DR. ADITYA MANEKAR - Academia.edu (original) (raw)

Papers by DR. ADITYA MANEKAR

PubMed, Apr 21, 2022

Oral swellings and ulcers in neonates are a spectrum of diseases often creating a sense of anxiet... more Oral swellings and ulcers in neonates are a spectrum of diseases often creating a sense of anxiety among parents. Early detection, high index of suspicion, proper investigations, and prompt diagnosis can aid in accurate management of the same. Lymphangiomas are benign hamartomas which are basically malformed lymphatics do not drain into other lymphatics or veins and hence there is lymphatic accumulation and enlargement following cystically dilated spaces. We hereby present a rare case of a neonate born with a cystic mucosal swelling at the upper gingival sulcus since birth.

PubMed, May 18, 2023

Background: Pancreatico-biliary maljunction (PBM) is often found to be associated with choledocha... more Background: Pancreatico-biliary maljunction (PBM) is often found to be associated with choledochal cysts (CCs). According to a European multicenter study, the prevalence of PBM in cases of CC is found to be 72.2%, however, there is no Indian study depicting the prevalence of PBM in Indian children with CCs, which is one of the main postulated factors in the etiopathogenesis of CC. In this study, we have attempted to observe prospectively the prevalence of PBM in children with CC and correlate this to its morphological and biochemical parameters. The association between the presence of PBM and histopathological findings such as epithelial changes of the mucosa of the CC, inflammation, metaplasia or dysplasia, and histopathology of the liver has also been evaluated. Materials and methods: We carried out a single center, prospective observational study with a single arm study group. We prospectively selected all patients of CC admitted for surgery from November 2018 to October 2020. Data on biochemical, radiological, and histopathological parameters were collected and analyzed. Results: We included a total of 20 patients in our study. The mean age of the participants was 6.22 ± 4.32 years. Among them, 11 (55.0%) were male and 9 (45%) were female. Abdominal pain was the most common presenting complaint among our patients (75.0%) and had a significant association with the presence of a PBM (P = 0.001). In symptomatic children, the mean duration of symptoms was 4.50 ± 2.26 months for jaundice, 4.50 ± 1.98 months for abdominal distension, and 5.07 ± 2.02 months for abdominal pain. Among the 3 children with cholangitis, the mean number of episodes was 3.33 ± 2.08, with a median of four episodes. Fourteen (70.0%) of the children had type I a CC, 1 (5.0%) participant each for types I b, I c, II and IV a and 2 (10.0%) of them had type IV b cyst. The mean size of the cyst (cm) was 7.41 ± 3.03 with a median of 6.85 cm. Among the children, 9 (45%) showed the presence of PBM on magnetic resonance cholangiopancreatography (MRCP), with 7 (77.8%) showing Komi's C-P type and 2 (22.2%) showing Komi's PC type. The mean common channel length (mm) on MRCP was 8.11 ± 2.47 with a median length of 8.00 mm. The biochemical analysis of a bile fluid amylase and lipase is the functional indicator of the presence of a PBM. Histopathological examination showed the presence of ulceration in the walls of the CC in 10 (50.0%) of the specimens. There was a significant association of the presence of PBM and ulceration in the mucosa of the CC (P ≤ 0.001), with the median levels being the highest in the PBM present group. Conclusion: Abdominal pain is the most common complaint in a child with CC, and when present, it is significantly associated with the presence of a PBM. MRCP is the gold standard tool to detect CCs and find out the morphology of PBM. The prevalence of PBM in children with CC of 45% with a mean common channel length of 8.11 mm. The biochemical analysis of a bile amylase and lipase is the functional indicator of the presence of a PBM and there is a significant association of their higher levels and presence of PBM. The presence of chronic inflammation and microscopic ulcers is significant histologic parameters depicting the presence of a PBM.

