MAHENDRA LODHA | All India Institute of Medical Sciences, Jodhpur (original) (raw)

Papers by MAHENDRA LODHA

Cureus, 2021

Introduction: Anasarca is well-known and refers to generalized edema caused by underlying clinica... more Introduction: Anasarca is well-known and refers to generalized edema caused by underlying clinical conditions and unknown risk factors in the patient. However, it is a relatively unexplored postoperative symptom following major abdominal surgeries. It is associated with poor patient outcomes in terms of delayed recovery and associated severe complications. Pedal edema is an early sign of post-operative anasarca, which progresses into an unfavorable clinical condition due to generalized edema followed by multiple organ dysfunction. Aim: This study aimed to assess risk factors and complications associated with postoperative anasarca among patients undergoing major abdominal surgery. Methods and material: The prospective observational study included 241 patients undergoing major abdominal surgeries from July 2019 to February 2021 in a tertiary care health centre in Rajasthan, India. Risk factors like age, nutritional parameters, addictions like smoking, alcohol intake, opium intake, le...

Feasibility of safe laparoscopic surgery performed by junior residents without exposure of open appendectomy: A retrospective study

Journal of Family Medicine and Primary Care, 2022

Background: Varicose veins are also common in short saphenous vein territory which has most varia... more Background: Varicose veins are also common in short saphenous vein territory which has most variable anatomy in lower extremity. Variations in the veins of the lower limb are very common. This may be due to the anomalous involvement of the main trunks of the veins or their tributaries alone. Detailed knowledge regarding the anatomical variations such as reduplication of vein and unusual course and termination of the vein is a prerequisite in the diagnosis and management of vascular diseases. Methods: Included in the study were 626 Limbs. They were referred to radiology department by physicians, surgeons, and orthopedicians for investigation of clinically detected superficial varicosities and suspected chronic venous disease. The examination includes history, clinical examination, and detailed duplex scanning of lower limb veins. Study data were based on the detailed examination and reporting of anatomic variation of termination of the short saphenous vein (SSV). Duplex scanning of lower limb veins was performed with the patient standing on low stool. Body weight was on placed on a contralateral limb which enabled examined side to be relaxed, slightly flexed, and externally rotated position. The popliteal fossa and calf venous system were evaluated with particular attention to termination of SSV. A real time B-mode zoom facility enabled optimal anatomic delineation of the SSV and Giacomini vein. The termination of SSV is variable and three patterns have been defined. Results: Following important observations was made: 410 out of 620 (65%) lower extremities shows the prevalence of Giacomini vein. In 45 out of 620 (7.2%) lower extremities, the SSV terminated into popliteal vein with further extension into thigh. In 171 out of 620 (27%) lower extremities, the SSV terminated into popliteal vein. Conclusion: A proper knowledge about the anatomy of the short saphenous vein and its communications with other veins and mode of termination of short saphenous vein is mandatory for a safe and successful intervention. The variant termination of the small saphenous vein may contribute to recurrent varicose veins in this territory; this aspect generally makes the subject of interest in the view of varicose vein operations.

Awareness and experience of health-care workers during coronavirus disease 2019 pandemic

BACKGROUND: During the 2nd week of July 2020, the coronavirus disease 2019 (COVID 19) infection s... more BACKGROUND: During the 2nd week of July 2020, the coronavirus disease 2019 (COVID 19) infection spreading in the community. Now more than 15 lakhs peoples have been infected in India, out of the 26816 patients were deceased. COVID 19 outbreaks become an additional hazard to the health-care workers (HCWs), leading to fatigue, anxiety, depression and fear of death. The objective of this questionnaire-based study is to know about the knowledge of HCWs about COVID 19, their experiences while dealing with the disease, and the protective measures taken to prevent the infection. MATERIALS AND METHODS: A cross-sectional, questionnaire-based study was conducted for 1 month starting from the 2nd week of June 2020 after getting institutional ethical clearance. This study included 240 HCWs posted in the medical and surgical Departments of All India Institute of Medical Sciences, Jodhpur, Rajasthan. This questionnaire was prepared in online Google forms and required 2 min to complete. Mean, medi...

Ultrasonic Dissection without Cystic Artery Clipping Versus Classical Electro-Dissection in Laparoscopic Cholecystectomy: A Randomized Control Trial

International Journal of Surgery and Medicine, 2020

Context: The ongoing Covid-19 pandemic and the subsequent nationwide lockdown, has impacted all a... more Context: The ongoing Covid-19 pandemic and the subsequent nationwide lockdown, has impacted all aspects of society including the medical profession. In hospitals, the focus has mainly shifted to prevention and treatment of Covid-19 infection. Owing to this, all elective surgeries are being postponed and only emergent surgeries are being performed. This has affected the patients differently depending on the progression of disease and development of complications. Aim: The aim of this study is to evaluate the attitude of the patients regarding their planned surgical treatment in view of COVID 19 pandemic. Settings and Design: Hospital based; Cross-sectional; Telephonic survey Methods and Material: A well-structured telephonic scripted questionnaire was administered to all patients who were given an appointment for any elective surgery. Data was collected regarding the status of disease including complications and the patient’s perspective on the method of treatment. Patients who devel...

