Dr Virendra Athavale - Academia.edu (original) (raw)
Papers by Dr Virendra Athavale
International Surgery Journal, 2017
Background: Aims and objectives of the study was to study the incidence of H. pylori infection in... more Background: Aims and objectives of the study was to study the incidence of H. pylori infection in our Hospital. To find out the sensitivity and specificity of rapid urease test (RUT) and histopathological examination for the detection of H. pylori on gastric biopsy. To study the effect of anti H. pylori drugs by performing follow-up endoscopy in terms of positive or negative Rapid Urease Test and Histopathological Examination report.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 years (from July 2012-September 2014) and is a prospective and comparative randomized type of study using 100 patients. The study was approved by the Institute’s Ethics Committee.Results: Data analysis showed that: In our study 84 patients (84%) were detected positive by RUT method. In our study 83 patients (83 %) were detected positive by HPE method. There was an association between RUT and HPE finding in study group with the sensitivity b...
Indian journal of applied research, 2017
Background: Hernia surgery has undergone tremendous refinement in technique. Various methods have... more Background: Hernia surgery has undergone tremendous refinement in technique. Various methods have been advocated by different authors but each has got its own merit. Lichtenstein open inguinal meshplasty (LOIN) involved placement of a mesh over the floor of the inguinal cannel .It is a tension free repair in contrary to Bassini and Shouldice suture repair. Laparoscopic Trans-abdominal Pre-Peritoneal meshplasty (TAPP) is a newer technique which results in less post operative pain, better cosmetic result, improves recovery. e aim of the study was to compare operative time , early complication & recurrence that occurs from both laparoscopic TAPP repair and Lichtenstein repair in patients of inguinal hernia. Mathodology : e present study comprises 25 cases underwent open Lichtenstein mesh repair and 25 cases underwent laparoscopic After surgery all patients were monitored carefully for pain, bleeding, wound infection and seroma formation. Patients were followed up to one year at regul...
Rapunzel syndrome is a rare trichobezoar, involving strands of swallowed hair extending as a tail... more Rapunzel syndrome is a rare trichobezoar, involving strands of swallowed hair extending as a tail through the duodenum, beyond the stomach. Trichobezoar usually occur in patients with history of trichotillomania, characterized by compulsive behavioral disorder of pulling own hairs, combined with trichophagia that consists of ingesting that hairs. It typically occurs in the stomach and rarely affects the small intestine. Trichobezoars are more common in adolescent females. Common presentation is a gastrointestinal tract obstruction with nausea, vomiting, gut perforation, hypo chromic anemia, vitamin B12 deficiency, weight loss, an abdominal mass, or other serious problems. Trichobezoar with Rapunzel syndrome is an uncommon diagnosis in children with <40 cases reported. It is predominantly found in emotionally disturbed or mentally retarded youngsters. Trichobezoar is a rare condition that may pose a diagnostic challenge. Patients with this condition often have an underlying psychi...
Dermoid cysts (benign cystic mature teratomas) are congenital tumors consisting of derivatives fr... more Dermoid cysts (benign cystic mature teratomas) are congenital tumors consisting of derivatives from the ectoderm, endoderm and mesoderm germ cell layers. A teratoma is considered to be a non-seminomatous germ cell tumour and is typically located in either the sacrococcygeal region or in the gonads. Retroperitoneal teratomas are commonly identified in early childhood, but are rarely reported in adults (1, . They constitute less than 4% of all extra-gonadal teratomas with less than 120 cases having been reported, and only part ly described in the retroperitoneum of adults . We report here a case of a histologically unusual retroperitoneal tumour detected on magnetic resonance imaging during the workup of low backache in a 55-year-old male. The evaluation and treatment of this condition and a review of the literature are included in this paper Case Report A 55-year-old Indian male presented with a complaint of low backache radiating to right lower limb and vague abdominal discomfort lo...
International Surgery Journal, May 24, 2018
Background: Early diagnosis represents the most important measure to decrease gastric cancer mort... more Background: Early diagnosis represents the most important measure to decrease gastric cancer mortality. Endoscopists should be trained to perform standardized extremely rigorous observation with a low threshold of suspicion for neoplasia. Objective of present study was to compare the efficacy of conventional endoscopy with chromoendoscopy for the detection of gastric premalignant lesions using methylene blue. Methods: 100 cases where enrolled in present study with chronic abdominal pain more than 6 months. All patients underwent conventional endoscopy followed by chromoendoscopy. Biopsies from pylorus, body and fundus were sent for HPE. Comparative study was done between biopsies from conventional endoscopies and chromo endoscopies, Inference (sensitivity, specificity and accuracy) were drawn. Results: Out of 100 patients, 4 of the patients were positive for pre-gastric malignancy. Total 4 biopsies were positive from pylorus of which 1 biopsy was positive by conventional endoscopy and 3 were positive from chromoendoscopy. In our study sensitivity of chromoendoscopy for detection of lesions in pylorus was 25%, specificity was 100% and accuracy was 97%P=0.04 Conclusions: Chromoendoscopy is superior to conventional endoscopy in detection of pre-gastric malignancy. Chromoendoscopy could be performed in the same setup of conventional endoscopy which was relatively cheaper than the other modalities and the results were equivocal with that of other commercial modalities.
