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Manoj Kumar Sharma,Sumeet Kainth,Sachin Kumar,Ankit Bhardwaj,Hemant Kumar Agarwal,Rakhi Maiwall,Kapil Dev Jamwal,Saggere Muralikrishna Shasthry,Ankur Jindal,Ashok Choudhary,Lovkesh Anand,Rajender Mal 대한간학회 2019 Clinical and Molecular Hepatology(대한간학회지) Vol.25 No.2
Background/Aims: The aim of this study was to study the efficacy and safety of zolpidem for sleep disturbances in patients with cirrhosis. Methods: Fifty-two Child-Turcotte-Pugh (CTP) class A or B cirrhotics with Pittsburgh Sleep Quality Index >5 were randomized to either zolpidem 5 mg daily (n=26) or placebo (n=26) for 4 weeks. Results: The therapy of 4 weeks was completed by 23 patients receiving zolpidem (3 stopped treatment due to excessive daytime drowsiness) and 24 receiving placebo (2 refused to continue the study). In the zolpidem group, after 4 weeks of therapy, there was significant increase in total sleep time (TST) and sleep efficiency compared to baseline and improvement in polysomnographic parameters of sleep initiation and maintenance (i.e., decrease in sleep latency time, decrease in wake time, and decreases in number of arousals and periodic limbs movements per hour of sleep), without any significant change in sleep architecture. Conclusions: Four weeks of 5 mg daily zolpidem in CTP class A or B cirrhosis patients with insomnia led to significant increases in TST and sleep efficiency and improvement in polysomnographic parameters of sleep initiation and maintenance without any significant change in sleep architecture.
Manoj Kumar,Siddharth Pandey,Ajay Aggarwal,Deepanshu Sharma,Gaurav Garg,Samarth Agarwal,Ashish Sharma,Satyanarayan Sankhwar 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.5
Purpose: To see the 30-day unplanned readmission rates in patients underdoing endo-urological surgeries for upper urinary tract calculi we conducted this retrospective study at King George's Medical University, Lucknow, India. Unplanned readmissions not only add to healthcare costs but also are bothersome for the patients. There are many studies on 30-day unplanned readmissions in general surgical patients. Although similar studies have been done in certain urological procedures, no study has reported readmission rates or its risk factors in patients undergoing surgeries for upper urinary tract calculi. Materials and Methods: We retrospectively reviewed our prospectively maintained database from 1st January 2009 to 31st December 2017, for the patients who underwent endo-urological procedures for upper urinary tract calculi and identified the patients who were re-admitted within 30 days of discharge. Results: Out of the total 3,209 patients undergoing endo-urological procedures for upper urinary tract calculi 56 were re-admitted. The readmission rate was 1.74% over the study period. The most common etiology for readmission was sepsis followed by hematuria. The significant risk factors for readmission in bivariate analysis included male gender, age >65 years, current smoking, chronic obstructive pulmonary disease, diabetes mellitus, bleeding disorder, prior cardiac disease, and American Society of Anesthesiologists (ASA) class ≥3. In multivariate risk adjusted logistic regression analysis ASA class ≥3 was the only independent risk factor for readmission. Conclusions: The readmission rates in endo-urological procedures for urolithiasis are less compared to other procedures. ASA class ≥3 is the most important independent predictor of unplanned 30-day readmissions.
Tribological Behavior of Silicon Carbide Ceramics - A Review
Sharma, Sandan Kumar,Kumar, B. Venkata Manoj,Kim, Young-Wook The Korean Ceramic Society 2016 한국세라믹학회지 Vol.53 No.6
A comprehensive review on sliding and solid particle erosion wear characteristics of silicon carbide (SiC) ceramics and SiC composites is provided. Sliding or erosion wear behavior of ceramics is dependent on various material characteristics as well as test parameters. Effects of microstructural and mechanical properties of SiC ceramics are particularly focused to understand tribological performance of SiC ceramics. Results obtained between varieties of pairs of SiC ceramics indicate complexity in understanding dominant mechanisms of material removal. Wear mechanisms during sliding are mainly divided in two groups as mechanical and tribochemical. In solid particle erosion conditions, wear mechanisms of SiC ceramics are explained by elastic-plastic deformation controlled micro-fracture on the surface followed by radial-lateral crack propagation beneath the plastic zone.
