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Anurag Sahu

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Papers by Anurag Sahu

Serum Concentration of Myelin Basic Protein as a Prognostic Marker in Mild-to-moderate Head Injury Patients: A Prospective Study in a Tertiary Care Center

Indian Journal of Neurosurgery

Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcom... more Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcome prediction among mild-to-moderate head injury patients. Materials and Methods It was a prospective study done at the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University from Jan 2018 to July 2019. All patients who presented to us within 48 hours of injury with mild-to-moderate head injury with apparently normal CT brain were include in the study. The serum sample were collected on the day of admission and 48 hours later, and patients were treated with standard protocols and observed 6 months postdischarge. Results Of the 32 patients enrolled, we observed mean MBP level was higher for severity of brain damage, but not associated with age, mode of injury, and radiological diagnosis. Mean MBP levels were not statistically associated with Glasgow coma scale (GCS) score at admission but was correlated to outcome with p < 0.05, with sensitivity of 50% and s...

A new innovative light-emitting diode habit-breaking appliance

Indian Journal of Multidisciplinary Dentistry, 2017

The aim of the present case report is to introduce a modified and innovative design for effective... more The aim of the present case report is to introduce a modified and innovative design for effective habit breaking with minimal patient discomfort. Abnormal oral habits are one of the major etiological factors in malocclusion. The harmful, unbalanced pressure bears upon the immature, highly malleable alveolar ridges and brings about potential changes in the position of teeth and occlusion. These habits can also cause behavioral problems and are socially unacceptable. Various methods and appliances are used to break the abnormal oral habits, as a part of treatment of malocclusion. The traditional habit-breaking appliances used so far can cause irritation to the tongue, subsequently leading to ulceration and in addition can also cause mastication and speech problems. The appliance is a regular Hawley's appliance with the addition of the light-emitting diode bulb and the switch. When the child's tongue or the finger touches the appliance, the light bulb gets illuminated, thus reminding the child to quit the habit. The said appliance utilizes easily available electrical gadgets that will function by disturbing the subconsciously built vicious cycle. The reminders send by its activation will break the pleasure perception obtained during the habit. Habit breaking through this appliance is effective as it is superior to other appliances in the mode of action as well as the design itself is attractive to the children.

4Consultant, MSG Strategic Consulting Pvt Ltd

Effect of educational intervention measures on knowledge about rabies and its preventive

Clinical, Surgical and Outcome Predictive Factor Analysis of Operated Acute Subdural Hematoma Cases: A Retrospective Study of 114 Operated Cases at Tertiary Centre

Indian Journal of Neurosurgery, 2021

Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural... more Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clini...

Band Gap Engineering of CdTe Quantum Dots by Hg Alloying in Infrared Region

Springer Proceedings in Physics, 2019

We synthesized Hg alloyed CdTe quantum dots (Cd1−xHgxTe) using hydrothermal route. N-acetyl-cyste... more We synthesized Hg alloyed CdTe quantum dots (Cd1−xHgxTe) using hydrothermal route. N-acetyl-cysteine is used as the capping agent for water dispersed Cd1−xHgxTe (x = 0, 0.05, 0.1 and 0.5) quantum dots. The diameter of the synthesized quantum dots is 3.8 ± 0.5 nm, as estimated from high resolution transmission electron micrographs. The mercury molar fraction modified band gap engineering is demonstrated with band gap changing from 2.5 eV for CdTe quantum dots to 1.25 eV for Cd0.5Hg0.5Te.

Clinical, surgical and postoperative outcome analysis of tumors occupying both posterior and middle cranial fossa

Introduction: This study aims to analyse clinical, surgical and postoperative outcome perspective... more Introduction: This study aims to analyse clinical, surgical and postoperative outcome perspectives of tumors occupying both middle and posterior cranial fossa. Methods and Materials: This retrospective cohort study includes 23 patients operated for tumors involving both middle and posterior cranial fossa in our department between August 2016 and August 2020. Each patient was evaluated for age, sex, co-morbidities, tumour histopathology, clinical presentation, radiological characteristics, surgical and outcome characteristics. Unpaired ttest and chi-square tests were used for statistical analysis. P < 0.05 was considered statistically significant. Results: The mean age was 46 years (range 40–57 years), with the majority of patients being female (56.5%). Most tumors (65.3%) were trigeminal schwannoma, with the remaining being vestibular schwannoma (21.7%), facial schwannoma (8.7%) and epidermoid (4.3%). The most commonly used surgical approach was the retrosigmoid approach (30.4%) ...

A Prospective Study and Analysis of Ventriculoperitoneal Shunt Surgery: Their Indication and Complication in a Single Tertiary Care Center

Indian Journal of Neurosurgery, 2021

Background Ventriculoperitoneal (VP) shunt insertion is routinely performed for the treatment of ... more Background Ventriculoperitoneal (VP) shunt insertion is routinely performed for the treatment of hydrocephalus due to different indications like congenital, infective, tumor, posttraumatic, and normal pressure hydrocephalus (NPH). A lot of common and rare complications following this procedure have been reported. Objectives To analyze the clinical profile, indications, anesthetic, and postoperative complications for VP shunt surgery in our center. Materials and Methods This prospective clinical review study was conducted in the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, between October 2018 to January 2020 and included 454 cases of hydrocephalus who underwent VP shunt surgery. The data was compiled and analyzed. Results A total of 454 patients with male predominance were studied. Pediatric and adolescent patients were 48.9% (222/454). Obstructive hydrocephalus due to tumors was the etiology of 48.7% (221/454) cases. The incidence o...

