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| 1 | Lessons learned from an audit of 1250 anal fistula patients operated at a single center:A retrospective review显示文摘BACKGROUND A complex anal fistula is a challenging disease to manage.AIM To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula center.METHODS Anal fistulas operated on by a single surgeon over 14 years were analyzed.Preoperative magnetic resonance imaging was done in all patients.Four procedures were performed:fistulotomy;two novel sphincter-saving procedures,proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts(PERFACT)and transanal opening of intersphincteric space(TROPIS),and anal fistula plug.PERFACT was initiated before TROPIS.As per the institutional GFRI algorithm,fistulotomy was done in simple fistulas,and TROPIS was done in complex fistulas.Fistulas with associated abscesses were treated by definitive surgery.Incontinence was evaluated objectively by Vaizey incontinence scores.RESULTS A total of 1351 anal fistula operations were performed in 1250 patients.The overall fistula healing rate was 19.4%in anal fistula plug(n=56),50.3%in PERFACT(n=175),86%in TROPIS(n=408),and 98.6%in fistulotomy(n=611)patients.Continence did not change significantly after surgery in any group.As per the new algorithm,1019 patients were operated with either the fistulotomy or TROPIS procedure.The overall success rate was 93.5%in those patients.In a subgroup analysis,the overall healing rate in supralevator,horseshoe,and fistulas with an associated abscess was 82%,85.8%,and 90.6%,respectively.The 90.6%healing rate in fistulas with an associated abscess was comparable to that of fistulas with no abscess(94.5%,P=0.057,not significant).CONCLUSION Fistulotomy had a high 98.6%healing rate in simple fistulas without deterioration of continence if the patient selection was done judiciously.The sphincter-sparing procedure,TROPIS,was safe,with a satisfactory 86%healing rate for complex fistulas.This is the largest anal fistula series to date. | Pankaj Garg Baljit Kaur Ankita Goyal Vipul D Yagnik Sushil Dawka Geetha R Menon | 2021 | World Journal of Gastrointestinal Surgery2021，13，4： | 8 |
| 2 | Lesion-symptom mapping with NIHSS sub-scores in ischemic stroke patients显示文摘Background Lesion-symptom mapping(LSM)is a statistical technique to investigate the population-specific relationship between structural integrity and post-stroke clinical outcome.In clinical practice,patients are commonly evaluated using the National Institutes of Health Stroke Scale(NIHSS),an 11-domain clinical score to quantitate neurological deficits due to stroke.So far,LSM studies have mostly used the total NIHSS score for analysis,which might not uncover subtle structure–function relationships associated with the specific sub-domains of the NIHSS evaluation.Thus,the aim of this work was to investigate the feasibility to perform LSM analyses with sub-score information to reveal category-specific structure–function relationships that a total score may not reveal.Methods Employing a multivariate technique,LSM analyses were conducted using a sample of 180 patients with NIHSS assessment at 48-hour post-stroke from the ESCAPE trial.The NIHSS domains were grouped into six categories using two schemes.LSM was conducted for each category of the two groupings and the total NIHSS score.Results Sub-score LSMs not only identify most of the brain regions that are identified as critical by the total NIHSS score but also reveal additional brain regions critical to each function category of the NIHSS assessment without requiring extensive,specialised assessments.Conclusion These findings show that widely available sub-scores of clinical outcome assessments can be used to investigate more specific structure–function relationships,which may improve predictive modelling of stroke outcomes in the context of modern clinical stroke assessments and neuroimaging. | Deepthi Rajashekar Matthias Wilms M Ethan MacDonald Serena Schimert Michael D Hill Andrew Demchuk Mayank Goyal Sean P Dukelow Nils Daniel Forkert | 2022 | Stroke & Vascular Neurology2022，7，2： | 7 |
