Probal Neogi - Academia.edu (original) (raw)

Papers by Probal Neogi

Indian journal of surgery, Feb 20, 2024

Indian journal of surgery, Feb 9, 2024

International Journal of Medical Science and Public Health, 2014

Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the birt... more Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the births. It may be partial, where the transposition is confined to either the abdominal or the thoracic viscera, or complete, i.e. involving both cavities. Change in anatomical position of organs gives rise to abnormal location of signs and symptoms, thus posing a difficulty in diagnosing the ailment, and also demands greater surgical skill. While there is no evidence to suggest that gall stones are more or less common in people with situs inversus, the presentation with left upper quadrant pain may delay the diagnosis of symptomatic gall stones. The approach in the operating room requires modification. We are reporting a case with complete situs inversus who presented with features of chronic cholecystitis and underwent laparoscopic cholecystectomy.

Journal of Clinical Pathology, 2008

Entamoeba histolytica is a common human intestinal protozoon in developing tropical countries and... more Entamoeba histolytica is a common human intestinal protozoon in developing tropical countries and is considered to be a major cause of morbidity and mortality. It usually colonizes the ileocaecal and rectosigmoid area of the colon and produces small, superficial flask shaped ulcers with their base on the muscularis mucosae. Rarely it may produce transmural necrosis and perforation1 Involvement of jejunum is rare. Its presence in the small intestine leading to symptoms and further complications is rarely reported.2–4 Extra-intestinal amoebiasis commonly occurs due to vascular invasion.5 Invasion of the lymphatics and spread to draining lymph nodes is rare.6 A case of jejunal amoebiasis with perforation and spread to the mesenteric lymph node is documented here due to its rarity. A 5-year-old male child presented with fever and abdominal pain for the last 5 days, with 5–6 episodes of vomiting for the last 2 days and inability to pass flatus and faeces since the evening before. The girth of the abdomen had been increasing for the past 2–3 days. On examination, the child looked malnourished and toxic, with hyperthermia and tachycardia. Pallor was present. There was no icterus or lymphadenopathy. Per-abdominally, signs of peritonitis with guarding and rebound tenderness were present. Bowel sounds were absent. Chest x ray (posteroanterior view in erect position) did not reveal gas under the diaphragm. Plain x ray of the abdomen in the supine position revealed small bowel distension, and an erect abdominal film showed multiple air …

International Journal of Medical Research and Review, 2016

The aim of study was to evaluate various types of stoma with regard to their indications, their c... more The aim of study was to evaluate various types of stoma with regard to their indications, their complications and methods to reduce them, at a tertiary hospital of central India. Methods: The study was carried out in Department of surgery at M. L. N. Medical College, Allahabad from August 2013 to July 2014. Adult patients who were admitted here and had Ileostomy/colostomy formation/closure as a part of their treatment were included. Data was collected by meticulous history taking, clinical examination and investigations. Results: A total of 100 patients were included (Avg. 34 year) and male: female ratio was 1.6:1. The most common stoma constructed was ileostomy (82%) with loop ileostomy (62%) being the most common subtype. Among colostomies, loop was most common (50%). Main indication of stoma formation was intestinal perforation (63%). In individual causes, Typhoid Perforation (44%) was most common indication. 85% patients had stoma complications, most common being peristomal skin excoriation (80%). Study of closure of stoma was done in a total of 50 patients. Closure of 43 ileostomies and 7 colostomies was done. Mean length of postoperative stay was 11 days. 28% developed complication among which paralytic ileus, (16%) was most common. Conclusion: Despite extensive surgical experience, complications of intestinal stomas still occur frequently and result in high morbidity. Meticulous skin care with regular follow-up, early detection of complications with their timely management along with education and counseling can decrease morbidity.

International Surgery Journal, 2018

Background: Pain following Milligan Morgan hemorrhoidectomy is a significant cause of morbidity. ... more Background: Pain following Milligan Morgan hemorrhoidectomy is a significant cause of morbidity. The present study was carried out to find out if using metronidazole in the post-operative period of these patients results in less post-operative pain.Methods: This was a prospective randomized controlled trial which was conducted on 67 consecutive patients attending the Surgical OPD at SRN Hospital, Allahabad during the study period between August 2016 and July 2017 who underwent surgery for grade 2, grade 3 and grade 4 hemorrhoids. The patients were allocated to 3 groups-one group was the control group, the second group received oral metronidazole post-operatively for 7 days while the third group received only topical metronidazole for 7 days. All the three groups received 500 mg of metronidazole in 100 ml infusion pre-operatively. The post-operative analgesic usage was standardized for all the three groups. Appropriate tests of significance were applied to assess if the difference in...

