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Papers by Dr pawan Agarwal

Research paper thumbnail of Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool “EMERGE”

Indian Journal of Surgery

The theoretical danger of virus transmission during laparoscopic surgery (LS) via surgical smoke ... more The theoretical danger of virus transmission during laparoscopic surgery (LS) via surgical smoke and laparoscopy gas has led to the formulation of many guidelines during the COVID-19 pandemic. This rapid scoping review of these guidelines was done to assess the quality of their evidence and appraise them for their impact on surgical services from the global south. A simple quality appraisal tool was constructed which can be used to evaluate rapidly emerging guidelines for evidence as well as for the needs of the global south. This rapid scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. Electronic databases were searched with predefined strategy and retrieved papers were screened according to relevant criteria. A simple objective tool to assess the quality of rapidly emerging guidelines including evidence, methodology, ease, resource optimization, geography, and the economy was constructed. Twenty studies met the inclusion criteria. None of the guidelines qualified to be evidence-based clinical practice guidelines as the level of evidence was uniformly rated "low". A newly constructed tool showed good validation, reliability, and internal consistency. This rapid scoping review found two major research gaps: lack of systematic review of evidence during their development and insufficient weightage of their impact on surgical services from the global south. These significant issues were addressed by constructing a simple and more representative tool for evaluating rapidly emerging guidelines which also gives the rightful importance of their impact on surgical services from the global south.

Research paper thumbnail of Simple Modification in Wiring for Efficient Application of Arch Bar to Achieve Intermaxillary Fixation

Indian Journal of Plastic Surgery

Research paper thumbnail of Low-cost procedure for deformity correction in rheumatoid hands

Scottish Medical Journal

Background Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumato... more Background Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumatoid arthritis (RA) is conventionally done by silicon joint arthroplasty which is expensive and may be associated with many complications. We report the outcome of low-cost autologous interpositional arthroplasty. Material and methods Five patients (8 hands, 32 arthroplasties) underwent correction of ulnar drift of MPJ by dorsal capsule interpositional arthroplasty. Results were assessed according to the degree of recovery of movement at the MPJ and correction of ulnar drift. Functional improvement was graded as excellent, good and fair. Pain alleviation was assessed by visual analogue score (VAS) score. Results Excellent results were seen in 3 patients (5 hands, 20 arthroplasties), good in 1 patient (2 hands, 8 arthroplasties) and fair in 1 patient (1 hand, 4 arthroplasties). VAS score for pain decreased from mean preoperative 8.2/10 to 1/10. On average follow up of 1.4 years there was go...

Research paper thumbnail of Ordinary PVC feeding tube: A low-cost alternative to silicon rod for staged flexor tendon reconstruction in zone II of hand

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Assessment of collateral hand circulation by modified Allen’s test in normal Indian subjects

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Roadmap for Restarting Elective Surgery During/After COVID-19 Pandemic

Indian Journal of Surgery

Research paper thumbnail of Tibialis posterior (TP) tendon transfer for foot drop: A single center experience

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

Indian Journal of Plastic Surgery

ABSTRACTSevere post burn neck contracture results in difficult intubation, which can be life thre... more ABSTRACTSevere post burn neck contracture results in difficult intubation, which can be life threatening and can result in multiple serious complications and sequels. Thirty patients with age ranging from 12 to 50 years were operated under local tumescent anesthesia supplemented with intravenous ketamine for release of post burn neck contracture and split skin grafted. This technique obviates the need for endotracheal intubation. There were no complications attributed to this anesthesia technique. There was no graft loss and blood loss was minimal.

Research paper thumbnail of Perception of plastic surgery in the society

Indian Journal of Plastic Surgery

ABSTRACTThe perception of plastic surgery in society is limited and underestimates the versatilit... more ABSTRACTThe perception of plastic surgery in society is limited and underestimates the versatility of the specialty. A survey was conducted in order to assess knowledge and to provide some initial evidence for education about the scope of plastic surgery amongst the public, medical and nursing students and general practitioners. A questionnaire was devised and four population groups of respondents were surveyed at random in one district. The results reveal that the majority of the public needs more information about the benefits that our specialty can offer them. Plastic surgeons are mainly associated with burns and cosmetic surgery and they are not necessarily identified as primary surgeons for procedures fundamental to our specialty. If patients are to receive the best treatment available, it is essential that we educate the public about our clinical interests and activities.

