Lalit Kumar Bansal - Academia.edu (original) (raw)

Papers by Lalit Kumar Bansal

Indian Journal of Surgery, Jun 7, 2018

Small bowel obstruction due to internal herniation is a rare entity specially when there is no hi... more Small bowel obstruction due to internal herniation is a rare entity specially when there is no history of previous surgery. Here, we have described a 14-year female without any previous surgical history admitted with features of small bowel obstruction. Without improvement of symptom by conservative management, an operation was performed. During surgery, it was observed that distal ileum was herniated through a mesenteric defect of small bowel itself. Because of this herniation, there was a segment of gangrenous ileum which was resected, and anastomosis was performed. Later, patient was discharged without any complication.

Indian Journal of Surgery

Intra-abdominal hypertension (IAH) is a known but neglected complication in acute pancreatitis. T... more Intra-abdominal hypertension (IAH) is a known but neglected complication in acute pancreatitis. The present study was conducted to establish the role of intra-abdominal pressure (IAP) as a prognostic marker in patients with acute pancreatitis and also to correlate IAP with APACHE II and SOFA scores. A prospective observational single-center cohort study was conducted on adult patients diagnosed with acute pancreatitis. Intra-abdominal pressure was measured through a transurethral Foley’s bladder catheter. APACHE II and SOFA scores were calculated at the time of admission (day 1). APACHE II score was reevaluated on day 3 and 5. SOFA score was reevaluated everyday till day 5. APACHE II score, SOFA score, and IAP at admission were significantly higher among non survivors when compared to survivors. There was significant correlation of IAP with APACHE II and SOFA scores. APACHE II and SOFA scores at cut-off values of 12 and 6 predicted IAP of > 12 (mm of Hg) with reasonable sensitivity and specificity. IAP could be used as a reliable negative prognostic marker in acute pancreatitis. APACHE II and SOFA scores could be used to predict intra-abdominal hypertension in patients of acute pancreatitis.

Polish Journal of Surgery

Purpose: Trauma is the leading cause of mortality in people below the age of 45 years. Abdominal ... more Purpose: Trauma is the leading cause of mortality in people below the age of 45 years. Abdominal trauma constitutes one-fourth of the trauma burden. Scoring systems in trauma are necessary for grading the severity of the injury and prior mobilization of resources in anticipation. The aim of this study was to evaluate RTS, ISS, CASS and TRISS scoring systems in blunt trauma abdomen. Materials and methods: A prospective single-center study was conducted on 43 patients of blunt trauma abdomen. Revised trauma score (RTS), Injury Severity Score (ISS), Clinical Abdominal Scoring System (CASS) and Trauma and Injury Severity Score (TRISS) were calculated and compared with the outcomes such as need for surgical intervention, post-operative complications and mortality. Results: The majority of the study subjects were males (83.7%). The most common etiology for blunt trauma abdomen as per this study was road traffic accident (72.1%). Spleen was the most commonly injured organ as per the study....

Polish Journal of Surgery

Introduction: Blunt trauma chest contributes to significant number of trauma admissions globally ... more Introduction: Blunt trauma chest contributes to significant number of trauma admissions globally and is a cause of major morbidity and mortality. Many scoring systems and risk factors have been defined in past for prognosticating blunt trauma chest but, none is considered to be gold standard. Aim: This study was conducted to reassess the significance of available scoring systems and others indicators of severity in prognosticating blunt trauma chest patients. Materials and Methods: In this prospective observational study from November 2016 till March 2018, 50 patients with age more than 12 years with blunt chest trauma who required hospitalization were included. Nine risk factors were assessed namely- age of the patient, duration of presentation after trauma, number of ribs fractured, bilateral thoracic injury, evidence of lung contusion, associated extra thoracic injury, need for mechanical ventilation, Revised trauma Score (RTS) and Modified Early Warning Sign Score (MEWS). Severi...

