A Prospective Study on the Feasibility, Safety, and Efficacy of a Modified Technique to Augment the Strength of Pedicle Screw in Osteoporotic Spine Fixation

Tandon Vikas,Kalidindi Kalyan Kumar Varma,Pacha Sandesh,Bhat Mohd Rafiq 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.3

Study Design: Prospective case study.Purpose: Osteoporotic spine fixation by pedicle screw instrumentation is complicated by screw loosening, migration, or pullout with rates of up to 62% documented in the literature. Contemporary solutions have not adequately addressed these complications. We propose a modified surgical technique of cement augmentation with bicortical pedicle screw fixation to address the issue related to implant failure in osteoporotic spine.Overview of Literature: Zindrick and his colleagues described a “windshield wiper” effect owing to the shift of center of rotation to the distal tip of the screw in the bicortical purchase of screws. An increase in pullout strength from 119% to 250% with polymethyl methacrylate augmentation has been documented in the literature. This technique has not been described in the literature.Methods: A prospective study was conducted with 40 patients who underwent surgery by the modified technique. Intraoperative and postoperative complications directly related to the procedure were assessed. Improvement in pain and functional status were assessed. Follow-up radiographs were assessed to check for appreciable screw migration, loosening, or pullout.Results: This technique was used in inserting 364 screws in 40 patients. We did not encounter any difficulty in inserting the screws. A total of 19 screws failed to breach the anterior cortex owing to an error in measurement. There were no complications during the procedure in any of the patients, and the postoperative period was uneventful. The mean follow-up period was 18 months. There were two patients in whom proximal junctional failure with kyphosis was noted during follow-up, who were surgically managed by extension of the fixation levels.Conclusions: Bicortical fixation with cement augmentation is a technically feasible, safe, and effective technique to augment the strength of pedicle screws in osteoporotic spine fixation. It has the potential to be established as a standard of care in osteoporotic spine fixation.

DNA structures embedded with functionalized nanomaterials for biophysical applications

Tandon Anshula,Park Sung Ha 한국물리학회 2021 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.78 No.5

DNA has emerged as a useful building block for the construction of various one-, two- and three-dimensional structures. DNA structures embedded with functionalized nanomaterials are emerging for various applications, especially for biophysical applications such as drug delivery, diagnostics, biolabeling, biosensing and biodevices. This review outlines the broad spectrum of recent advances in applied DNA nanotechnology and discusses various types of DNA structures, the construction of protein-embedded DNA structures, DNA structures for drug carriers, the usage of small nucleic-acid molecules and the significance of nanoparticle-attached, carbon-based, fluorescent nanomaterial-added and ion-doped DNA structures. Finally, it provides perspectives on nanoscale structuring, emphasizes the need for sufficient production yields and up-scalable synthesis and the structural stability and future development of nanomaterial-embedded DNA structures.

Sinonasal teratocarcinosarcoma treated with surgery followed by volumetric modulated radiotherapy: a case report with review of literature

Tandon, Sarthak,Gairola, Munish,Ahlawat, Parveen,Sharma, Kanika,Barik, Soumitra,Sachdeva, Nishtha,Pasricha, Sunil,Shenoy, Apeksha The Korean Society for Radiation Oncology 2018 Radiation Oncology Journal Vol.36 No.4

Surgical excision along with use of postoperative radiotherapy forms an integral management of sinonasal teratocarcinosarcoma (SNTCS). However, given the rarity of the tumor, no standardised guidelines, dose, technique and target delineation exist especially in the era of modern radiation delivery techniques. This is a case of 55-year-old male diagnosed as SNTCS treated with radical ethmoidectomy followed by volumetric modulated radiotherapy, showing good local control and acceptable toxicity profile.

Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

Tandon, Shruti,Lamba, Arundeep Kaur,Faraz, Farrukh,Aggarwal, Kamal,Ahad, Abdul,Yadav, Neha The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.1

Background: Profound anesthesia with adequate duration is required in periodontal flap surgery, which involves the manipulation of both hard and soft tissues. The anterior middle superior alveolar (AMSA) injection may be an alternative to multiple injections required for this purpose in the maxilla. The present study aimed to assess the effectiveness of AMSA injection using computer-controlled local anesthetic delivery (CCLAD) system to anesthetize buccal hard tissue (BHT), buccal soft tissue (BST), palatal hard tissue (PHT), and palatal soft tissue (PST) around the maxillary teeth. Methods: Thirty-five patients who were indicated for open flap debridement in a whole maxillary quadrant were given AMSA injection using the CCLAD. The effectiveness of anesthesia was evaluated using subjective and objective parameters around each tooth. Supraperiosteal infiltrations were administered to complete the surgery wherever the AMSA injection was ineffective. Results: The AMSA injection was more effective on the palatal tissues than on the buccal tissues, as 94.14% of PST and 87.89% of PHT sites were anesthetized compared to 49.22% and 43.75% of BHT and BST sites, respectively. There was no significant difference in the frequency of anesthesia around the anterior and posterior teeth. The PHT was significantly more anesthetized (P = 0.003) in males than in females. Conclusions: The AMSA injection using CCLAD is highly effective on palatal tissues and could be used as a first-line anesthesia for periodontal flap surgery. However, its effect on buccal tissues is less predictable, with supraperiosteal infiltration often required to supplement the AMSA injection.