Research paper thumbnail of Prophylactic mesh placement for emergency midline laparotomy in peptic perforation peritonitis: A prospective observational study of short term results

Research paper thumbnail of Tarsal tunnel release restores sensations in sole for diabetic sensorimotor polyneuropathy

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Orthoplastic surgery: Need of the hour

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Huntington's procedure revisited

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Retraction of edge of rectus sheath after midline laparotomy

Research paper thumbnail of Sciatic Nerve to Pudendal Nerve Transfer: Anatomical Feasibility for a New Proposed Technique

Indian Journal of Plastic Surgery

Aim Restoration of bladder and bowel continence after pudendal nerve anastomosis has been shown s... more Aim Restoration of bladder and bowel continence after pudendal nerve anastomosis has been shown successfully in animal models and may be applicable in humans. Aim of this cadaveric study was to assess feasibility of pudendal nerve neurotization using motor fascicles from sciatic nerve. Methods Pudendal and sciatic nerves were exposed via gluteal approach in 5 human cadavers (10 sites). Size of pudendal and sciatic nerves and the distance between two nerves was measured. Results There were four male and one female cadavers. Mean age was 62 (range, 50–70) years. Mean pudendal nerve diameter was 2.94 mm (right side) and 2.82 mm (left side). Mean sciatic nerve diameter was 11.2 mm (right side) and 14.2 mm (left side). The distance between two nerves was 23.4 mm on both sides. Conclusion Transfer of the motor fascicles from sciatic nerve to pudendal nerve to restore the bladder and bowel continence is feasible.

Research paper thumbnail of “What do surgeons think about just before an operation while scrubbing?”

Research paper thumbnail of Thermometry: A simple objective method for burn depth assessment

Research paper thumbnail of Congenital palatal fistula: an isolated entity

European Journal of Plastic Surgery

Traumatic and postoperative palatal fistulae are common, but congenital palatal fistula is the ra... more Traumatic and postoperative palatal fistulae are common, but congenital palatal fistula is the rarest of all deformities. A case of isolated congenital palatal fistula is reported with an attempt to correlate the presented malformation with embryologic development of the palate.

Research paper thumbnail of Saphenous nerve transfer: A new approach to restore sensation of the sole

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of Detrusor Myoplasty for Acontractile/Hypocontractile Bladder in Spinal Cord Injury Patients

Journal of Neurology & Neuromedicine

Research paper thumbnail of Rapid Scoping Review of Laparoscopic Surgery Guidelines During the COVID-19 Pandemic and Appraisal Using a Simple Quality Appraisal Tool “EMERGE”

Indian Journal of Surgery

The theoretical danger of virus transmission during laparoscopic surgery (LS) via surgical smoke ... more The theoretical danger of virus transmission during laparoscopic surgery (LS) via surgical smoke and laparoscopy gas has led to the formulation of many guidelines during the COVID-19 pandemic. This rapid scoping review of these guidelines was done to assess the quality of their evidence and appraise them for their impact on surgical services from the global south. A simple quality appraisal tool was constructed which can be used to evaluate rapidly emerging guidelines for evidence as well as for the needs of the global south. This rapid scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. Electronic databases were searched with predefined strategy and retrieved papers were screened according to relevant criteria. A simple objective tool to assess the quality of rapidly emerging guidelines including evidence, methodology, ease, resource optimization, geography, and the economy was constructed. Twenty studies met the inclusion criteria. None of the guidelines qualified to be evidence-based clinical practice guidelines as the level of evidence was uniformly rated "low". A newly constructed tool showed good validation, reliability, and internal consistency. This rapid scoping review found two major research gaps: lack of systematic review of evidence during their development and insufficient weightage of their impact on surgical services from the global south. These significant issues were addressed by constructing a simple and more representative tool for evaluating rapidly emerging guidelines which also gives the rightful importance of their impact on surgical services from the global south.

Research paper thumbnail of Simple Modification in Wiring for Efficient Application of Arch Bar to Achieve Intermaxillary Fixation

Indian Journal of Plastic Surgery

Research paper thumbnail of Low-cost procedure for deformity correction in rheumatoid hands

Scottish Medical Journal

Background Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumato... more Background Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumatoid arthritis (RA) is conventionally done by silicon joint arthroplasty which is expensive and may be associated with many complications. We report the outcome of low-cost autologous interpositional arthroplasty. Material and methods Five patients (8 hands, 32 arthroplasties) underwent correction of ulnar drift of MPJ by dorsal capsule interpositional arthroplasty. Results were assessed according to the degree of recovery of movement at the MPJ and correction of ulnar drift. Functional improvement was graded as excellent, good and fair. Pain alleviation was assessed by visual analogue score (VAS) score. Results Excellent results were seen in 3 patients (5 hands, 20 arthroplasties), good in 1 patient (2 hands, 8 arthroplasties) and fair in 1 patient (1 hand, 4 arthroplasties). VAS score for pain decreased from mean preoperative 8.2/10 to 1/10. On average follow up of 1.4 years there was go...