Indian Journal of Tuberculosis

Indian Journal of Surgical Oncology

The Surgery Journal, 2022

Addison's disease was first described by Thomas Addison in 1855. He demonstrated the destruct... more Addison's disease was first described by Thomas Addison in 1855. He demonstrated the destruction of bilateral adrenal gland by tuberculosis (TB) in six patients. Since then, the incidence of TB has declined in the Western world, but in developing countries, it is still the most common cause of adrenal insufficiency. Because of the introduction of antituberculous chemotherapy, the incidence of adrenal TB has been declined in the past decades. The most common symptoms are nonspecific; therefore, diagnosis is often delayed, and patients may first present with a life-threatening adrenal crisis. The most commonly identified organism for adrenal failure in adrenal TB is Mycobacterium tuberculosis infection. Adrenal TB involves bilateral adrenal glands more frequently than unilateral glands. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are useful investigations to differentiate between tuberculous Addison's disease and the other causes of adrenal insufficiency...

The incidence of parathyroid cysts in the general population is not known precisely. It very low ... more The incidence of parathyroid cysts in the general population is not known precisely. It very low in a large series of consecutive neck<br> USG (0.075%) and a prevalence of 3% was found in patients operated for cervical mass or hyperparathyroidism [1]. Moreover, a few<br> series have reported on the incidence of functional cysts, which may vary from 10 to 33% [2]. Symptomatic parathyroid cyst is a rare<br> entity. Hypercalcemic crisis with features of acute pancreatitis in parathyroid cyst is also rare. Aggressive and appropriate medical and<br> surgical management is required in these cases.<br> Here we are describing a case of hyperparathyroidism with features of hypercalcemia with acute pancreatitis. Later he was diagnosed<br> as right inferior parathyroid cyst for which excision was done and gradually patient was relieved from features of hypercalcemia and acute<br> pancreatitis.

Cutaneous metastases from systemic malignancy are relatively uncommon. Breast carcinoma is one of... more Cutaneous metastases from systemic malignancy are relatively uncommon. Breast carcinoma is one of the most common cancer in women which metastasize to skin. Skin metastasis found in 0.7% to 10.4% of all patient with systemic malignancy. Here we report a 36-year-old lady with advanced primary ductal carcinoma of right breast ( T4N1M1 ) stage 4 disease who presented us with 1 year history of right breast lump, progress from small 2 cm nodule in right breast, remain static for another 9 months and then suddenly progress to recent size of 15 × 15 cm with development of multiple skin swelling in abdomen, back, upper arm, and right thigh region simultaneously. These skin nodules are clinically mimicking lipoma. There is multiple mobile lump in left breast also mimicking fibroadenoma which are increasing in size and number in last 3 months. These swelling in skin and opposite breast are turn out to be metastatic nodules after histopathology report. After radiological examination metastatic...

Pancreaticobiliary maljunction (PBM) or anomaly is defined as an anatomical maljunction of the bi... more Pancreaticobiliary maljunction (PBM) or anomaly is defined as an anatomical maljunction of the biliary duct and pancreatic duct outside of the duodenal wall beyond the influence of the sphincter of Oddi. Children with this anomaly can present with choledochal cyst with recurrent attacks of acute pancreatitis, and their condition can be worse when not treated appropriately. Pancreaticobiliary maljunction or anomaly is considered to be a major risk factor for biliary tract cancer. In patients with this anomaly, free reflux of pancreatic juice into biliary tract may cause biliary tract damage. This can result in biliary malignancy. Therefore, in this condition, total excision of the extrahepatic bile duct with hepaticojejunostomy is recommended. Early diagnosis of this condition and early surgical treatment is recommended to prevent further complications. Proper follow-up is necessary to detect biliary tract malignancy in the early post-operative period, especially in patients demonstr...

Journal of Clinical and Diagnostic Research, 2021

Introduction: Septic complications are the most common cause of death in trauma patients who surv... more Introduction: Septic complications are the most common cause of death in trauma patients who survive beyond 48 hours. Early diagnosis and treatment of infectious complications is essential to prevent life-threatening complications like Systemic Inflammatory Response Syndrome (SIRS) and Multi-Organ Dysfunction Syndrome (MODS). Aim: To study the various risk factors for septic abdominal complications following laparotomy for trauma. Materials and Methods: A prospective longitudinal cohort single-center study was conducted from November 2016 to March 2018. Sixty patients above the age of 12 years, who underwent laparotomy for abdominal trauma in the Surgical Department of our hospital, were included in the study. Various patient variables were compared with postoperative septic abdominal complications like wound infection, wound dehiscence, anastomotic leak and intra-abdominal abscess. Data was analysed using Statistical Package for Social Sciences (SPSS) version 21.0. Results: In the ...