Retrospective Observational Study of 448 Cerebral Contusions in a Tertiary Care Trauma Centre: Analysis of Their Clinical Radiological Progression and Outcome

INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020

Introduction: Traumatic cerebral contusion is one of the leading cause of morbidity and mortality... more Introduction: Traumatic cerebral contusion is one of the leading cause of morbidity and mortality in Neurosurgery. Patients can be either treated conservatively or surgically. Many patients who are treated conservatively may have CT scan progression and need surgery secondarily. This retrospective study was designed to study the clinical presentation and interventions predicting CT progression of hematoma and final outcome. Material and Methods: The study was conducted from April 2017 to December 2019 on all the patients of traumatic cerebral contusions, diagnosed by CT scan. Patients received either conservative treatment initially or underwent upfront surgery, and had at least one other CT scan during the acute hospitalization. Patients clinical history, CT progression and any intervention were noted. The patient’s disposition status was classified as discharged home, or to another institution, or whether the patient died. Results: Among the total 448 patients, 78.5% patients requ...

Design criteria of transition metal dopants in TiO2/CdS photoelectrode for enhanced photovoltaic response

Journal of Physics and Chemistry of Solids, 2018

We investigated transition metals (nickel (Ni), manganese (Mn) and iron (Fe)) doping in TiO 2 /Cd... more We investigated transition metals (nickel (Ni), manganese (Mn) and iron (Fe)) doping in TiO 2 /CdS photoelectrodes for understanding their impact on photovoltaic performance. The work function of the transition metal is considered as the parameter of choice in evaluating and comparing their photovoltaic response. We observed that the photocurrent is enhanced up to 34% with Mn doping and reduced up to 20% and 87% with Ni and Fe doping, respectively. Further, the electron lifetime measurements revealed that average electron lifetime for Mn doped system is similar to that of the pure TiO 2 /CdS system and is reduced significantly for Fe doped system, causing poor photovoltaic response for Fe doped TiO 2 /CdS photoelectrode based devices.

TCT-770 Outcomes After Endograft Facilitated Transcatheter Pulmonary Valve Replacement for Failed Repair: Surgical vs. Transcatheter Procedures

Journal of the American College of Cardiology, 2019

A novel process for sensitization and infiltration of quantum dots in mesoporous metal oxide matrix for efficient solar photovoltaics response

Solar Energy, 2018

Cadmium telluride (CdTe) quantum dots are integrated with mesoporous titanium dioxide "TiO 2 " el... more Cadmium telluride (CdTe) quantum dots are integrated with mesoporous titanium dioxide "TiO 2 " electrode using an in-situ sensitization approach for the first time, where water soluble N-Acetyl Cysteine capped CdTe quantum dots (diameter 4-5 nm) are grown hydrothermally inside mesoporous TiO 2 electrode matrix. This insitu sensitization approach has shown the effective sensitization over the conventional reported sensitization processes. The in-situ CdTe sensitized TiO 2 electrodes are further unified with PbS counter electrode to realize the quantum dot sensitized solar cell (QDSSC). The fabricated CdTe QDSSC has shown the optimal short circuit current density 3.35 ± 0.21 mA/cm 2 and open circuit voltage 0.58 ± 0.01 V. The observed current density is the highest among such cell configurations, reported till date. The in-situ sensitized CdTe QDs are further treated with zinc sulfide for surface passivation to realize the reduced back recombination, if any. These ZnS passivated CdTe QDs sensitized solar cells in similar device configurations resulted into the significant reduction in the short circuit current density (20%) with the minimal change in open circuit voltage (5%). The impedance spectroscopy measurements suggest that the transmission resistance "R tr " has increased after ZnS treatment for these electrodes, however, the recombination resistance R rec has not changed much. The observed high R tr might be responsible for the observed current deterioration after ZnS surface passivation. These studies suggest that in-situ QD sensitization may provide a new method of integrating QDs into mesoporous TiO 2 matrix for effective QDSSC device performance without any additional surface passivation.

Nanostructured zinc titanate wide band gap semiconductor as a photoelectrode material for quantum dot sensitized solar cells

Solar Energy, 2018

We synthesized zinc titanate nanopowder in different crystal structures by varying calcination te... more We synthesized zinc titanate nanopowder in different crystal structures by varying calcination temperature and time and phase evolution is qualitatively investigated using reference intensity ratio (RIR) approach. The electronic properties showed 2.9 eV as indirect band transition, and 3.59 ± 0.02 eV as direct band transition for the highest temperature annealed rhombohedral ZnTiO 3 and cubic spinel Zn 2 TiO 4 zinc titanate materials. The intermediate temperature annealed (∼850°C) material consists of ZnTiO 3 , Zn 2 TiO 4 , and Zn 2 Ti 3 O 8 zinc titanate nanopowder, showing similar two electronic transitions. Zinc titanate with dominant rhombohedral phase ZnTiO 3 (900°C annealed) and dominant Zn 2 Ti 3 O 8 phase (750°C annealed) are used to synthesize mesoporous electrodes for integrating the ZnS passivated CdS quantum dots. Finally, Cu 2 S counter electrode is integrated with polysulfide electrolyte to realize 1 cm 2 area quantum dot sensitized solar cells (QDSSCs). QDSSCs with dominant ZnTiO 3 phase are showing lower photovoltaic performance (short circuit current 0.76 mA/cm 2 , open circuit voltage 0.55 V) with respect to that of dominant Zn 2 Ti 3 O 8 phase with 2.2 mA/cm 2 short circuit current and 0.69 V open circuit voltage, respectively. The observed difference is attributed to differences in electronic and morphological properties of the synthesized zinc titanate powders.

