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RISS 인기검색어
- 검색키워드
- 저자 : Naresh Kumar Sharma (검색결과 3 건)
- 무료
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Role of liver transplantation in severe alcoholic hepatitis
( Ravi Daswani ),( Ashish Kumar ),( Praveen Sharma ),( Vikas Singla ),( Naresh Bansal ),( Anil Arora ) 대한간학회 2018 Clinical and Molecular Hepatology(대한간학회지) Vol.24 No.1
Severe alcoholic hepatitis has very high short term mortality and corticosteroids have been the mainstay of treatment for decades. Patients with Lille score >0.45 are considered non-responders to steroids and have poor outcome. Recently Orthotopic Liver Transplantation (OLT) is being increasingly used as rescue treatment for these patients, without waiting for 6 months of abstinence. Liver transplant is the only rescue treatment which can potentially provide long term benefit for patients who are steroid non-responders. However, with scarcity of organs being a concern, all patients of severe alcoholic hepatitis cannot be chosen for transplantation in an arbitrary way. There is a need for development of predictive tools and objective protocols to select patients who can justify the use of precious liver grafts. With a stringent criteria for selection of patients receiving the graft, liver transplantation in severe alcoholic hepatitis can become a viable rescue therapeutic option conferring significant survival advantage of both short- and long-term basis. The optimal criteria for selection will also prevent misuse of the liver donor pool as well as to prevent mortality in salvageable patients. Further research needs to be done to identify subset of patients which are at low risk of recidivism and also cannot be managed with pharmacotherapy alone. We reviewed the current knowledge on role of OLT in patient with acute severe alcoholic hepatitis in the present review. (Clin Mol Hepatol 2018;24:43-50)
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Macroeconomic Response to Oil and Food Price Shocks: A Structural VAR Approach to the Indian Economy
Javed Ahmad Bhat,Aadil Ahmad ganaie,Naresh Kumar Sharma 한국국제경제학회 2018 International Economic Journal Vol.32 No.1
The study analyzed the dynamic impact of oil and food price shocks on the macroeconomy of India, using the monthly time series data from April 1994 to May 2016 in a structural vector autoregression (SVAR) framework. Being a net food exporter and net oil importer, the economy is found to face deleterious impacts of global oil and food price shocks on its macroeconomic performance. Output responds negatively to oil and food price hikes along with their volatility and positively to the fall in these prices. Inflation responds positively to all the three transformations of shocks with no signs of coming down, highlighting the price downward inflexibility in India. The study could not establish any evidence of negative demand shocks in face of oil and food price volatility. Central bank responds with a contractionary policy stance to negate the influences of external shocks. Forecast error variance decomposition points out the dominance of external shocks in influencing the domestic variables after their own shocks. Finally, the inflation downward rigidity is observed even in the long run.
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Akanksha Grover,Tej Prakash Soni,Nidhi Patni,Dinesh Kumar Singh,Naresh Jakhotia,Anil Kumar Gupta,Lalit Mohan Sharma,Shantanu Sharma,Ravindra Singh Gothwal 대한방사선종양학회 2021 Radiation Oncology Journal Vol.39 No.1
Purpose: Intensity-modulated radiotherapy (IMRT) provides higher dose to target volumes and limits the dose to normal tissues. IMRT may be applied using either simultaneous integrated boost (SIB-IMRT) or sequential boost (SEQ-IMRT) technique. The objectives of this study were to compare acute toxicity and objective response rates between SIB-IMRT and SEQ-IMRT in patients with locally advanced head and neck cancer. Materials and Methods: Total 110 patients with locally advanced carcinoma of oropharynx, hypopharynx, and larynx were randomized equally into the two arms (SIB-IMRT vs. SEQ-IMRT). Patients in SIB-IMRT arm received dose of 66 Gy in 30 fractions, 5 days a week, over 6 weeks. SEQ-IMRT arm’s patients received 70 Gy in 35 fractions over 7 weeks. Weekly concurrent cisplatin chemotherapy was given in both arms. Patients were assessed for acute toxicities during the treatment and for objective response at 3 months after the radiotherapy. Results: Grade 3 dysphagia was significantly more with SIB-IMRT compared to SEQ-IMRT (72% vs. 41.2%; p = 0.006) but other toxicities including mucositis, dermatitis, xerostomia, weight-loss, incidence of nasogastric tube intubation and hospitalization for supportive management were similar in both the arms. Patients in SIB-IMRT arm showed better treatment-compliance and had significantly less treatment-interruption compared to SEQ-IMRT arm (p = 0.028). Objective response rates were similar in both the arms (p = 0.783). Conclusion: Concurrent chemoradiation with SIB-IMRT for locally advanced head and neck cancer is well-tolerated and results in better treatment-compliance, similar objective response rates, comparable incidence of mucositis and higher incidence of grade 3 dysphagia compared to SEQ-IMRT.
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