Journal of Clinical and Diagnostic Research, 2020

Ileosigmoid Knotting is a rare cause of intestinal obstruction. It is also called as compound vol... more Ileosigmoid Knotting is a rare cause of intestinal obstruction. It is also called as compound volvulus or double volvulus. It is caused by the wrapping of the ileum around the sigmoid colon and its mesentery or vice-versa. It is a rapidly progressive condition, leads to acute intestinal obstruction and gangrene in ileum as well as in the sigmoid colon. Early diagnosis and intervention is the key to a better outcome. Due to the rarity and unfamiliarity of this entity, diagnosis is usually made intraoperatively. Surgical removal of the gangrenous segment with either stoma formation or anastomosis is the only hope.An additional systemic search of the literature was done in PubMed, MEDLINE, ISIS, Embase, and CAS searches with the following free text keywords: ileosigmoid knotting, intestinal knotting, compound volvulus and double volvulus in English literature. Around 64 studies were identified, out of which 38 studies were selected for this article after the removal of duplicates and u...

Polish Journal of Surgery, 2021

Objective: The aim of this study was to compare the post-operative effects of closed incision neg... more Objective: The aim of this study was to compare the post-operative effects of closed incision negative pressure wound therapy with conventional dressing in emergency laparotomy. Methods: This study was conducted from 1st November 2018 to 31st March 2020 in ABVIMS & Dr. R.M.L. Hospital, New Delhi. The potential candidates for the study were patients of 18 years and above who were admitted in surgical emergency and underwent emergency laparotomy by a midline incision. Fifty random patients were alternatively allotted to group A (25 patients) and group B (25 patients). In the patients of group A, closed incision negative pressure wound therapy (ciNPWT) was applied on midline closed wound after an exploratory laparotomy procedure. The patients in group B, standard dry gauze dressing was done. Results: The mean age of patients in group A and group B were 46.76±12.20 and 41.96±8.33 years, respectively (p-value-0.11). The wound infection was present in 12% of cases in group A and 32% in gr...

Journal of Emergency Practice and Trauma, 2021

Objective: Penetrating abdominal trauma secondary to bamboo stick injury is a rare entity in the ... more Objective: Penetrating abdominal trauma secondary to bamboo stick injury is a rare entity in the developed world. Most of such kind of trans abdominal penetrating bamboo stick injury is associated with multiple solid and hollow viscus injuries. In developing countries like India, where nearly 70% of the population reside in rural areas, it is not that uncommon. Aim of this report is to recognition of risk factors and explain optimum surgical management in trans-abdominal bamboo stick injury. Case Presentation: Here we describe a case of penetrating trans abdominal bamboo stick injury resulting due to fall over a branch of bamboo stick with multiorgan damage, which was successfully managed by early surgical exploration in our institute. Conclusion: There are many factors which can prognosticate the penetrating trauma cases. The most important factors include a long interval between injury and surgical exploration, presence or absence of shock, and other associated organ injuries at t...

Indian Journal of Surgery, 2021

Self-gripping mesh can be difficult to handle during spread to the inguinal floor because it can ... more Self-gripping mesh can be difficult to handle during spread to the inguinal floor because it can stick or adhere to the undesired structures because of micro-grips available on its underneath surface. This article aims to describe a new technique; we named it a four-fold technique to spread the self-gripping mesh to avoid this problem. The present study was a prospective comparative study between self-gripping mesh (polyester mesh with polylactic acid grips) and sutured mesh (polypropylene) in open inguinal hernioplasty under spinal anesthesia. This study was conducted from 1 November 2018 to 31 March 2020 in ABVIMS & Dr. R.M.L. Hospital, New Delhi. The potential candidates for the study were patients of 18 years age and above, presenting with a unilateral uncomplicated inguinal hernia that underwent open inguinal hernioplasty under spinal anesthesia. Sixty patients were alternatively allotted to group A (30 patients) and group B (30 patients) for comparison between self-gripping and sutured mesh. We used a 14 × 9-cm-size self-gripping mesh, which has semi-resorbable surface on one side and resorbable micro-grips on the other side to provide immediate fixation. Mesh was folded four times in a specific sequence before placing it, thus hiding the majority of the absorbable micro-grips. In this way, only the lower medial half of the mesh has the micro-grips exposed, and the mesh can now be fixed to the inguinal ligament without fixation to unintended tissues and structures underneath. Once the mesh is placed over the pubic tubercle and medial part of the inguinal ligament, it can be unfolded in the reverse order. The four-fold technique is an excellent method to spread the self-gripping mesh in inguinal hernia surgery to avoid sticking with undesired tissues.