PubMed, Aug 27, 2022

Background: Phimosis, a common paediatric condition, is defined as the inability to retract the p... more Background: Phimosis, a common paediatric condition, is defined as the inability to retract the preputial skin behind the glans. Current practice shows there is some confusion among the paediatricians towards this common condition and in differentiating it from the more common physiological preputial adhesion; leading to frequent referrals to a paediatric surgeon or a general surgeon, which can be addressed by the parents and the child physicians themselves. Aim: To find out the awareness towards the management of phimosis among the paediatricians. Materials and methods: A questionnaire on this topic was generated using 'Google Forms' and was circulated among junior and senior residents, faculty in various medical colleges and consultants in private practice all over India and their response was collected and analysed. Results: We received a total of 221 responses from all over India from paediatric medicine trainees and consultants. Among them, majority (48%) were senior residents. According to the survey participants, the most (46%) find inability to retract the prepuce as the major presenting complaint. A straight away reference to a paediatric surgeon was preferred by majority of paediatricians (62.9%), though most of them were aware of them were aware of physiological adhesions and conservative management (94.2%). There was a belief among 43% about counselling each and every patient presenting with phimosis for circumcision. Among the respondents, 60.2% advised ultrasound of kidneys, ureter, and bladder to their patients and believed that backpressure changes alter the management of the child. A urine routine examination was advised by 70.1% of participants, with 46.6% believing that the presence of urinary tract infection changes the management of phimosis. Waiting up to 1 year of age before going for surgery was advocated by 71.5%. A major proportion of respondents (76%) believed all cases of phimosis should be referred to a surgeon, only 58.8% would voluntarily follow them up. There is still a belief among 69.7% of participants that all cases of phimosis should be referred to a paediatric surgeon and only few of them, 5.4% feel referring only indicated cases. Conclusion: Physiological phimosis is a common condition which can be addressed by the paediatricians themselves. Awareness is to be increased among them, especially during the training period regarding the proper management of this common condition, avoiding unnecessary circumcisions.

International journal of applied research, Jul 1, 2016

We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock... more We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock Wave Lithotripsy) over a period of 15 years from 2000-2014. This is a retrospective and an observational study. The lithotripter used was "Dornier Compact Alpha", a latest state of art, from Germany-a gold standard in the Extracorporeal Shock Wave Lithotripsy therapy. Ultrasound was used as a sole imaging modality, thus picking up even small and radiolucent stones in radiograph of kidney, ureter and bladder (X-ray KUB). The energy source in the lithotripter used was an electromagnetic generator with isocentric focussing technique. Our ESWL machine has a mobile therapy head and a stable patient table, thus making it versatile and convenient to treat even vesical calculi and ureteric calculi, along with large renal calculi. The results with ESWL therapy are comparable to the endoscopic surgeries with ESWL having the advantage of being non invasive and having lesser number of complications than the latter.

Indian journal of applied research, Jun 2, 2016

A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surger... more A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surgery. A complete nephrectomy being planned initially, we performed a kidney sparing surgery (Marsupialization) and achieved complete removal of the cyst and the daughter cysts. There were no intraoperative or post operative complications. Marsupialization as a kidney sparing surgery can be performed effectively in a centre where laparoscopic facilities are not available

International journal of surgery science, Apr 1, 2018

We hereby present a case series of and epidemiological study on benign breast diseases among rura... more We hereby present a case series of and epidemiological study on benign breast diseases among rural population of North Maharashtra. Breast health awareness has resulted in increasing detection of early breast cancer and corresponding decrease in breast cancer morbidity. About 80% of breast biopsies result in a benign pathology. Women with a benign disorder, require treatment at some time in their lives. The concept of ANDI-Aberrations of Normal Development and Involution is gaining acceptance. This study highlights the spectrum of epidemiology of benign breast diseases in rural population.

International journal of surgery science, Oct 1, 2017

Since, its introduction in 1990s, vacuum assisted closure (V.A.C.) has been known to reduce the w... more Since, its introduction in 1990s, vacuum assisted closure (V.A.C.) has been known to reduce the wound healing time along with promotion of granulation tissue as compared to conventional dressing techniques. The therapy involves controlled application of negative pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump. Recent introduction of the commercial products for vacuum dressings have added to enormous costs of these dressings. We at our limited resource setup, provided our patients with a very cheap alternative for the vacuum assisted dressings with the help of locally available materials. We hereby present few of the challenges that our patients posed to us in the course of vacuum assisted closure therapy and how they were handled in our setup with limited available resources. Aims and Objectives: To provide a cheaper alternative to conventional expensive vacuum dressings with the help of locally available materials. Materials and Methods: Patients with non-healing ulcers were selected as candidates for our v.a.c. dressings after ruling out malignancy and osteomyelitis. V.A.C. dressings were given using sterilised plastic leggings, condoms, food wraps, balloons with a Ryle's tube / suction tubings inserted within and sealed using petroleum jelly with adhesive tapes. Negative pressure was created with the suction machine available in the wards. Results: Accentuated healing of the wounds was noticed with a healthy granulation tissue compared to conventional dressing techniques. Conclusion: V.A.C. dressings coupled with supportive treatment in the form of antibiotics, correction of the comorbid conditions and dietary modifications can be helpful in managing even difficult to treat non healing ulcers. Conflict of Interest: None to mention.