Journal of Medical Science And clinical Research, 2016
Chronic mesh infection is one of the most challenging clinical conditions in the abdominal wall s... more Chronic mesh infection is one of the most challenging clinical conditions in the abdominal wall surgery. Whether an infected mesh must be totally removed or not, the role of antibiotics, the right timing for a repair and guidelines on how to treat the abdominal wall must be discussed. Incidences of mesh-related infection after herniare pair of up to 8% have been reported. The rate of infection is influenced considerably by underlying co-morbidity, and seems to be increased in patients with diabetes, immunosuppression or obesity. A clinician should strongly consider the possibility of a mesh-related infection in any patient who presents with fever of unknown aetiology, symptoms and ⁄ or signs of inflammation of the abdominal wall in the area of the mesh, or other less common clinical manifestations of mesh infection, such as an enterocutaneous fistula or abdominal abscess in the area of the mesh. Imaging techniques, including ultrasound and ⁄ or computerised tomography, can be useful for the diagnosis of mesh infection. When a mesh-related infection occurs, a combined medical and surgical approach involving intravenous antimicrobial agents and complete surgical removal of the mesh is the preferred management strategy.
CHRISMED Journal of Health and Research, 2016
A hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared... more A hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared to detect them and apply the appropriate treatment. We retrospectively studied twenty patients with inguinal swellings who were admitted to our surgical department over a 2-year period including patients without a definitive diagnosis of inguinal hernia upon admission. Our aim was to present our experience with the unexpected findings during inguinal hernia surgery, either unusual hernial contents or pathologic entities, such as neoplastic masses, masquerading as a hernia.
Sudan Medical Monitor, 2015
Incidence of abdominal trauma is on an increasing trend but abdominal content herniation due to b... more Incidence of abdominal trauma is on an increasing trend but abdominal content herniation due to blunt trauma is rare. Traumatic disruption of the abdominal wall has only about 50 reports worldwide, and only one from India. We report here a case of 65 year old male who underwent blunt trauma due to bull horn injury and presented with a swelling in the left lumbar quadrant of anterior abdominal wall, without as much as an abrasion on the overlying skin. We conclude that a low impact, prolonged presentation, case of traumatic abdominal wall hernia can be managed electively by open anatomical repair.
Tropical Journal of Medical Research, 2015
Schawannomas (neuromas, neurilemmomas) are benign tumors originating from Schwann cells or nerve ... more Schawannomas (neuromas, neurilemmomas) are benign tumors originating from Schwann cells or nerve fiber sheet cells. They are solitary, encapsulated tumors usually attached to, or surrounded by, a nerve. Most schwannomas of the hypoglossal nerve originate from the intracranial portion, but they may extend extracranially. Solitary and extracranial schwannomas are extremely rare. The peripheral hypoglossal schwannomas are extremely rare. Treatment of these tumors depends on the extension of the tumor. We present the case of a 44-year-old male with swelling over left submandibular region. Patient was successfully treated surgically.
Archives of Medicine and Health Sciences, 2015
Saree cancer is a type of skin cancer that occurs along the waistline of Indian women wearing the... more Saree cancer is a type of skin cancer that occurs along the waistline of Indian women wearing the traditional costume of ′saree′. The incidence of malignancy in scar tissues is 0.1-2.5%. Highly hypopigmented and thickened scars are more likely to progress into malignant lesions. Khanolkar and Suryabai described a new type of skin cancer - ′dhoti cancer′ in 1945. Persistent and long term use results in chronic friction/irritation in the region of waist which in term leads to waist-dermatosis.
Thyroid Research and Practice, 2014
A thyroid abscess is an infrequently encountered condition with a rarity that is attributable to ... more A thyroid abscess is an infrequently encountered condition with a rarity that is attributable to anatomic and physiologic characteristics of the gland that impart a unique quality of infection resistance. The differential diagnosis for a painful thyroid is limited, with sub-acute and chronic thyroiditis being the most often-encountered processes. Acute suppurative thyroiditis with abscess formation, although rare, is a formidable clinical scenario with morbid complications. The common causative organisms responsible for thyroid abscess are Staphylococci and Streptococci species. We describe a case of thyroid abscess due to methicillin resistant Staphylococcus aureus in young female. The patient was successfully treated with open surgical drainage and appropriate antimicrobial agents.
