Anterior pancreatic duct split prior to duct-to-mucosa pancreatico-jejunal anastomosis in pancreaticoduodenectomy

Srikanth Gadiyaram,Murugappan Nachiappan 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.3

A secure pancreatic-enteric anastomosis is widely accepted as the ‘Achilles heel’ in reconstruction following a pancreaticoduodenectomy. Most morbidity following the procedure is related to the failure of this anastomosis, resulting in intra-abdominal collections, secondary haemorrhage, delayed gastric emptying, need for radiological interventions and re-operation for some patients. Of several techniques available, the ‘duct-to-mucosa’ technique is widely employed for pancreaticojejunal anastomosis. Among several refinements to facilitate this anastomosis, viz; mobilization of pancreatic stump, magnification with loupes and modifications made on the jejunal side to enable a tension free anastomosis, none seems to address the pancreatic duct in particular. The operative technique of anterior pancreatic duct split described by us enables a wider, well visualized pancreatic duct for a secure duct to mucosa pancreaticojejunal anastomosis.

Role of hyperforin in diabetes and its associated hyperlipidemia in rats

Srikanth Ineedi,Anshul Shakya,Gireesh Kumar Singh,Vikas Kumar 셀메드 세포교정의약학회 2012 TANG Vol.2 No.3

The aim of the present study was to evaluate the possible roles of hyperforin against hyperglycemia, hyperlipidemia and oxidative stress in streptozotocin-induced diabetic rats. Diabetes was induced by a single intraperitoneal injection of streptozotocin (65 mg/kg). Biochemical parameters were measured following hyperforin treatment (10 mg/kg, i.p.) for 7 days. Hyperforin treatment significantly reversed the elevations in plasma glucose, triglycerides, total cholesterol and LDL-cholesterol. Hyperforin also reversed the declines in plasma HDL-cholesterol and liver glycogen, but did not reverse the change in plasma insulin levels when compared to the diabetic control rats. Hyperforin treatment also reversed the oxidative stress induced by streptozotocin. Moreover, the effect of the hyperforin on peripheral glucose utilization in normal rats was evaluated by an oral glucose tolerance test (OGTT). Hyperforin treatment significantly increased (p < 0.05) the glucose tolerance compared to the vehicle in OGTT. The antihyperglycemic, antihyperlipidemic and antioxidant activities of hyperforin (10 mg/kg, i.p.) were comparable qualitatively to glibenclamide (1 mg/kg, p.o.). In conclusion, we report for the first time through an in vivo study that hyperforin is potentially valuable for the treatment of diabetes and its associated hyperlipidemia and oxidative stress by enhancing the glucose utilization by peripheral tissues such as muscle and adipose tissues.

Securing the Periphery: China-North Korea Security Relations

Srikanth Kondapalli 통일연구원 2006 International journal of korean unification studie Vol.15 No.2

Laparoscopic ‘D2 first’ approach for obscure gallbladders

Srikanth Gadiyaram,Murugappan Nachiappan 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.4

Laparoscopic cholecystectomy has a reported incidence of 4%–15% of conversion to an open procedure and one of the main reasons behind the conversion is a gallbladder (GB) wrapped with dense adhesions. It is prudent to convert the procedure to an open operation in patients with particularly dense adhesions when the GB is not visible, preventing safe dissection which carries a potential risk of duodenal or colonic injury. The technique described, namely laparoscopic ‘D2 first’ approach, enables the completion of laparoscopic procedure in patients with ‘obscure’ GBs.

Rehabilitation Professionals’ Perspectives on Psychosocial Needs of Family Caregivers of Persons with Spinal Cord Injury: A Qualitative Study from India

Srikanth Pallerla,Shanivaram Reddy Krishnareddy,Nirmala Berigai Parthasarathy,Janardhana Navaneetham,Anupam Gupta 대한가정의학회 2023 Korean Journal of Family Medicine Vol.44 No.3

Background: This study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals.Methods: An exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes.Results: Nine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral.Conclusion: The findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.

