate implementation of the changes required to improve current standards of patient care.

RFLP Analysis of cry1 and cry2 Genes of Bacillus thuringiensis Isolates from India

( Patel Ketan D. ),( Sanjay S. Ingle ) 한국미생물 · 생명공학회 2012 Journal of microbiology and biotechnology Vol.22 No.6

The PCR-RFLP method has been useful for detection of known genes and identification of novel genes. In the present study, degenerate primers were designed from five groups of cry1 genes for PCR-RFLP analysis. Bacillus thuringiensis (Bt) isolates from different regions were evaluated for PCR amplification of various cry1 genes using newly designed primers and cry2 genes using reported primers. PCR analysis showed an abundance of cry1A genes and especially cry1Ac genes in isolates from all regions. RFLP analysis revealed the presence of multiple cry1A genes in isolates from central and southern regions. Unique digestion patterns of cry1A genes were observed in isolates from each region. Few of the isolates represented a digestion pattern of cry1A genes that did match to any of the known cry1A genes. RFLP analysis suggested an abundance of cry2Ab along with a novel cry2 gene in Bt isolates from different regions of India. Sequence analysis of the novel cry2 gene revealed 95% sequence identity to cry2Ab and cry2Ah genes. Phylogenetic analysis revealed that the novel cry2 gene could have diverged earlier than the other cry2 genes. Our results encourage finding of more diverse cry2 genes in Bt isolates. Rarefaction analysis was used to compare cry1A gene diversity in isolates from different soil types. It showed a higher degree of cry1A gene diversity in isolates from central region. In the present study, we propose the use of novel degenerate primers for cry1 genes and the PCR-RFLP method using a single enzyme to distinguish multiple cry1A and cry2 genes as well as identify novel genes.

Development and characterization of mouth dissolving tablets of prednisolone

Biswajit Basu,Ketan R. Aviya,Amitava Bhattacharya 한국약제학회 2014 Journal of Pharmaceutical Investigation Vol.44 No.2

Prednisolone is a glucocorticoid with the generalproperties of the corticosteroids. It is used as antiinflammatoryor immunosuppressive agent in asthmaticcondition mostly in pediatric and geriatric population. Sothe present investigation was conducted with an aim of toformulate a taste masked patient friendly dosage form i.e. mouth dissolving tablets of prednisolone. In this study,taste masking of drug was critical parameter for this study. Masking of bitter taste of prednisolone was carried outusing techniques like preparation of solid dispersion withPEG 6000, complex formation with Indion-204 resinand b-cyclodextrin. Among them complex prepared fromb-cyclodextrin in weight ratio 1:4 was optimized basis ontaste panel evaluation and drug release from complex. Asuccessful taste masking of complex was confirmed bytime intensity method and also by taking drug release insimulated gastric fluid and in simulated salivary fluid. Thevalues of pre-compression parameters evaluated, werewithin prescribed limits and indicated good free flowingproperties. Tablets optimization was carried out through 32full factorial designs, concentration of superdisintegrantslike croscarmellose sodium and sodium starch glycolate asindependent variable. Whereas wetting time, disintegratingtime and cumulative percentage of drug release as dependentvariable. The data obtained of post-compressionparameters such as weight variation, hardness, friability,wetting time, water absorption ratio, content uniformity,disintegration time and dissolution was found withinspecified limit. Prepared check point batch having disintegratingtime 16.12 s and drug release 98.34 after 30 minwas selected as optimized formula. This formula wascompared with marketed formulation and was found betterdisintegration and drug release property. Optimized formulationwas subjected for accelerated stability study asper ICH guideline.

Delayed versus Delayed-Immediate Autologous Breast Reconstruction: A Blinded Evaluation of Aesthetic Outcomes

Frank P Albino,Ketan M Patel,Jesse R Smith,Maurice Y Nahabedian 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.3