Research paper thumbnail of Ordinary PVC feeding tube: A low-cost alternative to silicon rod for staged flexor tendon reconstruction in zone II of hand

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Assessment of collateral hand circulation by modified Allen’s test in normal Indian subjects

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Roadmap for Restarting Elective Surgery During/After COVID-19 Pandemic

Indian Journal of Surgery

Research paper thumbnail of Tibialis posterior (TP) tendon transfer for foot drop: A single center experience

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

Indian Journal of Plastic Surgery

ABSTRACTSevere post burn neck contracture results in difficult intubation, which can be life thre... more ABSTRACTSevere post burn neck contracture results in difficult intubation, which can be life threatening and can result in multiple serious complications and sequels. Thirty patients with age ranging from 12 to 50 years were operated under local tumescent anesthesia supplemented with intravenous ketamine for release of post burn neck contracture and split skin grafted. This technique obviates the need for endotracheal intubation. There were no complications attributed to this anesthesia technique. There was no graft loss and blood loss was minimal.

Research paper thumbnail of Perception of plastic surgery in the society

Indian Journal of Plastic Surgery

ABSTRACTThe perception of plastic surgery in society is limited and underestimates the versatilit... more ABSTRACTThe perception of plastic surgery in society is limited and underestimates the versatility of the specialty. A survey was conducted in order to assess knowledge and to provide some initial evidence for education about the scope of plastic surgery amongst the public, medical and nursing students and general practitioners. A questionnaire was devised and four population groups of respondents were surveyed at random in one district. The results reveal that the majority of the public needs more information about the benefits that our specialty can offer them. Plastic surgeons are mainly associated with burns and cosmetic surgery and they are not necessarily identified as primary surgeons for procedures fundamental to our specialty. If patients are to receive the best treatment available, it is essential that we educate the public about our clinical interests and activities.

Research paper thumbnail of Prophylactic mesh placement for emergency midline laparotomy in peptic perforation peritonitis: A prospective observational study of short term results

Research paper thumbnail of Tarsal tunnel release restores sensations in sole for diabetic sensorimotor polyneuropathy

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Orthoplastic surgery: Need of the hour

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Huntington's procedure revisited

Journal of Clinical Orthopaedics and Trauma

Research paper thumbnail of Retraction of edge of rectus sheath after midline laparotomy

Research paper thumbnail of Sciatic Nerve to Pudendal Nerve Transfer: Anatomical Feasibility for a New Proposed Technique

Indian Journal of Plastic Surgery

Aim Restoration of bladder and bowel continence after pudendal nerve anastomosis has been shown s... more Aim Restoration of bladder and bowel continence after pudendal nerve anastomosis has been shown successfully in animal models and may be applicable in humans. Aim of this cadaveric study was to assess feasibility of pudendal nerve neurotization using motor fascicles from sciatic nerve. Methods Pudendal and sciatic nerves were exposed via gluteal approach in 5 human cadavers (10 sites). Size of pudendal and sciatic nerves and the distance between two nerves was measured. Results There were four male and one female cadavers. Mean age was 62 (range, 50–70) years. Mean pudendal nerve diameter was 2.94 mm (right side) and 2.82 mm (left side). Mean sciatic nerve diameter was 11.2 mm (right side) and 14.2 mm (left side). The distance between two nerves was 23.4 mm on both sides. Conclusion Transfer of the motor fascicles from sciatic nerve to pudendal nerve to restore the bladder and bowel continence is feasible.

Research paper thumbnail of “What do surgeons think about just before an operation while scrubbing?”

Research paper thumbnail of Thermometry: A simple objective method for burn depth assessment

Research paper thumbnail of Congenital palatal fistula: an isolated entity

European Journal of Plastic Surgery

Traumatic and postoperative palatal fistulae are common, but congenital palatal fistula is the ra... more Traumatic and postoperative palatal fistulae are common, but congenital palatal fistula is the rarest of all deformities. A case of isolated congenital palatal fistula is reported with an attempt to correlate the presented malformation with embryologic development of the palate.

Research paper thumbnail of Saphenous nerve transfer: A new approach to restore sensation of the sole

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of Detrusor Myoplasty for Acontractile/Hypocontractile Bladder in Spinal Cord Injury Patients

Journal of Neurology & Neuromedicine