International journal of surgery science, Oct 1, 2017

Objective: Cryptorchidism or undescended testes is a common birth condition in children and infan... more Objective: Cryptorchidism or undescended testes is a common birth condition in children and infants. Numerous complications can arise if untreated, but can be prevented by timely intervention. This prospective study is done to determine the epidemiological parameters of undescended testes in rural population of North Maharashtra. Methodology: This case series included 89 patients presenting to our OPD at ACPM Medical College, Dhule, From June 2014 to March 2016.Variables studied were the age of presentation, the population distribution, position of testes, size of testes and surgical outcomes. Results: Among 89 patients, over all incidence of cryptorchidism in boys in our study was found to be around 0.7% (total pediatric OPD cases were 12,714). This rate was slightly lower to similar studies conducted elsewhere. No definite etiology could be found but there are some persistent factors like socio economic status. Higher rate of cyptorchidism was noted in lower socioeconomic class. About 20.22% patients were preterm suggesting higher preponderance with prematurity. 10.1% patients had a positive family history indicating a possible role in etiology. Maximum frequency of presentation was in 0 to 2 years age group followed by 3 to 5 years age group. But about 13.48% patients presented as late as 11 to 13 years thereby having a higher risk of testicular atrophy. Diagnostic investigation in all patients was abdominal ultrasound. All the testes impalpable on examination could be located with ultrasound in various regions of abdomen and pelvis, thereby aiding advanced planning of intervention required. Two staged orchidopexy can give good results but should be reserved for high lying testies, especially abdominal, for rest, a single stage orchidopexy can give satisfactory results. Conclusion: Undescended testes is a common birth problem among paediatric population and surgical approach has shown to have good results.

International journal of surgery science, Oct 1, 2017

Objective: Cryptorchidism or undescended testes is a common birth condition in children and infan... more Objective: Cryptorchidism or undescended testes is a common birth condition in children and infants. Numerous complications can arise if untreated, but can be prevented by timely intervention. This prospective study is done to determine the epidemiological parameters of undescended testes in rural population of North Maharashtra. Methodology: This case series included 89 patients presenting to our OPD at ACPM Medical College, Dhule, From June 2014 to March 2016.Variables studied were the age of presentation, the population distribution, position of testes, size of testes and surgical outcomes. Results: Among 89 patients, over all incidence of cryptorchidism in boys in our study was found to be around 0.7% (total pediatric OPD cases were 12,714). This rate was slightly lower to similar studies conducted elsewhere. No definite etiology could be found but there are some persistent factors like socio economic status. Higher rate of cyptorchidism was noted in lower socioeconomic class. About 20.22% patients were preterm suggesting higher preponderance with prematurity. 10.1% patients had a positive family history indicating a possible role in etiology. Maximum frequency of presentation was in 0 to 2 years age group followed by 3 to 5 years age group. But about 13.48% patients presented as late as 11 to 13 years thereby having a higher risk of testicular atrophy. Diagnostic investigation in all patients was abdominal ultrasound. All the testes impalpable on examination could be located with ultrasound in various regions of abdomen and pelvis, thereby aiding advanced planning of intervention required. Two staged orchidopexy can give good results but should be reserved for high lying testies, especially abdominal, for rest, a single stage orchidopexy can give satisfactory results. Conclusion: Undescended testes is a common birth problem among paediatric population and surgical approach has shown to have good results.