Quality of Life of Patients With Major Amputations in the Tertiary Care Center of Western Rajasthan: A Prospective Observational Study in 2019-2020

Cureus

The non-traumatic perforations of the small intestine are pathological entities.The primary sourc... more The non-traumatic perforations of the small intestine are pathological entities.The primary sources of the perforation might be foreign bodies, inflammatory diseases, tumors, infectious diseases, etc. In most cases intestinal perforation is discovered only by laparotomy and the definitive diagnosis is made only after histopathologic examination. Small bowel malignancies are rare; among them, lymphomas rank third in frequency, being mostly Bcell non Hodgkin lymphomas.Primary non-Hodgkin's lymphoma of the small bowel with hepatitis B presenting as a perforated viscus entity with peritonitis is extremely rare. A 58 year old man presented with pain abdomen and distension. An emergency laparotomy revealed a perforation in jejunum with enlarged mesenteric lymph nodes and mesenteric thickening which required segmental resection and anastomosis. Histopathological examination of the resected segment of jejunum revealed extranodal follicular lymphoma of small intestine. The nonspecific cl...

DOI: 10.21276/sjmcr.2018.6.3.10 Abstract: Small bowel malignancy is a rare entity. Adenocarcinoma... more DOI: 10.21276/sjmcr.2018.6.3.10 Abstract: Small bowel malignancy is a rare entity. Adenocarcinoma is a most common histologic subtype. Primary jejunal carcinoma is rare and is difficult to diagnose clinically due to non-specific symptoms. Surgical resection is the treatment of choice. There is no standard protocol for unrespectable or metastatic disease. We report here a 52 year old female with mucinous adenocarcinoma of jejunum, lacking specific symptoms in early stage and later presented with occasional biliary vomiting with soft abdomen, leading to delay of 6 months in diagnosis. At laparotomy, growth was present in mid jejunum. The patient underwent segmental resection of intestine. The jejunal growth was diagnosed as mucinous adenocarcinoma on histopathology examination. The patient was given adjuvant chemotherapy after surgery and she is doing well after 6 months of follow up.

A Correlation of BPH Related Lower Urinary Tract Symptoms in Patients with Inguinal Hernia

International journal of scientific research, 2019

AIM - To correlate presence of lower urinary tract symptoms related to BPH in patients with ingui... more AIM - To correlate presence of lower urinary tract symptoms related to BPH in patients with inguinal hernia. MATERIALS AND METHODS- This Cross sectional observationalstudy was performed at department of General surgery of a tertiary care hospital with sample size 100 and 18 months durations. RESULTS- Non-Significant correlation was seen between operative findings of hernia and mean peak flow rates (p= 0.541), IPSS (p= 0.831), prostatomegaly (p= 0.63 ). CONCLUSION- Patient with inguinal hernia had similar LUTS symptom scores (IPSS) and similar uroflowmetric parameters compared to general population. There was no statistically significant association between configuration of inguinal hernia and other parameters like grades of prostatomegaly, IPSS scores and mean peak flow rates.

Left-Sided Strangulated Obturator Hernia: A Rare Case Report and Literature Review

International Journal of Applied and Basic Medical Research, 2021

Obturator hernia is a rare type of pelvic hernia and considers more common in female patients. Th... more Obturator hernia is a rare type of pelvic hernia and considers more common in female patients. The obturator canal is a narrow space, leading to high chances of bowel strangulation. It is rarely diagnoses, especially on the left side. The mortality rate of obturator hernia is high due to delayed diagnosis. We are presenting a case of a 70-year-old woman, admitted with the clinical features of acute intestinal obstruction. On clinical examination, she had a nontender, distended abdomen, and all hernial orifices were normal. Per rectal and vaginal examination was also normal. She diagnosed a left-sided obturator hernia with the help of a computed tomography scan abdomen. We should consider a differential diagnosis of obturator hernia, especially in old, thin-built female patients with recurrent episodes of obstructive features. Early diagnosis and timely operative intervention may reduce the chances of complications and mortality.

Human Visceral Adipose Tissue (VAT) Inflammation Is Not Associated With Perforin Deficiency in Type 2 Diabetes Mellitus (DM) Subjects as Compared to Health Controls

Journal of the Endocrine Society, 2021

Introduction: Role of T cells in VAT inflammation is poorly characterised. Perforin deficiency is... more Introduction: Role of T cells in VAT inflammation is poorly characterised. Perforin deficiency is associated with autoimmune inflammatory diseases like Hemophagocytosis Lymphohistiocytosis,as also in context of type 1 DM pathogenesis. Data from animal models suggest that perforin deficiency leads to VAT inflammation1Objective: We hypothesized CD8+/perf+ and CD56+/perf+ cells to be decreased in type 2 DM as compared to healthy controls. The present study also explored the difference in activation of T/NK cells between two groups Methods: 2×2 cm omental tissue was obtained from subjects undergoing elective abdominal surgery. The sample was transported in RPMI solution and stored in -80 ℃. Processing involved thawing, incubation at 37.6 ℃ for 24 hours with type IV Collagenase (1 mg/ml, Sigma Aldrich) 1ml/g of tissue,centrifuge (32g for 10 min at 10℃). The resultant Stromal Vascular fraction (SVF) was suspended in phosphate buffer saline (PBS), passed through cell strainer to make singl...