Medical Journal of Dr. D.Y. Patil University, 2014
Aim: The aim was to study the 3-year epidemiological trend of acute appendicitis in a rural setup... more Aim: The aim was to study the 3-year epidemiological trend of acute appendicitis in a rural setup. Materials and Methods: This is a retrospective study of patients who were admitted with a diagnosis of appendicitis over a period of 3 years excluding negative appendectomy cases. Totally, 130 cases were diagnosed as an acute appendicitis, on clinical suspicion and investigations during this period. We reviewed and studied these cases regarding incidence of appendicitis in different age groups, sex, according to dietary pattern and seasonal trend. Results: Occurrence of appendicitis was the highest in the 11-20 years age group which constituted 44.6%. Followed by 21-30 years age group, which constituted 36.1%. The incidence of appendicitis between the age group 31 and 40 years constituted 11.5% while between 0 and 10 years age group was 3%. Between 41-50 years and 51-75 years of age group 2.3% each. The youngest case recorded was 8 years of age and the oldest 65 years of age. In this study occurrence of appendicitis in both male and female was almost equal. Nonvegetarians were affected more than vegetarians. The occurrence of appendicitis was peak in the spring and low in the summer. Conclusion: Acute appendicitis should be suspected irrespective of age, sex and socioeconomic status of individual. Age-specific occurrence, sex ratio of appendicitis give the impression that epidemiologic features of acute appendicitis are different with worldwide data. It is difficult to diagnose appendicitis in young children, young women and elderly people. Total leukocyte count, urine microscopy, ultrasonography and computed tomography abdomen should be used as a diagnostic aid in doubtful cases in association with physical findings, but it does not replace the clinical skills of a general surgeon.
Medical Journal of Dr. D.Y. Patil University, 2014
Purpose: Acute soft tissue abscess is a very common condition. This study was undertaken to compa... more Purpose: Acute soft tissue abscess is a very common condition. This study was undertaken to compare the outcome of conventional incision and drainage versus incision and drainage with primary closure of wound in acute abscesses with regards to better healing rate, less postoperative pain, less hospital stay, low cost of treatment, and less recurrence rate. Introduction: Acute soft tissue abscesses are common conditions in surgical practice. The established principle of surgical management of abscesses has been incision and drainage. This modality of treatment has been challenged with the introduction of antibiotics. The aim of our study was to compare the conventional method of incision and drainage with the alternative method of incision and drainage with primary closure and negative suction drain. Materials and Methods: In our study, 100 patients admitted with superficial abscess excluding patient suffering from systemic diseases. Deep seated abscesses (e.g., intra-abdominal abscess, pelvic), abscess cavity of internal diameter of >5 cm. Patients were randomly divided into two groups. Group A included 50 patients treated by conventional incision and drainage; Group B included 50 patients treated by the incision and drainage with Primary closure and negative suction drain. Patient were assessed during the hospital stay and follow-up on following criteria for postoperative pain by visual analog score, days of hospital stay, wound healing, treatment cost and recurrence. Results: A total of 100 patients were randomized to primary or secondary closure. The time of wound healing, length of hospital stay and postoperative pain were less for Group B patients than in Group A patients. Results found significant pertaining to wound healing, postoperative pain, days of hospital stay treatment cost and recurrence in Group B than Group A. Conclusion: In our study, incision and drainage with primary closure combined with use negative suction drain is more effective than that of incision and drain.
Medical Journal of Dr. D.Y. Patil University, 2014
Medical Journal of Dr. D.Y. Patil University, 2014
Background: Twenty seven patients of perforated duodenal ulcer admitted in our institution betwee... more Background: Twenty seven patients of perforated duodenal ulcer admitted in our institution between December 2010 and November 2012 were treated and studied Material and Methods: All patients were diagnosed on the basis of clinical and radiological findings, exploratory laparotomy was performed and simple closure of perforation with placement of Graham's omental patch was carried out. This was followed by triple regimen for H .pylori eradication. Results: All patients were male, maximum incidence (61.54%) was noted in the age group of 21 to 30,O+ve blood group was most commonly observed in our patients. Eight patients had history suggestive of acute acid peptic disease. Mean time interval between start of symptoms and surgery was 43 hrs. No morbidity except minimal pleural effusion was seen in one case. There was no mortality in our series. Conclusion: We conclude that although a number of definitive surgeries have been described for acid peptic disease but requirement of such procedures has come down due to increasing use of H. pylori eradication therapy and proton pump inhibitors. However surgery for complications especially for duodenal ulcer perforation has not reduced concomitantly. Incidence has been greater in young males. Nowadays perforations are seen more in acute peptic ulcer disease. NSAID is one of the contributing etiological factors. Early diagnosis and timely management is advocated to reduce morbidity and mortality.
