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RISS 인기검색어
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- 저자 : ( Alok Bhalla ) (검색결과 2 건)
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Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops
( Rishi Dhillan ),( Alok Bhalla ),( Sushil Kumar Jha ),( Hakam Singh ),( Aman Arora ) 대한외상학회 2019 大韓外傷學會誌 Vol.32 No.2
Purpose: Penetrating vascular trauma though less common poses a challenge to all Surgeons. This study was designed to analyse the profile, management modalities of vascular trauma and the outcomes thereof at a Trauma Care Centre in a Tertiary care setting in hostile environment in India. Methods: A prospective review of all patients with arterial and venous injuries being transferred to the Trauma Center at out Tertiary Care Center between June 2015 and May 2018 was done. Demographics, admission data, treatment, and complications were reviewed. Results: There were a total of 46 patients with 65 vascular injuries, 39 arterial injuries and 26 venous injuries. The age range was 21 to 47 years. Nineteen patients had both arterial and venous injuries. A total of 42 cases presented within 12 hours of injury and complete arterial transections were found in 33 cases (80.49%). There were three mortalities (6.52%) and three amputations (8.33%). The overall limb salvage rate was 91.67% with popliteal artery being the commonest injured artery. Poor prognosticators for limb salvage were increasing time to present to the trauma centre, hypovolemic shock, multi-organ trauma and associated venous injuries. Conclusions: Penetrating missile trauma leading to vascular injuries has not been widely reported. Attempting limb salvage even in cases with delayed presentation should be weighed with the threat to life before revascularisation and should preferably be done at a centre with vascular expertise. A team approach with vascular, orthopaedic, general surgeons, and critical care anaesthesiologists all aboard improve the outcomes manifold. Use of tourniquets and early fasciotomies have been emphasized as is the use of native veins as the bypass conduit. This is probably the largest study on penetrating Vascular trauma in anti-terrorism ops from the Indian subcontinent. It highlights the significance of prompt recognition and availability of vascular expertise in optimally managing cases of vascular trauma.
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Shashank Srivastava,Suresh Bhalla,Alok Madan 대한의용생체공학회 2019 Biomedical Engineering Letters (BMEL) Vol.9 No.4
In the recent years, there has been a growing interest in research community towards the application of smart materials forbio-medical structural health monitoring. Amongst the smart materials, directly bonded piezo sensors (DBPS), based on theelectro-mechanical impedance (EMI) technique, have been successfully employed for the above purpose. The principle behindthe EMI technique is that high frequency excitations (typically > 30 kHz) generated by a surface bonded PZT patch are usedto detect changes in structural drive point impedance caused by cracks or any other type of damage. Bone healing and damagehave been shown to be successfully monitored using the DBPS. However, in most of the diagnostic cases of live humanand animal subjects, directly bonding a PZT patch is always an irritant or hazard for a live subject. To circumvent directbonding, the authors have developed and experimentally demonstrated a non-bonded piezo sensor (NBPS) confi guration asa good alternative to DBPS while maintaining the eff ectiveness of measurement well within discernible limits. This paperpresents further improvement in the NBPS confi guration aiming at autonomous operation of the gripping mechanism usingshape memory alloy (SMA) wires. The experiments are performed on replicas of femur bone in healthy and osteoporosisstate. This paper shows the eff ective use of SMA clamping for bone identifi cation and its damage assessment in comparisonto earlier mechanical gripping using jubilee clamps. This paper also covers impedance based identifi cation applied to SMAand clamp based NBPS confi gurations. In place of raw admittance signatures, eff ective drive point impedance is utilized forthe purpose of bone diagnostics which provides a more realistic assessment of the condition of bone.
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