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Siddharth Pandey,Satyanarayan Sankhwar,Apul Goel,Manoj Kumar,Ajay Aggarwal,Deepanshu Sharma,Samarth Agarwal,Tushar Pandey 대한비뇨의학회 2019 Investigative and Clinical Urology Vol.60 No.2
Purpose: To analyze the utility of quick Sequential Organ Failure Assessment (qSOFA) in patients with uro-sepsis due to acute pyelonephritis (APN) with upper urinary tract calculi, we conducted this study. The role of qSOFA as a tool for rapid prognostication in patients with sepsis is emerging. But there has been a great debate on its utility. Literature regarding utility of qSOFA in uro-sepsis is scarce. Materials and Methods: Ours was a retrospective study including 162 consecutive patients who were admitted for APN with upper urinary tract calculi over a 3 and half years (total 42 months) period. We evaluated the accuracy of qSOFA in predicting inhospital mortality and intensive care unit (ICU) admissions and compared this with the predictive accuracy of systemic inflammatory response syndrome (SIRS). We used the Area Under Curve (AUC) of the Receiver Operator Characteristic curve to calculate it and also calculated the optimum cut off for qSOFA score. Results: The overall mortality and ICU admission rates were 7.4% and 12.9%, respectively. qSOFA had a higher predictive accuracy for in-hospital mortality (AUC, 0.981; 95% confidence interval [CI], 0.962–1.000) and ICU admissions (AUC, 0.977; 95% CI, 0.955–0.999) than SIRS. A qSOFA score of ≥2 was an optimum cut off for predicting prognosis. In a multivariate model qSOFA ≥2 was a highly significant predictor of in-hospital mortality and ICU admissions (p<0.001). Conclusions: qSOFA is a reliable and rapid bedside tool in patients with sepsis with accuracy more than SIRS in predicting inhospital mortality and ICU admissions.
Siddharth Narasimhan Aiyer,Ajit Kumar,Ajoy Prasad Shetty,Rishi Mugesh Kanna,Shanmuganath Rajasekaran 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.6
Study Design: Prospective observational study. Purpose: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. Overview of Literature: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. Methods: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. Results: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/ decompression, and higher postoperative pain scores (p <0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. Conclusions: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.
ON STUDY OF f-APPROXIMATION PROBLEMS AND σ-INVOLUTORY VARIATIONAL INEQUALITY PROBLEMS
Siddharth Mitra,Prasanta Kumar Das 경남대학교 기초과학연구소 2022 Nonlinear Functional Analysis and Applications Vol.27 No.2
The purpose of the paper is to define f-projection operator to develop the f-projection method. The existence of a variational inequality problem is studied using fixed point theorem which establishes the existence of f-projection method. The concept of ρ-projective operator and σ-involutory operator are defined with suitable examples. The relation in between ρ-projective operator and σ-involutory operator are shown. The concept of σ-involutory variational inequality problem is defined and its existence theorem is also established.
Algorithm for Vertical Handover Decision using Least Cost Function
Siddharth Goutam,Srija Unnikrishnan,Sundary S. Prabavathy,Archana Karandikar 대한전자공학회 2021 IEIE Transactions on Smart Processing & Computing Vol.10 No.1
Next Generation Networks (NGNs) will be heterogeneous due to the presence of the various Radio Access Technologies (RATs). The number of smartphone users is increasing exponentially, and smartphones are being equipped with multiple network interfaces. Smartphone users desire to be connected to the best network among the available networks while moving across geography. The requirement of seamless connectivity along with a maintained Quality of Service (QoS) can be achieved through Vertical Handover (VHO).Vertical Handover is an important factor to be considered in network design. The full potential of various access networks can be achieved using efficient and effective Vertical Handover Decision Algorithms (VHDAs). In this context, the research paper proposes a model for VHDA based on a Least Cost function. The primary function of VHDA is to provide “All-Time Connectivity to the Best Possible Network with the Best Quality of Service at the Least Cost”. The main parameters considered in the VHDA are RSS, bandwidth, network coverage, packet loss, jitter, and latency.
Siddharth Pandey,Deepanshu Sharma,Satyanarayan Sankhwar,Manmeet Singh,Gaurav Garg,Ajay Aggarwal,Ashish Sharma,Samarth Agarwal 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.6
Purpose: To compare patients with sepsis due to obstructive urolithiasis (Sep-OU) and underwent drainage by percutaneous nephrostomy (PCN) or a double-J (DJ)-ureteral stent and to identify predictive risk factors of DJ stent failure in these patients. Materials and Methods: We reviewed our records from January 2013 to July 2018 and identified 286 adult patients with Sep-OU out of which 36 had bilateral involvement, thus total 322 renal units were studied. Urologic residents in training carried out both ureteral stenting and PCN tube placement. Demographic data and stone characteristics were recorded along with Charlson comorbidity index. For predicting risk factors of DJ stent failure, those variables that had a p-value <0.1 in univariate analysis were combined in a multinomial regression analysis model. Results: The patients with PCN placement were significantly older than those with DJ stent placement (p=0.001) and also had significant number of units with multiple calculi (p=0.018). PCN was also placed more frequently in those patients with a upper ureteric calculi (p<0.05). On multinomial regression analysis multiple calculi (p=0.014; odds ratio [OR], 4.878; 95% confidence interval [CI], 1.377–17.276) and larger calculi size (p=0.040; OR, 0.974; 95% CI, 0.950–0.999) were the significant predictors of DJ stent failure. Conclusions: In patients with sepsis from obstructive urolithiasis due to larger and multiple calculi a PCN placement might be better suited although this data requires further prospective randomized studies to be extrapolated.
Burst criterion for Indian PHWR fuel cladding under simulated loss-of-coolant accident
Siddharth Suman 한국원자력학회 2019 Nuclear Engineering and Technology Vol.51 No.6
The indigenous nuclear power program of India is based mainly on a series of Pressurised Heavy WaterReactors (PHWRs). A burst correlation for Indian PHWR fuel claddings has been developed and empiricalburst parameters are determined. The burst correlation is developed from data available in literature forsingle-rod transient burst tests performed on Indian PHWR claddings in inert environment. The heatingrate and internal overpressure were in the range of 7 K/se73 K/s and 3 bare80 bar, respectively, duringthe burst tests. A burst criterion for inert environment, which assumes that deformation is controlled bysteady state creep, has been developed using the empirical burst parameters. The burst criterion hasbeen validated with experimental data reported in literature and the prediction of burst parameters is ina fairly good agreement with the experimental data. The burst criterion model reveals that increasing theheating rate increases the burst temperature. However, at higher heating rates, burst strain is decreasedconsiderably and an early rupture of the claddings without undergoing considerable ballooning isobserved. It is also found that the degree of anisotropy has significant influence on the burst temperatureand burst strain. With increasing degree of anisotropy, the burst temperature for claddings increases butthere is a decrease in the burst strain. The effect of anisotropy in the a-phase is carried over to aþb-phaseand its effect on the burst strain in the aþb-phase too can be observed.