Medical Journal of Dr. D.Y. Patil University, 2014
Sebaceous carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. This arises ... more Sebaceous carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. This arises mostly from sebaceous glands in the skin and thus may arise anywhere in the body where these glands exist. Approximately, 75% of these tumors arise in the periocular region, which is rich in sebaceous glands. Fewer than 120 cases of sebaceous cell carcinoma have been reported at the extraocular sites as in our case.
Indian Journal of Surgery, 2011
Abdominal masses have always been a dilemma for the surgeons and this problem is more so in retro... more Abdominal masses have always been a dilemma for the surgeons and this problem is more so in retroperitoneal masses. In our case, the patient presented with retroperitoneal mass in the left lumbar region with no other specific local or systemic symptoms. The diagnosis of Castleman's disease was established only after histopathological examination of the mass after resection. Castleman's disease is an angiofollicular lymph node hyperplasia presenting either as a localized or a systemic disease. In our case, the patient presented with the localized form of the disease and as it is a rare presentation we are presenting this case.
Medical Journal of Dr. D.Y. Patil University, 2014
A prospective study on early enteral feeding v/s Nil by mouth was done on 74 patients in two grou... more A prospective study on early enteral feeding v/s Nil by mouth was done on 74 patients in two groups. The study mainly focused on incidence of surgical site infection, post-operative complications, such as pulmonary complications, anastomotic leakage, abdominal distension, vomiting, and cost of treatment in both groups. It was observed that maximum patients in our study were in the age group of 31-40 years with male preponderance having an average of 12 gm % hemoglobin levels and average BMI of 23, which were divided in two groups. In our study, early enteral feeding has less incidence of surgical site infection with most infection by Klebsiella pneumonia in both groups, clinically less complications and less cost incurred. The incidence of vomiting was increased in early enteral fed group but did not lead to cessation of feeding. Early mobilization of patient and early establishment of bowel sounds are the other factors noticed in patients of early enteral fed groups in our study. Cost of treatment is emphasized in our study. Myth of patients keeping nil by mouth after surgery is to be discouraged. Early enteral feeding enhances recovery and can be safely given after all major gastrointestinal surgeries.
Medical Journal of Dr. D.Y. Patil University, 2014
Background : Chronic wounds, especially non-healing types, are one of the most common surgical co... more Background : Chronic wounds, especially non-healing types, are one of the most common surgical conditions a surgeon comes across. The peculiarity of a chronic wound is that, whatever management you give, they refuse to heal, especially the pressure ulcers or bed sores. Many therapeutic methods are available to effect wound healing such as topical application of insulin, growth factors, negative pressure-assisted wound closure, oxidized regenerated cellulose/collagen, hyaluronic acid conjugated with glycidyl methacrylate or gelatin dressings. A less clinically and economically complicated approach to healing chronic wounds seems necessary. Objectives: To study the efficacy of topical use of insulin in wound healing in following terms:-(1) rate of wound healing; (2) safety evaluation; (3) hospital stay. Materials and Methods: This was a prospective study carried out in a tertiary health centre from July 2010 to September 2012 in 50 patients after taking an informed and written consent of the patients having chronic ulcer. All the patients who were satisfying inclusion/exclusion criteria patient were randomized into two groups, Group A and Group B. Each group was again sub-divided into 1 and 2 i.e. sub-group A1, A2 and sub-group B1, B2. Patients with diabetes were grouped as A1 and B1 and non-diabetic patients were grouped as A2 and B2. Group A patients were treated with insulin dressings and Group B patient's ulcers were treated with normal saline dressings. Ulcer size and healing was recorded on weekly basis. Strict glycemic control was maintained in all diabetic patients. Results were compared at complete healing or at the end of 12 weeks which ever was earlier. Results: Our study included both diabetic and non-diabetic patients. There was no significant change in BSL(R) values after use of insulin on wounds. The number of days required for wound healing in Group A patients in both subgroups (A1 and A2) was significantly less as compared to Group B (B1 and B2). The mean rate of healing of wounds was much faster in Group A as compared to Group B. The hospital stay in Group A patients was significantly less than Group B. Conclusion: The use of topical Insulin strongly suggests accelerated wound healing in chronic ulcer. Topical insulin in chronic ulcer is safe and effective without any systemic side effect. Topical insulin significantly reduces the hospital stay of patients with chronic ulcers. Early return to work decreased economical load.
Medical Journal of Dr. D.Y. Patil University, 2014
The incidence of tuberculosis is high in developing country; primary tuberculosis of breast is ex... more The incidence of tuberculosis is high in developing country; primary tuberculosis of breast is extremely rare, 3-4% of all breast lesions. Tuberculosis of breast often mimics breast cancers clinically. We are reporting here three cases of primary tuberculosis of breast presented with painless breast lump. Diagnosis was difficult and made by several parameters in different cases. Made by excision biopsy or the presence of acid-fast bacilli or Tuberculin test or Fine needle aspiration cytology of breast lump depending upon the cases. All the patients responded well to anti-tubercular regimen.