Indian Journal of Tuberculosis, 2020

The MIT Faculty has made this article openly available. Please share how this access benefits you... more The MIT Faculty has made this article openly available. Please share how this access benefits you. Your story matters. Citation Honda, T. et al. "An exploration of the role of system level variable choice in Multidisciplinary design" [Technical papers of the] 10th

Indian Journal of Surgery, 2020

Congenital diaphragmatic hernia (CDH) is a condition characterized by defect in the diaphragm whi... more Congenital diaphragmatic hernia (CDH) is a condition characterized by defect in the diaphragm which leads to protrusion of abdominal contents or viscera into the thoracic cavity interfering with normal development of the lungs. CDH is a developmental defect of diaphragm associated with significant neonatal mortality and morbidity. Incomplete development of diaphragm allows the abdominal content to invade the thoracic cavity resulting in compression of the developing lungs. Most of the CDH diagnosed in the new born or early childhood. Around 1% with CDH have no symptoms and may be detected incidentally. Diaphragmatic hernias can be divided into two broad categories: congenital and acquired. A congenital diaphragmatic hernia (CDH) occurs through embryologic defects in the diaphragm, and most patients present early in life rather than later. However, a subset of adults may present with a smaller CDH that was undetected during childhood. Infants with CDH often present in the neonatal period with severe respiratory distress. Early surgery is mainstay of treatment in newborn as mortality is very high in this condition. Here, we are describing very late presentation of a case of congenital diaphragmatic hernia treated by surgery with good post operative outcome. This case report summarizes how to diagnose and manage a late-presenting congenital diaphragmatic hernia to prevent further complications.

Indian Journal of Surgery, Jun 7, 2018

Small bowel obstruction due to internal herniation is a rare entity specially when there is no hi... more Small bowel obstruction due to internal herniation is a rare entity specially when there is no history of previous surgery. Here, we have described a 14-year female without any previous surgical history admitted with features of small bowel obstruction. Without improvement of symptom by conservative management, an operation was performed. During surgery, it was observed that distal ileum was herniated through a mesenteric defect of small bowel itself. Because of this herniation, there was a segment of gangrenous ileum which was resected, and anastomosis was performed. Later, patient was discharged without any complication.

Indian Journal of Surgery

Intra-abdominal hypertension (IAH) is a known but neglected complication in acute pancreatitis. T... more Intra-abdominal hypertension (IAH) is a known but neglected complication in acute pancreatitis. The present study was conducted to establish the role of intra-abdominal pressure (IAP) as a prognostic marker in patients with acute pancreatitis and also to correlate IAP with APACHE II and SOFA scores. A prospective observational single-center cohort study was conducted on adult patients diagnosed with acute pancreatitis. Intra-abdominal pressure was measured through a transurethral Foley’s bladder catheter. APACHE II and SOFA scores were calculated at the time of admission (day 1). APACHE II score was reevaluated on day 3 and 5. SOFA score was reevaluated everyday till day 5. APACHE II score, SOFA score, and IAP at admission were significantly higher among non survivors when compared to survivors. There was significant correlation of IAP with APACHE II and SOFA scores. APACHE II and SOFA scores at cut-off values of 12 and 6 predicted IAP of > 12 (mm of Hg) with reasonable sensitivity and specificity. IAP could be used as a reliable negative prognostic marker in acute pancreatitis. APACHE II and SOFA scores could be used to predict intra-abdominal hypertension in patients of acute pancreatitis.