Gastrointestinal Tumors

Primary gastrointestinal NHL accounts for 30–40% of all extranodal NHL. Primary gastrointestinal ... more Primary gastrointestinal NHL accounts for 30–40% of all extranodal NHL. Primary gastrointestinal lymphomas constitute 5% of total gut neoplasms. Bowel perforation is a severe life-threatening complication and sometimes initial presentation of gastrointestinal lymphoma. A 60-year-old man presented with complaints of abdominal pain, distension, nausea and vomiting. There was clinical suspicion of acute intestinal perforation, which was confirmed by radiology. The patient underwent emergency laparotomy. The resected bowel on histopathological examination and immunohistochemistry was diagnosed as the high-grade transformation of follicular lymphoma (FL). The patient received 6 cycles of chemotherapy and is doing well at 3 years of follow-up. Herein, we report this rare malignancy of the small intestine. FL mostly presents as a nodal disease but also involves the extranodal sites. The most common site of primary gastrointestinal-follicular lymphoma (GI-FL) is the small intestine. The cel...

Post-COVID-19 Intestinal and Mesenteric Mucormycosis

The American Surgeon

A thirty-eight-year-old uncontrolled diabetic with a recent COVID-19 infection presented with ext... more A thirty-eight-year-old uncontrolled diabetic with a recent COVID-19 infection presented with extensive bowel ischemia and gangrene with a microscopic diagnosis of intestinal and mesenteric mucormycosis. Although there are a few reported cases of primary gastrointestinal mucormycosis, our case showing involvement of the intestine and/or mesentery, that too in a post-COVID patient, is quite uncommon. The immunosuppressive effect of the COVID-19 disease, uncontrolled diabetes, and the use of corticosteroids for the treatment of severe COVID are the most probable reasons for the emergence of severe opportunistic infections, both as a coinfection and as a sequalae to COVID.

Indian Journal of Clinical Anatomy and Physiology, May 15, 2018

Ectopic liver is a very rare developmental anomaly of liver , it is rairly diagnosed preoperative... more Ectopic liver is a very rare developmental anomaly of liver , it is rairly diagnosed preoperatively because of rairrity of condition and very scarcely produces any symtom,it is missed in radiology .we report a case of ectopic liver which was diagnosed intraoperatively on laparoscopy as a incidental finding while doing a right radical nephrectomy,it is not clear in literatur what is to be done for this incidentaly diagnosed normal ecctopic liver while doing other surgery. A brief review of its prevalance, embriology, diagnosis, and pathology which develop in ectopic liver will be disccused in this review.

Simultaneous primary testicular and laryngeal non-Hodgkin lymphoma in a 56 year old male - A rare presentation

International Journal of Medical Reviews and Case Reports

International Surgery Journal

Thoracic trauma is a significant cause of morbidity and mortality, if not treated promptly. 80% t... more Thoracic trauma is a significant cause of morbidity and mortality, if not treated promptly. 80% to 85% of chest injuries can be treated with chest tube insertion alone. However, in about four to 20% of population, there is incomplete clearance of hemothorax following tube insertion and can lead to a condition called retained hemothorax. The purpose of this review is to establish the role and effectiveness of Video assisted thoracoscopic surgery (VATS) in successful evacuation of retained hemothorax following blunt thoracic trauma. Relevant articles from databases like Pubmed, Google scholar, Medline and Cochrane library were included. A retained hemothorax is defined as the persistence of residual clots in the pleural cavity, which is radiologically evident, 72 hours following initial tube thoracostomy. The various options to manage this condition include observation, insertion of second thoracostomy tube, intrapleural fibrinolytic, VATS or thoracotomy. Based on review of existing s...

International Journal of Research in Medical Sciences

Background: In spite of the numerous chronic diseases that have been linked to obesity, studies f... more Background: In spite of the numerous chronic diseases that have been linked to obesity, studies focusing on awareness regarding Body mass index (BMI) and its correlates to prevent and control obesity are lacking in the literature, especially in developing countries such as India, where obesity is culturally accepted and nurtured in the society.Methods: A cross-sectional prospective survey was done between November 2018 and November 2019 in a tertiary care research institute after approval from institutional ethics committee. A pre-designed questionnaire was used to collect data in excel sheet (Microsoft Corp, Redmond, WA) and analysed using SPSS.Results: total 264 (80.3% urban and 19.7% rural background) patients with mean age of 42 years with different educational level participated in the study. 1.1% patients were underweight, 2.7% mean BMI of studied population was 34.76. BMI distribution curve was bilaterally symmetrical. No one in the study population was well aware of about th...

Does laparoscopic hernia repair affect the vascularity of testis?

Journal of Family Medicine and Primary Care