159 results on '"Jahnavi, K."'
Search Results
152. Counter-Clockwise Rotation of Roux-en-Y Limb Significantly Reduces Internal Herniation in Laparoscopic Roux-en-Y Gastric Bypass (LRYGB)
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S. Scott Davis, Edward Lin, Farah A. Husain, John F. Sweeney, Kalyana C. Nandipati, and Jahnavi K. Srinivasan
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Internal hernia ,Adult ,Male ,medicine.medical_specialty ,Hernia ,Rotation ,education ,Gastric bypass ,Gastric Bypass ,Anastomosis ,digestive system ,Morbid obesity ,Humans ,Medicine ,Mesentery ,Clockwise ,Chi-Square Distribution ,Hepatology ,business.industry ,Gastroenterology ,nutritional and metabolic diseases ,Anastomosis, Roux-en-Y ,Middle Aged ,Roux-en-Y anastomosis ,humanities ,Surgery ,surgical procedures, operative ,Jejunum ,Multivariate Analysis ,Female ,Laparoscopy ,business - Abstract
Internal hernias continue to be a significant source of morbidity after LRYGB. Literature addressing the technique of Roux limb construction as a predisposing factor is sparse. The objective of this study is to evaluate the impact of Roux limb construction technique on the development of internal hernias.In this study, we included 444 (367 (82.7%) were females and 77 (17.3%) were males, two deaths excluded from the analysis) consecutive patients from our institutional bariatric database who underwent LRYGB. Variables collected include demographics, body mass index (BMI) before and after the procedure, and postoperative small bowel obstruction secondary to internal herniation. Technical details collected include: type of Roux-en-Y limb construction, Peterson's defect closure at initial operation, and reoperative findings. Roux limbs were constructed in 291 patients by a clockwise rotation of the bowel and jejunojejunostomy performed on the right side of the axis of the mesentery (group 1). In 151 patients, the Roux limb was constructed by a counterclockwise rotation of the Roux limb resulting in the jejunojejunostomy on the left side of the axis of the mesentery (group 2). We also analyzed the impact of Peterson's space closure on internal hernias. Fisher's exact test and Chi-square test were used for the analysis.Of a total 442 (mean age, 43.7 ± 10.3 years; mean BMI pre-op was 46.4 ± 5.1; and BMI after median follow-up of 12 months was 34.5 ± 6.98) patients included in the study, 21 (4.7%) internal hernias were identified. Of 21 internal hernias, 17 (81%) were through Peterson's space and four (19%) were through the mesenteric defect. Group 1 patients had significantly higher overall internal hernias (20/291, 6.9% vs. 1/151, 0.7%; P = 0.0018) and Peterson's hernias (16/291, 5.5% vs. 1/151, 0.7%; P = 0.0089) compared with group 2. In addition, no significant difference was noted in the incidence of Peterson's hernia whether the defect was closed or not closed (closed group, 4/117 and 3.4% vs. not closed, 13/325, 4%; P = 1.00). Within the group where Peterson's defect was closed, clockwise rotation and anastomosis on the right side of the axis of the mesentery was associated with significantly higher incidence of Peterson's hernias compared with counterclockwise rotation (4/54 vs. 0/63; P = 0.043). In the group where Peterson's defect was not closed, clockwise rotation was associated with higher incidence of internal hernias that did not reach statistical significance (12/237, 5.1% vs. 1/88, 1.1%; P = 0.12). This study demonstrates that the technique for construction of the Roux limb is a major factor in the development of internal hernias. Construction of the Roux limb with a counterclockwise rotation of the bowel, such that both jejunojejunostomy anastomosis and ligament of Treitz are to the left of the axis of the mesentery significantly reduces the incidence of internal hernias.
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- 2011
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153. Overview of Anterior Cervical Plating
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Mummaneni, Praveen V., primary, Srinivasan, Jahnavi K., additional, Regis, W. Haid Jr., additional, and Mizuno, Junichi, additional
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- 2002
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154. Laparoscopic sleeve gastrectomy outcomes in patients with polycystic ovary syndrome
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Tina Constantin, Edward Lin, Anthony J. Millard, Christopher G Yheulon, Jahnavi K. Srinivasan, Jamil L. Stetler, Fadi M. Balla, Ankit Patel, S. Scott Davis, Arinbjorn Jonsson, and Arvinpal Singh
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medicine.medical_specialty ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Population ,Retrospective cohort study ,General Medicine ,medicine.disease ,Obesity ,Gastroenterology ,Polycystic ovary ,Weight loss ,Internal medicine ,Cohort ,medicine ,Gastrectomy ,medicine.symptom ,education ,Laparoscopy ,business - Abstract
Polycystic ovary syndrome (PCOS) is a common disease among the bariatric population. However, there are limited data regarding the impact of laparoscopic sleeve gastrectomy (SG) on these patients. The study was conducted at University Hospital, United States. The purpose of this study was to examine per cent excess body weight loss (%EWL) and diabetes control in patients who have PCOS compared with those without PCOS. A total of 550 female patients underwent SG between December 2011 and October 2016. Retrospective analysis was completed to include follow-up data at 1, 3, 6, and 12 months and yearly after that. Outcomes measured were %EWL and hemoglobin A1c (HgbA1c). The mean and median follow-up for the entire cohort was 21 and 15 months, respectively. Seventy-eight per cent of patients completed at least 12 months of follow-up for %EWL, although only 21 per cent had similar follow-up for HgbA1c. PCOS patients had similar age (36.3 vs 36.2 years, P = 0.90), preoperative BMI (47.2 vs 47.2, P = 0.99), preoperative HgbA1c (6% vs 5.8%, P = 0.31), conversion rate to gastric bypass, and other associated comorbidities compared with non-PCOS comparisons. There was no difference in %EWL at 12-month (49.7% vs 53.1%, P = 0.53) or 24-month (43% vs 49.8%, P = 0.46) postoperative intervals. There was no difference in absolute change of HgbA1c at 12 months (-0.47% vs -0.67%, P = 0.39). SG has equivalent short-term results in %EWL and reduction in HgbA1c for patients who have PCOS and those who do not.