Performance Analysis of Different Wavelet Families Over Fading Environments for Mobile WiMAX System
Harpreet Kaur,Manoj Kumar,Ajay K Sharma,Harjit P. Singh 보안공학연구지원센터 2015 International Journal of Future Generation Communi Vol.8 No.1
Orthogonal Frequency Division Multiplexing (OFDM) has made tremendous improvement possible in wireless technology. Wavelet analysis is used as an alternative to Fourier analysis in OFDM system to transform and map data onto orthogonal subcarriers, as it is a time-frequency domain operation thus it offers the advantages of optimal flexibility with less complexity. This paper presents performance analysis in terms of Bit Error rate (BER) of different wavelet families in OFDM System under the joint effect of path loss, multipath fading and noisy environment for Mobile WiMAX. The results obtained show that the performance of the mobile-multipath environments for 16-QAM modulation schemes is enhanced as Daubechies and Biorthogonal wavelet families offers lower BER with different Path loss model. The performance measurements and analysis was done in simulation developed in MATLAB.
Manoj Kumar Reddy Somagutta,Maria Kezia Lourdes Pormento,Muhammad Adnan Khan,Alaa Hamdan,Namrata Hange,Manish KC,Sukrut Pagad,Molly Sanjay Jain,Sivasthikka Lingarajah,Vishal Sharma,Jaspreet Kaur,Berna 대한중환자의학회 2021 Acute and Critical Care Vol.36 No.3
Background: Previous studies have suggested favorable outcomes of hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT) therapy in patients with sepsis. However, similar results have not been duplicated in sequential studies. This meta-analysis aimed to reevaluate the value of HAT treatment in patients with sepsis. Methods: Electronic databases were searched up until October 2020 for any studies that compared the effect of HAT versus non-HAT use in patients with sepsis. Results: Data from 15 studies (eight randomized controlled trials [RCTs] and seven cohort studies) involving 67,349 patients were included. The results from the RCTs show no significant benefit of triple therapy on hospital mortality (risk ratio [RR], 0.99; P=0.92; I2=0%); intensive care unit (ICU) mortality (RR, 0.77; P=0.20; I2=58%); ICU length of stay (weighted mean difference [WMD], 0.11; P=0.86; I2=37%) or hospital length of stay (WMD: 0.57; P=0.49; I2=17%), and renal replacement therapy (RR, 0.64; P=0.44; I2=39%). The delta Sequential Organ Failure Assessment (SOFA) score favored treatment after a sensitivity analysis (WMD, –0.72; P=0.01; I2=32%). However, a significant effect was noted for the duration of vasopressor use (WMD, –25.49; P<0.001; I2=46%). The results from cohort studies have also shown no significant benefit of HAT therapy on hospital mortality, ICU mortality, ICU length of stay, length of hospital stay, the delta SOFA score, the use of renal replacement therapy, or vasopressor duration. Conclusions: HAT therapy significantly reduced the duration of vasopressor use and improved the SOFA score but appeared not to have significant benefits in other outcomes for patients with sepsis. Further RCTs can help understand its benefit exclusively.
Agrobacterium tumefaciens Mediated Genetic Transformation of Pigeonpea [Cajanus cajan (L.) Millsp.]
Kumar, S.Manoj,Syamala, D.,Sharma, Kiran K.,Devi, Prathibha The Korean Society of Plant Biotechnology 2004 Plant molecular biology and biotechnology research Vol.6 No.2
Optimal protocol for efficient genetic transformation has been defined to aid future strategies of genetic engineering in pigeon pea with agronomically important genes. Transgenic pigeonpea plants were successfully produced through Agrobacterium tumefaciens-mediated genetic transformation method using cotyledonary node explants by employing defined culture media. The explants were co-cultivated with A. tumefaciens strain C-58 harboring the binary plasmid, pCAMBIA-1301 [con-ferring $\beta$-glucuronidase(GUS) activity and resistance to hygromycin] and cultured on selection medium (regeneration medium supplemented with hygromycin) to select putatively transformed shoots. The shoots were then rooted on root induction medium and transferred to pots containing sand and soil mixture in the ratio of 1:1. About 22 putative TO transgenic plants have been produced. Stable expression and integration of the transgenes in the putative transgenics were confirmed by GUS assay, PCR and Southern blot hybridization with a transformation efficiency of over 45%. Stable integration and expression of the marker gene has been confirmed in the TO and T1 transgenics through PCR, and Southern hybridization.
