Ankit Vyas - Academia.edu (original) (raw)

Papers by Ankit Vyas

Circulation, Nov 8, 2022

Background: Obesity is usually associated with worse cardiovascular outcomes. However, fewer stud... more Background: Obesity is usually associated with worse cardiovascular outcomes. However, fewer studies have evaluated its impact on long-term major adverse cardiovascular events (MACE) following CTO PCI. We conducted a meta-analysis to assess the same. Methods: PUBMED, Scopus, and EMBASE were systematically searched for studies reporting long-term (at least >1 year) outcomes with obesity vs no obesity in patients with CTO PCI. MACE events [all-cause mortality, cardiac mortality, revascularization, restenosis/reocclusion, recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) were the primary endpoint. Pooled odds ratios (OR) and heterogeneity were assessed with random-effects models and I2 statistics respectively. Subgroup analysis was performed to assess the risk by age group and follow-up duration. The leave-one-study-out method was used for sensitivity analysis. Results: After an initial electronic search of thirty-two studies, five studies were selected, and between 2016 to 2021 selected were included in the final analysis. The sample size consisted of 5022 patients with a median age of 63. No significant impact of higher BMI/obesity was seen overall on a median duration of 2.6 yrs [OR(95% CI)= 0.95 (0.82-1.11), p=0.53, I 2 = 90.86%)] (Fig 1). However, on a subgroup analysis, the geriatric age group (≥65 yrs) demonstrated an "Obesity Paradox" effect on MACE after CTO PCI, [OR (95%CI)=0.64 (0.47-0.88), I 2= 42.13, p<0.01]. There was no difference in a subgroup analysis based on follow-up duration (≥3 years [OR (95%CI)=0.73 (0.42-1.27)] vs <3 years OR (95%CI)=1.04 (0.84-1.27)]. Conclusions: Although higher BMI/obesity was not associated with overall long-term MACE in CTO PCI, the subgroup analysis demonstrated the "Obesity Paradox" (protective) effect in studies with a predominantly geriatric population.

International journal of anatomy radiology and surgery, 2023

A 31-year-old full term (38 weeks) pregnant female G3P3L2 (Gravida 3 Para 3 Live 2) presented in ... more A 31-year-old full term (38 weeks) pregnant female G3P3L2 (Gravida 3 Para 3 Live 2) presented in labour. All blood parameters and results of urinalysis were within normal limits. Ultrasonography (USG) scans were done multiple times during pregnancy even as recently as four days before delivery but none of them revealed any abnormality. The patient remained asymptomatic throughout pregnancy. She was taken for an LSCS in view of history of the same. The baby was delivered safely and placenta was removed. Dense adhesions were noticed between the posterior wall of bladder and uterus. Additionally, a foreign body could be palpated inside the bladder. Adhesiolysis was performed and a rent was noticed in the uterine wall and the posterior wall of bladder through which a limb of Copper T was seen [Table/Fig-1]. The Intrauterine Device (IUD) was removed in its entirety, margins of the bladder were refashioned, the rent was closed and a Suprapubic Catheter (SPC) and Perurethral Catheter (PUC) were inserted [Table/Fig-2]. Upon enquiry, she revealed to have the IUD inserted four years ago but presumed that it had subsequently fallen out.