155. Impact of a Postoperative Bariatric Surgery Phone Call Quality Improvement Intervention on 30-day Hospital Readmissions and Emergency Department Visits.
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MAJUMDAR, MELISSA C., GRUNEWALD, ZACHARY I., FALCONER, ELISSA A., DILLER, MAGGIE L., OYEFULE, MOBOLA, SERROT, FEDERICO J., STETLER, JAMIL L., PATEL, ANKIT D., SRINIVASAN, JAHNAVI K., DAVIS JR., SCOTT, LIN, EDWARD, and HECHENBLEIKNER, ELIZABETH M.
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PATIENT readmissions , *BARIATRIC surgery , *TELEPHONE calls , *HOSPITAL emergency services , *INTEGRATED health care delivery - Abstract
Objective: Outpatient care coordination phone calls can improve postoperative outcomes in certain surgical specialties but are not well described in metabolic and bariatric surgery (MBS). This quality improvement (QI) initiative evaluated a standardized postoperative MBS phone call intervention on 30-day emergency department (ED) visits and hospital readmissions. Design: A phone call was conducted following MBS to inquire into patients' postoperative recovery and wellbeing. Retrospective chart review was done pre- (1/2019-3/2020) and postintervention (5/2020-6/2021) for variables and outcomes. Two-sample t-tests were used; p-values less than 0.05 were statistically significant. Setting: 532-bed mixed community and academic hospital. Participants: Patients aged 18 years or older undergoing primary or revisional MBS. Measurements: Patient and operative characteristics, monthly ED visit and readmission rates, postoperative day of presentation, and underlying reasons for ED visits and readmissions. Results: Overall, 522 patients were identified (263 preintervention, 259 postintervention) with 32 (6.1%) ED visits (20 preintervention, 12 postintervention) and 23 (4.4%) readmissions (9 preintervention, 14 postintervention). The top three reasons for ED visits were oral intake problems, constipation, and wound problems. The top three reasons for readmissions included surgical complications or issues, oral intake problems, and venous thromboembolism events. Average monthly ED visit rates decreased by 54 percent, from 8.4 to 3.9 percent (pre- and postintervention, respectively), while average monthly readmission rates increased from 3.1 to 3.9 percent (pre- and postintervention, respectively). Conclusion: Standardized MBS phone calls are a promising postoperative care coordination adjunct and might help reduce ED visits. Further QI work will include improving postoperative education, identifying higher risk patients before discharge, and larger scale data collection efforts. [ABSTRACT FROM AUTHOR]
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- 2023
156. Tube Gastrostomy Management for Acute Sleeve Gastrectomy Leaks.
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STETLER, JAMIL LUKE, DAVIS Jr., S. SCOTT, SRINIVASAN, JAHNAVI K., SINGH, ARVINPAL, JOHNSON, COLIN, PATEL, ANKIT D., and LIN, EDWARD
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GASTROSTOMY , *MORBID obesity , *EPIDEMICS , *BARIATRIC surgery , *SURGICAL wound dehiscence - Abstract
Morbid obesity is an epidemic, and the number of bariatric surgeries performed each year is rising. One of the most feared complications of bariatric surgery is a leak. There are multiple modalities for treating this complication with varying efficacy, with the combination of these modalities rendering the majority (90%) of leak management nonoperative. However, some of these treatment options lack widespread availability and usually require skilled practitioners to employ. There will be times where transfer to another facility with these capabilities is not feasible. Therefore, this is an opportunity to remind management teams of using a tube gastrostomy as a treatment option for this complication. The tube gastrostomy follows the basic principles of managing deep abdominal sepsis and can be applied in most community settings. [ABSTRACT FROM AUTHOR]
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- 2018
157. Long-term Outcomes Following Colectomy and Liver Transplantation for Inflammatory Bowel Disease with Primary Sclerosing Cholangitis.
