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Experiences and Conceptualisation of Spinal Intramedullary Tuberculoma Management
Manish Jaiswal,Ashok Gandhi,Achal Sharma,Radhey Shyam Mittal 대한척추신경외과학회 2015 Neurospine Vol.12 No.1
Objective: Spinal intramedullary tuberculoma (SIMT) is rare, accounting for 2/100,000 cases of tuberculosis and only 0.2% of all cases of central nervous system(CNS) tuberculosis. We share our experiences of 11 cases of this entity for improving diagnosis and conceptualize the management of this rare disease. Methods: The clinical profile, radiological data and management of 11 cases of SIMT which were managed either conservatively or by surgical intervention during last 27 years (1987-2014) were analysed. Results: Male:female ratio was 1.75:1. Five cases had associated pulmonary Koch’s. Most common site was thoracic cord. Two cases had concurrent multiple intracranial tuberculoma. Most common presentation was paraparesis. X-ray myelography was performed in two patients in the initial period of study suggesting intramedullary pathology. In the subsequent nine cases who had magnetic resonance imaging (MRI), seven showed typical ‘‘target sign’’ and conglomerate ring lesion. Out of 8 surgically managed patients, 6 cases improved rapidly and in 2 patients gradual improvement was seen in follow-up. Most common indication of surgical excision was rapid neurological deterioration followed by diagnosis in doubt. Histopathology confirmed tuberculous etiology of the intramedullary lesion in all. Clinical and radiological improvement was seen in all 3 conservatively managed patients in follow-up. Conclusion: MRI findings of SIMT were specific and proven histologically correct. Surgical intervention may be indicated if there is no response to chemotherapy, the diagnosis is in doubt, or there is a rapid deterioration in neurological function because surgical outcome is good in these circumstances.
Comparative Performance Analysis of High Speed Low Power Area Efficient FIR Adaptive Filter
Jaiswal, Manish The Institute of Electronics and Information Engin 2014 IEIE Transactions on Smart Processing & Computing Vol.3 No.5
This paper presents the comparative performance of an adaptive FIR filter for a Delayed LMS algorithm. The delayed error signal was used to obtain a Delayed LMS algorithm to allow efficient pipelining for achieving a small critical path and area efficient implementation. This paper presents hardware efficient results (device utilization parameters) and power consumed. The FPGA families (Artix-7, Virtex-7, and Kintex-7) for a low voltage perspective are shown. The synthesis results showed that the artix-7 CMOS family achieves the lowest power consumption of 1.118 mW with 83.18 % device utilization. Different Precision strategies, such as the speed optimization and power optimization, were imposed to achieve these results. The algorithm was implemented using MATLAB (2013b) and synthesized on the Leonardo spectrum.
Prajapati Hanuman,Ansari Ahmad,Jaiswal Manish 대한뇌혈관외과학회 2022 Journal of Cerebrovascular and Endovascular Neuros Vol.24 No.2
Keyhole surgery recently evolved as a minimal invasive surgical approach for treatment of anterior circulation aneurysm. This review was done to evaluate the keyhole approach for anterior circulation aneurysms, their indications, advantages, technical limitations, complications and their avoidance. The literature review was performed with the phrase “keyhole approach for anterior circulation aneurysm” as a search term in PubMed central, Medline, Google scholar and Embase data base to identify all the articles published till December 2020. Out of 113 articles searched, 22 were included in this review after screening for eligibility. On analyzing these articles, there was total 2058 aneurysm in 1871 patients. Out of 2058 aneurysm, 988 were ruptured and 547 unruptured. In 5 studies, which include 344 aneurysms in 344 cases, aneurysm ruptured or unruptured status was not specified. The most frequent aneurysm site was anterior communicating artery (n=573). The size of the aneurysm mentioned in most of the study was <15 mm. The rate of complete occlusion was ranged from 93.6-100%. The range of intra operative rupture (IOR) was 0-28.6%. The mean operative time was ranged from 70 min-5.34 hours as reported in 13 studies. Good outcome [Glasgow outcome scale (GOS): 4-5] were seen in 75-100% cases. The frontalis muscle weakness has been reported in 3 studies and ranged from 0-1.99%. Keyhole surgery can be a safe and effective treatment modality for treatment of a selected anterior circulation aneurysm. In the experienced hand it has certain advantages over standard pterional craniotomy.
Gastric salvage after venous congestion during major pancreatic resections: A series of three cases
Ravi Chandra Reddy,Vikram Chaudhari,Amit Chopde,Abhishek Mitra,Dushyant Jaiswal,Shailesh V. Shrikhande,Manish S. Bhandare 한국간담췌외과학회 2024 Annals of hepato-biliary-pancreatic surgery Vol.28 No.1
Pancreatic resections, depending on the location of the tumor, usually require division of the vasculature of either the distal or proximal part of the stomach. In certain situations, such as total pancreatectomy and/or with splenic vein occlusion, viability of the stomach may be threatened due to inadequate venous drainage. We discuss three cases of complex pancreatic surgeries performed for carcinoma of the pancreas at a tertiary care center in India, wherein the stomach was salvaged by reimplanting the veins in two patients and preserving the only draining collateral in one case after the gastric venous drainage was compromised. The perioperative and postoperative course in these patients and the complications were analyzed. None of these 3 patients developed any complication related to gastric venous congestion, and additional gastrectomy was avoided in all these patients. Re-establishment of the Gastric venous outflow after extensive pancreatic resections helps to avoid additional gastric resection secondary to venous congestive changes.