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426 results on '"Shrestha, Suraj"'

37. A Wolff-Parkinson-White (WPW) Electrocardiographic Pattern in Asymptomatic Patient – State-of-the-Art-Review

Author

Yadav Vijay, Thapa Sanjeev, Gajurel Ratna Mani, Poudel Chandra Mani, Manandhar Bhawani, Sharma Manju, Adhikari Suman, and Shrestha Suraj

Abstract

A comprehensive approach to asymptomatic adults with Wolff-Parkinson-White (WPW) pattern discovered incidentally on routine electrocardiography (ECG) is debatable. The objective of this review article is to update the most recent evidence on the management of young patients with asymptomatic WPW patterns. A substantial proportion of adults with WPW patterns on ECG may remain asymptomatic but the lifetime risk for fatal arrhythmias still exists. The inherent properties of the accessory pathway determine the risk of sudden cardiac death. A low-risk pathway is considered when the pre-excitation is intermittent on ambulatory monitoring or when it disappears completely or abruptly during exercise testing. On the other hand, a high-risk pathway in EP study is suggested by the presence of the shortest pre-excited RR interval (SPERRI) during atrial fibrillation of ≤ 250 ms or accessory pathway effective refractory period (APERP) ≤ 240 ms. The cardiac evaluation may thus be considered in asymptomatic patients with WPW to determine the individual risk for future symptomatic arrhythmia. A shared-decision making must be performed before offering catheter ablation whose procedural success rate is high.

Published
2022

39. Xanthogranulomatous Cholecystitis Mimicking Carcinoma Gallbladder

Author

Poddar, Elisha, primary, Mainali, Prakash, additional, Shrestha, Suraj, additional, Gautam, Pratima, additional, Twayana, Anuradha, additional, Pathak, Niharika, additional, Tiwari, Ashish, additional, Bhattarai, Abhishek, additional, Awale, Laligen, additional, and Kansakar, Prasan Singh, additional

Published
2023
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42. Design and construction of a bubbling fluidized bed reactor with two side nozzles as inlet flow boundary condition

Author

Shrestha, Suraj and Thapa, Rajan Kumar

Abstract

Fluidized bed reactors are commonly used in industrial applications such as waste to energy conversion, chemical synthesis, granulation, catalyst regeneration, biomass gasification, pyrolysis, etc. They are used in such applications due to their efficient mixing, uniform heat, and mass transfer and better temperature control. Gas distribution inside the reactor plays a crucial role in determining the conversion process and fluidization regime. The air distributor plate is the most common method of gas distribution. However, it has drawbacks such as increased auxiliary power requirements and frequent cleaning and maintenance due to clogging of pores by sintering and small particles. As an alternative, fluidizing the particle bed with a nozzle helps overcome air distribution problems. This study focuses on the construction of bubbling fluidized bed reactor with two side nozzles as inlet flow boundary conditions. The results of the bubbling fluidized reactor with side nozzles are compared with the bubbling fluidized bed reactor with distributor plate. This is done by studying the flow behavior of binary mixtures of Geldart B and Geldart D particles through a series of experiments. A Computational Particle Fluid Dynamics (CPFD) model was developed using EMMS-Yang-2004 drag models in Barracuda Software and validated using experimental data. The results indicate that the reactor with two side nozzles has lower fluidization velocity than the reactor with distributor plate. The results also show that as the percentage of biomass increases in both reactors the minimum fluidization velocity decreases. In both reactors, good mixing of biomass and sand particles was observed after fluidization, and segregation of binary mixture was observed at a higher superficial gas velocity. Good mixing of binary mixture decreased on increasing biomass percentage in sand particles. Biomass segregates from the middle part of reactor with side nozzles whereas particles segregate from the bottom end of the reactor with uniform distribution. Mostly larger Bubbles were seen from the sides of the reactor after fluidization in the reactor with side nozzles. However, smaller bubbles were seen all over the reactor bed with the distributor plate reactor.

Published
2023

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