Experimental work on leaching of printed circuit boards

( Srikanth Srivatsa ),( Sankar Bhattacharya ) 한국폐기물자원순환학회 2022 ISSE 초록집 Vol.2022 No.-

Ground printed circuit boards (PCB) were pyrolysed to devolatilize the plastic components to fuel oils and gas for energy recovery. The by-product is a mixture of metals which is further treated with acids to dissolve the metals into leach liquor. A significant number of experiments were conducted with three inorganic acids and three organic acids using the metallic residues after pyrolysis. The major conclusions are: · The plastics can be easily converted into oil which can be used for on-site heat generation to support the pyrolysis process. The pyrolysis process can be accomplished in around 400℃ · The inorganic acids HCl, H₂SO₄ and HNO₃ are studied for the leaching of metals from the PCB metal mixture. · Cu, Al, Li, and Co can be easily extracted using either of the three acids. · Zn and Sn leaching has very low efficiency in all the three acids · Ni and Fe are poorly extracted into the leach liquor, with HCl showing relatively better extraction. · Au and Ag is easily extracted into HCl with efficiency reduced in HNO₃. However, the use of inorganic acids has its own difficulties in handling and disposal of waste liquid to meet environmental standards. Hence as alternative organic acids were used for the leaching of metals, organic acids are environmentally benign and bio-degradable. The organic acids tested for the purpose are citric acid, lactic acid and oxalic acid. The results suggest the following - · Oxalic acid has superior activity dissolving the majority of the metals present in the PCB mixture except for Sn and Fe. · 1M oxalic acid between 50-75 ℃ and for a duration of 2-4 h is sufficient to dissolve majority of the metals in the solution. The work is currently being scaled up.

Real Earnings Management and Persistence of Firm Value: Evidence from India

Srikanth POTHARLA,Kaushik BHATTACHARJEE,Durga Prasad SAMONTARAY 한국유통과학회 2021 The Journal of Asian Finance, Economics and Busine Vol.8 No.12

The present study aims to examine the impact of real earnings management on the future value of the firm and its persistence. The study also tests suspect firm effects on the relationship between real earnings management and the future value of the firm. The sample of the present study consists of all listed non-financial firms from the year 2011 to 2018. Real earnings management has been measured in three alternative ways viz., abnormal operating cash flows, abnormal discretionary spending, and abnormal production cost. Tobin’s Q is used as a measure of firm value. The interaction term of real earnings management and Tobin’s Q is used to test firm value persistence. The results of the analysis disclose that out of three measures of real earnings management, abnormal reduction in discretionary spending only has a significant negative impact on the persistence of firm value. Moreover, the suspect firm analysis reveals that when the underlying motive of real earnings management is to meet zero earnings, both abnormal increases in operating cash flows and abnormal reduction in discretionary spending have a significant negative impact on firm value persistence.

Reciprocal Changes in Sagittal Alignment in Adolescent Idiopathic Scoliosis Patients Following Strategic Pedicle Screw Fixation

Srikanth Reddy Dumpa,Ajoy Prasad Shetty,Siddharth N. Aiyer,Rishi Mugesh Kanna,S Rajasekaran 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.2

