Post-cholecystectomy acute injury: What can go wrong?

Vikas Gupta,Ashish Gupta,Thakur Deen Yadav,Bhagwant Rai Mittal,Rakesh Kochhar 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.2

Backgrounds/Aims: Most of the emphasis of postcholecystectomy injuries is laid on iatrogenic bilary trauma. However, they can involve a wide spectrum of injuries. Methods: We prospectively evaluated 42 patients with postcholecystectomy injuries referred to us from July 2011 to December 2012. Based on spectrum of injuries, we proposed an algorithm of management. Results: Injuries occurred following laparoscopy in 20 (2 converted) patients and open in 22 patients. Mean time of detection of injury was 4.32±2.33 days. The nature of drainage was bilious in 36, bile with blood in 2, only blood in 2, and enteric in 2. Nine had organ failure at presentation. Six (14%) needed re-operation. Source of hemorrhage was from right hepatic artery in three and small bowel mesentry in 1. Enteric injuries were one each to duodenum and colon. Six patient (14%) died. Advancing age and organ failure were the predictors of mortality. Persistant biliary fistula was seen in 5 (14%). Ten had lateral leaks that closed at 28.89±2.34 days. Twenty-two formed stricture which was successfully managed with definitive hepaticojejunostomy. Conclusions: Post cholecystectomy acute injury does not limit itself to bile duct or vascular injury but it can traumatize adjacent hollow viscus or mesentery. It is important to diagnose and intervene enteric injury early. Presentation and management for such injury should be followed as per the proposed algorithm.

Early Outcomes of Medial Pivot Total Knee Arthroplasty Compared to Posterior-Stabilized Design: A Randomized Controlled Trial

Kulshrestha Vikas,Sood Munish,Kanade Sarang,Kumar Santhosh,Datta Barun,Mittal Gaurav 대한정형외과학회 2020 Clinics in Orthopedic Surgery Vol.12 No.2

Background: The indications for total knee arthroplasty (TKA) have been expanded to include younger, demanding patients. Some TKA patients expect a return to high-performance activities to restore optimum quality of life. The concept of the medial pivot (MP) TKA is that more natural knee kinematics can be achieved by altering the bearing design. In the present study, we compared the early outcomes of MP TKA with posterior-stabilized (PS) TKA in terms of patient-reported outcomes, function, and performance. Methods: This randomized study was performed in a high volume joint replacement facility of a tertiary care military hospital. We enrolled 40 patients each in the MP group and PS group and assessed knee flexion, patient-reported outcome (new Knee Society Score [new KSS]), patient performance (Delaware Osteoarthritis Profile Score [DOPS]), and function (Forgotten Joint Score [FJS]) at 2 years after surgery. Results: Compared to PS group patients, MP group patients had similar patient-reported outcomes assessed by new KSS (satisfaction, expectation, and activity scales) and FJS. MP knee patients had better performance in the timed up and go test (p < 0.026) and self-paced walk test (p < 0.002) of DOPS. The gain in knee flexion (9.3° ± 14°) compared to baseline was significantly greater in the PS group (p < 0.013). Conclusions: When assessed by DOPS, getting up from chair and walking speed were significantly better in MP knee patients than in PS knee patients. However, considering the predictable rollback ensured by cam and post, the PS knee produced better knee flexion. Despite these results, patients were equally satisfied with the two designs.

Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study

Yadav, Sunil,Mittal, Hitesh Chander,Malik, Sunita,Dhupar, Vikas,Sachdeva, Akash,Malhotra, Vijaylaxmy,Singh, Gurdarshan The Korean Association of Oral and Maxillofacial S 2016 대한구강악안면외과학회지 Vol.42 No.5

Objectives: We evaluated and recorded post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve (IAN) in mandibular fracture in order to identify associated risk factors. Materials and Methods: This was a prospective cohort study composed of 60 patients treated for mandibular fracture. The primary study variable was the change between the post-traumatic IAN neurosensory examination score and the score after fracture reduction. Risk factors were categorized as demographic, anatomic, fracture displacement, and treatment. Appropriate descriptive and bivariate statistics were computed. Results: Sixty patients with unilateral mandibular fracture reported within 24 hours of injury were evaluated over a one-year period. A post-traumatic neurosensory deficit was observed in 52 patients (86.7%), the percentage of which was reduced to 23.3% over the follow-up period. Abnormal postoperative neurosensory scores were significantly higher in angle fracture cases (33.3%) compared to body fracture cases (11.1%). When recovered and non-recovered neurosensory scores were compared by fracture location, 88.9% of body fracture cases showed significant recovery compared to 66.7% of mandibular angle fracture cases. Cases with less than 5 mm fracture displacement showed statistically significantly higher neurosensory recovery scores (90.6%) compared to those with more than 5 mm fracture displacement (60.7%). Conclusion: Use of a miniplate with mono-cortical screws does not play a role in increasing IAN post-traumatic neurosensory deficit. Early management can reduce the chances of permanent neurosensory deficit. Mandibular fracture displacement of 5 mm or more and fracture location were found to be associated with an increased risk of post-traumatic IAN neurosensory score worsening.