Circulation-cardiovascular Quality and Outcomes, May 1, 2022

Background: Coronary artery disease associates with increasing age and correlates with CABG being... more Background: Coronary artery disease associates with increasing age and correlates with CABG being more common in elderly. However, prognostic data of ischemic events post-CABG is limited especially in geriatric patients who are underrepresented in clinical-trials. Furthermore, CKD accelerates coronary atherosclerosis and although treatment practices improved, incidence of ischemic events remain high due to oxygen supple-demand mismatch. Thus, we aim to evaluate impact of CKD on risk of Type-2 Myocardial Infarction (T2MI) in geriatric patients post-bypass grafting. Methods: Data from National Inpatient Sample (2018) was used to identify T2MI-related hospitalizations in geriatric patients with prior history of CABG and CKD. Logistic regression was used to assess the odds of T2MI with CKD. In-hospital outcomes and co-morbidities were compared between CKD & non-CKD cohorts. Results: T2MI-associated hospitalizations among studied population has higher odds when controlled for confounders (OR 1.48, 95%CI: 1.33-1.64, p<0.001). The two cohorts, CKD(n=399485) vs non-CKD(n=676550), had comparable sociodemographics (Table 1b); age at admission (78 vs 77); males (70.6% vs 70%); race- white (77.9% vs 83.5%), black (8.7% vs 5.4%), Hispanic (7.8% vs 6.5%). The odds of adverse cardiac events (cardiac arrest, cardiogenic shock, and dysrhythmia), all-cause mortality, and hospital length-of-stay was higher in CKD cohort with an exception for stroke (Table 1c). Statistical significance was observed (p<0.001) for all co-morbidities (except age) and outcomes. Conclusion: CKD confers an increased risk of T2MI-related hospitalizations and adverse in-hospital outcomes in geriatric patients post-bypass grafting. It finds significance in the need to mitigate risk factors of T2MI and adopt appropriate treatment practices in this population subset.

Journal of the American College of Cardiology, Mar 1, 2020

Background: Recent studies have proposed a link of prediabetes with cardiovascular mortality, how... more Background: Recent studies have proposed a link of prediabetes with cardiovascular mortality, however, pooled data on the impact of prediabetes on long-term outcomes of percutaneous coronary intervention (PCI) remains non-existent. Methods: We included observational studies and clinical trials with data on the impact of prediabetes on all-cause mortality or major adverse cardiac events (MACE) following PCI using database search through October 2019. The pooled prevalence and odds ratio (ORs) of all-cause mortality and MACE were described with 95% confidence intervals (95% CIs). Results: A total of 19 studies involving 23,019 PCI procedures (5,292=prediabetes & 17,727=control) were included with a median followup of 12 months. The pooled rates of all-cause mortality [5.8% (95CI 1.2%-13.1%) vs. 3.0% (95CI 0.0%-9.3%)] and MACE [17.3% (95CI 10.1%-25.9%) vs. 10.5% (95CI 6.6%-15.2%)] following PCI were higher in the prediabetes cohort undergoing PCI, with an even greater frequency in multicenter studies (6.0% vs. 5.6%) as compared to single-center studies. Patients with prediabetes undergoing PCI showed higher odds of all-cause mortality (OR 2.48, 95% CI=1.64-3.76, p<0.001) and MACE (OR 1.64, 95% CI=1.16-2.33, p=0.006) on 1-year median follow-up as compared to the control group (Figure 1AB). Conclusion: This meta-analysis reveals that patients with prediabetes undergoing PCI have a 2.5 times higher risk of all-cause mortality and 1.6 times higher odds of MACE at 1-year median follow-up.

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Europace, Jun 1, 2017

Background: Potential benefit of antitachycardia pacing (ATP) is an important reason to deem pati... more Background: Potential benefit of antitachycardia pacing (ATP) is an important reason to deem patients unsuitable for a subcutaneous ICD (S-ICD). Data on the incidence and benefit of ATP in transvenous ICD (TV-ICD) patients is limited. Purpose: This study aims to determine the incidence of appropriate ATP therapy in a general ICD population and determine pre-implant predictors of ATP and shock therapy in order to evaluate the S-ICD suitable population. Methods: All de novo single and dual chamber TV-ICD patients implanted between March 2011 and December 2015 were included. Appropriate ICD therapy was defined as therapy for ventricular fibrillation (VF) or ventricular tachycardia (VT). Ventricular arrhythmias terminated by ATP and not followed by a shock were considered successful ATP therapy. Cox proportional hazard analysis was performed to assess the independent effect of multiple predictors for appropriate ICD therapy. Results: 431 Patients were included with a median follow-up of 26 months. 99 Patients (23%) received appropriate ATP therapy, of which 67 (16%) patients received successful ATP therapy. At baseline 221 patients (50%) had occurrence of NS(VT), of these patients 65 received appropriate ATP (29%). In patients without occurrence NS(VT) at baseline, 23 patients (11%) received appropriate ATP which is significantly less than in patients with NS(VT) (p < 0.001). Successful ATP was also significantly less in patients without occurrence of NS(VT) at baseline 14 (7%) versus 52 (24%) patients (p < 0.001). Occurrence of non-sustained VT (NSVT) or VT, prior to implant, was the only predictor for appropriate ATP therapy in the multivariable model (HR 2.73, p < 0.001)(figure). Secondary prevention was the only predictor in the multivariable model for appropriate shock therapy (HR 1.82, p ¼ 0.05). Conclusion: A minority (23%) of all TV-ICD patients received appropriate ATP therapy. The only predictor for appropriate ATP was occurrence of NSVT or MVT prior to implant, this was not associated with appropriate shock therapy. Secondary prevention ICD indication was the only predictor for appropriate shock therapy. This model could contribute to improved device selection for individual patients.

