Ajay Choudhary - Academia.edu (original) (raw)

Papers by Ajay Choudhary

Iranian Journal of Neurosurgery, 2021

Background and Aim: The major concerns related to the Endoscopic Endonasal Transsphenoidal (EET) ... more Background and Aim: The major concerns related to the Endoscopic Endonasal Transsphenoidal (EET) surgery for sellar and suprasellar tumors include the risks of post-operative Cerebrospinal Fluid (CSF) leak, leading to morbidity and at times mortality, due to severe meningitis. Time is required to develop possible preventive measures that can reduce the risk of post-operative CSF rhinorrhea. The present study aimed to evaluate the effects of pre-operative CSF diversion by lumbar drainage in EET tumor surgeries on preventing post-operative CSF leak and its effect on the length of hospital stay. Methods and Materials/Patients: We conducted a prospective study on 20 patients with a pituitary tumor that underwent EET surgery between October 2018 and December 2019. Preoperative Lumbar Drain (LD) was inserted after induction in all explored patients. The tumor was excised with continuous intraoperative CSF drainage. Post-operatively, the LD was kept for 3 days and clamped for the next 24 h...

Indian Journal of Neurotrauma, 2017

Introduction Posterior fossa extradural hematomas (PFEDH) comprise 4 to 7% of all intracranial ex... more Introduction Posterior fossa extradural hematomas (PFEDH) comprise 4 to 7% of all intracranial extradural hematomas (EDHs). Material and Methods A prospective study of 25 patients who presented with PFEDH was conducted in PGIMER, Dr. Ram Manohar Lohia (RML) Hospital, New Delhi in department of neurosurgery from January 2011 to July 2012. The patients were analyzed in relation to age, sex, mode of injury, Glasgow coma scale (GCS) at the time of presentation, computed tomography findings of the head, and therapeutic outcome. Duration of follow-up was 6 months. Results In the authors’ study, male-to-female ratio was 22:3. Age range was 6 months to 62 years and mean age was 23.70 years. Mode of trauma was fall from height in 12 patients, road traffic accident (RTA) in 12, and assault in 1. Most patients had acute course (80%) followed by subacute course (20%). GCS was between 8 and 15. Fracture was associated in 21 patients out of 25. Associated intracranial injury was present in 22 pat...

2021 IEEE International Conference on Fuzzy Systems (FUZZ-IEEE), 2021

Learning in non-stationary environments require modern tools and algorithms to quickly adapt to t... more Learning in non-stationary environments require modern tools and algorithms to quickly adapt to the new pattern because concept drift can change the underlying distribution. So, the existing assumption that the data is independent and identically distributed may be invalid in data stream scenarios. Given the massive volume of high-speed data streams and the concept drift, traditional machine learning algorithms must be self-adapting. One of the difficulties in handling regression tasks is the complexities of equations for the regression models when combined with drift handling techniques. The high dimensional protein data is a major challenge for bioinformatics researchers to analyse the dynamics of the sequences. This paper proposes a Scalable Fuzzy Clustering induced Regression (SFC-R) algorithm to predict the isoelectric point of the plant protein sequences using Apache Spark clusters. The SFC-R algorithm uses the input features extracted from the plant protein sequences and validates performance in terms of mean squared error (MAE) and root-mean-square error (RMSE). Experiments on plant protein datasets are carried out to validate the high accuracy and robustness of our approach.

Aims: The purpose of this study was to estimate the prevalence, seve... more Aims: The purpose of this study was to estimate the prevalence, severity and associations of dental anxiety in a sample of the adult population visiting comprehensive Rural Health Service Department, Ballabgarh, Haryana. Dental anxiety is a common problem both for dental practitioners and the people. Settings and Design: The study was conducted in CRHSP Ballabgarh, Faridabad .The study was conducted in 5 weeks duration. Questionnaire based study was done using closed ended MODIFIED DENTAL ANXIETY SCALE (MDAS) questionnaire. Methods and Material: A sample of 379 adults (age ranging between 15 to 60 years; mean age male = 35.89 ± 14.10 and female 35.01 ± 12.38). The Modified Dental Anxiety Scale (MDAS) is a brief, self-complete questionnaire consisting of five questions (Q1 to Q5) and summed together to produce a total score ranging from 1 to 5. Statistical Analysis Used: SSP version 16 software, the percentage, means and standard deviation. Results: The results revealed that females were more apprehensive, compare to men. Based on distribution of anxiety according to age group, males between the age group 15 to 23 and 24 to 33 belonged fairly anxious group and only slight anxiety was observed in higher age group (44 to 53 yr). On the other hand, females were found to be very anxious at higher age group of 24-33 and 34-43. Conclusions: It is recommended that dental education and health care services should be promoted to overcome the fear and anxiety factor.

