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RISS 인기검색어
- 검색키워드
- 저자 : Pandey Swapnil (검색결과 4 건)
- 무료
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When to Discharge a Patient After Endoscopy: A Narrative Review
Swapnil Sahebrao Walke,Shamshersingh Chauhan,Vikas Pandey,Rahul Jadhav,Vipul Chaudhari,Deepti Vishwanathan,Kailash Kolhe,Meghraj Ingle 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1
Video endoscopy is an important modality for the diagnosis and treatment of various gastrointestinal diseases. Most endoscopicprocedures are performed as outpatient basis, sometimes requiring sedation and deeper levels of anesthesia. Moreover, advancesin endoscopic techniques have allowed invasion into the third space and the performance of technically difficult procedures thatrequire the utmost precision. Hence, formulating strategies for the discharge of patients requiring endoscopy is clinically and legallychallenging. In this review, we have discussed the various criteria and scores for the discharge of patients who have undergoneendoscopic procedures with and without anesthesia.
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Swapnil Patel,Sriniket Raghavan,Amar Prem,Mayank Tripathi,Saumya Chopra,Durgatosh Pandey 대한종양외과학회 2021 대한임상종양학회 학술대회지 Vol.2021 No.6
Background/Aims Laparoscopic approach for total colectomy is acceptable ontologically if executed with a complete mesocolic excision and central vascular ligation to ensure radical D3 lymphadenectomy. Methods This is an illustrative video vignette showing a step by step approach to total colectomy with complete mesocolic excision with central vascular ligation. Our patient was a 45yr gentleman with adenocarcinoma of the transverse colon extending to splenic flexure and descending colon with synchronous polyps in right colon on colonoscopy. Staging computed tomography scan did not show any distant metastases. Results Total colectomy was done using laparoscopic approach with a complete mesocolic excision. Stapled ileo-rectal anastomosis was performed. Blood loss was 200mL and intra-operative period was uneventful. Post-operative period was uneventful and patient was discharged on day 6. Final histopathology revealed a moderately differentiated adenocarcinoma of transverse colon and left colon (pT3N1, 0/56 nodes) with dysplastic polyps in right colon. Patient was referred to Medical Oncology for adjuvant chemotherapy. Conclusions This video vignette highlights step by step conduct of a technically challenging procedure using laparoscopy while ensuring oncological adequacy.
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Metagenomics Analysis of Thrombus Samples Retrieved from Mechanical Thrombectomy
Vajpeyee Atulabh,Chauhan Puneet Singh,Pandey Swapnil,Tiwari Shivam,Yadav Lokendra Bahadur,Shroti Akhilesh Kumar,Vajpeyee Manisha 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.1
Purpose: The purpose of this study was to assess the microbiota in middle cerebral artery thrombi retrieved in mechanical thrombectomy arising out of symptomatic carotid plaque within 6 hours of acute ischemic stroke. Thrombi were subjected to next-generation sequencing for a bacterial signature to determine their role in atherosclerosis.Materials and Methods: We included 4 human middle cerebral artery thrombus samples (all patients were male). The median age for the patients was 51±13.6 years. Patients enrolled in the study from Pacific Medical University and Hospital underwent mechanical thrombectomy in the stroke window period. All patients underwent brain magnetic resonance angiography (MRA) and circle of Willis and neck vessel MRA along with the standard stroke workup to establish stroke etiology. Only patients with symptomatic carotid stenosis and tandem lesions with ipsilateral middle cerebral artery occlusion were included in the study. Thrombus samples were collected, stored at –80 degrees, and subjected to metagenomics analysis.Results: Of the 4 patients undergoing thrombectomy for diagnosis with ischemic stroke, all thrombi recovered for bacterial DNA in qPCR were positive. More than 27 bacteria were present in the 4 thrombus samples. The majority of bacteria were <i>Lactobacillus, Stenotrophomonas, Pseudomonas, Staphylococcus</i>, and <i>Finegoldia</i>.Conclusion: Genesis of symptomatic atherosclerotic carotid plaque leading to thromboembolism could be either due to direct mechanisms like acidification and local inflammation of plaque milieu with lactobacillus, biofilm dispersion leading to inflammation like with pseudomonas fluorescence, or enterococci or indirect mechanisms like Toll 2 like signaling by gut microbiota.
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Aditya Narayan Shiv Shankar Swain,Suvankar Ganguly,Arunava Sengupta,Elanjickal Zachariah Chacko,Swapnil Dhakate,Pankaj Kumar Pandey 대한금속·재료학회 2022 METALS AND MATERIALS International Vol.28 No.10
A coupled thermofluidic-mechanical model has been developed to analyse the thermomechanical state of the solidifying shellin a continuously cast steel billet. The computational fluid dynamics (CFD) based solver simulates the three-dimensionalflow field and solidification of molten steel as it flows inside the mould. Finite element method based thermomechanicalmodel is coupled with the CFD model to determine the resultant temperature distribution and stress–strain evolution in thesolidifying strand. The heat transfer at the mould-billet interface is taken into account by the calculation of heat flux using anovel inverse heat transfer algorithm. Temperature measurements made in the industrial billet mould have been used for thepurpose. Plant experiments and observations are correlated with the numerical results to provide quantitative understandingof the complex thermomechanical process during billet casting. Various parametric studies are also undertaken to examinethe effects of casting speed, superheat and heat flux changes on resultant strain and temperature distribution. It is observedthat the accumulated plastic strains exceed the critical strain at the off-corner region thereby indicating the possibility ofcrack formation in this region. Reduction of heat flux can lead to lowering of the strain rate at the corners and offer a viablesolution for reducing corner cracks.
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