Annals of International medical and Dental Research, Dec 20, 2016

Background: Colorectal cancers are one of the leading causes of cancer related deaths worldwide. ... more Background: Colorectal cancers are one of the leading causes of cancer related deaths worldwide. Its a common knowledge that the colorectal cancers usually occur in older age groups. This has led to low index of suspicion of having this malignancy in young patients who are less than 40 years of age. We conducted this study of colorectal cancers in young patient to emphasise the importance of keeping in entity in mind while dealing with the patient presenting with complaints consistent with colorectal malignancy even if there age is less than forty year. the stage at which the diagnosis is made is of crucial importance in colorectal malignancy and a delayed diagnosis can have serious consequences for the patient. Objectives: (1) To determine incidence of colorectal malignancy in young patient. (2) To study the symptom complex (3) To determine sex and site distribution (4) To determine operability and respectability of tumour in young patients (5) To study the histopathological types and grading in young patients. Methods: This study was a prospective cohort study of 42 cases of colorectal malignancy of age 40 years and below conducted in patients admitted in department of surgery at a tertiary care institute. The duration of study was 2 years. Results: In this study of colorectal cancers in young patient maximum number of patients were found in the age group of 31-40 years (69.4%) followed by in the age group of 21-30 years (28.57%)and 11-20 years (2.38 %). Males were found to be affected more (54.76%) than females (45.23%). Most common site of involvement was found to be rectum(57.14%) followed by rectosigmoid (16.66%) , caecum and descending colon (11.90%).Most common sign was found to be bleeding per rectum (69.04%) and most common symptom was found to be altered bowel habits (50%) followed by pain abdomen (59.52%). Mucinous adenocarcinoma (52.38%) was found to be most common histological type of colorectal malignancy followed by adenocarcinoma (42.85%). Most patients were diagnosed in Stage C (47.61%) of duke staging followed by stage B (23.80), stage D (19.04%) and stage A (9.52%). Metastasis were seen in 6 patients. 38 patients were operated. Most common surgical procedure done was abdominoperineal resection (11 patients) followed by Palliative sigmoid colostomy (10 patients), Right hemicolectomy (5 patients), anterior resection (5 patients), while left colectomy and palliative transverse colectomy was done in 3 patients each. Only 1 patient underwent total proctocolectomy with ileostomy. 4 patients were not operated as they had advanced stages of the disease.Adjuvant chemotherapypy and radiotherapy was given in all patients except in 2 patients who had favourable histological stage and was under follow up. Total 9 patients died during follow up period. 2 refused treatment and 31 patients are still under follow up. Conclusion: Our study was aimed at analysing colorectal malignancy in young patients. It should promote high index of suspicion on the part of treating surgeons about this entity even in young patients.

Aquatic Procedia, 2015

This study in the paper aims to the appraisal of the prevailing standards of the quality of water... more This study in the paper aims to the appraisal of the prevailing standards of the quality of water used for irrigation purposes. The paper focuses on the diversification of various processes involved for the determination of the physical, chemical and biological water quality parameters and the consequences. The validity of any process rests on the meteorological parameters existing at a particular place. The paper have commentated the methods being used by Bureau of Indian Standards (BIS) and the Environmental Protection Agency (EPA) of America for the determination of parameters of water quality. The information which has been inferred from the study is that any process involved has its own suitability as per the needs which may be in terms of accuracy and economy.