Background: The technique of delayed-immediate breast reconstruction includes immediate insertion of a tissue expander, post-mastectomy radiation, followed by reconstruction. The aesthetic benefits of delayed-immediate reconstruction compared to delayed reconstruction are postulated but remain unproven. The purpose of this study was to compare aesthetic outcomes in patients following delayed and delayed-immediate autologous breast reconstruction. Methods: A retrospective analysis was performed of all patients who underwent delayed or delayed-immediate autologous breast reconstruction by the senior author from 2005 to 2011. Postoperative photographs were used to evaluate aesthetic outcomes: skin quality, scar formation, superior pole contour, inferior pole contour, and overall aesthetic outcome. Ten non-biased reviewers assessed outcomes using a 5-point Likert scale. Fisher’s Exact and Wilcoxon-Mann-Whitney tests were used for comparative analysis. Results: Patient age and body mass index were similar between delayed (n=20) and delayed-immediate (n=20) cohorts (P>0.05). Skin and scar quality was rated significantly higher in the delayed-immediate cohort (3.74 vs. 3.05, P<0.001 and 3.41 vs. 2.79, P<0.001; respectively). Assessment of contour-related parameters, superior pole and inferior pole, found significantly improved outcomes in the delayed-immediate cohort (3.67 vs. 2.96, P<0.001 and 3.84 vs. 3.06, P<0.001; respectively). Delayed-immediate breast reconstruction had a significantly higher overall score compared to delayed breast reconstructions (3.84 vs. 2.94, P<0.001). Smoking and the time interval from radiation to reconstruction were found to affect aesthetic outcomes (P<0.05). Conclusions: Preservation of native mastectomy skin may allow for improved skin/scar quality, breast contour, and overall aesthetic outcomes following a delayed-immediate reconstructive algorithm as compared to delayed breast reconstruction.

Efficacy of Three Different Plant Species for Arsenic Phytoextraction from Hydroponic System

Sarita Tiwari,Bijaya Ketan Sarangi,Ram Avatar Pandey 대한환경공학회 2014 Environmental Engineering Research Vol.19 No.2

Arsenic (As) is one of the heavy metals which causes acute bio-toxicity even at low concentration and has disastrous effect on environment. In some countries, As contamination has become alarming and increasing day by day as consequences of unsustainable management practices. Many existing physical, chemical and biological processes for As removal from water system are not feasible due to techno-economic limitations. The present study highlights the scope of biological strategy for As removal through phytoextraction. Arsenic uptake and accumulation in the biomass of three plant species and their As tolerance abilities have been investigated to develop an efficient phytoextraction system in combination of these plant species. Three non-crop plant species, Pteris vittata; Mimosa pudica, and Eichhornia crassipus were treated with 0.200 mg/L As in liquid nutrient solution for 14 days. P. vittata accumulated total 9,082.2 mg (8,223 mg in fronds) As/kg biomass and Eichhornia total 6,969 mg (4,517 mg in fronds)/kg biomass at 200 mg/L As concentration, respectively. Bioaccumulation factor (BF) and translocation factor (TF) were estimated to differentiate between excluders, accumulators and accumulation in above ground biomass. Pteris and Eichhornia have highest BF (67 and 17) and TF (64 and 3), respectively. In contrast, Mimosa accumulated up to 174 mg As/kg plant biomass which is low in comparison with other two plants, and both BF and TF were ≤1. This study reveals that Pteris and Eichhornia are As hyperaccumulator, and potential candidates for As removal from water system.

Delayed versus Delayed-Immediate Autologous Breast Reconstruction: A Blinded Evaluation of Aesthetic Outcomes

Albino, Frank P.,Patel, Ketan M.,Smith, Jesse R.,Nahabedian, Maurice Y. Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.3

Background The technique of delayed-immediate breast reconstruction includes immediate insertion of a tissue expander, post-mastectomy radiation, followed by reconstruction. The aesthetic benefits of delayed-immediate reconstruction compared to delayed reconstruction are postulated but remain unproven. The purpose of this study was to compare aesthetic outcomes in patients following delayed and delayed-immediate autologous breast reconstruction. Methods A retrospective analysis was performed of all patients who underwent delayed or delayed-immediate autologous breast reconstruction by the senior author from 2005 to 2011. Postoperative photographs were used to evaluate aesthetic outcomes: skin quality, scar formation, superior pole contour, inferior pole contour, and overall aesthetic outcome. Ten non-biased reviewers assessed outcomes using a 5-point Likert scale. Fisher's Exact and Wilcoxon-Mann-Whitney tests were used for comparative analysis. Results Patient age and body mass index were similar between delayed (n=20) and delayed-immediate (n=20) cohorts (P>0.05). Skin and scar quality was rated significantly higher in the delayed-immediate cohort (3.74 vs. 3.05, P<0.001 and 3.41 vs. 2.79, P<0.001; respectively). Assessment of contour-related parameters, superior pole and inferior pole, found significantly improved outcomes in the delayed-immediate cohort (3.67 vs. 2.96, P<0.001 and 3.84 vs. 3.06, P<0.001; respectively). Delayed-immediate breast reconstruction had a significantly higher overall score compared to delayed breast reconstructions (3.84 vs. 2.94, P<0.001). Smoking and the time interval from radiation to reconstruction were found to affect aesthetic outcomes (P<0.05). Conclusions Preservation of native mastectomy skin may allow for improved skin/scar quality, breast contour, and overall aesthetic outcomes following a delayed-immediate reconstructive algorithm as compared to delayed breast reconstruction.