An Improved Method for Robust and Efficient Clustering Using EM Algorithm with Gaussian Kernel

Aakash Soor,Vikas Mittal 보안공학연구지원센터 2014 International Journal of Database Theory and Appli Vol.7 No.3

CRITICAL ANALYSIS OF DIFFERENT FEATURES FOR HINDI ASR USING ANN

ASHOK KUMAR,VIKAS MITTAL 장전수학회 2021 Proceedings of the Jangjeon mathematical society Vol.24 No.4

Features play a vital role in Automatic Speech Recognition (ASR). They also aect the performance of speech recognizers in all environments to an extent. There are many types of features used in automatic speech recognition. Each feature type has its own signicance depending upon its unique characteristics. LPC (Linear Predictive Coding), LPCC (Linear Predictive Cepstral Coecients), Mel Frequency Cepstral Coecients (MFCC), Perceptual Linear Prediction (PLP) and Relative spectral Analysis (RASTA) are some of the features that are generally used. Better results can be obtained by combining coecients of dierent features. For instance, MFCC and PLP show better results when they are jointly used to recognize a speech signal. This paper aims to compare the performance of dierent features using ANN for same number of speech datasets. The result shows that proposed technique increases the recognition rate by 8.33% as compared to MFCC alone.

Variational Bayesian Inference Based Image Inpainting using Gamma Distribution Prior

Rohit Sain,Vikas Mittal,Vrinda Gupta 보안공학연구지원센터 2015 International Journal of Signal Processing, Image Vol.8 No.12

Variational Bayesian (VB) inference is the latest iterative method for prediction of data in machine learning. It provides the solution for intractable integration in Bayesian methodology. In this paper, a simple VB linear regression is applied for prediction of the damaged pixels in an image. Bayesian linear regression model is used for prediction of the pixels. For this neighbor pixels are used as training data to generate the parameters of the prediction function. Now using this prediction function, damaged pixels are predicted and incorporated into the image. Proposed method is linear while image is a non-linear object, generally. Hence, for linearity, a small image window size is used to avoid the nonlinearities in image.

Evaluation of Iron Nickel Oxide Nanopowder as Corrosion Inhibitor: Effect of Metallic Cations on Carbon Steel in Aqueous NaCl

( A. U. Chaudhry ),( Vikas Mittal ),( Brajendra Mishra ) 한국부식방식학회(구 한국부식학회) 2016 Corrosion Science and Technology Vol.15 No.1

The aim of this study was to evaluate the use of iron-nickel oxide (Fe2O3.NiO) nanopowder (FeNi) as an anti-corrosion pigment for a different application. The corrosion protection ability and the mechanism involved was determined using aqueous solution of FeNi prepared in a corrosive solution containing 3.5 wt.% NaCl. Anti-corrosion abilities of aqueous solution were determined using electrochemical impedance spectroscopy (EIS) on line pipe steel (API 5L X-80). The protection mechanism involved the adsorption of metallic cations on the steel surface forming a protective film. Analysis of EIS spectra revealed that corrosion inhibition occurred at low concentration, whereas higher concentration of aqueous solution produced induction behavior.

Esophageal Submucosal Injection of Capsaicin but Not Acid Induces Symptoms in Normal Subjects

( Robert H Lee ),( Hariprasad Korsapati ),( Vikas Bhalla ),( Nissi Varki ),( Ravinder K Mittal ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2016 Journal of Neurogastroenterology and Motility (JNM Vol.22 No.3