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2019

Background/Purpose: To compare the changes in hepatic enzymes and comfort level of the surgeon in... more Background/Purpose: To compare the changes in hepatic enzymes and comfort level of the surgeon in low-pressure pneumoperitoneum laparoscopic cholecystectomy (LPPLC, 7 mm Hg) with that of normal pressure pneumoperitoneum laparoscopic cholecystectomy (NPPLC, 14 mm Hg). Methods: Eighty-two patients were randomly divided into 2 groups (LPPLC and NPPLC). Serum levels of bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, alkaline phosphatase, and lactate dehydrogenase were measured before the operation, at the time of reversal from anesthesia, 24 hours after the operation, and on day 7. Serious adverse events, intra-operative complications, surgeon’s comfort level of dissection, operative time, conversion rates to an open procedure, or normal pressure pneumoperitoneum were recorded. Results: Of the 41 patients randomized for LPPLC, 8 patients were converted to NPPLC due to difficulty in dissection and 1 converted to open in each group. There was statistically significant fall in mean serum bilirubin level in both the groups in the immediate postoperative period (P<0.05). Statistically significant increase in its level was observed after 24 hours in the NPPLC group only (P<0.05). Levels of mean serum serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, and lactate dehydrogenase increased significantly (P<0.05) in immediate postoperative period and a further increase was observed after 24 hours (P<0.05) in the NPPLC group only. The comfort level of surgeon was found to be significantly better in the NPPLC group. Conclusions: LPPLC is a safe procedure, especially in the hands of an experienced surgeon with clinically insignificant systemic effects. But the comfort level of surgeon is better in normal pressure when compared with low pressure. In patients with deranged hepatic functions undergoing advanced laparoscopic procedures, it is advisable to start the surgery with low-pressure pneumoperitoneum. Pressure may be escalated further as per the surgeon’s comfort.

International Surgery Journal, 2018

Background: Postoperative pain after open mesh repair of inguinal hernia is an important challeng... more Background: Postoperative pain after open mesh repair of inguinal hernia is an important challenge. Such type of pain sometimes does not respond to medical treatment including non-steroidal anti-inflammatory drugs and opiates. The objective of the present study was to evaluate the effect of preservation or division of the Ilioinguinal nerve on pain and post-operative symptoms, after open mesh repair of inguinal hernia.Methods: All patients undergoing surgery for tension free Lichtenstein mesh repair over a period of 1 year were included. Patients below the age of 18 years and patients with bilateral or recurrent hernias were excluded.Results: In present study of 42 patients, early mean postoperative pain at day 1 was 1.8 on VAS scale in ilioinguinal neurectomised patient compared to 1.5 in nerve preserved group (P=0.1408). Postoperative pain at week 1 was 1.25 in neurectomised patients compared to 1.32 in nerve preserved group (P=0.7161). Late Postoperative pain and chronic groin pa...

International Surgery Journal, 2017

Background: Inguinal hernia is a very common surgical problem for which, mesh-based techniques, p... more Background: Inguinal hernia is a very common surgical problem for which, mesh-based techniques, particularly the Lichtenstein repair is considered standard. However, problems like foreign body sensation, wound infection, cord fibrosis, chronic pain and recurrence are major concern. Desarda tissue repair (non-mesh technique), which was given by an Indian surgeon, is now being used in many countries because of low cost of procedure with very low recurrence rates. The objective of this study was to evaluate the feasibility of Desarda tissue repair at a tertiary care centre of Central India as a treatment of primary inguinal hernia, by comparing it with Lichtenstein repair in terms of various post-operative parameters.Methods: Patients between age of 18 and 70 years with primary inguinal hernia were included in this randomised controlled trial. Patients with strangulated, obstructed or recurrent hernia, surgically unfit patients and patients having unmanaged urinary obstruction, cough o...

International Journal of Medical Science and Public Health, 2014

Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the birt... more Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the births. It may be partial, where the transposition is confined to either the abdominal or the thoracic viscera, or complete, i.e. involving both cavities. Change in anatomical position of organs gives rise to abnormal location of signs and symptoms, thus posing a difficulty in diagnosing the ailment, and also demands greater surgical skill. While there is no evidence to suggest that gall stones are more or less common in people with situs inversus, the presentation with left upper quadrant pain may delay the diagnosis of symptomatic gall stones. The approach in the operating room requires modification. We are reporting a case with complete situs inversus who presented with features of chronic cholecystitis and underwent laparoscopic cholecystectomy.