Repeat Pulmonary Valve Replacement

JACC: Cardiovascular Interventions, 2018

OBJECTIVES This study compares 30-day, 1-year, and 3-year echocardiographic findings and clinical... more OBJECTIVES This study compares 30-day, 1-year, and 3-year echocardiographic findings and clinical outcomes of transcatheter pulmonary valve-in-valve replacement (TPVR) and repeat surgical pulmonary valve replacement (SPVR). BACKGROUND In patients with adult congenital heart disease and previous pulmonary valve replacement (PVR) who require redo PVR, it is unclear whether TPVR or repeat SPVR is the preferred strategy. METHODS We retrospectively identified 66 patients (TPVR, n ¼ 36; SPVR, n ¼ 30) with bioprosthetic pulmonary valves (PVs) who underwent either TPVR or repeat SPVR at Emory Healthcare from January 2007 to August 2017. RESULTS The TPVR cohort had fewer men and more patients with baseline New York Heart Association (NYHA) functional class III or IV. There was no difference in mortality, cardiovascular readmission, or post-procedural PV reintervention at 30 days, 1 year, or 3 years. Post-procedural echocardiographic findings showed no difference in mean PV gradients between the TPVR and SPVR groups at 30 days, 1 year, or 3 years. In the TPVR cohort, there was less right ventricular dysfunction at 30 days (2.9% vs. 46.7%; p < 0.01), despite higher baseline NYHA functional class in the SPVR cohort. CONCLUSIONS In patients with bioprosthetic PV dysfunction who underwent either TPVR or SPVR, there was no difference in mortality, cardiovascular readmission, or repeat PV intervention at 30 days, 1 year, or 3 years. Additionally, TPVR and SPVR had similar intermediate-term PV longevity, with no difference in PV gradients or PVR. The TPVR cohort also had less right ventricular dysfunction at 30 days despite a higher baseline NYHA functional classification. These intermediate-term results suggest that TPVR may be an attractive alternative to SPVR in patients with previous bio

Neuronavigation-Guided Versus Fluoroscopic-Guided Microneurosurgical Transsphenoidal Pituitary Surgery

Journal of Evolution of Medical and Dental Sciences, 2018

BACKGROUND The transsphenoidal route for resection of pituitary adenomas eliminates the need for ... more BACKGROUND The transsphenoidal route for resection of pituitary adenomas eliminates the need for craniotomy to expose the pituitary gland. It creates narrow access to a deep region of the skull rich with critical neurovascular structures. To ensure an appropriate trajectory, intraoperative image-guidance has been used in transsphenoidal surgeries for decades. The evolution of image-guidance in pituitary surgery has included the use of intraoperative fluoroscopy, CT, ultrasound and MRI. The neuronavigational systems have been used successfully in the setting of pituitary adenoma resection, but comparative analysis with commonly available fluoroscopic-guided surgery is lacking. The objective of this study is to compare the effectiveness and significance of neuronavigation vs fluoroscopy in transsphenoidal microneurosurgical removal of pituitary adenoma. MATERIALS AND METHODS This is a non-randomised controlled trial. Data of patients who were surgically treated for a pituitary lesion at the Department of Neurosurgery between May 2012 and May 2017 was collected. Age, sex, race, presenting symptoms, length of hospital stay, surgical approach, duration of surgery, tumour pathological features, Gross Total Resection (GTR) of tumour, recurrence of the lesion and intraoperative and postoperative complications were noted. All procedures were performed by the neurosurgical team, who were initially unfamiliar with the neuronavigation approach and therefore used traditional fluoroscopy. RESULTS 30 patients who underwent fluoroscopic-guided and 30 patients who underwent neuronavigation-guided microsurgical removal of pituitary were included in the study. The mean time taken during surgery was significantly less (p < 0.001) in neuronavigation group as compared to the fluoroscopy group. Also, there was significantly less amount of intraoperative blood loss in neuronavigation group. Postoperative residual tumour volume as assessed by a postoperative CT scan was less than 0.5 mL in 67% patients in neuronavigation group, while it was between 1-1.5 mL in 60% patients with fluoroscopy. Other postoperative complications like diabetes insipidus, CSF rhinorrhoea, meningitis, vision loss and sinusitis were comparable between the two groups. CONCLUSION The application of neuronavigation in the transsphenoidal surgery for resection of pituitary adenoma can improve the safety of transsphenoidal approach, decreases surgical complications and duration of surgery.

Gas-Forming Intracerebral Abscess with Pediatric Parafalcine Subdural Empyema with Review of Literature

Indian Journal of Neurosurgery, 2015

An 8-year-old girl presented at our hospital with history of purulent discharge from left ear sin... more An 8-year-old girl presented at our hospital with history of purulent discharge from left ear since 1 year, progressive headache, seizures, and altered sensorium since 2 days. Before presenting at our hospital, patient had taken treatment from a private hospital where her laboratory parameters were hemoglobin 11.4 g/dL, total leucocyte Keywords ► gas-forming intracerebral abscess ► subdural empyema ► chronic suppurative otitis media

Cerebral intraventricular echinococcosis in an adult

Surgical Neurology International, 2015

Background: Echinococcosis in humans occurs as a result of infection by the larval stages of taen... more Background: Echinococcosis in humans occurs as a result of infection by the larval stages of taeniid cestodes of the genus echinococcus. Intracranial hydatid cysts usually develop at an intraparenchymal site. Hydatid cyst within the cerebral ventricle is quite unusual. Methods: We reviewed the literature on adult intraventricular hydatid cyst and found case reports mainly in children with an only handful of cases in adults. We reported a rare case of cerebral intraventricular (left lateral ventricle) hydatid cyst in a 21-year-old adult female. Results: Although cerebral hydatid cysts are most commonly seen in children and young adults cerebral intraventricular hydatid cyst are comparatively rarer in adults. Conclusion: The possibility of infection with Echinococcus granulosus should be included in the differential diagnosis of raised intracranial hypertension in patients from endemic areas.