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Matar AJ, Falconer E, LaBella M, Kapadia MR, Justiniano CF, Olortegui KS, Steinhagen R, Schultz K, Pratap A, Leeds I, Weaver L, Gaertner W, Finger EB, Thompson M, Fair L, Fichera A, Lovasik BP, Chapman WC, McGeoch CL, Camacho MC, Kazimi M, Kim SC, Shaffer VO, and Srinivasan JK
- Abstract
Objective: To investigate the long-term outcomes of patients with combined primary sclerosing cholangitis/inflammatory bowel disease (PSC-IBD) undergoing both liver transplantation (LT) and total abdominal colectomy (TAC)., Summary Background Data: The fraction of patients with PSC-IBD that require both LT and TAC is small, thereby limiting significant conclusions regarding long-term outcomes., Methods: Adult and pediatric patients from nine centers from the US IBD Surgery Collaborative who underwent staged LT and TAC for PSC-IBD were included. Long-term outcomes, including survival, were assessed., Results: Among 127 patients, 66 underwent TAC-before-LT, with a median time from TAC to LT of 7.9 yrs, while 61 underwent LT-before-TAC, with a median time from LT to TAC of 4.4 years. Median patient survival post TAC was significantly worse in those undergoing LT-before-TAC (16.0 yrs vs. 42.6 yrs, P=0.007), while post LT survival was not impacted by the order of TAC and LT (21.6 yrs vs. 22.0 yrs, P=0.81). Patients undergoing TAC for medically refractory disease had a higher incidence of recurrent PSC (rPSC) (P=0.02) and biliary complications (0.09) compared to those undergoing TAC for oncologic indications. Definitive TAC reconstruction with either end ileostomy or ileal-pouch anal anastomosis (IPAA) did not impact post-LT or post-TAC outcomes., Conclusions: Long term survival in PSC-IBD was contingent upon progression to LT and was not impacted by the need for TAC. PSC-IBD patients undergoing TAC for medically refractory disease had a higher incidence of rPSC and biliary complications. The use of IPAA in PSC-IBD was a viable alternative to end ileostomy., Competing Interests: Conflict of Interest Statement: All authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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158. Early Diagnosis of Cardiovascular Diseases in the Era of Artificial Intelligence: An In-Depth Review.
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Almansouri NE, Awe M, Rajavelu S, Jahnavi K, Shastry R, Hasan A, Hasan H, Lakkimsetti M, AlAbbasi RK, Gutiérrez BC, and Haider A
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Cardiovascular diseases (CVDs) are significant health issues that result in high death rates globally. Early detection of cardiovascular events may lower the occurrence of acute myocardial infarction and reduce death rates in people with CVDs. Traditional data analysis is inadequate for managing multidimensional data related to the risk prediction of CVDs, heart attacks, medical image interpretations, therapeutic decision-making, and disease prognosis due to the complex pathological mechanisms and multiple factors involved. Artificial intelligence (AI) is a technology that utilizes advanced computer algorithms to extract information from large databases, and it has been integrated into the medical industry. AI methods have shown the ability to speed up the advancement of diagnosing and treating CVDs such as heart failure, atrial fibrillation, valvular heart disease, hypertrophic cardiomyopathy, congenital heart disease, and more. In clinical settings, AI has shown usefulness in diagnosing cardiovascular illness, improving the efficiency of supporting tools, stratifying and categorizing diseases, and predicting outcomes. Advanced AI algorithms have been intricately designed to analyze intricate relationships within extensive healthcare data, enabling them to tackle more intricate jobs compared to conventional approaches., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Almansouri et al.)
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- 2024
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159. An EEG Database and Its Initial Benchmark Emotion Classification Performance.
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Seal A, Reddy PPN, Chaithanya P, Meghana A, Jahnavi K, Krejcar O, and Hudak R
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- Benchmarking, Brain anatomy & histology, Brain physiology, Brain Waves physiology, Computational Biology, Databases, Factual, Electroencephalography statistics & numerical data, Emotions physiology, Female, Humans, Machine Learning, Male, Mathematical Concepts, Neural Networks, Computer, Photic Stimulation, Video Recording, Algorithms, Electroencephalography methods, Emotions classification
- Abstract
Human emotion recognition has been a major field of research in the last decades owing to its noteworthy academic and industrial applications. However, most of the state-of-the-art methods identified emotions after analyzing facial images. Emotion recognition using electroencephalogram (EEG) signals has got less attention. However, the advantage of using EEG signals is that it can capture real emotion. However, very few EEG signals databases are publicly available for affective computing. In this work, we present a database consisting of EEG signals of 44 volunteers. Twenty-three out of forty-four are females. A 32 channels CLARITY EEG traveler sensor is used to record four emotional states namely, happy, fear, sad, and neutral of subjects by showing 12 videos. So, 3 video files are devoted to each emotion. Participants are mapped with the emotion that they had felt after watching each video. The recorded EEG signals are considered further to classify four types of emotions based on discrete wavelet transform and extreme learning machine (ELM) for reporting the initial benchmark classification performance. The ELM algorithm is used for channel selection followed by subband selection. The proposed method performs the best when features are captured from the gamma subband of the FP1-F7 channel with 94.72% accuracy. The presented database would be available to the researchers for affective recognition applications., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Ayan Seal et al.)
- Published
- 2020
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