Clinical and Radiological Outcomes after Reducing Adult Lytic High-Grade Spondylolisthesis Using a Hybrid Technique: Combination of Percutaneous Pedicle Screws with Midline Microscopic Transforaminal Decompression

Patel Bharat K.,Bapat Mihir R.,Gujral Amandeep 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.6

Study Design: Retrospective study.Purpose: To analyze the results and effectiveness of percutaneous screws (PS) with midline microscopic transforaminal decompression (MTFD) technique in reducing adult stiff lytic high-grade spondylolisthesis (HGSL) and compare it with the conventional technique.Overview of Literature: Pedicle screw cannulation and segmental kyphosis negotiation are surgical challenges in HGSL. Open reduction is the preferred approach. PS have the advantage of optimized trajectory and minimized soft tissue exposure. The role of minimally invasive surgery in HGSL remains unknown. We propose a hybrid technique combining PS with MTFD for lytic HGSL.Methods: This study included 25 patients with adult lytic HGSL (Meyerding grade III and IV) operated using a hybrid technique from 2012 to 2015. Data were compared with retrospective data on conventional open reduction (n=23) operated from 2000 to 2015. The minimum follow-up was 5 years. Clinical outcomes were assessed using the Visual Analog Scale (VAS) score and modified Oswestry Disability Index (m-ODI). The spinopelvic and perioperative parameters were recorded. The inter-body fusion and adjacent segment degeneration (ASD) were assessed on radiographs at the final follow-up.Results: The average age in the MTFD and open groups was 45.84±12.70 years (nine males and 16 females) and 49.26±13.33 years (eight males and 15 females), respectively. Further, 22 and three patients in the MTFD group and 19 and four in the open group had grade III and IV listhesis, respectively. The MTFD group demonstrated less operative time, blood loss, and hospital stays than the open group. Significant improvements were observed in VAS and m-ODI in subsequent follow-ups in both groups. The MTFD group fared better at 3 months but outcomes were comparable at the final follow-up. Both techniques were equally effective in restoring spinopelvic parameters. The incidence of ASD is comparable.Conclusions: The technique was proven effective in reducing HGSL. The long-term clinical and radiological outcomes were favorable and comparable with the conventional approach.

Formulation consideration and skin retention study of microemulsion containing tazarotene for targeted therapy of acne

Mrunali R. Patel,Rashmin B. Patel,Jolly R. Parikh,Bharat G. Patel 한국약제학회 2016 Journal of Pharmaceutical Investigation Vol.46 No.1

The objective of this study was to develop and evaluate a novel microemulsion (ME) formulation containing tazarotene for targeted topical therapy of acne. Microemulsions (MEs) were formulated by spontaneous microemulsification method using 12 % Isopropyl myristate, mixed emulsifiers 15 % Labrasol-Cremophor-RH 40 (1:1), 15 % Capmul MCM and 58 % water (w/w) as an external phase. All plain and tazarotene loaded MEs were clear and showed physicochemical parameters for desired topical delivery and stability. The permeation profile of tazarotene through rat skin from selected ME formulation exhibited highest skin uptake. The microscopic observations indicated that the optimized ME had no significant effect on the microscopic structure of the skin and epithelial cells appeared mostly unchanged. The surface epithelium lining and the granular cellular structure of the skin were totally intact. The developed ME may be a potential drug delivery vehicle for targeted topical delivery of tazarotene in the treatment of acne.

Does the Surgical Timing and Decompression Alone or Fusion Surgery in Lumbar Stenosis Influence Outcome in Cauda Equina Syndrome?

Bharat Rajendraprasad Dave,Puspak Samal,Romin Sangvi,Devanand Degulmadi,Denish Patel,Ajay Krishnan 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.2

Study Design: A retrospective comparative analysis of 64 patients with cauda equina syndrome (CES), who underwent either decompression alone (NF) or fusion (F) surgery. Purpose: We compared the outcomes and timing effects. Overview of Literature: CES can cause loss of autonomic control of vesicular function and lower limb neurological deficits. Prompt diagnosis and emergency surgery markedly improve outcome. Although decompression only is a mainstream technique, there is guarded recovery of vesicular dysfunction. Decompression ventrally in a narrow window requires manipulation of neural tissue in an already jeopardised critical canal and may accentuate irreversible damages. In F surgery, the adequate exposure leads to a lower neural manipulation. Methods: Until January 2008, we treated CES with decompression (laminectomy and/or discectomy). However, from that month forward, all our single-level CES patients have received a fusion operation. In this study, characteristic categorical variables and outcomes were analysed. Results: In a retrospective analysis of 64 patients, NF (n=37) and F (n=27) who received treatment, we found that both groups improved significantly on follow-up in all objective parameters. Although, the comparison of clinical and functional outcome data between the two groups was statistically insignificant, the average value of objective outcome such as vesicular function, low back pain (LBP), and complications was better for patients in F group compared with NF group. However, the patient satisfaction for the F group was also lower, in view of their residual symptoms and disabilities. Contrary to common perceptions, we found that the timing of surgery does not influence the recovery rate for either approach. Conclusions: Although both the techniques appear to be equally effective, the fusion approach overall showed a definite edge over non-fusion, with respect to reduced incidence of iatrogenic dural tears, LBP, and overall outcome, even despite the lower patient satisfaction.