International Surgery Journal, 2017
Background: Aims and objectives of the study was to study the incidence of H. pylori infection in... more Background: Aims and objectives of the study was to study the incidence of H. pylori infection in our Hospital. To find out the sensitivity and specificity of rapid urease test (RUT) and histopathological examination for the detection of H. pylori on gastric biopsy. To study the effect of anti H. pylori drugs by performing follow-up endoscopy in terms of positive or negative Rapid Urease Test and Histopathological Examination report.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital, DPU University, for a period of 2 years (from July 2012-September 2014) and is a prospective and comparative randomized type of study using 100 patients. The study was approved by the Institute’s Ethics Committee.Results: Data analysis showed that: In our study 84 patients (84%) were detected positive by RUT method. In our study 83 patients (83 %) were detected positive by HPE method. There was an association between RUT and HPE finding in study group with the sensitivity b...
Indian journal of applied research, 2017
Background: Hernia surgery has undergone tremendous refinement in technique. Various methods have... more Background: Hernia surgery has undergone tremendous refinement in technique. Various methods have been advocated by different authors but each has got its own merit. Lichtenstein open inguinal meshplasty (LOIN) involved placement of a mesh over the floor of the inguinal cannel .It is a tension free repair in contrary to Bassini and Shouldice suture repair. Laparoscopic Trans-abdominal Pre-Peritoneal meshplasty (TAPP) is a newer technique which results in less post operative pain, better cosmetic result, improves recovery. e aim of the study was to compare operative time , early complication & recurrence that occurs from both laparoscopic TAPP repair and Lichtenstein repair in patients of inguinal hernia. Mathodology : e present study comprises 25 cases underwent open Lichtenstein mesh repair and 25 cases underwent laparoscopic After surgery all patients were monitored carefully for pain, bleeding, wound infection and seroma formation. Patients were followed up to one year at regul...
Rapunzel syndrome is a rare trichobezoar, involving strands of swallowed hair extending as a tail... more Rapunzel syndrome is a rare trichobezoar, involving strands of swallowed hair extending as a tail through the duodenum, beyond the stomach. Trichobezoar usually occur in patients with history of trichotillomania, characterized by compulsive behavioral disorder of pulling own hairs, combined with trichophagia that consists of ingesting that hairs. It typically occurs in the stomach and rarely affects the small intestine. Trichobezoars are more common in adolescent females. Common presentation is a gastrointestinal tract obstruction with nausea, vomiting, gut perforation, hypo chromic anemia, vitamin B12 deficiency, weight loss, an abdominal mass, or other serious problems. Trichobezoar with Rapunzel syndrome is an uncommon diagnosis in children with <40 cases reported. It is predominantly found in emotionally disturbed or mentally retarded youngsters. Trichobezoar is a rare condition that may pose a diagnostic challenge. Patients with this condition often have an underlying psychi...
Dermoid cysts (benign cystic mature teratomas) are congenital tumors consisting of derivatives fr... more Dermoid cysts (benign cystic mature teratomas) are congenital tumors consisting of derivatives from the ectoderm, endoderm and mesoderm germ cell layers. A teratoma is considered to be a non-seminomatous germ cell tumour and is typically located in either the sacrococcygeal region or in the gonads. Retroperitoneal teratomas are commonly identified in early childhood, but are rarely reported in adults (1, . They constitute less than 4% of all extra-gonadal teratomas with less than 120 cases having been reported, and only part ly described in the retroperitoneum of adults . We report here a case of a histologically unusual retroperitoneal tumour detected on magnetic resonance imaging during the workup of low backache in a 55-year-old male. The evaluation and treatment of this condition and a review of the literature are included in this paper Case Report A 55-year-old Indian male presented with a complaint of low backache radiating to right lower limb and vague abdominal discomfort lo...
International Surgery Journal, May 24, 2018
Background: Early diagnosis represents the most important measure to decrease gastric cancer mort... more Background: Early diagnosis represents the most important measure to decrease gastric cancer mortality. Endoscopists should be trained to perform standardized extremely rigorous observation with a low threshold of suspicion for neoplasia. Objective of present study was to compare the efficacy of conventional endoscopy with chromoendoscopy for the detection of gastric premalignant lesions using methylene blue. Methods: 100 cases where enrolled in present study with chronic abdominal pain more than 6 months. All patients underwent conventional endoscopy followed by chromoendoscopy. Biopsies from pylorus, body and fundus were sent for HPE. Comparative study was done between biopsies from conventional endoscopies and chromo endoscopies, Inference (sensitivity, specificity and accuracy) were drawn. Results: Out of 100 patients, 4 of the patients were positive for pre-gastric malignancy. Total 4 biopsies were positive from pylorus of which 1 biopsy was positive by conventional endoscopy and 3 were positive from chromoendoscopy. In our study sensitivity of chromoendoscopy for detection of lesions in pylorus was 25%, specificity was 100% and accuracy was 97%P=0.04 Conclusions: Chromoendoscopy is superior to conventional endoscopy in detection of pre-gastric malignancy. Chromoendoscopy could be performed in the same setup of conventional endoscopy which was relatively cheaper than the other modalities and the results were equivocal with that of other commercial modalities.