Dipayan Roy,Purvi Purohit,Manoj Khokhar,Anupama Modi,Ravindra Kumar Gayaprasad Shukla,Ramkaran Chaudhary,Shrimanjunath Sankanagoudar,Praveen Sharma 대한비만학회 2023 Journal of obesity & metabolic syndrome Vol.32 No.1
Background: Growth differentiation factor-15 (GDF-15) is involved in insulin resistance and diabetes. In this study, we determine the associations of GDF-15 with miR-181b-5p, miR-330-3p, mothers against decapentaplegic homolog 7 (SMAD7), and insulin resistance in visceral adipose tissue (VAT) and peripheral blood mononuclear cells (PBMCs) in type 2 diabetes mellitus (T2DM) patients. Methods: Sixty patients, equally divided into those with T2DM and non-diabetic controls, were recruited for gene expression analysis. Protein-protein interaction (STRING), target prediction (miRNet), and functional enrichment were conducted accordingly. Results: Our study showed that VAT and PBMCs had similar expression profiles, where GDF-15 and miR-181b-5p were upregulated, whereas SMAD7 and miR-330-3p were downregulated. Serum GDF-15 could differentiate between T2DM and non-diabetic patients (P<0.001). Target prediction revealed a microRNA (miRNA)-messenger RNA regulatory network, transcription factors, and functional enrichment for the miRNA that suggested involvement in T2DM pathogenesis. Conclusion: VAT GDF-15 is associated with insulin resistance and is possibly regulated by miR-181b-5p, miR-330-3p, and SMAD7 in T2DM.
Sooraj Parkash,Anurag Sharma,Manoj Kumar,Harsukhpreet Singh 보안공학연구지원센터 2015 International Journal of Signal Processing, Image Vol.8 No.8
In this paper, Decision Feedback Equalization (DFE) and Feed forward Equalization (FFE)based on minimum mean square error optimization has been employed to improve the performance of 32 channels, gigabit capacity WDM-PON network. An optical line terminal (OLT) installed at the transmitter end which continuous transmit 32 channels having different colors (wavelengths) of 20GB/s data rate , which is multiplexed by optical multiplexer and transmit through standard single mode fiber (SMF) having length 40km. A link design for 1:64 optical splitters is used as Passive Optical Network (PON) element which creates communication between OLT to different end users. It is observed that FFE and DFE significantly reduce BER by 1.0798e-010, 1.1556e-011, 1.2960e-010 and 8.8979e-009 at four different wavelengths 1550nm, 1559.6nm, 1562.8nm and 1574.8nm by using NRZ (non return zero) modulation format at 20GB/s for 64 users having 40km fiber length respectively. Sharp increase in BER 2.6916e-002, 4.6519e-002, 3.8804e-001 and 5.1570e-002 occurs if data rate increases up to 25 GB/s.
Thakur, Priyanka,Seam, Rajeev Kumar,Gupta, Manoj Kumar,Rastogi, Madhup,Gupta, Manish,Bhattacharyya, Tapesh,Sharma, Mukesh,Revannasiddaiah, Swaroop Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.10
Purpose: Blood hemoglobin levels are known to influence response to radiotherapy. This retrospective analysis compared the effect of hemoglobin levels upon response to radiation among patients treated with radiation alone (by accelerated hyperfractionated radiotherapy) versus those treated with concurrent cisplatin chemoradiotherapy. Materials and Methods: Among patients treated for locally advanced carcinoma of the cervix (LACC) during 2009-10, a total of 60 fulfilled the eligibility criteria. In this time frame, external beam radiotherapy was delivered with either concurrent chemoradiotherapy (CRT, n=31) (45Gy over 25 fractions, with weekly cisplatin at 40mg/m2), or with accelerated hyperfractionated radiotherapy (AHRT, n=29) (20Gy over 10 daily fractions over the first two weeks, followed by 30Gy over 20 fractions over the next two weeks, with two fractions of 1.5Gy per day, without the use of chemotherapy). Mean weekly hemoglobin (MWH) levels of all patients were calculated as the arithmetic means of weekly recorded blood hemoglobin levels. As per MWH, patients in both of the AHRT or the CRT groups were classified into two subgroups-those with MWH between 10-10.9g/dL, or with MWH>11g/dL. Complete response (CR) to external beam RT phase (prior to brachytherapy) was declared after clinical examinations and computed tomography. The CR rate was noted for both MWH sub-groups within each of the AHRT and CRT groups. Results: Within the AHRT group, patients with MWH>11g/dL had a much better CR rate in comparison to those with MWH:10-10.9g/dL (80% vs. 21.1%) which was statistically significant (p 0.0045). Within the CRT group, there was no significant difference in the outcomes within the MWH>11g/dL and MWH:10-10.9g/dL sub-groups (CR rates of 80% vs. 61.9%, p=0.4285). Conclusions: The importance of maintaining a minimum hemoglobin level of 11g/dL during RT is much greater for patients treated with RT alone, than for patients treated with concurrent chemoradiotherapy. Enhanced haemoglobin levels during RT may to an extent negate the ill-effects that may otherwise arise due to non-use of concurrent chemotherapy.