Journal of Thrombosis and Thrombolysis, Jan 23, 2019

Early assessment of thrombogenicity and antithrombotic drug effects may be important for therapeu... more Early assessment of thrombogenicity and antithrombotic drug effects may be important for therapeutic decision making in patients presenting with acute stroke. In this prospective, single center, pilot study, a bedside thrombelastography assay (TEG6s) was used to measure thrombogenicity and antithrombotic drug response in serial patients presenting emergently with symptoms of acute stroke (n = 90). TEG6s measures were compared against diagnosis obtained by NIH Stroke Scale/ Score and imaging. Acute ischemic stroke (AIS) was diagnosed in 30 patients, intracerebral hemorrhage (ICH) in 19, transient ischemic attack (TIA) in 10 and stroke mimic (SM) in 31. Patients with AIS had a higher prevalence of A-Fib (33.3% vs. 11.6%, p = 0.01), and ACE inhibitor use (56.3% vs. 21.6%, p < 0.001) compared to combined non-AIS group. Time to initial clot formation (R) was shorter in AIS vs. TIA, ICH, and SM (p < 0.05). Comparing patients with AIS and combined non-AIS group the AUC for R was 0.83 (cut point of ≤ 4.8, sensitivity = 67%; specificity = 84%, p < 0.001). In AIS patients, 46% had suboptimal response (< 30% MA AA inhibition) to aspirin and 80% of patients on P2Y 12 therapy had high platelet reactivity (> 50% ADP-induced platelet aggregation). Patients receiving tissue plasminogen activator had significant reduction in clot strength and near complete lysis at 30 min which normalized within 2 h after treatment (p < 0.001 for both). The rapid bedside measurement of thrombogenicity and antithrombotic drug effects is feasible in patients presenting with symptoms of acute stroke. Our preliminary data suggest that AIS is associated with faster ex-vivo clot formation, and poor antiplatelet response. Future study of the TEG6s to "blueprint" hemostasis is warranted in the stroke population.

Recognition of facial expressions plays a major role in many automated system applications like r... more Recognition of facial expressions plays a major role in many automated system applications like robotics, education, artificial intelligence, and security. Recognizing facial expressions accurately is challenging. Approaches for solving FER (Facial Expression Recognition) problem can be categorized into 1) Static single images and 2) Image sequences. Traditionally, different techniques like Multi-layer Perceptron Model, k-Nearest Neighbours, Support Vector Machines were used by researchers for solving FER. These methods extracted features like Local Binary Patterns, Eigenfaces, Face-landmark features, and Texture features. Among all these methods, Neural Networks have gained very much popularity and they are extensively used for FER. Recently, CNNs (Convolutional Neural Networks) have gained popularity in field of deep learning because of their casual architecture and ability to provide good results without requirement of manual feature extraction from raw image data. This paper focuses on survey of various face expression recognition techniques based on CNN. It includes state-of-the-art methods suggested by different researchers. The paper also shows steps needed for usage of CNN for FER. This paper also includes analysis of CNN based approaches and issues requiring attention while choosing CNN for solving FER.

Circulation, Nov 19, 2019

Background: Cardiogenic shock (CS) remains the most dreaded complication in patients with takotsu... more Background: Cardiogenic shock (CS) remains the most dreaded complication in patients with takotsubo cardiomyopathy (TC) and has been linked to higher in-hospital mortality. The first systematic rev...