Journal of Medical Science And clinical Research, 2016
Chronic mesh infection is one of the most challenging clinical conditions in the abdominal wall s... more Chronic mesh infection is one of the most challenging clinical conditions in the abdominal wall surgery. Whether an infected mesh must be totally removed or not, the role of antibiotics, the right timing for a repair and guidelines on how to treat the abdominal wall must be discussed. Incidences of mesh-related infection after herniare pair of up to 8% have been reported. The rate of infection is influenced considerably by underlying co-morbidity, and seems to be increased in patients with diabetes, immunosuppression or obesity. A clinician should strongly consider the possibility of a mesh-related infection in any patient who presents with fever of unknown aetiology, symptoms and ⁄ or signs of inflammation of the abdominal wall in the area of the mesh, or other less common clinical manifestations of mesh infection, such as an enterocutaneous fistula or abdominal abscess in the area of the mesh. Imaging techniques, including ultrasound and ⁄ or computerised tomography, can be useful for the diagnosis of mesh infection. When a mesh-related infection occurs, a combined medical and surgical approach involving intravenous antimicrobial agents and complete surgical removal of the mesh is the preferred management strategy.
CHRISMED Journal of Health and Research, 2016
A hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared... more A hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared to detect them and apply the appropriate treatment. We retrospectively studied twenty patients with inguinal swellings who were admitted to our surgical department over a 2-year period including patients without a definitive diagnosis of inguinal hernia upon admission. Our aim was to present our experience with the unexpected findings during inguinal hernia surgery, either unusual hernial contents or pathologic entities, such as neoplastic masses, masquerading as a hernia.
Sudan Medical Monitor, 2015
Incidence of abdominal trauma is on an increasing trend but abdominal content herniation due to b... more Incidence of abdominal trauma is on an increasing trend but abdominal content herniation due to blunt trauma is rare. Traumatic disruption of the abdominal wall has only about 50 reports worldwide, and only one from India. We report here a case of 65 year old male who underwent blunt trauma due to bull horn injury and presented with a swelling in the left lumbar quadrant of anterior abdominal wall, without as much as an abrasion on the overlying skin. We conclude that a low impact, prolonged presentation, case of traumatic abdominal wall hernia can be managed electively by open anatomical repair.
Tropical Journal of Medical Research, 2015
Schawannomas (neuromas, neurilemmomas) are benign tumors originating from Schwann cells or nerve ... more Schawannomas (neuromas, neurilemmomas) are benign tumors originating from Schwann cells or nerve fiber sheet cells. They are solitary, encapsulated tumors usually attached to, or surrounded by, a nerve. Most schwannomas of the hypoglossal nerve originate from the intracranial portion, but they may extend extracranially. Solitary and extracranial schwannomas are extremely rare. The peripheral hypoglossal schwannomas are extremely rare. Treatment of these tumors depends on the extension of the tumor. We present the case of a 44-year-old male with swelling over left submandibular region. Patient was successfully treated surgically.
Archives of Medicine and Health Sciences, 2015
Saree cancer is a type of skin cancer that occurs along the waistline of Indian women wearing the... more Saree cancer is a type of skin cancer that occurs along the waistline of Indian women wearing the traditional costume of ′saree′. The incidence of malignancy in scar tissues is 0.1-2.5%. Highly hypopigmented and thickened scars are more likely to progress into malignant lesions. Khanolkar and Suryabai described a new type of skin cancer - ′dhoti cancer′ in 1945. Persistent and long term use results in chronic friction/irritation in the region of waist which in term leads to waist-dermatosis.
Thyroid Research and Practice, 2014
A thyroid abscess is an infrequently encountered condition with a rarity that is attributable to ... more A thyroid abscess is an infrequently encountered condition with a rarity that is attributable to anatomic and physiologic characteristics of the gland that impart a unique quality of infection resistance. The differential diagnosis for a painful thyroid is limited, with sub-acute and chronic thyroiditis being the most often-encountered processes. Acute suppurative thyroiditis with abscess formation, although rare, is a formidable clinical scenario with morbid complications. The common causative organisms responsible for thyroid abscess are Staphylococci and Streptococci species. We describe a case of thyroid abscess due to methicillin resistant Staphylococcus aureus in young female. The patient was successfully treated with open surgical drainage and appropriate antimicrobial agents.