New Indian Journal of Surgery, 2018

Annals of Pediatric Surgery, Oct 4, 2021

Background: Mobile caecum along with malfixed small bowel mesentery in malrotation is incriminate... more Background: Mobile caecum along with malfixed small bowel mesentery in malrotation is incriminated to cause intussusception in children. This dual association is very rare and is labeled as Waugh's syndrome. This is often missed during conservative management of intussusception and may manifest as chronic intussusception. Case presentation: We report a rare case of intestinal malrotation in a 13-year-old boy who presented as recurrent intussusception. The child was resuscitated and was operated, where malrotation of gut was detected. We discuss the clinical presentation, radiological findings, and management of this rare association in light of current available literature. Conclusion: The presence of mobile caecum and redundant bowel loops with narrow mesentery in case of malrotation is an important factor leading to intussusception.

Journal of Pediatric Surgery Case Reports

African Journal of Paediatric Surgery, Aug 27, 2022

Journal of Indian Society of Pedodontics and Preventive Dentistry, Apr 21, 2022

We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock... more We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock Wave Lithotripsy) over a period of 15 years from 2000-2014. This is a retrospective and an observational study. The lithotripter used was "Dornier Compact Alpha", a latest state of art, from Germany-a gold standard in the Extracorporeal Shock Wave Lithotripsy therapy. Ultrasound was used as a sole imaging modality, thus picking up even small and radiolucent stones in radiograph of kidney, ureter and bladder (X-ray KUB). The energy source in the lithotripter used was an electromagnetic generator with isocentric focussing technique. Our ESWL machine has a mobile therapy head and a stable patient table, thus making it versatile and convenient to treat even vesical calculi and ureteric calculi, along with large renal calculi. The results with ESWL therapy are comparable to the endoscopic surgeries with ESWL having the advantage of being non invasive and having lesser number of com...

New Indian Journal of Surgery, 2018

Objective: Cryptorchidism or undescended testes is a common birth condition in children and infan... more Objective: Cryptorchidism or undescended testes is a common birth condition in children and infants. Numerous complications can arise if untreated, but can be prevented by timely intervention. This prospective study is done to determine the epidemiological parameters of undescended testes in rural population of North Maharashtra. Methodology: This case series included 89 patients presenting to our OPD at ACPM Medical College, Dhule, From June 2014 to March 2016.Variables studied were the age of presentation, the population distribution, position of testes, size of testes and surgical outcomes. Results: Among 89 patients, over all incidence of cryptorchidism in boys in our study was found to be around 0.7% (total pediatric OPD cases were 12,714). This rate was slightly lower to similar studies conducted elsewhere. No definite etiology could be found but there are some persistent factors like socio economic status. Higher rate of cyptorchidism was noted in lower socioeconomic class. A...

Indian journal of applied research, 2018

We hereby present to you a rare case in a 7 old baby suffering from phimosis who presented to us ... more We hereby present to you a rare case in a 7 old baby suffering from phimosis who presented to us with a fistula post treatment of dorsal slit. Paraphimosis is a urologic emergency, occurring in uncircumcised males, in which the foreskin becomes trapped behind the corona and forms a tight band of constricting tissue. Often iatrogenically induced, paraphimosis can be prevented by returning the prepuce to cover the glans following penile manipulation. Treatment often begins with reduction of edema, followed by a variety of options, including mechanical compression, pharmacologic therapy, puncture technique and dorsal slit. Prevention and early intervention are key elements in the management of paraphimosis.

Indian journal of applied research, 2016

A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surger... more A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surgery. A complete nephrectomy being planned initially, we performed a kidney sparing surgery (Marsupialization) and achieved complete removal of the cyst and the daughter cysts. There were no intraoperative or post operative complications. Marsupialization as a kidney sparing surgery can be performed effectively in a centre where laparoscopic facilities are not available.

We hereby present a case series of and epidemiological study on benign breast diseases among rura... more We hereby present a case series of and epidemiological study on benign breast diseases among rural population of North Maharashtra. Breast health awareness has resulted in increasing detection of early breast cancer and corresponding decrease in breast cancer morbidity. About 80% of breast biopsies result in a benign pathology. Women with a benign disorder, require treatment at some time in their lives. The concept of ANDI – Aberrations of Normal Development and Involution is gaining acceptance. This study highlights the spectrum of epidemiology of benign breast diseases in rural population.