Acta bio-medica : Atenei Parmensis, 2008

Enteroenteric intussusceptions are rarely observed in adults. Most of these are associated with t... more Enteroenteric intussusceptions are rarely observed in adults. Most of these are associated with tumors. We operated a 25-year old female with suspected stricture in the third part of the duodenum. However during laparotomy, duodenojejunal intussusception was found along with an adenoma in the third part of the duodenum associated with a lax ligament of Treitz. The intussusception was reduced and the parts of the duodenum containing the adenoma were resected, followed by an end-to-end duodenojejunal anastomosis. To the best of our knowledge, this is the first reported case of tubulovillous adenoma in the third part of the duodenum presenting as intussusception in an adult.

Annals of The Royal College of Surgeons of England, 2007

Situs inversus is a morphological anomaly of positioning of internal viscera wherein there is a r... more Situs inversus is a morphological anomaly of positioning of internal viscera wherein there is a reversal of the usual 'handedness' of visceral topography. The reversal may be thoracic, abdominal or both. It is estimated to occur in 1 in 5000-20,000 births. 1,2 Though situs inversus on its own is not pathological, it may be associated with cardiorespiratory, hepatopancreaticobiliary, gastrointestinal, neurological, orthopaedic and urological anomalies, some of which may be life-threatening. 1,3 In the published literature, there have been only about 40 reports of open cholecystectomy in the pre-laparoscopic era and 20 reports of laparoscopic cholecystectomy in patients with situs inversus. 2,4,5 The variation from the norm of the sidedness of the gall bladder is attended by differences in presentation, difficulties in diagnosis and the need for modifications in operative technique as reported below. Case report A 57-year-old woman presented to the surgical clinic with a few months' history of intermittent left upper quadrant pain, radiating to the left scapular region and aggravated by fatty food. Imaging by an ultrasound scan and subsequently by a magnetic resonance cholangiopancreatogram showed abdominal situs inversus with gall stones in a left-sided gall bladder (Fig. 1). The liver was oriented in a mirror image of its usual anatomical lie, with the larger anatomical lobe lying on the left side while the smaller lobe crossed the midline to the right.

International Surgery Journal, 2019

Background: Mastalgia is a common problem and 60-70% women encounter it at least once in their li... more Background: Mastalgia is a common problem and 60-70% women encounter it at least once in their lifetime. Many drugs have been used and are been used with varying response, like Tamoxifen, Danazol, primrose oil, topical analgesics and recently Centchroman. The objective of the present study was to compare the three most commonly used drugs in the treatment of mastalgia, namely Centchroman, Tamoxifen and Danazol with a placebo.Methods: All consecutive female patients more than 25 years of age with history of mastalgia for more than 3 months were taken up for the study. Patients were distributed into four groups and administered Centchroman, danazol, tamoxifen and placebo, respectively.Results: In present study of 78 patients, the median visual analogue score (VAS) in Centchroman group were 3, 1 and 3 after treatment of 4, 12 and 24 weeks, respectively with a pre-treatment VAS of 8. Similarly, in the danazol group, VAS at 4, 12 and 24 weeks were 4, 1.5 and 5, respectively. In the Tamox...

Indian journal of surgery, Feb 20, 2024

Indian journal of surgery, Feb 9, 2024

International Journal of Medical Science and Public Health, 2014

Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the birt... more Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the births. It may be partial, where the transposition is confined to either the abdominal or the thoracic viscera, or complete, i.e. involving both cavities. Change in anatomical position of organs gives rise to abnormal location of signs and symptoms, thus posing a difficulty in diagnosing the ailment, and also demands greater surgical skill. While there is no evidence to suggest that gall stones are more or less common in people with situs inversus, the presentation with left upper quadrant pain may delay the diagnosis of symptomatic gall stones. The approach in the operating room requires modification. We are reporting a case with complete situs inversus who presented with features of chronic cholecystitis and underwent laparoscopic cholecystectomy.