Polish Journal of Surgery

Purpose: Trauma is the leading cause of mortality in people below the age of 45 years. Abdominal ... more Purpose: Trauma is the leading cause of mortality in people below the age of 45 years. Abdominal trauma constitutes one-fourth of the trauma burden. Scoring systems in trauma are necessary for grading the severity of the injury and prior mobilization of resources in anticipation. The aim of this study was to evaluate RTS, ISS, CASS and TRISS scoring systems in blunt trauma abdomen. Materials and methods: A prospective single-center study was conducted on 43 patients of blunt trauma abdomen. Revised trauma score (RTS), Injury Severity Score (ISS), Clinical Abdominal Scoring System (CASS) and Trauma and Injury Severity Score (TRISS) were calculated and compared with the outcomes such as need for surgical intervention, post-operative complications and mortality. Results: The majority of the study subjects were males (83.7%). The most common etiology for blunt trauma abdomen as per this study was road traffic accident (72.1%). Spleen was the most commonly injured organ as per the study....

Polish Journal of Surgery

Introduction: Blunt trauma chest contributes to significant number of trauma admissions globally ... more Introduction: Blunt trauma chest contributes to significant number of trauma admissions globally and is a cause of major morbidity and mortality. Many scoring systems and risk factors have been defined in past for prognosticating blunt trauma chest but, none is considered to be gold standard. Aim: This study was conducted to reassess the significance of available scoring systems and others indicators of severity in prognosticating blunt trauma chest patients. Materials and Methods: In this prospective observational study from November 2016 till March 2018, 50 patients with age more than 12 years with blunt chest trauma who required hospitalization were included. Nine risk factors were assessed namely- age of the patient, duration of presentation after trauma, number of ribs fractured, bilateral thoracic injury, evidence of lung contusion, associated extra thoracic injury, need for mechanical ventilation, Revised trauma Score (RTS) and Modified Early Warning Sign Score (MEWS). Severi...

Indian Journal of Tuberculosis

Indian Journal of Surgical Oncology

The Surgery Journal, 2022

Addison's disease was first described by Thomas Addison in 1855. He demonstrated the destruct... more Addison's disease was first described by Thomas Addison in 1855. He demonstrated the destruction of bilateral adrenal gland by tuberculosis (TB) in six patients. Since then, the incidence of TB has declined in the Western world, but in developing countries, it is still the most common cause of adrenal insufficiency. Because of the introduction of antituberculous chemotherapy, the incidence of adrenal TB has been declined in the past decades. The most common symptoms are nonspecific; therefore, diagnosis is often delayed, and patients may first present with a life-threatening adrenal crisis. The most commonly identified organism for adrenal failure in adrenal TB is Mycobacterium tuberculosis infection. Adrenal TB involves bilateral adrenal glands more frequently than unilateral glands. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are useful investigations to differentiate between tuberculous Addison's disease and the other causes of adrenal insufficiency...

The incidence of parathyroid cysts in the general population is not known precisely. It very low ... more The incidence of parathyroid cysts in the general population is not known precisely. It very low in a large series of consecutive neck<br> USG (0.075%) and a prevalence of 3% was found in patients operated for cervical mass or hyperparathyroidism [1]. Moreover, a few<br> series have reported on the incidence of functional cysts, which may vary from 10 to 33% [2]. Symptomatic parathyroid cyst is a rare<br> entity. Hypercalcemic crisis with features of acute pancreatitis in parathyroid cyst is also rare. Aggressive and appropriate medical and<br> surgical management is required in these cases.<br> Here we are describing a case of hyperparathyroidism with features of hypercalcemia with acute pancreatitis. Later he was diagnosed<br> as right inferior parathyroid cyst for which excision was done and gradually patient was relieved from features of hypercalcemia and acute<br> pancreatitis.

Cutaneous metastases from systemic malignancy are relatively uncommon. Breast carcinoma is one of... more Cutaneous metastases from systemic malignancy are relatively uncommon. Breast carcinoma is one of the most common cancer in women which metastasize to skin. Skin metastasis found in 0.7% to 10.4% of all patient with systemic malignancy. Here we report a 36-year-old lady with advanced primary ductal carcinoma of right breast ( T4N1M1 ) stage 4 disease who presented us with 1 year history of right breast lump, progress from small 2 cm nodule in right breast, remain static for another 9 months and then suddenly progress to recent size of 15 × 15 cm with development of multiple skin swelling in abdomen, back, upper arm, and right thigh region simultaneously. These skin nodules are clinically mimicking lipoma. There is multiple mobile lump in left breast also mimicking fibroadenoma which are increasing in size and number in last 3 months. These swelling in skin and opposite breast are turn out to be metastatic nodules after histopathology report. After radiological examination metastatic...