PubMed, Apr 21, 2022

Oral swellings and ulcers in neonates are a spectrum of diseases often creating a sense of anxiet... more Oral swellings and ulcers in neonates are a spectrum of diseases often creating a sense of anxiety among parents. Early detection, high index of suspicion, proper investigations, and prompt diagnosis can aid in accurate management of the same. Lymphangiomas are benign hamartomas which are basically malformed lymphatics do not drain into other lymphatics or veins and hence there is lymphatic accumulation and enlargement following cystically dilated spaces. We hereby present a rare case of a neonate born with a cystic mucosal swelling at the upper gingival sulcus since birth.

PubMed, May 18, 2023

Background: Pancreatico-biliary maljunction (PBM) is often found to be associated with choledocha... more Background: Pancreatico-biliary maljunction (PBM) is often found to be associated with choledochal cysts (CCs). According to a European multicenter study, the prevalence of PBM in cases of CC is found to be 72.2%, however, there is no Indian study depicting the prevalence of PBM in Indian children with CCs, which is one of the main postulated factors in the etiopathogenesis of CC. In this study, we have attempted to observe prospectively the prevalence of PBM in children with CC and correlate this to its morphological and biochemical parameters. The association between the presence of PBM and histopathological findings such as epithelial changes of the mucosa of the CC, inflammation, metaplasia or dysplasia, and histopathology of the liver has also been evaluated. Materials and methods: We carried out a single center, prospective observational study with a single arm study group. We prospectively selected all patients of CC admitted for surgery from November 2018 to October 2020. Data on biochemical, radiological, and histopathological parameters were collected and analyzed. Results: We included a total of 20 patients in our study. The mean age of the participants was 6.22 ± 4.32 years. Among them, 11 (55.0%) were male and 9 (45%) were female. Abdominal pain was the most common presenting complaint among our patients (75.0%) and had a significant association with the presence of a PBM (P = 0.001). In symptomatic children, the mean duration of symptoms was 4.50 ± 2.26 months for jaundice, 4.50 ± 1.98 months for abdominal distension, and 5.07 ± 2.02 months for abdominal pain. Among the 3 children with cholangitis, the mean number of episodes was 3.33 ± 2.08, with a median of four episodes. Fourteen (70.0%) of the children had type I a CC, 1 (5.0%) participant each for types I b, I c, II and IV a and 2 (10.0%) of them had type IV b cyst. The mean size of the cyst (cm) was 7.41 ± 3.03 with a median of 6.85 cm. Among the children, 9 (45%) showed the presence of PBM on magnetic resonance cholangiopancreatography (MRCP), with 7 (77.8%) showing Komi's C-P type and 2 (22.2%) showing Komi's PC type. The mean common channel length (mm) on MRCP was 8.11 ± 2.47 with a median length of 8.00 mm. The biochemical analysis of a bile fluid amylase and lipase is the functional indicator of the presence of a PBM. Histopathological examination showed the presence of ulceration in the walls of the CC in 10 (50.0%) of the specimens. There was a significant association of the presence of PBM and ulceration in the mucosa of the CC (P ≤ 0.001), with the median levels being the highest in the PBM present group. Conclusion: Abdominal pain is the most common complaint in a child with CC, and when present, it is significantly associated with the presence of a PBM. MRCP is the gold standard tool to detect CCs and find out the morphology of PBM. The prevalence of PBM in children with CC of 45% with a mean common channel length of 8.11 mm. The biochemical analysis of a bile amylase and lipase is the functional indicator of the presence of a PBM and there is a significant association of their higher levels and presence of PBM. The presence of chronic inflammation and microscopic ulcers is significant histologic parameters depicting the presence of a PBM.