Correlation between Preoperative Magnetic Resonance Imaging Signal Intensity Changes and Clinical Outcomes in Patients Surgically Treated for Cervical Myeloradiculopathy

Chaitanya Baban Chikhale,Ketan Shripad Khurjekar,Ashok Kumar Shyam,Parag Kantilal Sancheti 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.2

Study Design: This was a single surgeon, single center-based retrospective study with prospective data collection. Purpose: To assess the correlation between T2-weighted magnetic resonance imaging (MRI) signal intensity (SI) changes and factors such as age, duration of symptoms, baseline modified Japanese Orthopedic Association (mJOA) score and to determine its prognostic value in predicting recovery after surgery. Overview of Literature: Whether intramedullary cord T2-weighted MRI SI changes can predict operative outcomes of cervical myeloradiculopathy remains debatable, with only a few prospective studies analyzing the same. Methods: Forty-six consecutive patients who underwent cervical myeloradiculopathy were included and were followed up for an average of 1 year. Preoperative T2-weighted MRI SI grading was performed for all patients. The correlation between MRI SI changes and age, duration of symptoms, preoperative mJOA score, and mJOA score at 1-year follow-up were analyzed. Results: Fifteen patients had single-level (21.73%) or double-level (10.86%) prolapsed discs; 54.34% had degenerative cervical spondylosis with canal stenosis or multilevel disc prolapse and 13.07% had ossified posterior longitudinal ligaments. The mean age was 56.17±9.53 years (range, 35–81 years). The mean baseline mJOA score was 10.83±2.58 (range, 6–16), which postoperatively improved to 13.59±2.28 (range, 8–17; p <0.001). There was a statistically significant correlation between mJOA score at 1 year and MRI T2 SI grading (p =0.017). Conclusions: Patients with longer symptom durations had high grades of intramedullary cord T2-weighted MRI SI changes. Age and preoperative neurological status were not significantly correlated with the existence of intramedullary cord SI changes. However, patients without or with mild and diffuse intramedullary cord T2-weighted MRI SI changes had better postoperative neurological recovery than those with sharp and focal SI changes.

Comparison of Classical and Quantum Optimization for Airline Scheduling Problems

Changjin Lim,Jordan Makansi,Ketan Savla,Youngbum Hur 대한산업공학회 2023 대한산업공학회 추계학술대회논문집 Vol.2023 No.11

Mass transfer analysis of ultrafiltration using spacers based on triply periodic minimal surfaces: Effects of spacer design, directionality and voidage

Sreedhar, Nurshaun,Thomas, Navya,Al-Ketan, Oraib,Rowshan, Reza,Hernandez, Hector H.,Abu Al-Rub, Rashid K.,Arafat, Hassan A. Elsevier 2018 Journal of membrane science Vol.561 No.-

<P><B>Abstract</B></P> <P>An ideal feed spacer balances high flux and low pressure drop while minimizing fouling. In this work, several feed spacer with complex triply periodic minimal surface (TPMS) geometries were designed and fabricated using additive manufacturing (AM) processing. AM technology was employed to vary the voidage and directionality of the spacers. The fabricated spacers were tested to determine their impact on mass transfer, pressure drop and critical flux in a flat-sheet ultrafiltration (UF) setup for protein separation in aqueous medium. Dimensionless numbers analysis was conducted with dextran filtration, while critical flux was determined via the flux-stepping method by filtration of bovine serum albumin (BSA). All the tested TPMS spacers displayed an increase in mass transfer compared to a commercial spacer design, with the Gyroid spacer (84% voidage) exhibiting a 67% increase in Sherwood number. The Gyroid design also showed an 8% improvement in critical flux. Modification of the spacer voidage and direction also showed significant influence on performance. By increasing the voidage of the Gyroid spacer from 84% to 90%, we observe a 97% increase in Sherwood Number and an 18% decrease in Power number, compared to commercial spacer. The findings of this study show the advantages of TPMS architectures as candidates for spacer design in UF.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Spacers based on triply periodic minimal surfaces (TPMS) were made. </LI> <LI> Mass transfer study of TPMS spacers in ultrafiltration. </LI> <LI> Modification of directionality and porosity of TPMS spacers evaluated. </LI> <LI> Spacer with gradually changing porosity fabricated and tested. </LI> <LI> Superior critical flux using some TPMS architectures compared to commercial design. </LI> </UL> </P>