Study Design: Retrospective observational study. Purpose: To analyze the effect of low-density (LD) strategic pedicle screw fixation on the correction of coronal and sagittal parameters in adolescent idiopathic scoliosis (AIS) patients. Overview of Literature: LD screw fixation achieves favorable coronal correction, but its effect on sagittal parameters is not well established. AIS is often associated with decreased thoracic kyphosis (TK), and the use of multi-level pedicle screws may result in further flattening of the sagittal profile. Methods: A retrospective analysis was performed on 92 patients with AIS to compare coronal and sagittal parameters preoperatively and at 2-year follow-up. All patients underwent posterior correction via LD strategic pedicle screw fixation. Radiographs were analyzed for primary Cobb angle (PCA), coronal imbalance, cervical sagittal angle (CSA), TK, lumbar lordosis (LL), pelvic incidence, pelvic tilt (PT), sacral slope (SS), C7 plumb line, spino–sacral angle, curve flexibility, and screw density. Results: PCA changed significantly from 57.6°±13.9° to 19°±8.4° (p <0.0001) with 67% correction, where the mean curve flexibility was 41% and screw density was 68%. Regional sagittal parameters did not change significantly, including CSA (from 10.76° to 10.56°, p =0.893), TK (from 24.4° to 22.8°, p =0.145), and LL (from 50.3° to 51.1°, p =0.415). However, subgroup analysis of the hypokyphosis group (<10º) and the hyperkyphosis group (>40º) showed significant correction of TK (p <0.0001 in both). Sacro–pelvic parameters showed a significant decrease of PT and increase of SS, suggesting a reduction in pelvic retroversion SS (from 37° to 40°, p =0.0001) and PT (from 15° to 14°, p =0.025). Conclusions: LD strategic pedicle screw fixation provides favorable coronal correction and improves overall sagittal sacro–pelvic parameters. This technique does not cause significant flattening of TK and results in a favorable restoration of TK in patients with hypokyphosis or hyperkyphosis.

Use of Allogenic Mesenchymal Cellular Bone Matrix in Anterior and Posterior Cervical Spinal Fusion: A Case Series of 21 Patients

Srikanth Naga Divi,Mark M. Mikhael 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.3

Study Design: Retrospective case series. Purpose: To report our early experience using allogenic mesenchymal cellular bone matrix (CBM) products in cervical spine fusion. Overview of Literature: Multi-level cervical fusions have historically yielded lower fusion rates than single level fusions, especially in patients with high risk medical comorbidities. At this time, significant literature in cervical fusion outcomes with this cellular allograft technology is lacking. Methods: Twenty-one patients underwent either multilevel (3 or 4 level) anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, or posterior cervical fusion. ViviGen (DePuy Synthes Spine, Raynham, MA, USA), an allogenic bone matrix product, was used in addition to standard instrumentation. Radiographic evaluation was performed at 2 weeks, 12 weeks, 24 weeks and 1 year postoperative. Visual analog scale (VAS) and neck disability index (NDI) scores along with return to work and leisure activity were recorded. Results: At 6 months postoperative, all patients had radiographic evidence of bone fusion regardless of age or medical comorbidities. All patients reported subjective improvement with a mean decrease in VAS from 8.3 to 1.5 and a mean decrease in NDI from 40.3% to 6.0% at 1 year. All patients also returned to work and/or regular leisure activity within 3 months. Conclusions: Twenty-one patients undergoing high-risk anterior and posterior cervical spine fusion, with the use of a commercially available mesenchymal CBM product, went on to radiographic fusion and all had improvement in subjective outcomes. While further effort and research is needed to validate its widespread use, this study shows favorable use of CBM in cervical fusion for high-risk cases.

A Study of the Flow Characteristics through a Dump Diffuser

Srikanth V. Deshpande,V.R. Sanal Kumar,H.D. Kim(김희동) 대한기계학회 2005 대한기계학회 춘추학술대회 Vol.2005 No.11

Experimental and numerical studies have been carried out to examine the internal flow features of dump diffusers with straight walled pre-diffuser at different inlet velocities. Experimental studies have been carried out in a wind tunnel facility. Numerical studies have been carried out using a two-dimensional standard kepsilon turbulence model. It was observed that at sufficiently low inlet velocities the experimental and the computational values are comparable. It was observed that a favorable pressure recovery can be obtained and the compressed air with high axial velocity can be decelerated to low values in order to facilitate efficient combustion in the flame tube zone. The observations made here lead us to execute more parametric studies in order to understand the flow conditions better and for optimized design of a dump diffuser.