Medical Journal of Dr. D.Y. Patil University, 2014
Aim: The aim was to study the 3-year epidemiological trend of acute appendicitis in a rural setup... more Aim: The aim was to study the 3-year epidemiological trend of acute appendicitis in a rural setup. Materials and Methods: This is a retrospective study of patients who were admitted with a diagnosis of appendicitis over a period of 3 years excluding negative appendectomy cases. Totally, 130 cases were diagnosed as an acute appendicitis, on clinical suspicion and investigations during this period. We reviewed and studied these cases regarding incidence of appendicitis in different age groups, sex, according to dietary pattern and seasonal trend. Results: Occurrence of appendicitis was the highest in the 11-20 years age group which constituted 44.6%. Followed by 21-30 years age group, which constituted 36.1%. The incidence of appendicitis between the age group 31 and 40 years constituted 11.5% while between 0 and 10 years age group was 3%. Between 41-50 years and 51-75 years of age group 2.3% each. The youngest case recorded was 8 years of age and the oldest 65 years of age. In this study occurrence of appendicitis in both male and female was almost equal. Nonvegetarians were affected more than vegetarians. The occurrence of appendicitis was peak in the spring and low in the summer. Conclusion: Acute appendicitis should be suspected irrespective of age, sex and socioeconomic status of individual. Age-specific occurrence, sex ratio of appendicitis give the impression that epidemiologic features of acute appendicitis are different with worldwide data. It is difficult to diagnose appendicitis in young children, young women and elderly people. Total leukocyte count, urine microscopy, ultrasonography and computed tomography abdomen should be used as a diagnostic aid in doubtful cases in association with physical findings, but it does not replace the clinical skills of a general surgeon.
Medical Journal of Dr. D.Y. Patil University, 2014
Purpose: Acute soft tissue abscess is a very common condition. This study was undertaken to compa... more Purpose: Acute soft tissue abscess is a very common condition. This study was undertaken to compare the outcome of conventional incision and drainage versus incision and drainage with primary closure of wound in acute abscesses with regards to better healing rate, less postoperative pain, less hospital stay, low cost of treatment, and less recurrence rate. Introduction: Acute soft tissue abscesses are common conditions in surgical practice. The established principle of surgical management of abscesses has been incision and drainage. This modality of treatment has been challenged with the introduction of antibiotics. The aim of our study was to compare the conventional method of incision and drainage with the alternative method of incision and drainage with primary closure and negative suction drain. Materials and Methods: In our study, 100 patients admitted with superficial abscess excluding patient suffering from systemic diseases. Deep seated abscesses (e.g., intra-abdominal abscess, pelvic), abscess cavity of internal diameter of >5 cm. Patients were randomly divided into two groups. Group A included 50 patients treated by conventional incision and drainage; Group B included 50 patients treated by the incision and drainage with Primary closure and negative suction drain. Patient were assessed during the hospital stay and follow-up on following criteria for postoperative pain by visual analog score, days of hospital stay, wound healing, treatment cost and recurrence. Results: A total of 100 patients were randomized to primary or secondary closure. The time of wound healing, length of hospital stay and postoperative pain were less for Group B patients than in Group A patients. Results found significant pertaining to wound healing, postoperative pain, days of hospital stay treatment cost and recurrence in Group B than Group A. Conclusion: In our study, incision and drainage with primary closure combined with use negative suction drain is more effective than that of incision and drain.
Medical Journal of Dr. D.Y. Patil University, 2014
Medical Journal of Dr. D.Y. Patil University, 2014
Background: Twenty seven patients of perforated duodenal ulcer admitted in our institution betwee... more Background: Twenty seven patients of perforated duodenal ulcer admitted in our institution between December 2010 and November 2012 were treated and studied Material and Methods: All patients were diagnosed on the basis of clinical and radiological findings, exploratory laparotomy was performed and simple closure of perforation with placement of Graham's omental patch was carried out. This was followed by triple regimen for H .pylori eradication. Results: All patients were male, maximum incidence (61.54%) was noted in the age group of 21 to 30,O+ve blood group was most commonly observed in our patients. Eight patients had history suggestive of acute acid peptic disease. Mean time interval between start of symptoms and surgery was 43 hrs. No morbidity except minimal pleural effusion was seen in one case. There was no mortality in our series. Conclusion: We conclude that although a number of definitive surgeries have been described for acid peptic disease but requirement of such procedures has come down due to increasing use of H. pylori eradication therapy and proton pump inhibitors. However surgery for complications especially for duodenal ulcer perforation has not reduced concomitantly. Incidence has been greater in young males. Nowadays perforations are seen more in acute peptic ulcer disease. NSAID is one of the contributing etiological factors. Early diagnosis and timely management is advocated to reduce morbidity and mortality.