| 3 | Diagnosis of anorectal tuberculosis by polymerase chain reaction,GeneXpert and histopathology in 1336 samples in 776 anal fistula patients显示文摘BACKGROUND The association of tuberculosis(TB)with anal fistulas can make its treatment quite difficult.The main challenge is timely detection of TB in anal fistulas and its proper management.There is little data available on diagnosis and management of TB in anal fistulas.AIM To detect TB in fistula-in-ano patients were analyzed in different methods utilized.METHODS A retrospective analysis of different methods,polymerase chain-reaction(PCR),GeneXpert and histopathology(HPE),utilized to detect tuberculosis in fistula-inano patients,treated between 2014-2020,was performed.The sampling was done for tissue(fistula tract lining)and pus(when available).The detection rate of various tests to detect TB and prevalence rate of TB in simple vs complex fistulae were studied.RESULTS In 1336 samples(776 patients)tested,TB was detected in 133 samples(122 patients).TB was detected in 52/703(7.4%)samples tested by PCR-tissue,in 77/331(23.2%)samples tested by PCR-pus,3/197(1.5%)samples tested with HPE-tissue and 1/105(0.9%)samples tested by GeneXpert.To detect TB,PCRtissue was significantly better than HPE-tissue(52/703 vs 3/197 respectively)(P=0.0012,significant,Fisher’s exact test)and PCR-pus was significantly better than PCR-tissue(77/331 vs 52/703 respectively)(P<0.00001,significant,Fisher’s exact test).TB fistulas were more complex than non-tuberculous fistulas[78/113(69%)vs 278/727(44.3%)respectively](P<0.00001,significant,Fisher’s exact test)but the overall healing rate was similar in tuberculous and non-tuberculous fistula groups[90/102(88.2%)vs 518/556(93.2%)respectively](P=0.10,not significant,Fisher’s exact test).CONCLUSION This is the largest study of anorectal TB to be published.The detection of TB by polymerase chain-reaction was significantly higher than by histopathology and GeneXpert.Amongst polymerase chain-reaction,pus had a higher detection rate than tissue.TB fistulas were more complex than non-tuberculous fistulas but aggressive diagnosis and meticulous treatment led to comparable overall success rates in both groups. | Pankaj Garg Ankita Goyal Vipul D Yagnik Sushil Dawka Geetha R Menon | 2021 | World Journal of Gastrointestinal Surgery2021，13，4： | 3 |
| 4 | Effect of sulfur surface structure on nucleation of oxide seed layers on textured metals for coated conductor applications 显示文摘 | Cantoni C Christen D K Goyal A | 2002 | Materials Research Society2002，689，： | 1 |
| 5 | Functional anatomy and physiology of the upper esophageal sphincter显示文摘 | Sivarao D V Goyal R K | 2000 | Am J Med2000，108，4： | 1 |
| 6 | Fly ash as a soil ameliorant for improving crop production-a review显示文摘 | Jala S Goyal D | 2006 | Bioresource Technology2006，97，9： | 1 |
| 7 | Microbial and Plant De- rived Biomass for Removal of Heavy Metals from Wastewater显示文摘 | Ahluwalia S S Goyal D | 2007 | Bioresource Technology2007，98，12： | 1 |
| 8 | Pituitary adenomapresenting with CSF rhinnorhea as the sole symptom 显示文摘 | Goyal N Borkar S Agrawal D | 2012 | Neurol India2012，60，： | 1 |
| 9 | Chronological immunohitochemical detection and localization of porcine reproductive and respiratory syndrome vires infection in gnotobiotic pigs显示文摘 | ROSSOW D BENFIELD D A GOYAL S M | 1996 | Vet Pathol1996，33，： | 1 |
| 10 | Positive pressure mechanical ventilation显示文摘 | GALI B GOYAL D G | 2003 | Emerg Med Clin North Am2003，21，2： | 1 |
| 11 | Analysis of junctional ectopy during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia 显示文摘 | JENTZER J H GOYAL R WILLIAMSON B D | 1994 | Circulation1994，90，： | 1 |
| 12 | Epitaxial YBa2 Cu3 07 on Biaxially Textured Nickel (001) : An Approach to Superconducting Tapes with High Critical Current Density显示文摘 | Norton D P Goyal A Budai J D | 1996 | Science1996，274，5288： | 1 |
| 13 | Lysophosphatidic acid stimulation of platelets rapidly induces Ca(2 +)-dependent dephosphorylation of cofilin that is independent of dense granule secretion and aggregation显示文摘 | Pandey D Goyal P Siess W | 2007 | Blood Cell Mol Dis2007，38，3： | 1 |
| 14 | Entoptic narration during phacoemulsification by an ophthalmologist显示文摘 | Singh R Goyal D Vasavada AR | 2002 | J Cataract Refract Surg2002，28，： | 1 |
| 15 | Cartilage repair:2013 Asian update显示文摘 | Hui JH Goyal D Nakamura N | 2013 | Arthroscopy2013，29，12： | 1 |
| 16 | Empirical modeling of chemoviscosity of hydroxy terminated polybutadiene based solid composite propellant slurry显示文摘 | Mahanta Abhay K Goyal Monika Pathak Devendra D | 2010 | Malaysian Polymer Journal2010，5，1： | 1 |
| 17 | High-resolution transmission electron microscopy/analytical electron microscopy characterization of epitaxial oxide multilayers fabricated by laser ablation on biaxially textured Ni显示文摘 | Sun E Y Goyal A Norton D P | 1999 | Physica C1999，321，： | 1 |
| 18 | Influence of Carbon-Oxygen Surface Groups on the Adsorption of Phenol by Activated Carbons显示文摘 | Bansal R C Aggarwal D Goyal M | 2002 | Indian Journal of Chemical Technology2002，9，4： | 1 |
| 19 | Effects of doping concentration and annealing temperature on properties of highly-oriented Al-doped ZnO films显示文摘 | Goyal D J Agashe C M Marathe B R l | 1992 | Journal of Materials Science Letters1992，，11： | 1 |
| 20 | Microbial and plant derived biomass for removal of heavy metals from wastewater显示文摘 | Ahluwalia S S Goyal D | 2007 | Bioresour Technol2007，98，12： | 1 |
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