Pregnancy in a Previously Conjoined Thoracopagus Twin with a Crisscross Heart

Case Reports in Obstetrics and Gynecology, 2015

Background. Crisscross heart (CCH) is a complex, rare, congenital, rotational, cardiac abnormalit... more Background. Crisscross heart (CCH) is a complex, rare, congenital, rotational, cardiac abnormality that accounts for <0.1% of congenital heart defects (CHD). CCH is characterized by the crossing of the inflow streams of the two ventricles due to an abnormal twisting of the heart. A case of maternal CCH has not been previously reported.Case. We report a case of a primigravida with a CCH, who was separated at birth from her thoracopagus conjoined twin. Pregnancy was managed by congenital cardiology, maternal-fetal medicine, anesthesiology, and obstetrics. She underwent a 39-week vaginal delivery without maternal or neonatal complication.Conclusion. A successful term pregnancy outcome was achieved in a patient with CCH using a multidisciplinary approach to address her cardiac condition.

Diastolic Dysfunction by Doppler Echocardiogram is Associated with Major Adverse Events in Adult Fontan Patients

Journal of the American College of Cardiology, 2015

Background: Diastolic dysfunction severity is a well-established prognostic marker in the general... more Background: Diastolic dysfunction severity is a well-established prognostic marker in the general population. Little is known about diastolic dysfunction severity as a prognostic marker in Fontan patients. This study evaluates correlation between diastolic function parameters and adverse events in Fontan patients with long-term follow-up. methods: Retrospective review of pulsed-wave Doppler data in 104 adult Fontan patients between 2005-2014 was conducted. Dominant atrioventricular (AV) valvular flow and free-wall tissue Doppler were measured. Patients with prosthetic AV valve were excluded. Survival analysis was performed to analyze the association between adverse events (death, heart transplantation) and diastolic variables (E, e', E/e' ratio, and myocardial performance index (MPI)). Diastolic variables were compared by dominant ventricle type using two-sample t-test. results: 104 post-Fontan adult patients (71% systemic left ventricle, 72% lateral tunnel Fontan, age 27.2±7.0 years, time since Fontan operation 21.5±5.2 years) were analyzed. There were 18 adverse evens: 9 deaths, 9 transplants. Adjusting for potential confounders including dominant ventricular morphology and Fontan type, survival analysis demonstrated significant association between peak E wave velocity and major adverse event: hazard ratio=1.9 [95%CI 1.03-3.38], p=0.033. MPI, e', or E/e' ratio was not significantly associated with events. Means of the following variables were compared between patients with right vs. left dominant ventricles: E velocity was 67±58 vs. 69±62 cm/sec (p=0.8), e' velocity was 7.6±3.0 vs. 9.3±2.9 cm/sec (p=0.02), E/e' ratio was 10.1±5.3 vs 7.8±3.6 (p=0.06), and MPI was 0.63±0.32 vs 0.54±0.19 (p=0.2). Conclusion: Diastolic dysfunction by Doppler is characterized for the first time in adult Fontan population. Increase in E wave velocity was associated with increased risk of death or need for heart transplantation. Comparing left and right ventricle, right dominant ventricle manifested with lower e' velocity.

Nonanatomical mitral valve replacement in the pulmonary venous confluence for heavily calcified aortic or mitral annulus

Seminars in thoracic and cardiovascular surgery, 2011

Mitral valve replacement surgery after previous aortic valve surgery can be extremely challenging... more Mitral valve replacement surgery after previous aortic valve surgery can be extremely challenging. The presence of heavy calcification and scarring in the aortic and/or mitral annulus can make suture placement nearly impossible. Although novel techniques have been described, even these alternatives might not be feasible. We present a case of nonanatomical mitral valve replacement in the pulmonary venous confluence as a salvage operation. This can provide adequate hemodynamics and survival until a subsequent care plan can be established.

Transplant-Free Survival and Hospitalizations Late After the Fontan Palliation

Journal of the American College of Cardiology, 2013

Background: The Fontan operation is standard palliation for single ventricle heart defects. Outco... more Background: The Fontan operation is standard palliation for single ventricle heart defects. Outcomes beyond 20 yrs after Fontan palliation are not well known. We describe late outcomes in a cohort of adult patients post-Fontan. methods: A chart review of all patients post Fontan who survived to adulthood, seen at Emory since 1998 was performed. Diagnosis, surgical history, cardiac hospitalizations (heart failure, arrhythmia, thromboembolic events, or surgical admissions), death and need for transplant were obtained. Outcomes were plotted using Kaplan Meier and tested for difference by Fontan type and ventricular morphology. results: 134 patients (57.5% male) were identified (mean age 28.4 yrs [18-55.2], mean time from Fontan completion 21.4 yrs [5.1-34.8]). Ventricular morphological was right (RV) n=31, left (LV) n=98, or equal ventricles n=5. 55 patients had atriopulmonary Fontan (APC), 24 of which were revised, 77 lateral tunnel, 2 extracardiac. 14 patients died, 10 required transplant. Fig. 1 shows overall survival. LV patients had improved survival compared to RV (p=0.035), with no differences by Fontan type. Freedom from hospitalization was 69%, 38.6%, and 6.4% at 20, 25 and 30 yrs since Fontan, with no difference by Fontan type or ventricular morphology. conclusions: In a cohort of Fontan patients with adult survival, hospitalization is common and transplant-free survival decreases with time since Fontan, approaching 50% at 30 yrs following Fontan. Systemic RV confers worse late survival.