The fourth wave: vaccination status and intensive care unit mortality at a large hospital system in New York City

Pranai Tandon,Evan Leibner,Anna Hackett,Katherine Maguire,Kayla Leonardi,Matthew A. Levin,Roopa Kohli-Seth 대한중환자의학회 2022 Acute and Critical Care Vol.37 No.3

Background: We aim to describe the demographics and outcomes of patients with severe disease with the Omicron variant. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus continues to mutate, and the availability of vaccines and boosters continue to rise, it is important to understand the health care burden of new variants. We analyze patients admitted to intensive care units (ICUs) in a large Academic Health System during New York City’s fourth surge beginning on November 27, 2021.Methods: All patients admitted to an ICU were included in the primary analysis. Key demographics and outcomes were retrospectively compared between patients stratified by vaccination status. Univariate and multivariate logistic regression was used to identify risk factors for in-hospital mortality.Results: In-hospital mortality for all admitted patients during the fourth wave was significantly lower than in previous waves. However, among patients requiring intensive care, in-hospital mortality was high across all levels of vaccination status. In a multivariate model older age was associated with increased in-hospital mortality, vaccination status of overdue for booster was associated with decreased in hospital mortality, and vaccination status of up-to-date with vaccination showed a trend to reduced mortality.Conclusions: In-hospital mortality of patients with severe respiratory failure from coronavirus disease 2019 (COVID-19) remains high despite decreasing overall mortality. Vaccination against SARS-CoV-2 was protective against mortality. Vaccination remains the best and safest way to protect against serious illness and death from COVID-19. It remains unclear that any other treatment will have success in changing the natural history of the disease.

Sentinel Based Malicious Relay Detection in Wireless IoT Networks

Anshoo Tandon,Teng Joon Lim,Utku Tefek 한국통신학회 2019 Journal of communications and networks Vol.21 No.5

Increased device connectivity and information sharingin wireless IoT networks increases the risk of cyber attack by maliciousnodes. In this paper, we present an effective and practicalscheme for detecting data integrity and selective forwarding attackslaunched by malicious relays in wireless IoT networks. Theproposed scheme exploits the broadcast nature of wireless transmissionand provides a sentinel based approach to intrusion detection. Our detection scheme assumes a general noise model for thenetwork where different wireless links may have different packeterror probability (PEP). Further, our detection scheme is effectiveeven in scenarios where different wireless links in the networkemploy distinct modulation and coding schemes at the physicallayer. This detection scheme has application in practical wirelessIoT networks, such as those based on the recently introduced IEEE802.11ah standard.

Consumer Awareness towards Internet Banking : A Comparative Study of Public, Private and Foreign Banks

Ashima Tandon,Manisha Goel,Sunita Bishnoi 보안공학연구지원센터 2016 International Journal of Hybrid Information Techno Vol.9 No.6

Internet banking is regarded as a delivery channel, which over a period of time has gained recognition. It in fact has experienced growth in many countries and has changed the traditional way of banking. This channel has provided competitive advantage to the banks. With the help of internet banking the consumer has an access to number of services just at the click of a mouse. The present study is based on the responses of 450 consumers surveyed in Delhi and National Capital Region to understand the consumer awareness towards internet banking and the respondents were selected from public, private and foreign sector banks. To achieve the objectives of the study a questionnaire with five-point Likert scale consisting of various aspects related to internet banking was designed and random sampling method was adopted to collect the responses. The results of the study indicate that the level of consumer awareness is higher in case of private and foreign sector banks in comparison to public sector banks. Public sector banks need to focus on their working in order to battle with the private and foreign sector banks.