Journal of emerging technologies and innovative research, Dec 1, 2017

Journal of emerging technologies and innovative research, Nov 1, 2017

The preservation of irrigation water is often of primary importance to the agriculture developmen... more The preservation of irrigation water is often of primary importance to the agriculture development of a country. The reduction or eliminate of seepage losses in irrigation canals by means of linings assures better utilization of the conveyed water and an improved economic situation, seepage losses from earthen irrigation channels depend on a number of factors and vary from (30 to 50) percent of the discharge available at the head of an irrigation system. The main focus of the study was to determine the seepage losses through lined canal. The studies on estimation and measurement of seepage losses were of much interest to the irrigation scientist. The research workers have done lot of work on the seepage aspect of the irrigation water management. The main objective of this investigation study is to measure seepage losses between Masitawali (Hanumangarh) head to Bridhwal head (Shri Ganga Nagar), to determine the rate of conveyance losses at a limited section of Indira Gandhi Nahar Project, the comparison of measurement of water losses with inflow-outflow and ponding method, to check out the conveyance efficiency of earthen watercourse and to determine the total quantity of water lost from earthen water course with seepage alone.

The Nepal Forestry Initiative is a project developed through discussions between the US Agency fo... more The Nepal Forestry Initiative is a project developed through discussions between the US Agency for International Development (AID) and His Majesty&#39;s Government of Nepal and managed for AID by Argonne National Laboratory. The project seeks to facilitate widespread acceptance of multipurpose tree species cultivated under various production systems. Production systems selected for research and demonstration include alley cropping, contour hedgerow,

Intelligent Decision Technologies, Jun 29, 2021

Face Expression Recognition (FER) has gained very much attraction to researchers in the field of ... more Face Expression Recognition (FER) has gained very much attraction to researchers in the field of computer vision because of its major usefulness in security, robotics, and HMI (Human-Machine Interaction) systems. We propose a CNN (Convolutional Neural Network) architecture to address FER. To show the effectiveness of the proposed model, we evaluate the performance of the model on JAFFE dataset. We derive a concise CNN architecture to address the issue of expression classification. Objective of various experiments is to achieve convincing performance by reducing computational overhead. The proposed CNN model is very compact as compared to other state-of-the-art models. We could achieve highest accuracy of 97.10% and average accuracy of 90.43% for top 10 best runs without any pre-processing methods applied, which justifies the effectiveness of our model. Furthermore, we have also included visualization of CNN layers to observe the learning of CNN.

Current Problems in Cardiology, Sep 1, 2023

European Heart Journal, Oct 1, 2022

Background Considering a paucity of large-scale data on predictors of pulmonary embolism (PE) and... more Background Considering a paucity of large-scale data on predictors of pulmonary embolism (PE) and its higher association with complications and worse outcomes, we aimed to determine the predictors of PE in this United States population-based analysis using Artificial Neural Network (ANN) Model in a nationally representative cohort. Methods We identified PE-related hospitalizations using 2018's National Inpatient Sample database. The relevant predictive factors for ANN were selected for this cohort. Of all admissions (unweighted n=7,105,498, weighted n=35,527,481), PE cohort (weighted n=387805) consisted of 1.1% of all admissions in 2018. The 2018 cohort was randomly split into training data (unweighted n=4716132, 70.0%) which were used to calibrate ANN and testing data (unweighted n=2019290, 30%) which were used to assess the accurateness of the algorithm. We equated the rate of incorrect prediction between training and testing data and measured the Area under Receiver Operator Curve (AUC) to determine ANN's efficacy in predicting PE hospitalizations. Results Patients hospitalized with PE often consisted of older (mean age 62.5±17.1 years), female (51.3%), white (70.5%) patients, and patients from lower-income quartile (0–25% income quartile: 28.8%%), often admitted non-electively (93.7%) with higher rates of cardiovascular disease risk factors. PE admissions revealed significantly higher (6.5% vs. 1.9%, p<0.001) in-hospital mortality, less frequent routine discharges (51.4% vs. 68.1%) and more frequent other facility transfers and requirement of home health care. Normalized Predictors of PE admissions are displayed in Fig. 1. Our ANN model had AUC 0.873 which correlates with an excellent prediction model. Our data demonstrated low levels (0.8%) error in both testing and training models. Conclusion Our ANN model showed high performance to predict risk factors for PE admissions in the US population. It will enable clinicians to screen patients at high-risk for PE admissions, curtail complication rate, improve survival and lower the healthcare cost. Funding Acknowledgement Type of funding sources: None.