PubMed, Aug 27, 2022

Background: Phimosis, a common paediatric condition, is defined as the inability to retract the p... more Background: Phimosis, a common paediatric condition, is defined as the inability to retract the preputial skin behind the glans. Current practice shows there is some confusion among the paediatricians towards this common condition and in differentiating it from the more common physiological preputial adhesion; leading to frequent referrals to a paediatric surgeon or a general surgeon, which can be addressed by the parents and the child physicians themselves. Aim: To find out the awareness towards the management of phimosis among the paediatricians. Materials and methods: A questionnaire on this topic was generated using 'Google Forms' and was circulated among junior and senior residents, faculty in various medical colleges and consultants in private practice all over India and their response was collected and analysed. Results: We received a total of 221 responses from all over India from paediatric medicine trainees and consultants. Among them, majority (48%) were senior residents. According to the survey participants, the most (46%) find inability to retract the prepuce as the major presenting complaint. A straight away reference to a paediatric surgeon was preferred by majority of paediatricians (62.9%), though most of them were aware of them were aware of physiological adhesions and conservative management (94.2%). There was a belief among 43% about counselling each and every patient presenting with phimosis for circumcision. Among the respondents, 60.2% advised ultrasound of kidneys, ureter, and bladder to their patients and believed that backpressure changes alter the management of the child. A urine routine examination was advised by 70.1% of participants, with 46.6% believing that the presence of urinary tract infection changes the management of phimosis. Waiting up to 1 year of age before going for surgery was advocated by 71.5%. A major proportion of respondents (76%) believed all cases of phimosis should be referred to a surgeon, only 58.8% would voluntarily follow them up. There is still a belief among 69.7% of participants that all cases of phimosis should be referred to a paediatric surgeon and only few of them, 5.4% feel referring only indicated cases. Conclusion: Physiological phimosis is a common condition which can be addressed by the paediatricians themselves. Awareness is to be increased among them, especially during the training period regarding the proper management of this common condition, avoiding unnecessary circumcisions.

International journal of applied research, Jul 1, 2016

We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock... more We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock Wave Lithotripsy) over a period of 15 years from 2000-2014. This is a retrospective and an observational study. The lithotripter used was "Dornier Compact Alpha", a latest state of art, from Germany-a gold standard in the Extracorporeal Shock Wave Lithotripsy therapy. Ultrasound was used as a sole imaging modality, thus picking up even small and radiolucent stones in radiograph of kidney, ureter and bladder (X-ray KUB). The energy source in the lithotripter used was an electromagnetic generator with isocentric focussing technique. Our ESWL machine has a mobile therapy head and a stable patient table, thus making it versatile and convenient to treat even vesical calculi and ureteric calculi, along with large renal calculi. The results with ESWL therapy are comparable to the endoscopic surgeries with ESWL having the advantage of being non invasive and having lesser number of complications than the latter.

Indian journal of applied research, Jun 2, 2016

A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surger... more A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surgery. A complete nephrectomy being planned initially, we performed a kidney sparing surgery (Marsupialization) and achieved complete removal of the cyst and the daughter cysts. There were no intraoperative or post operative complications. Marsupialization as a kidney sparing surgery can be performed effectively in a centre where laparoscopic facilities are not available

International journal of surgery science, Apr 1, 2018

We hereby present a case series of and epidemiological study on benign breast diseases among rura... more We hereby present a case series of and epidemiological study on benign breast diseases among rural population of North Maharashtra. Breast health awareness has resulted in increasing detection of early breast cancer and corresponding decrease in breast cancer morbidity. About 80% of breast biopsies result in a benign pathology. Women with a benign disorder, require treatment at some time in their lives. The concept of ANDI-Aberrations of Normal Development and Involution is gaining acceptance. This study highlights the spectrum of epidemiology of benign breast diseases in rural population.

International journal of surgery science, Oct 1, 2017

Since, its introduction in 1990s, vacuum assisted closure (V.A.C.) has been known to reduce the w... more Since, its introduction in 1990s, vacuum assisted closure (V.A.C.) has been known to reduce the wound healing time along with promotion of granulation tissue as compared to conventional dressing techniques. The therapy involves controlled application of negative pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump. Recent introduction of the commercial products for vacuum dressings have added to enormous costs of these dressings. We at our limited resource setup, provided our patients with a very cheap alternative for the vacuum assisted dressings with the help of locally available materials. We hereby present few of the challenges that our patients posed to us in the course of vacuum assisted closure therapy and how they were handled in our setup with limited available resources. Aims and Objectives: To provide a cheaper alternative to conventional expensive vacuum dressings with the help of locally available materials. Materials and Methods: Patients with non-healing ulcers were selected as candidates for our v.a.c. dressings after ruling out malignancy and osteomyelitis. V.A.C. dressings were given using sterilised plastic leggings, condoms, food wraps, balloons with a Ryle's tube / suction tubings inserted within and sealed using petroleum jelly with adhesive tapes. Negative pressure was created with the suction machine available in the wards. Results: Accentuated healing of the wounds was noticed with a healthy granulation tissue compared to conventional dressing techniques. Conclusion: V.A.C. dressings coupled with supportive treatment in the form of antibiotics, correction of the comorbid conditions and dietary modifications can be helpful in managing even difficult to treat non healing ulcers. Conflict of Interest: None to mention.