A Bio-inspired Hybrid Cross-Layer Routing Protocol for Energy Preservation in WSN-Assisted IoT

( Aditya Tandon ),( Pramod Kumar ),( Vinay Rishiwal ),( Mano Yadav ),( Preeti Yadav ) 한국인터넷정보학회 2021 KSII Transactions on Internet and Information Syst Vol.15 No.4

Nowadays, the Internet of Things (IoT) is adopted to enable effective and smooth communication among different networks. In some specific application, the Wireless Sensor Networks (WSN) are used in IoT to gather peculiar data without the interaction of human. The WSNs are self-organizing in nature, so it mostly prefer multi-hop data forwarding. Thus to achieve better communication, a cross-layer routing strategy is preferred. In the cross-layer routing strategy, the routing processed through three layers such as transport, data link, and physical layer. Even though effective communication achieved via a cross-layer routing strategy, energy is another constraint in WSN assisted IoT. Cluster-based communication is one of the most used strategies for effectively preserving energy in WSN routing. This paper proposes a Bio-inspired cross-layer routing (BiHCLR) protocol to achieve effective and energy preserving routing in WSN assisted IoT. Initially, the deployed sensor nodes are arranged in the form of a grid as per the grid-based routing strategy. Then to enable energy preservation in BiHCLR, the fuzzy logic approach is executed to select the Cluster Head (CH) for every cell of the grid. Then a hybrid bio-inspired algorithm is used to select the routing path. The hybrid algorithm combines moth search and Salp Swarm optimization techniques. The performance of the proposed BiHCLR is evaluated based on the Quality of Service (QoS) analysis in terms of Packet loss, error bit rate, transmission delay, lifetime of network, buffer occupancy and throughput. Then these performances are validated based on comparison with conventional routing strategies like Fuzzy-rule-based Energy Efficient Clustering and Immune-Inspired Routing (FEEC-IIR), Neuro-Fuzzy- Emperor Penguin Optimization (NF-EPO), Fuzzy Reinforcement Learning-based Data Gathering (FRLDG) and Hierarchical Energy Efficient Data gathering (HEED). Ultimately the performance of the proposed BiHCLR outperforms all other conventional techniques.

Clinical Correlation between Muscle Damage and Oswestry Disability Index Score after Open Lumbar Surgery: Does Open Surgery Reduces Functional Ability?

Rushama Tandon,Vivek Kiyawat,Neeraj Kumar 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.3

Study Design: Single-surgeon, single-center prospective study with prospective data collection. Purpose: To clinically evaluate muscle damage after open lumbar surgery and its relationship to functional activity and to validatethe improvement in function as indicated by improved Oswestry Disability Index (ODI) score despite muscle damage. Overview of Literature: Few studies have analyzed the functional loss and recovery pattern of muscles after open lumbar surgery. Methods: The study included 30 patients who underwent open lumbar spine fusion surgery at our institution between August 2013 and May 2015. Preoperatively and at 6 months postoperatively, the patients were subjected to functional, biochemical, electrophysiological, and radiological assessments as outpatients, and the results were compared. Results: Mean preoperative and 6-month postoperative values were as follows: creatine phosphokinase levels, 133.07±17.57 and 139±17.7 U/L (p <0.001); Visual Analog Scale scores for backache, 6.73±0.88 and 3.27±0.96 (p <0.001); and ODI scores, 41.6±5.51 and 22.4±4.48 (p <0.001), respectively. Preoperatively, electrophysiological studies showed that 20% of the patients had a polyphasic configuration whereas at 6 months postoperatively, all patients had polyphasic configuration (p <0.001). The mean cross-sectional area of the multifidus observed using magnetic resonance imaging (MRI) decreased from 742.67±76.62 mm2 preoperatively to 598.27±66.38 mm2 6 months postoperatively (p <0.001), with all the patients exhibiting grade 2 atrophy. Conclusions: Open lumbar fusion surgery resulted in significant damage to the lumbar paraspinal muscles, as indicated by a reduction in the cross-sectional area of the multifidus by MRI and denervation of the multifidus demonstrated using electromyography. Nevertheless, the patients reported reduced back pain and improved quality of life, which may have been due to increased stability of the previously unstable lumbar spinal segment after the surgery.

Sinonasal teratocarcinosarcoma treated with surgery followed by volumetric modulated radiotherapy: a case report with review of literature

Sarthak Tandon,Munish Gairola,Parveen Ahlawat,Kanika Sharma,Soumitra Barik,Nishtha Sachdeva,Sunil Pasricha,Apeksha Shenoy 대한방사선종양학회 2018 Radiation Oncology Journal Vol.36 No.4

Surgical excision along with use of postoperative radiotherapy forms an integral management of sinonasal teratocarcinosarcoma (SNTCS). However, given the rarity of the tumor, no standardised guidelines, dose, technique and target delineation exist especially in the era of modern radiation delivery techniques. This is a case of 55-year-old male diagnosed as SNTCS treated with radical ethmoidectomy followed by volumetric modulated radiotherapy, showing good local control and acceptable toxicity profile.