Serum Concentration of Myelin Basic Protein as a Prognostic Marker in Mild-to-moderate Head Injury Patients: A Prospective Study in a Tertiary Care Center

Indian Journal of Neurosurgery

Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcom... more Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcome prediction among mild-to-moderate head injury patients. Materials and Methods It was a prospective study done at the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University from Jan 2018 to July 2019. All patients who presented to us within 48 hours of injury with mild-to-moderate head injury with apparently normal CT brain were include in the study. The serum sample were collected on the day of admission and 48 hours later, and patients were treated with standard protocols and observed 6 months postdischarge. Results Of the 32 patients enrolled, we observed mean MBP level was higher for severity of brain damage, but not associated with age, mode of injury, and radiological diagnosis. Mean MBP levels were not statistically associated with Glasgow coma scale (GCS) score at admission but was correlated to outcome with p < 0.05, with sensitivity of 50% and s...

A new innovative light-emitting diode habit-breaking appliance

Indian Journal of Multidisciplinary Dentistry, 2017

The aim of the present case report is to introduce a modified and innovative design for effective... more The aim of the present case report is to introduce a modified and innovative design for effective habit breaking with minimal patient discomfort. Abnormal oral habits are one of the major etiological factors in malocclusion. The harmful, unbalanced pressure bears upon the immature, highly malleable alveolar ridges and brings about potential changes in the position of teeth and occlusion. These habits can also cause behavioral problems and are socially unacceptable. Various methods and appliances are used to break the abnormal oral habits, as a part of treatment of malocclusion. The traditional habit-breaking appliances used so far can cause irritation to the tongue, subsequently leading to ulceration and in addition can also cause mastication and speech problems. The appliance is a regular Hawley's appliance with the addition of the light-emitting diode bulb and the switch. When the child's tongue or the finger touches the appliance, the light bulb gets illuminated, thus reminding the child to quit the habit. The said appliance utilizes easily available electrical gadgets that will function by disturbing the subconsciously built vicious cycle. The reminders send by its activation will break the pleasure perception obtained during the habit. Habit breaking through this appliance is effective as it is superior to other appliances in the mode of action as well as the design itself is attractive to the children.

4Consultant, MSG Strategic Consulting Pvt Ltd

Effect of educational intervention measures on knowledge about rabies and its preventive

Clinical, Surgical and Outcome Predictive Factor Analysis of Operated Acute Subdural Hematoma Cases: A Retrospective Study of 114 Operated Cases at Tertiary Centre

Indian Journal of Neurosurgery, 2021

Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural... more Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clini...

Band Gap Engineering of CdTe Quantum Dots by Hg Alloying in Infrared Region

Springer Proceedings in Physics, 2019

We synthesized Hg alloyed CdTe quantum dots (Cd1−xHgxTe) using hydrothermal route. N-acetyl-cyste... more We synthesized Hg alloyed CdTe quantum dots (Cd1−xHgxTe) using hydrothermal route. N-acetyl-cysteine is used as the capping agent for water dispersed Cd1−xHgxTe (x = 0, 0.05, 0.1 and 0.5) quantum dots. The diameter of the synthesized quantum dots is 3.8 ± 0.5 nm, as estimated from high resolution transmission electron micrographs. The mercury molar fraction modified band gap engineering is demonstrated with band gap changing from 2.5 eV for CdTe quantum dots to 1.25 eV for Cd0.5Hg0.5Te.

Clinical, surgical and postoperative outcome analysis of tumors occupying both posterior and middle cranial fossa

Introduction: This study aims to analyse clinical, surgical and postoperative outcome perspective... more Introduction: This study aims to analyse clinical, surgical and postoperative outcome perspectives of tumors occupying both middle and posterior cranial fossa. Methods and Materials: This retrospective cohort study includes 23 patients operated for tumors involving both middle and posterior cranial fossa in our department between August 2016 and August 2020. Each patient was evaluated for age, sex, co-morbidities, tumour histopathology, clinical presentation, radiological characteristics, surgical and outcome characteristics. Unpaired ttest and chi-square tests were used for statistical analysis. P < 0.05 was considered statistically significant. Results: The mean age was 46 years (range 40–57 years), with the majority of patients being female (56.5%). Most tumors (65.3%) were trigeminal schwannoma, with the remaining being vestibular schwannoma (21.7%), facial schwannoma (8.7%) and epidermoid (4.3%). The most commonly used surgical approach was the retrosigmoid approach (30.4%) ...

A Prospective Study and Analysis of Ventriculoperitoneal Shunt Surgery: Their Indication and Complication in a Single Tertiary Care Center

Indian Journal of Neurosurgery, 2021

Background Ventriculoperitoneal (VP) shunt insertion is routinely performed for the treatment of ... more Background Ventriculoperitoneal (VP) shunt insertion is routinely performed for the treatment of hydrocephalus due to different indications like congenital, infective, tumor, posttraumatic, and normal pressure hydrocephalus (NPH). A lot of common and rare complications following this procedure have been reported. Objectives To analyze the clinical profile, indications, anesthetic, and postoperative complications for VP shunt surgery in our center. Materials and Methods This prospective clinical review study was conducted in the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, between October 2018 to January 2020 and included 454 cases of hydrocephalus who underwent VP shunt surgery. The data was compiled and analyzed. Results A total of 454 patients with male predominance were studied. Pediatric and adolescent patients were 48.9% (222/454). Obstructive hydrocephalus due to tumors was the etiology of 48.7% (221/454) cases. The incidence o...