Medical Journal of Dr. D.Y. Patil University, 2014
Sebaceous carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. This arises ... more Sebaceous carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. This arises mostly from sebaceous glands in the skin and thus may arise anywhere in the body where these glands exist. Approximately, 75% of these tumors arise in the periocular region, which is rich in sebaceous glands. Fewer than 120 cases of sebaceous cell carcinoma have been reported at the extraocular sites as in our case.
Indian Journal of Surgery, 2011
Abdominal masses have always been a dilemma for the surgeons and this problem is more so in retro... more Abdominal masses have always been a dilemma for the surgeons and this problem is more so in retroperitoneal masses. In our case, the patient presented with retroperitoneal mass in the left lumbar region with no other specific local or systemic symptoms. The diagnosis of Castleman's disease was established only after histopathological examination of the mass after resection. Castleman's disease is an angiofollicular lymph node hyperplasia presenting either as a localized or a systemic disease. In our case, the patient presented with the localized form of the disease and as it is a rare presentation we are presenting this case.
Medical Journal of Dr. D.Y. Patil University, 2014
A prospective study on early enteral feeding v/s Nil by mouth was done on 74 patients in two grou... more A prospective study on early enteral feeding v/s Nil by mouth was done on 74 patients in two groups. The study mainly focused on incidence of surgical site infection, post-operative complications, such as pulmonary complications, anastomotic leakage, abdominal distension, vomiting, and cost of treatment in both groups. It was observed that maximum patients in our study were in the age group of 31-40 years with male preponderance having an average of 12 gm % hemoglobin levels and average BMI of 23, which were divided in two groups. In our study, early enteral feeding has less incidence of surgical site infection with most infection by Klebsiella pneumonia in both groups, clinically less complications and less cost incurred. The incidence of vomiting was increased in early enteral fed group but did not lead to cessation of feeding. Early mobilization of patient and early establishment of bowel sounds are the other factors noticed in patients of early enteral fed groups in our study. Cost of treatment is emphasized in our study. Myth of patients keeping nil by mouth after surgery is to be discouraged. Early enteral feeding enhances recovery and can be safely given after all major gastrointestinal surgeries.
Medical Journal of Dr. D.Y. Patil University, 2014
Background : Chronic wounds, especially non-healing types, are one of the most common surgical co... more Background : Chronic wounds, especially non-healing types, are one of the most common surgical conditions a surgeon comes across. The peculiarity of a chronic wound is that, whatever management you give, they refuse to heal, especially the pressure ulcers or bed sores. Many therapeutic methods are available to effect wound healing such as topical application of insulin, growth factors, negative pressure-assisted wound closure, oxidized regenerated cellulose/collagen, hyaluronic acid conjugated with glycidyl methacrylate or gelatin dressings. A less clinically and economically complicated approach to healing chronic wounds seems necessary. Objectives: To study the efficacy of topical use of insulin in wound healing in following terms:-(1) rate of wound healing; (2) safety evaluation; (3) hospital stay. Materials and Methods: This was a prospective study carried out in a tertiary health centre from July 2010 to September 2012 in 50 patients after taking an informed and written consent of the patients having chronic ulcer. All the patients who were satisfying inclusion/exclusion criteria patient were randomized into two groups, Group A and Group B. Each group was again sub-divided into 1 and 2 i.e. sub-group A1, A2 and sub-group B1, B2. Patients with diabetes were grouped as A1 and B1 and non-diabetic patients were grouped as A2 and B2. Group A patients were treated with insulin dressings and Group B patient's ulcers were treated with normal saline dressings. Ulcer size and healing was recorded on weekly basis. Strict glycemic control was maintained in all diabetic patients. Results were compared at complete healing or at the end of 12 weeks which ever was earlier. Results: Our study included both diabetic and non-diabetic patients. There was no significant change in BSL(R) values after use of insulin on wounds. The number of days required for wound healing in Group A patients in both subgroups (A1 and A2) was significantly less as compared to Group B (B1 and B2). The mean rate of healing of wounds was much faster in Group A as compared to Group B. The hospital stay in Group A patients was significantly less than Group B. Conclusion: The use of topical Insulin strongly suggests accelerated wound healing in chronic ulcer. Topical insulin in chronic ulcer is safe and effective without any systemic side effect. Topical insulin significantly reduces the hospital stay of patients with chronic ulcers. Early return to work decreased economical load.
Medical Journal of Dr. D.Y. Patil University, 2014
The incidence of tuberculosis is high in developing country; primary tuberculosis of breast is ex... more The incidence of tuberculosis is high in developing country; primary tuberculosis of breast is extremely rare, 3-4% of all breast lesions. Tuberculosis of breast often mimics breast cancers clinically. We are reporting here three cases of primary tuberculosis of breast presented with painless breast lump. Diagnosis was difficult and made by several parameters in different cases. Made by excision biopsy or the presence of acid-fast bacilli or Tuberculin test or Fine needle aspiration cytology of breast lump depending upon the cases. All the patients responded well to anti-tubercular regimen.