World neurosurgery, 2020

BACKGROUND Neurocysticercosis, a common parasitic infection in developing areas, usually exists i... more BACKGROUND Neurocysticercosis, a common parasitic infection in developing areas, usually exists in supratentorial parenchyma. Literature review shows few case reports published for cerebellopontine angle cysticercosis, but its coexistence with a schwannoma in the same cistern has never been seen before. This leads to confusion in preoperative diagnosis and management. CASE DESCRIPTION Such a unique case in which dual pathology (i.e., coexisting trigeminal schwannoma along with neurocysticercosis) was present in same location with relevant radiology and histopathology and management is discussed in this case report. CONCLUSIONS Cysticercosis should be kept as a differential diagnosis in cystic lesions of the CP angle, especially in endemic areas and even in cases showing obvious cystic schwannoma on imaging. Care should be taken to prevent spillage of cyst contents while puncturing the cyst wall for a better outcome.

World Neurosurgery: X, 2021

A prospective study of novel therapeutic targets interleukin-6 (IL-6), TNF-alpha, and INF-gamma a... more A prospective study of novel therapeutic targets interleukin-6 (IL-6), TNF-alpha, and INF-gamma as a predictive biomarker for the development of post-traumatic epilepsy.

Advances in Intelligent Systems and Computing, 2021

International Journal of Neuroscience, 2021

Background Deficiency of vitamin D along with traumatic brain injury (TBI) augments the risk of i... more Background Deficiency of vitamin D along with traumatic brain injury (TBI) augments the risk of injury severity. This possibly affects the therapeutic regimen prescribed for TBI which may pessimistically affects its outcome.Methods Studies literature search was conducted in Google Scholar and PubMed. The inclusions were studies performed clinically on both male and female. All included studies' references were also reviewed to find any additional relevance related to this review. Studies published in English were considered for this review. This review focuses upon the incidence of vitamin D deficiency in TBI and how it affects the Quality of life of the sufferer.Results A total of 176 studies were reviewed and 58 were thoroughly focussed for review as they met inclusion criteria. These studies demonstrate that levels of vitamin D influence the recovery outcome after TBI. Vitamin D deficiency has been found to cause more deterioration in severe TBI than in patients with mild TBI.Conclusion Paucity of vitamin D significantly affects the outcome after brain injury. This clearly validates the necessity for screening of vitamin D levels in neurological deficit in order to reduce the risk of morbidity in terms of neurocognitive disorder.

Indian Journal of Neurotrauma, 2020

Introduction In modern emergency service systems, patients are often treated with sedation, intub... more Introduction In modern emergency service systems, patients are often treated with sedation, intubation, and ventilation at the accident site. But neurosurgical assessment before all these emergency services is important. Thus, this study was designed to investigate the relationships between various parameters of initial CT scan findings and the outcomes of the patients. Methodology A total of 56 adult patients of traumatic acute subdural hematoma (SDH) whose computed tomography (CT) scan was performed within 8 hours of injury were recruited. The patients with prolonged hypotension, open head injury or depressed skull fracture, bilateral side acute SDH, or contusions/hematoma/extradural hematoma on the contralateral side were excluded. Six separate CT findings were analyzed and recorded, including hematoma, midline shift, subarachnoid hemorrhage (SAH), presence of basal cistern obliteration (BCO), intraparenchymal hematoma/contusion in the same hemisphere, and presence of effacement ...