Retrospective Observational Study of 448 Cerebral Contusions in a Tertiary Care Trauma Centre: Analysis of Their Clinical Radiological Progression and Outcome

INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020

Introduction: Traumatic cerebral contusion is one of the leading cause of morbidity and mortality... more Introduction: Traumatic cerebral contusion is one of the leading cause of morbidity and mortality in Neurosurgery. Patients can be either treated conservatively or surgically. Many patients who are treated conservatively may have CT scan progression and need surgery secondarily. This retrospective study was designed to study the clinical presentation and interventions predicting CT progression of hematoma and final outcome. Material and Methods: The study was conducted from April 2017 to December 2019 on all the patients of traumatic cerebral contusions, diagnosed by CT scan. Patients received either conservative treatment initially or underwent upfront surgery, and had at least one other CT scan during the acute hospitalization. Patients clinical history, CT progression and any intervention were noted. The patient’s disposition status was classified as discharged home, or to another institution, or whether the patient died. Results: Among the total 448 patients, 78.5% patients requ...

Design criteria of transition metal dopants in TiO2/CdS photoelectrode for enhanced photovoltaic response

Journal of Physics and Chemistry of Solids, 2018

We investigated transition metals (nickel (Ni), manganese (Mn) and iron (Fe)) doping in TiO 2 /Cd... more We investigated transition metals (nickel (Ni), manganese (Mn) and iron (Fe)) doping in TiO 2 /CdS photoelectrodes for understanding their impact on photovoltaic performance. The work function of the transition metal is considered as the parameter of choice in evaluating and comparing their photovoltaic response. We observed that the photocurrent is enhanced up to 34% with Mn doping and reduced up to 20% and 87% with Ni and Fe doping, respectively. Further, the electron lifetime measurements revealed that average electron lifetime for Mn doped system is similar to that of the pure TiO 2 /CdS system and is reduced significantly for Fe doped system, causing poor photovoltaic response for Fe doped TiO 2 /CdS photoelectrode based devices.

TCT-770 Outcomes After Endograft Facilitated Transcatheter Pulmonary Valve Replacement for Failed Repair: Surgical vs. Transcatheter Procedures

Journal of the American College of Cardiology, 2019

A novel process for sensitization and infiltration of quantum dots in mesoporous metal oxide matrix for efficient solar photovoltaics response

Solar Energy, 2018

Cadmium telluride (CdTe) quantum dots are integrated with mesoporous titanium dioxide "TiO 2 " el... more Cadmium telluride (CdTe) quantum dots are integrated with mesoporous titanium dioxide "TiO 2 " electrode using an in-situ sensitization approach for the first time, where water soluble N-Acetyl Cysteine capped CdTe quantum dots (diameter 4-5 nm) are grown hydrothermally inside mesoporous TiO 2 electrode matrix. This insitu sensitization approach has shown the effective sensitization over the conventional reported sensitization processes. The in-situ CdTe sensitized TiO 2 electrodes are further unified with PbS counter electrode to realize the quantum dot sensitized solar cell (QDSSC). The fabricated CdTe QDSSC has shown the optimal short circuit current density 3.35 ± 0.21 mA/cm 2 and open circuit voltage 0.58 ± 0.01 V. The observed current density is the highest among such cell configurations, reported till date. The in-situ sensitized CdTe QDs are further treated with zinc sulfide for surface passivation to realize the reduced back recombination, if any. These ZnS passivated CdTe QDs sensitized solar cells in similar device configurations resulted into the significant reduction in the short circuit current density (20%) with the minimal change in open circuit voltage (5%). The impedance spectroscopy measurements suggest that the transmission resistance "R tr " has increased after ZnS treatment for these electrodes, however, the recombination resistance R rec has not changed much. The observed high R tr might be responsible for the observed current deterioration after ZnS surface passivation. These studies suggest that in-situ QD sensitization may provide a new method of integrating QDs into mesoporous TiO 2 matrix for effective QDSSC device performance without any additional surface passivation.

Nanostructured zinc titanate wide band gap semiconductor as a photoelectrode material for quantum dot sensitized solar cells

Solar Energy, 2018

We synthesized zinc titanate nanopowder in different crystal structures by varying calcination te... more We synthesized zinc titanate nanopowder in different crystal structures by varying calcination temperature and time and phase evolution is qualitatively investigated using reference intensity ratio (RIR) approach. The electronic properties showed 2.9 eV as indirect band transition, and 3.59 ± 0.02 eV as direct band transition for the highest temperature annealed rhombohedral ZnTiO 3 and cubic spinel Zn 2 TiO 4 zinc titanate materials. The intermediate temperature annealed (∼850°C) material consists of ZnTiO 3 , Zn 2 TiO 4 , and Zn 2 Ti 3 O 8 zinc titanate nanopowder, showing similar two electronic transitions. Zinc titanate with dominant rhombohedral phase ZnTiO 3 (900°C annealed) and dominant Zn 2 Ti 3 O 8 phase (750°C annealed) are used to synthesize mesoporous electrodes for integrating the ZnS passivated CdS quantum dots. Finally, Cu 2 S counter electrode is integrated with polysulfide electrolyte to realize 1 cm 2 area quantum dot sensitized solar cells (QDSSCs). QDSSCs with dominant ZnTiO 3 phase are showing lower photovoltaic performance (short circuit current 0.76 mA/cm 2 , open circuit voltage 0.55 V) with respect to that of dominant Zn 2 Ti 3 O 8 phase with 2.2 mA/cm 2 short circuit current and 0.69 V open circuit voltage, respectively. The observed difference is attributed to differences in electronic and morphological properties of the synthesized zinc titanate powders.