International journal of surgery science, Oct 1, 2017

Objective: Cryptorchidism or undescended testes is a common birth condition in children and infan... more Objective: Cryptorchidism or undescended testes is a common birth condition in children and infants. Numerous complications can arise if untreated, but can be prevented by timely intervention. This prospective study is done to determine the epidemiological parameters of undescended testes in rural population of North Maharashtra. Methodology: This case series included 89 patients presenting to our OPD at ACPM Medical College, Dhule, From June 2014 to March 2016.Variables studied were the age of presentation, the population distribution, position of testes, size of testes and surgical outcomes. Results: Among 89 patients, over all incidence of cryptorchidism in boys in our study was found to be around 0.7% (total pediatric OPD cases were 12,714). This rate was slightly lower to similar studies conducted elsewhere. No definite etiology could be found but there are some persistent factors like socio economic status. Higher rate of cyptorchidism was noted in lower socioeconomic class. About 20.22% patients were preterm suggesting higher preponderance with prematurity. 10.1% patients had a positive family history indicating a possible role in etiology. Maximum frequency of presentation was in 0 to 2 years age group followed by 3 to 5 years age group. But about 13.48% patients presented as late as 11 to 13 years thereby having a higher risk of testicular atrophy. Diagnostic investigation in all patients was abdominal ultrasound. All the testes impalpable on examination could be located with ultrasound in various regions of abdomen and pelvis, thereby aiding advanced planning of intervention required. Two staged orchidopexy can give good results but should be reserved for high lying testies, especially abdominal, for rest, a single stage orchidopexy can give satisfactory results. Conclusion: Undescended testes is a common birth problem among paediatric population and surgical approach has shown to have good results.

International journal of surgery science, Oct 1, 2017

Objective: Cryptorchidism or undescended testes is a common birth condition in children and infan... more Objective: Cryptorchidism or undescended testes is a common birth condition in children and infants. Numerous complications can arise if untreated, but can be prevented by timely intervention. This prospective study is done to determine the epidemiological parameters of undescended testes in rural population of North Maharashtra. Methodology: This case series included 89 patients presenting to our OPD at ACPM Medical College, Dhule, From June 2014 to March 2016.Variables studied were the age of presentation, the population distribution, position of testes, size of testes and surgical outcomes. Results: Among 89 patients, over all incidence of cryptorchidism in boys in our study was found to be around 0.7% (total pediatric OPD cases were 12,714). This rate was slightly lower to similar studies conducted elsewhere. No definite etiology could be found but there are some persistent factors like socio economic status. Higher rate of cyptorchidism was noted in lower socioeconomic class. About 20.22% patients were preterm suggesting higher preponderance with prematurity. 10.1% patients had a positive family history indicating a possible role in etiology. Maximum frequency of presentation was in 0 to 2 years age group followed by 3 to 5 years age group. But about 13.48% patients presented as late as 11 to 13 years thereby having a higher risk of testicular atrophy. Diagnostic investigation in all patients was abdominal ultrasound. All the testes impalpable on examination could be located with ultrasound in various regions of abdomen and pelvis, thereby aiding advanced planning of intervention required. Two staged orchidopexy can give good results but should be reserved for high lying testies, especially abdominal, for rest, a single stage orchidopexy can give satisfactory results. Conclusion: Undescended testes is a common birth problem among paediatric population and surgical approach has shown to have good results.