Statins Ticagrelor and Rhabdomyolysis: A Coincidence or a Drug Interaction?

Ramesh Patel,Jai Bharat Sharma,Saraswati Rajput 한국지질동맥경화학회 2024 지질·동맥경화학회지 Vol.13 No.1

ObjectiveStatins play a key role in the management of atherosclerotic cardiovascular disease for both primary and secondary prevention. However, their increasing usage has correspondingly led to a higher incidence of adverse effects, with muscle symptoms being the most common. An intriguing drug interaction exists between ticagrelor and high-intensity statins, which may exacerbate the adverse effects of statin-induced rhabdomyolysis, leading to significant consequences. This study was conducted to examine the profile of patients who have experienced statin-induced rhabdomyolysis while undergoing percutaneous transluminal coronary angioplasty (PTCA). MethodsThis was an observational study that included 1,862 patients who underwent PTCA at our institute over the course of 1 year. ResultsOver a 1-year period, we encountered four patients who were being treated with high-intensity statin therapy following acute coronary syndrome. These patients presented with muscle weakness and kidney injury. A notable commonality among all patients was the co-prescription of ticagrelor. Two patients died, while the other 2 were successfully managed through hydration, electrolyte balance, dialysis, and alternative lipid management drugs. ConclusionThe concomitant use of ticagrelor and high-intensity statins should be carefully considered due to the additional risk of rhabdomyolysis and kidney injury. Future pharmacokinetic studies are needed to establish a causal relationship and predict potential drug interactions, which, if not avoided, could be fatal.

Copper nano-sol loaded woven fabrics: structure and color characterization

Pragnya Kanade,Bharat Patel 한국의류학회 2017 Fashion and Textiles Vol.4 No.1

Nano technology is an upcoming branch where lot of research work is being done with the intention of improving/changing properties of the materials. In this study polyester, cotton and polyester-cotton blended fabrics were coated with copper nano particles by pad-dry-cure technique. The morphology of nano-composite fabrics characterized using scanning electron microscope reveals that nanoparticles were dispersed on the fabric samples. The elemental analysis for confirming the presence of copper in the fabric samples was done using the Fourier transform infrared spectroscopy and energy dispersive X-ray spectroscopy techniques. The X-ray diffraction analysis of the fabric samples helped to unveil that incorporation of copper nano particles increased the d-spacing value in polyester fabric to a greater extent in comparison to the cotton and polyester-cotton blended fabrics. The nano treated woven fabric samples were dyed using myrobolan; a natural dye. The samples were evaluated in terms of colourimetric parameters and colour fastness. The copper nano-sol treatment was found to improve both K/S and colour fastness.

The Relationship of Facet Joint Orientation and Tropism with Lumbar Disc Herniation and Degenerative Spondylolisthesis in the Lower Lumbar Spine

Devanand Degulmadi,Bharat Dave,Ajay Krishnan,Denish Patel 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.1

Study design: Retrospective study. Purpose: This study aimed to clarify the relationship of both facet tropism (FT) and the sagittally aligned facet (SAF) joint with lumbar disc herniation (LDH) and degenerative spondylolisthesis (DS). Overview of Literature: Despite several studies conducted, there is no consensus on the association of the SAF joint and FT with DH and DS. Methods: Between June 2015 and December 2017, magnetic resonance imaging scans of 250 consecutive patients who underwent surgery for LDH and DS were analyzed. The facet angles at all the lower lumbar levels were calculated, and SAF and FT were noted. The relationship between the side of disc herniation and that of the SAF joint were also determined. Statistical analysis was performed, and the relation of SAF and FT to LDH and DS was noted. Results: We observed a positive relationship between SAF and LDH at L4–5 and L5–S1 with a p -value of 0.02 (<0.05). FT demonstrated a positive association with LDH at L4–5 (p =0.047) but not at L3–4 or L5–S1. SAF demonstrated a positive relationship with DS at L3–4 (p <0.001) but not at L3–4 or L5–S1. FT demonstrated a significant relation with DS at L4–5 (p <0.001), whereas no positive association was observed at L3–4 and L5–S1. Conclusions: The L4–5 level demonstrated a significant association with SAF and FT in LDH and DS. Moreover, SAF at L5–S1 demonstrated a positive association with LDH. These findings provide useful information for future longitudinal studies to elucidate the possible causes for such phenomena.