Surgical Neurology International, 2020

Background: Spinal dermoid cysts are benign tumors that result from congenital or acquired ectode... more Background: Spinal dermoid cysts are benign tumors that result from congenital or acquired ectodermal inclusions. Long segment intramedullary involvement of the spinal cord is exceedingly rare, and there are only a handful of case reports found in the literature. Case Description: A 30-year-old female presented with a 3-month history of myelopathy characterized by progressive quadriparesis and urinary incontinence. Magnetic resonance imaging revealed multifocal heterogeneous intramedullary masses extending from C2 to T4 and at T12–L1 with similar intensity lesions seen within the central cord from T5 to T11 level. Following tumor decompression, she showed significant improvement in neurological function 1 month later. The histopathological examination confirmed the diagnosis of a multifocal intramedullary dermoid cyst. Conclusion: Partial surgical extirpation is a reasonable treatment for long segment intramedullary dermoid cysts, particularly when the tumor capsule is adherent to c...

Interdisciplinary Neurosurgery, 2021

Abstract The incidence of spinal teratoma ranges from 0.2–0.5% of all spinal cord tumours. They m... more Abstract The incidence of spinal teratoma ranges from 0.2–0.5% of all spinal cord tumours. They may be associated with neural tube defects causing tethered cord syndrome and are rarely localized at the level of filum terminale. Only 0.15–0.18% of spinal tumours has been classified as teratomas. Unlike intra spinal teratomas in infants and children, the symptoms of these tumours in adult patients typically lack specific clinical features that, upon diagnosis, may cause confusion with other spinal tumours. In this case report, a 25-year-old male presented with history of back pain for 3 years weakness in both lower limbs since 2 years and urinary incontinence for 4 months. Upon investigation MRI revealed a D12-L2 intradural multi loculated cystic leision measuring 6.7*2.1*3cm heterogeneously enhancing with evidence of fat suppression at the level of the conus medullaris. T12-L2 decompressive laminectomies were performed and Subtotal resection of the lesion was achieved because the tumour was adherent to conus. Teratomas should be taken into consideration in the differential diagnosis of intramedullary lesions when the imaging reveals variable signal intensity as a result of tissue heterogeneity. A partial resection is a viable treatment option when the lesion is attached to vital structures due to the low recurrence rates reported in the literature.

Indian Journal of Pathology and Microbiology, 2019

Arachnoiditis ossificans (AO) is a rare type of chronic arachnoiditis characterized by the presen... more Arachnoiditis ossificans (AO) is a rare type of chronic arachnoiditis characterized by the presence of calcification or ossification of the spinal arachnoid which is usually associated with progressive neurological deficits. It is usually followed by prior history of trauma, surgery, infection, or myelography. Magnetic resonance imaging and computed tomography are the characteristics that are helpful in the diagnosis of most cases. Prognosis and treatment depends on the site and clinical presentation of the patients. We present a case of a young female who presented with a long-standing history of neurological symptoms and a intradural lesion mimicking a tumor.

Asian journal of neurosurgery

The objective of this study was to compare safety and efficacy of endoscopic third ventriculostom... more The objective of this study was to compare safety and efficacy of endoscopic third ventriculostomy (ETV) versus ventriculoperitoneal (VP) shunt in the treatment of hydrocephalus in tuberculous meningitis (TBM) and to assess clinical and radiological profiles of patients with TBM that would be better suited to either VP shunt or ETV. This study was a single-center randomized prospective study on 52 patients with TBM hydrocephalus in the pediatric age group (<18 years of age). Patients included in the study were randomized into undergo either VP shunt or ETV. Both groups were followed up for a minimum of 5 months and assessed for success and failure rates as well as procedural complications and neurologic sequelae. Twenty-six patients underwent ETV with a success rate of 65.4% with six of nine failures occurring within the first 16 days after surgery (median time to failure - 3 days). In the VP shunt group, there was a success rate of 61.54% and a median time to failure of 50 days....

Journal of pediatric neurosciences

Asian journal of neurosurgery

Pneumorrhachis (PR) - the phenomenon of intraspinal air - is a rare radiological finding. The pre... more Pneumorrhachis (PR) - the phenomenon of intraspinal air - is a rare radiological finding. The presence of intraspinal air is usually after epidural injections, spinal manipulations, synovial cysts, degenerative disc disease, and epidural abscess. PR is mostly asymptomatic but can also be symptomatic. We report a case with PR after chest trauma and attempt to explain its development.