Repeat Pulmonary Valve Replacement

JACC: Cardiovascular Interventions, 2018

OBJECTIVES This study compares 30-day, 1-year, and 3-year echocardiographic findings and clinical... more OBJECTIVES This study compares 30-day, 1-year, and 3-year echocardiographic findings and clinical outcomes of transcatheter pulmonary valve-in-valve replacement (TPVR) and repeat surgical pulmonary valve replacement (SPVR). BACKGROUND In patients with adult congenital heart disease and previous pulmonary valve replacement (PVR) who require redo PVR, it is unclear whether TPVR or repeat SPVR is the preferred strategy. METHODS We retrospectively identified 66 patients (TPVR, n ¼ 36; SPVR, n ¼ 30) with bioprosthetic pulmonary valves (PVs) who underwent either TPVR or repeat SPVR at Emory Healthcare from January 2007 to August 2017. RESULTS The TPVR cohort had fewer men and more patients with baseline New York Heart Association (NYHA) functional class III or IV. There was no difference in mortality, cardiovascular readmission, or post-procedural PV reintervention at 30 days, 1 year, or 3 years. Post-procedural echocardiographic findings showed no difference in mean PV gradients between the TPVR and SPVR groups at 30 days, 1 year, or 3 years. In the TPVR cohort, there was less right ventricular dysfunction at 30 days (2.9% vs. 46.7%; p < 0.01), despite higher baseline NYHA functional class in the SPVR cohort. CONCLUSIONS In patients with bioprosthetic PV dysfunction who underwent either TPVR or SPVR, there was no difference in mortality, cardiovascular readmission, or repeat PV intervention at 30 days, 1 year, or 3 years. Additionally, TPVR and SPVR had similar intermediate-term PV longevity, with no difference in PV gradients or PVR. The TPVR cohort also had less right ventricular dysfunction at 30 days despite a higher baseline NYHA functional classification. These intermediate-term results suggest that TPVR may be an attractive alternative to SPVR in patients with previous bio

Neuronavigation-Guided Versus Fluoroscopic-Guided Microneurosurgical Transsphenoidal Pituitary Surgery

Journal of Evolution of Medical and Dental Sciences, 2018

BACKGROUND The transsphenoidal route for resection of pituitary adenomas eliminates the need for ... more BACKGROUND The transsphenoidal route for resection of pituitary adenomas eliminates the need for craniotomy to expose the pituitary gland. It creates narrow access to a deep region of the skull rich with critical neurovascular structures. To ensure an appropriate trajectory, intraoperative image-guidance has been used in transsphenoidal surgeries for decades. The evolution of image-guidance in pituitary surgery has included the use of intraoperative fluoroscopy, CT, ultrasound and MRI. The neuronavigational systems have been used successfully in the setting of pituitary adenoma resection, but comparative analysis with commonly available fluoroscopic-guided surgery is lacking. The objective of this study is to compare the effectiveness and significance of neuronavigation vs fluoroscopy in transsphenoidal microneurosurgical removal of pituitary adenoma. MATERIALS AND METHODS This is a non-randomised controlled trial. Data of patients who were surgically treated for a pituitary lesion at the Department of Neurosurgery between May 2012 and May 2017 was collected. Age, sex, race, presenting symptoms, length of hospital stay, surgical approach, duration of surgery, tumour pathological features, Gross Total Resection (GTR) of tumour, recurrence of the lesion and intraoperative and postoperative complications were noted. All procedures were performed by the neurosurgical team, who were initially unfamiliar with the neuronavigation approach and therefore used traditional fluoroscopy. RESULTS 30 patients who underwent fluoroscopic-guided and 30 patients who underwent neuronavigation-guided microsurgical removal of pituitary were included in the study. The mean time taken during surgery was significantly less (p < 0.001) in neuronavigation group as compared to the fluoroscopy group. Also, there was significantly less amount of intraoperative blood loss in neuronavigation group. Postoperative residual tumour volume as assessed by a postoperative CT scan was less than 0.5 mL in 67% patients in neuronavigation group, while it was between 1-1.5 mL in 60% patients with fluoroscopy. Other postoperative complications like diabetes insipidus, CSF rhinorrhoea, meningitis, vision loss and sinusitis were comparable between the two groups. CONCLUSION The application of neuronavigation in the transsphenoidal surgery for resection of pituitary adenoma can improve the safety of transsphenoidal approach, decreases surgical complications and duration of surgery.

Gas-Forming Intracerebral Abscess with Pediatric Parafalcine Subdural Empyema with Review of Literature

Indian Journal of Neurosurgery, 2015

An 8-year-old girl presented at our hospital with history of purulent discharge from left ear sin... more An 8-year-old girl presented at our hospital with history of purulent discharge from left ear since 1 year, progressive headache, seizures, and altered sensorium since 2 days. Before presenting at our hospital, patient had taken treatment from a private hospital where her laboratory parameters were hemoglobin 11.4 g/dL, total leucocyte Keywords ► gas-forming intracerebral abscess ► subdural empyema ► chronic suppurative otitis media

Cerebral intraventricular echinococcosis in an adult

Surgical Neurology International, 2015

Background: Echinococcosis in humans occurs as a result of infection by the larval stages of taen... more Background: Echinococcosis in humans occurs as a result of infection by the larval stages of taeniid cestodes of the genus echinococcus. Intracranial hydatid cysts usually develop at an intraparenchymal site. Hydatid cyst within the cerebral ventricle is quite unusual. Methods: We reviewed the literature on adult intraventricular hydatid cyst and found case reports mainly in children with an only handful of cases in adults. We reported a rare case of cerebral intraventricular (left lateral ventricle) hydatid cyst in a 21-year-old adult female. Results: Although cerebral hydatid cysts are most commonly seen in children and young adults cerebral intraventricular hydatid cyst are comparatively rarer in adults. Conclusion: The possibility of infection with Echinococcus granulosus should be included in the differential diagnosis of raised intracranial hypertension in patients from endemic areas.