Pancreaticobiliary maljunction (PBM) or anomaly is defined as an anatomical maljunction of the bi... more Pancreaticobiliary maljunction (PBM) or anomaly is defined as an anatomical maljunction of the biliary duct and pancreatic duct outside of the duodenal wall beyond the influence of the sphincter of Oddi. Children with this anomaly can present with choledochal cyst with recurrent attacks of acute pancreatitis, and their condition can be worse when not treated appropriately. Pancreaticobiliary maljunction or anomaly is considered to be a major risk factor for biliary tract cancer. In patients with this anomaly, free reflux of pancreatic juice into biliary tract may cause biliary tract damage. This can result in biliary malignancy. Therefore, in this condition, total excision of the extrahepatic bile duct with hepaticojejunostomy is recommended. Early diagnosis of this condition and early surgical treatment is recommended to prevent further complications. Proper follow-up is necessary to detect biliary tract malignancy in the early post-operative period, especially in patients demonstr...

Journal of Clinical and Diagnostic Research, 2021

Introduction: Septic complications are the most common cause of death in trauma patients who surv... more Introduction: Septic complications are the most common cause of death in trauma patients who survive beyond 48 hours. Early diagnosis and treatment of infectious complications is essential to prevent life-threatening complications like Systemic Inflammatory Response Syndrome (SIRS) and Multi-Organ Dysfunction Syndrome (MODS). Aim: To study the various risk factors for septic abdominal complications following laparotomy for trauma. Materials and Methods: A prospective longitudinal cohort single-center study was conducted from November 2016 to March 2018. Sixty patients above the age of 12 years, who underwent laparotomy for abdominal trauma in the Surgical Department of our hospital, were included in the study. Various patient variables were compared with postoperative septic abdominal complications like wound infection, wound dehiscence, anastomotic leak and intra-abdominal abscess. Data was analysed using Statistical Package for Social Sciences (SPSS) version 21.0. Results: In the ...

Journal of Clinical and Diagnostic Research, 2020

Ileosigmoid Knotting is a rare cause of intestinal obstruction. It is also called as compound vol... more Ileosigmoid Knotting is a rare cause of intestinal obstruction. It is also called as compound volvulus or double volvulus. It is caused by the wrapping of the ileum around the sigmoid colon and its mesentery or vice-versa. It is a rapidly progressive condition, leads to acute intestinal obstruction and gangrene in ileum as well as in the sigmoid colon. Early diagnosis and intervention is the key to a better outcome. Due to the rarity and unfamiliarity of this entity, diagnosis is usually made intraoperatively. Surgical removal of the gangrenous segment with either stoma formation or anastomosis is the only hope.An additional systemic search of the literature was done in PubMed, MEDLINE, ISIS, Embase, and CAS searches with the following free text keywords: ileosigmoid knotting, intestinal knotting, compound volvulus and double volvulus in English literature. Around 64 studies were identified, out of which 38 studies were selected for this article after the removal of duplicates and u...

Polish Journal of Surgery, 2021

Objective: The aim of this study was to compare the post-operative effects of closed incision neg... more Objective: The aim of this study was to compare the post-operative effects of closed incision negative pressure wound therapy with conventional dressing in emergency laparotomy. Methods: This study was conducted from 1st November 2018 to 31st March 2020 in ABVIMS & Dr. R.M.L. Hospital, New Delhi. The potential candidates for the study were patients of 18 years and above who were admitted in surgical emergency and underwent emergency laparotomy by a midline incision. Fifty random patients were alternatively allotted to group A (25 patients) and group B (25 patients). In the patients of group A, closed incision negative pressure wound therapy (ciNPWT) was applied on midline closed wound after an exploratory laparotomy procedure. The patients in group B, standard dry gauze dressing was done. Results: The mean age of patients in group A and group B were 46.76±12.20 and 41.96±8.33 years, respectively (p-value-0.11). The wound infection was present in 12% of cases in group A and 32% in gr...