Inorganic chemistry, Jan 18, 2017

A density functional theory (DFT) investigation performed at the B3LYP/TZVP//B3LYP/6-31G(d)-LANL2... more A density functional theory (DFT) investigation performed at the B3LYP/TZVP//B3LYP/6-31G(d)-LANL2DZ level of theory on the hydroamination of dimethylamine (Me2NH) on an activated olefin (namely, acrylonitrile (CH2═CHCN)), as catalyzed by a 1,2,4-triazol based nickel(II) N-heterocyclic carbene complex (namely, [1,4-dimethyl-1,2,4-triazole-5-ylidene]2 nickel dichloride) revealed that the olefin coordination pathway is favorable over the amine coordination pathway, although the initial olefin coordination step is higher in energy than the initial amine coordination step. Significantly enough, the reaction involved a crucial 1,3-proton transfer step between the resonance intermediates, i.e., the C-bound [(NHC)2Ni(CH(CN)CH2NHMe2)]+ (D) species or N-bound [(NHC)2Ni(NCCHCH2NHMe2)]+ (E) species and the intermediate [(NHC)2Ni(NCCH2CH2NMe2)]+ (F), depicting the cleavage of a N-H bond and the formation of a C-H bond facilitated by a water-assisted/amine-assisted proton shuttle. Overall, among ...

Injury, Jan 21, 2017

The ability of diffusion tensor imaging (DTI) to complement conventional MR imaging by diagnosing... more The ability of diffusion tensor imaging (DTI) to complement conventional MR imaging by diagnosing subtle injuries to the spinal cord is a subject of intense research. We attempted to study change in the DTI indices, namely fractional anisotropy (FA) and mean diffusivity (MD) after traumatic cervical spinal cord injury and compared these with corresponding data from a control group of individuals with no injury. The correlation of these quantitative indices to the neurological profile of the patients was assessed. 20 cases of acute cervical trauma and 30 age and sex matched healthy controls were enrolled. Scoring of extent of clinical severity was done based on the Frankel grading system. MRI was performed on a 3T system. Following the qualitative tractographic evaluation of white matter tracts, quantitative datametrics were calculated. In patients, the Mean FA value at the level of injury (0.43+/-0.08) was less than in controls (0.62+/-0.06), which was statistically significant (p v...

International Journal of Diabetes in Developing Countries, 2016

Neurology India

The authors analyze epidemiology, location, clinical profile and outcome of double extradural hem... more The authors analyze epidemiology, location, clinical profile and outcome of double extradural hematoma (EDH) or EDH at more than one site. Design: A retrospective clinical study. Materials and Methods: 46 cases of double EDH were studied. All the cases were evaluated for their mode of injury, clinical presentation, level of sensorium at the time of injury, CT scan finding and outcome after surgery, and were compared with single EDH cases. Results: Out of 1025 cases 46 cases had 'double' EDH. There was bilateral EDH in 39 cases; multiple EDH in 3 cases and ipsilateral double EDH was present in 4 cases. The most common site was frontal (70%). The majority of the patients (80.3%) were in altered sensorium from the time of injury, similar situation was seen in 52.2% of cases with single EDH. The number of patients having a low GCS score was higher when first examined in the double EDH group and the mortality rate was 34.8% as compared to 9% in the single EDH group. Conclusion: Majority of the double EDH cases presented with a low GCS and there was a relatively quick neurological deterioration in these cases.

Iranian Journal of Neurosurgery, 2021

Indian Journal of Neurotrauma, 2017

2021 IEEE International Conference on Fuzzy Systems (FUZZ-IEEE), 2021

World neurosurgery, 2020

World Neurosurgery: X, 2021

Advances in Intelligent Systems and Computing, 2021

International Journal of Neuroscience, 2021

Indian Journal of Neurotrauma, 2020

Surgical Neurology International, 2020

Interdisciplinary Neurosurgery, 2021

Indian Journal of Pathology and Microbiology, 2019

Asian journal of neurosurgery

Journal of pediatric neurosciences

Asian journal of neurosurgery

Inorganic chemistry, Jan 18, 2017

Injury, Jan 21, 2017

International Journal of Diabetes in Developing Countries, 2016

Neurology India