New Indian Journal of Surgery, 2018

Annals of Pediatric Surgery, Oct 4, 2021

Background: Mobile caecum along with malfixed small bowel mesentery in malrotation is incriminate... more Background: Mobile caecum along with malfixed small bowel mesentery in malrotation is incriminated to cause intussusception in children. This dual association is very rare and is labeled as Waugh's syndrome. This is often missed during conservative management of intussusception and may manifest as chronic intussusception. Case presentation: We report a rare case of intestinal malrotation in a 13-year-old boy who presented as recurrent intussusception. The child was resuscitated and was operated, where malrotation of gut was detected. We discuss the clinical presentation, radiological findings, and management of this rare association in light of current available literature. Conclusion: The presence of mobile caecum and redundant bowel loops with narrow mesentery in case of malrotation is an important factor leading to intussusception.

Journal of Pediatric Surgery Case Reports

African Journal of Paediatric Surgery, Aug 27, 2022

Journal of Indian Society of Pedodontics and Preventive Dentistry, Apr 21, 2022

We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock... more We hereby present a study of 3000 cases of renal calculi treated using ESWL (Extracorporeal Shock Wave Lithotripsy) over a period of 15 years from 2000-2014. This is a retrospective and an observational study. The lithotripter used was "Dornier Compact Alpha", a latest state of art, from Germany-a gold standard in the Extracorporeal Shock Wave Lithotripsy therapy. Ultrasound was used as a sole imaging modality, thus picking up even small and radiolucent stones in radiograph of kidney, ureter and bladder (X-ray KUB). The energy source in the lithotripter used was an electromagnetic generator with isocentric focussing technique. Our ESWL machine has a mobile therapy head and a stable patient table, thus making it versatile and convenient to treat even vesical calculi and ureteric calculi, along with large renal calculi. The results with ESWL therapy are comparable to the endoscopic surgeries with ESWL having the advantage of being non invasive and having lesser number of com...

New Indian Journal of Surgery, 2018

Objective: Cryptorchidism or undescended testes is a common birth condition in children and infan... more Objective: Cryptorchidism or undescended testes is a common birth condition in children and infants. Numerous complications can arise if untreated, but can be prevented by timely intervention. This prospective study is done to determine the epidemiological parameters of undescended testes in rural population of North Maharashtra. Methodology: This case series included 89 patients presenting to our OPD at ACPM Medical College, Dhule, From June 2014 to March 2016.Variables studied were the age of presentation, the population distribution, position of testes, size of testes and surgical outcomes. Results: Among 89 patients, over all incidence of cryptorchidism in boys in our study was found to be around 0.7% (total pediatric OPD cases were 12,714). This rate was slightly lower to similar studies conducted elsewhere. No definite etiology could be found but there are some persistent factors like socio economic status. Higher rate of cyptorchidism was noted in lower socioeconomic class. A...

Indian journal of applied research, 2018

We hereby present to you a rare case in a 7 old baby suffering from phimosis who presented to us ... more We hereby present to you a rare case in a 7 old baby suffering from phimosis who presented to us with a fistula post treatment of dorsal slit. Paraphimosis is a urologic emergency, occurring in uncircumcised males, in which the foreskin becomes trapped behind the corona and forms a tight band of constricting tissue. Often iatrogenically induced, paraphimosis can be prevented by returning the prepuce to cover the glans following penile manipulation. Treatment often begins with reduction of edema, followed by a variety of options, including mechanical compression, pharmacologic therapy, puncture technique and dorsal slit. Prevention and early intervention are key elements in the management of paraphimosis.

Indian journal of applied research, 2016

A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surger... more A 23 year old female was successfully treated for renal hydatid cyst by techniques of open surgery. A complete nephrectomy being planned initially, we performed a kidney sparing surgery (Marsupialization) and achieved complete removal of the cyst and the daughter cysts. There were no intraoperative or post operative complications. Marsupialization as a kidney sparing surgery can be performed effectively in a centre where laparoscopic facilities are not available.

We hereby present a case series of and epidemiological study on benign breast diseases among rura... more We hereby present a case series of and epidemiological study on benign breast diseases among rural population of North Maharashtra. Breast health awareness has resulted in increasing detection of early breast cancer and corresponding decrease in breast cancer morbidity. About 80% of breast biopsies result in a benign pathology. Women with a benign disorder, require treatment at some time in their lives. The concept of ANDI – Aberrations of Normal Development and Involution is gaining acceptance. This study highlights the spectrum of epidemiology of benign breast diseases in rural population.