Background/Aims Transient receptor potential vanilloid-1 (TRPV1) is a candidate for mediating acid-induced symptoms in the esophagus. We conducted studies to determine if the presence of acid in the mucosa/submucosa and direct activation of TRPV1 by capsaicin elicited symptoms in normal healthy subjects. We also studied the presence of TRPV1 receptors in the esophagus. Methods Unsedated endoscopy was performed on healthy subjects with no symptoms. Using a sclerotherapy needle, normal saline (pH 2.0- 7.5) was injected into the mucosa/submucosa, 5 cm above the Z line. In a separate group of healthy subjects, injection of capsaicin and vehicle was also studied. Quality of symptoms was reported using the McGill Pain Questionnaire, and symptom intensity using the visual analogue scale (VAS). Immunohistochemistry was performed on 8 surgical esophagus specimens using TRPV1 antibody. Results Acid injection either did not elicit or elicited mild symptoms in subjects at all pH solutions. Capsaicin but not the vehicle elicited severe heartburn/chest pain in all subjects. Mean VAS for capsaicin was 91 ± 3 and symptoms lasted for 25 ± 1 minutes. Immunohistochemistry revealed a linear TRPV1 staining pattern between the epithelial layer and the submucosa that extended into the papillae. Eighty-five percent of papillae stained positive for TRPV1 with a mean 1.1 positive papillae per high-powered field. Conclusions The mechanism of acid-induced heartburn and chest pain is not the simple interaction of hydrogen ions with afferents located in the esophageal mucosa and submucosa. TRPV1 receptors are present in the lamina propria and their activation induces heartburn and chest pain. (J Neurogastroenterol Motil 2016;22:436-443)

Magnesium Aluminium Layered Double Hydroxide Assisted Dispersion of Multiwalled Carbon Nanotubes for Enhanced Reinforcement of Ethylene-co-Vinyl Acetate Matrix

Bhagabat Bhuyan,Suneel Kumar Srivastava,Sreeraj Puravankara,Vikas Mittal 한국고분자학회 2018 Macromolecular Research Vol.26 No.10

Successful utilization of natural anionic clays like montmorillonite and hectorite for the homogeneous dispersion of multiwalled carbon nanotubes (MWCNTs) in ethylene-co-vinyl acetate (EVA), motivated us to investigate the role of magnesium aluminium layered double hydroxide (MgAl-LDH) in a similar role. MWCNT/MgAl-LDH 3D hybrid filler (HML) was prepared from the unmodified constituents in 1:1 wt. ratio by simple dry grinding method. The dispersion of this hybrid filler with extraordinary stability was subsequently used in the preparation of EVA/HML nanocomposites by solution intercalation method. Analysis shows MWCNTs to be homogeneously dispersed in the polymer matrix in presence of LDH layers. Reinforcing efficiency of HML in EVA matrix was evaluated through detailed studies of the nanocomposites. Mechanical, thermal and dielectric properties of neat EVA are substantially improved with HML content. Maximum improvement observed in tensile strength, elongation at break and toughness are 182%, 87%, and 300% respectively at 4 wt% HML. However, best dielectric response with ~400 and ~89 times enhancement in AC conductivity and dielectric constant are observed 1 wt% HML content. Comparison of HML with previously reported MWCNT/montmorillonite (MMT) and MWCNT/hectorite 3D hybrid fillers confirms superior reinforcing efficiency of the former. Improvements in properties are attributed to homogeneous dispersion of fillers and improved polymer-filler interaction on account of synergy between MWCNTs and LDH.

Binary Cu/ZnO decorated graphene nanocomposites as an efficient anode for lithium ion batteries

Liyamol Jacob,K. Prasanna,M.R. Vengatesan,P. Santhoshkumar,이창우,Vikas Mittal 한국공업화학회 2018 Journal of Industrial and Engineering Chemistry Vol.59 No.-

Binary metal/metal oxide doped graphene nanocomposites have received wide attention as an effective anode material in Li-ion batteries. The binary composition metal/metal oxide improves the storage space and the conductivity of the electrode. The doped graphene enhances the structural and electronic properties of the electrode. In the present work, we report a Cu/ZnO hybrid nanoparticle-decorated graphene nanocomposite as an advanced anode material for the high-performance Li-ion batteries. Three different compositions of the hybrid Cu/ZnO/graphene nanocomposites have been synthesized by changing the concentration of Cu precursors in the hybrid. The nanocomposite of 0.05 M Cu precursor and 0.1 M ZnO precursor shows higher surface area (SBET = 168.7 g/m2) and excellent electrochemical results. X-ray photoelectron spectroscopy (XPS) analysis revealed that the Cu nanoparticle exists in +2 oxidation state on the ZnO lattice with the graphene nanostructure. Transmission electron microscopy (TEM) analysis shows the distribution of Cu/ZnO nanoparticles over the graphene sheets with a size of around 10–50 nm. From the electrochemical analysis, we inferred that the hybrid possesses a stable and specific capacity of 630 mAh g−1 at a current rate of 100 mA g−1 with almost 95% capacity retention for up to 100 cycles. To highlight the importance of binary Cu/ZnO doped graphene nanocomposites, their respective base namely, ZnO/graphene and Cu/graphene composites have also been studied.