Journal of Emergency Practice and Trauma, 2021

Objective: Penetrating abdominal trauma secondary to bamboo stick injury is a rare entity in the ... more Objective: Penetrating abdominal trauma secondary to bamboo stick injury is a rare entity in the developed world. Most of such kind of trans abdominal penetrating bamboo stick injury is associated with multiple solid and hollow viscus injuries. In developing countries like India, where nearly 70% of the population reside in rural areas, it is not that uncommon. Aim of this report is to recognition of risk factors and explain optimum surgical management in trans-abdominal bamboo stick injury. Case Presentation: Here we describe a case of penetrating trans abdominal bamboo stick injury resulting due to fall over a branch of bamboo stick with multiorgan damage, which was successfully managed by early surgical exploration in our institute. Conclusion: There are many factors which can prognosticate the penetrating trauma cases. The most important factors include a long interval between injury and surgical exploration, presence or absence of shock, and other associated organ injuries at t...

Indian Journal of Surgery, 2021

Self-gripping mesh can be difficult to handle during spread to the inguinal floor because it can ... more Self-gripping mesh can be difficult to handle during spread to the inguinal floor because it can stick or adhere to the undesired structures because of micro-grips available on its underneath surface. This article aims to describe a new technique; we named it a four-fold technique to spread the self-gripping mesh to avoid this problem. The present study was a prospective comparative study between self-gripping mesh (polyester mesh with polylactic acid grips) and sutured mesh (polypropylene) in open inguinal hernioplasty under spinal anesthesia. This study was conducted from 1 November 2018 to 31 March 2020 in ABVIMS & Dr. R.M.L. Hospital, New Delhi. The potential candidates for the study were patients of 18 years age and above, presenting with a unilateral uncomplicated inguinal hernia that underwent open inguinal hernioplasty under spinal anesthesia. Sixty patients were alternatively allotted to group A (30 patients) and group B (30 patients) for comparison between self-gripping and sutured mesh. We used a 14 × 9-cm-size self-gripping mesh, which has semi-resorbable surface on one side and resorbable micro-grips on the other side to provide immediate fixation. Mesh was folded four times in a specific sequence before placing it, thus hiding the majority of the absorbable micro-grips. In this way, only the lower medial half of the mesh has the micro-grips exposed, and the mesh can now be fixed to the inguinal ligament without fixation to unintended tissues and structures underneath. Once the mesh is placed over the pubic tubercle and medial part of the inguinal ligament, it can be unfolded in the reverse order. The four-fold technique is an excellent method to spread the self-gripping mesh in inguinal hernia surgery to avoid sticking with undesired tissues.

Indian Journal of Tuberculosis, 2020

The MIT Faculty has made this article openly available. Please share how this access benefits you... more The MIT Faculty has made this article openly available. Please share how this access benefits you. Your story matters. Citation Honda, T. et al. "An exploration of the role of system level variable choice in Multidisciplinary design" [Technical papers of the] 10th

Indian Journal of Surgery, 2020

Congenital diaphragmatic hernia (CDH) is a condition characterized by defect in the diaphragm whi... more Congenital diaphragmatic hernia (CDH) is a condition characterized by defect in the diaphragm which leads to protrusion of abdominal contents or viscera into the thoracic cavity interfering with normal development of the lungs. CDH is a developmental defect of diaphragm associated with significant neonatal mortality and morbidity. Incomplete development of diaphragm allows the abdominal content to invade the thoracic cavity resulting in compression of the developing lungs. Most of the CDH diagnosed in the new born or early childhood. Around 1% with CDH have no symptoms and may be detected incidentally. Diaphragmatic hernias can be divided into two broad categories: congenital and acquired. A congenital diaphragmatic hernia (CDH) occurs through embryologic defects in the diaphragm, and most patients present early in life rather than later. However, a subset of adults may present with a smaller CDH that was undetected during childhood. Infants with CDH often present in the neonatal period with severe respiratory distress. Early surgery is mainstay of treatment in newborn as mortality is very high in this condition. Here, we are describing very late presentation of a case of congenital diaphragmatic hernia treated by surgery with good post operative outcome. This case report summarizes how to diagnose and manage a late-presenting congenital diaphragmatic hernia to prevent further complications.