Silicon Carbide Coating on Graphite and Isotropic C/C Composite by Chemical Vapour Reaction

L.M. Manocha,Bharat Patel,S. Manocha 한국탄소학회 2007 Carbon Letters Vol.8 No.2

The application of Carbon and graphite based materials in unprotected environment is limited to a temperature of 450℃ or so because of their susceptibility to oxidation at this temperature and higher. To over come these obstacles a low cost chemical vapour reaction process (CVR) was developed to give crystalline and high purity SiC coating on graphite and isotropic C/C composite. CVR is most effective carbothermal reduction method for conversation of a few micron of carbon layer to SiC. In the CVR method, a sic conversation layer is formed by reaction between carbon and gaseous reagent silicon monoxide at high temperature. Characterization of SiC coating was carried out using SEM. The other properties studied were hardness density and conversion efficiency.

Energy Requirements and Tillage Performance Under Different Active Tillage Treatments in Sandy Loam Soil

Choudhary Swapnil,Upadhyay Ganesh,Patel Bharat,Naresh,Jain Mukesh 한국농업기계학회 2021 바이오시스템공학 Vol.46 No.4

Purpose To assess the operational energy requirement (OER) and tillage performance index (TPI) of four different active tillage treatments and identification of the best efficient tillage practice among them to achieve an alternative to the conventional practice T1 (1×Cultivator+2×Offset disc harrow), which involves only purely passive type of tillage tools. Methods The active tillage treatments considered were as follows: T2 (1×Combined offset disc harrow), T3 (1×Cultivator+ 1×Single rotor type rotavator), T4 (1×Double rotor type rotavator), and T5 (1×Power harrow). Each implement in the respective treatment was operated at their best suitable forward speed and rotor rpm. Results Compared to the conventional practice T1, the amount of fuel saved per hectare in tillage practices, T2, T4, and T5, was 49.8%, 17.9%, and 20.3%, respectively. However, tillage treatment T3 was found to consume 6.9% more fuel. Compared to T1, the amount of time saved by T2, T3, T4, and T5 tillage practices was found to be 61.1%, 9.54%, 40.6%, and 44.6%, respectively. The maximum OER of 1445.32 MJ ha−1 was observed in T3 followed by 1360.40, 1105.86, 1085.86, and 681.36 MJ ha−1 in T1, T4, T5, and T2, respectively. Further, compared to T1, the TPI for tillage treatments, T2 and T4, was found to be higher by 74.07% and 133.33%, respectively. However, the TPI for tillage treatment T3 was found to be lower by 88.88%. Conclusions Active tillage implements helped in time and fuel-saving in seedbed preparation. The maximum percentage of operational energy was consumed in the form of fuel energy. The front active and rear passive configuration of combined offset disc harrow was found to be the most effective among all the tested active tillage implements in terms of both operational energy and tillage performance criteria.

Production of Methanol from Methane by Encapsulated Methylosinus sporium

( Sanjay K. S. Patel ),( Jae-hoon Jeong ),( Sanjeet Mehariya ),( Sachin V. Otari ),( Bharat Madan ),( Jung Rim Haw ),( Jung-kul Lee ),( Liaoyuan Zhang ),( In-won Kim ) 한국미생물 · 생명공학회 2016 Journal of microbiology and biotechnology Vol.26 No.12

Massive reserves of methane (CH₄) remain unexplored as a feedstock for the production of liquid fuels and chemicals, mainly because of the lack of economically suitable and sustainable strategies for selective oxidation of CH4 to methanol. The present study demonstrates the bioconversion of CH₄ to methanol mediated by Type I methanotrophs, such as Methylomicrobium album and Methylomicrobium alcaliphilum. Furthermore, immobilization of a Type II methanotroph, Methylosinus sporium, was carried out using different encapsulation methods, employing sodium-alginate (Na-alginate) and silica gel. The encapsulated cells demonstrated higher stability for methanol production. The optimal pH, temperature, and agitation rate were determined to be pH 7.0, 30oC, and 175 rpm, respectively, using inoculum (1.5 mg of dry cell mass/ml) and 20% of CH₄ as a feed. Under these conditions, maximum methanol production (3.43 and 3.73 mM) by the encapsulated cells was recorded. Even after six cycles of reuse, the Na-alginate and silica gel encapsulated cells retained 61.8% and 51.6% of their initial efficiency for methanol production, respectively, in comparison with the efficiency of 11.5% observed in the case of free cells. These results suggest that encapsulation of methanotrophs is a promising approach to improve the stability of methanol production.

Silicon Carbide Coating on Graphite and Isotropic C/C Composite by Chemical Vapour Reaction

Manocha, L.M.,Patel, Bharat,Manocha, S. Korean Carbon Society 2007 Carbon Letters Vol.8 No.2

The application of Carbon and graphite based materials in unprotected environment is limited to a temperature of $450^{\circ}C$ or so because of their susceptibility to oxidation at this temperature and higher. To over come these obstacles a low cost chemical vapour reaction process (CVR) was developed to give crystalline and high purity SiC coating on graphite and isotropic C/C composite. CVR is most effective carbothermal reduction method for conversation of a few micron of carbon layer to SiC. In the CVR method, a sic conversation layer is formed by reaction between carbon and gaseous reagent silicon monoxide at high temperature. Characterization of SiC coating was carried out using SEM. The other properties studied were hardness density and conversion efficiency.