Pregnancy in a Previously Conjoined Thoracopagus Twin with a Crisscross Heart

Case Reports in Obstetrics and Gynecology, 2015

Background. Crisscross heart (CCH) is a complex, rare, congenital, rotational, cardiac abnormalit... more Background. Crisscross heart (CCH) is a complex, rare, congenital, rotational, cardiac abnormality that accounts for <0.1% of congenital heart defects (CHD). CCH is characterized by the crossing of the inflow streams of the two ventricles due to an abnormal twisting of the heart. A case of maternal CCH has not been previously reported.Case. We report a case of a primigravida with a CCH, who was separated at birth from her thoracopagus conjoined twin. Pregnancy was managed by congenital cardiology, maternal-fetal medicine, anesthesiology, and obstetrics. She underwent a 39-week vaginal delivery without maternal or neonatal complication.Conclusion. A successful term pregnancy outcome was achieved in a patient with CCH using a multidisciplinary approach to address her cardiac condition.

Diastolic Dysfunction by Doppler Echocardiogram is Associated with Major Adverse Events in Adult Fontan Patients

Journal of the American College of Cardiology, 2015

Background: Diastolic dysfunction severity is a well-established prognostic marker in the general... more Background: Diastolic dysfunction severity is a well-established prognostic marker in the general population. Little is known about diastolic dysfunction severity as a prognostic marker in Fontan patients. This study evaluates correlation between diastolic function parameters and adverse events in Fontan patients with long-term follow-up. methods: Retrospective review of pulsed-wave Doppler data in 104 adult Fontan patients between 2005-2014 was conducted. Dominant atrioventricular (AV) valvular flow and free-wall tissue Doppler were measured. Patients with prosthetic AV valve were excluded. Survival analysis was performed to analyze the association between adverse events (death, heart transplantation) and diastolic variables (E, e', E/e' ratio, and myocardial performance index (MPI)). Diastolic variables were compared by dominant ventricle type using two-sample t-test. results: 104 post-Fontan adult patients (71% systemic left ventricle, 72% lateral tunnel Fontan, age 27.2±7.0 years, time since Fontan operation 21.5±5.2 years) were analyzed. There were 18 adverse evens: 9 deaths, 9 transplants. Adjusting for potential confounders including dominant ventricular morphology and Fontan type, survival analysis demonstrated significant association between peak E wave velocity and major adverse event: hazard ratio=1.9 [95%CI 1.03-3.38], p=0.033. MPI, e', or E/e' ratio was not significantly associated with events. Means of the following variables were compared between patients with right vs. left dominant ventricles: E velocity was 67±58 vs. 69±62 cm/sec (p=0.8), e' velocity was 7.6±3.0 vs. 9.3±2.9 cm/sec (p=0.02), E/e' ratio was 10.1±5.3 vs 7.8±3.6 (p=0.06), and MPI was 0.63±0.32 vs 0.54±0.19 (p=0.2). Conclusion: Diastolic dysfunction by Doppler is characterized for the first time in adult Fontan population. Increase in E wave velocity was associated with increased risk of death or need for heart transplantation. Comparing left and right ventricle, right dominant ventricle manifested with lower e' velocity.

Nonanatomical mitral valve replacement in the pulmonary venous confluence for heavily calcified aortic or mitral annulus

Seminars in thoracic and cardiovascular surgery, 2011

Mitral valve replacement surgery after previous aortic valve surgery can be extremely challenging... more Mitral valve replacement surgery after previous aortic valve surgery can be extremely challenging. The presence of heavy calcification and scarring in the aortic and/or mitral annulus can make suture placement nearly impossible. Although novel techniques have been described, even these alternatives might not be feasible. We present a case of nonanatomical mitral valve replacement in the pulmonary venous confluence as a salvage operation. This can provide adequate hemodynamics and survival until a subsequent care plan can be established.

Transplant-Free Survival and Hospitalizations Late After the Fontan Palliation

Journal of the American College of Cardiology, 2013

Background: The Fontan operation is standard palliation for single ventricle heart defects. Outco... more Background: The Fontan operation is standard palliation for single ventricle heart defects. Outcomes beyond 20 yrs after Fontan palliation are not well known. We describe late outcomes in a cohort of adult patients post-Fontan. methods: A chart review of all patients post Fontan who survived to adulthood, seen at Emory since 1998 was performed. Diagnosis, surgical history, cardiac hospitalizations (heart failure, arrhythmia, thromboembolic events, or surgical admissions), death and need for transplant were obtained. Outcomes were plotted using Kaplan Meier and tested for difference by Fontan type and ventricular morphology. results: 134 patients (57.5% male) were identified (mean age 28.4 yrs [18-55.2], mean time from Fontan completion 21.4 yrs [5.1-34.8]). Ventricular morphological was right (RV) n=31, left (LV) n=98, or equal ventricles n=5. 55 patients had atriopulmonary Fontan (APC), 24 of which were revised, 77 lateral tunnel, 2 extracardiac. 14 patients died, 10 required transplant. Fig. 1 shows overall survival. LV patients had improved survival compared to RV (p=0.035), with no differences by Fontan type. Freedom from hospitalization was 69%, 38.6%, and 6.4% at 20, 25 and 30 yrs since Fontan, with no difference by Fontan type or ventricular morphology. conclusions: In a cohort of Fontan patients with adult survival, hospitalization is common and transplant-free survival decreases with time since Fontan, approaching 50% at 30 yrs following Fontan. Systemic RV confers worse late survival.