Journal of Clinical Pathology, 2008

Entamoeba histolytica is a common human intestinal protozoon in developing tropical countries and... more Entamoeba histolytica is a common human intestinal protozoon in developing tropical countries and is considered to be a major cause of morbidity and mortality. It usually colonizes the ileocaecal and rectosigmoid area of the colon and produces small, superficial flask shaped ulcers with their base on the muscularis mucosae. Rarely it may produce transmural necrosis and perforation1 Involvement of jejunum is rare. Its presence in the small intestine leading to symptoms and further complications is rarely reported.2–4 Extra-intestinal amoebiasis commonly occurs due to vascular invasion.5 Invasion of the lymphatics and spread to draining lymph nodes is rare.6 A case of jejunal amoebiasis with perforation and spread to the mesenteric lymph node is documented here due to its rarity. A 5-year-old male child presented with fever and abdominal pain for the last 5 days, with 5–6 episodes of vomiting for the last 2 days and inability to pass flatus and faeces since the evening before. The girth of the abdomen had been increasing for the past 2–3 days. On examination, the child looked malnourished and toxic, with hyperthermia and tachycardia. Pallor was present. There was no icterus or lymphadenopathy. Per-abdominally, signs of peritonitis with guarding and rebound tenderness were present. Bowel sounds were absent. Chest x ray (posteroanterior view in erect position) did not reveal gas under the diaphragm. Plain x ray of the abdomen in the supine position revealed small bowel distension, and an erect abdominal film showed multiple air …

International Journal of Medical Research and Review, 2016

The aim of study was to evaluate various types of stoma with regard to their indications, their c... more The aim of study was to evaluate various types of stoma with regard to their indications, their complications and methods to reduce them, at a tertiary hospital of central India. Methods: The study was carried out in Department of surgery at M. L. N. Medical College, Allahabad from August 2013 to July 2014. Adult patients who were admitted here and had Ileostomy/colostomy formation/closure as a part of their treatment were included. Data was collected by meticulous history taking, clinical examination and investigations. Results: A total of 100 patients were included (Avg. 34 year) and male: female ratio was 1.6:1. The most common stoma constructed was ileostomy (82%) with loop ileostomy (62%) being the most common subtype. Among colostomies, loop was most common (50%). Main indication of stoma formation was intestinal perforation (63%). In individual causes, Typhoid Perforation (44%) was most common indication. 85% patients had stoma complications, most common being peristomal skin excoriation (80%). Study of closure of stoma was done in a total of 50 patients. Closure of 43 ileostomies and 7 colostomies was done. Mean length of postoperative stay was 11 days. 28% developed complication among which paralytic ileus, (16%) was most common. Conclusion: Despite extensive surgical experience, complications of intestinal stomas still occur frequently and result in high morbidity. Meticulous skin care with regular follow-up, early detection of complications with their timely management along with education and counseling can decrease morbidity.

International Surgery Journal, 2018

Background: Pain following Milligan Morgan hemorrhoidectomy is a significant cause of morbidity. ... more Background: Pain following Milligan Morgan hemorrhoidectomy is a significant cause of morbidity. The present study was carried out to find out if using metronidazole in the post-operative period of these patients results in less post-operative pain.Methods: This was a prospective randomized controlled trial which was conducted on 67 consecutive patients attending the Surgical OPD at SRN Hospital, Allahabad during the study period between August 2016 and July 2017 who underwent surgery for grade 2, grade 3 and grade 4 hemorrhoids. The patients were allocated to 3 groups-one group was the control group, the second group received oral metronidazole post-operatively for 7 days while the third group received only topical metronidazole for 7 days. All the three groups received 500 mg of metronidazole in 100 ml infusion pre-operatively. The post-operative analgesic usage was standardized for all the three groups. Appropriate tests of significance were applied to assess if the difference in...

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2019

Background/Purpose: To compare the changes in hepatic enzymes and comfort level of the surgeon in... more Background/Purpose: To compare the changes in hepatic enzymes and comfort level of the surgeon in low-pressure pneumoperitoneum laparoscopic cholecystectomy (LPPLC, 7 mm Hg) with that of normal pressure pneumoperitoneum laparoscopic cholecystectomy (NPPLC, 14 mm Hg). Methods: Eighty-two patients were randomly divided into 2 groups (LPPLC and NPPLC). Serum levels of bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, alkaline phosphatase, and lactate dehydrogenase were measured before the operation, at the time of reversal from anesthesia, 24 hours after the operation, and on day 7. Serious adverse events, intra-operative complications, surgeon’s comfort level of dissection, operative time, conversion rates to an open procedure, or normal pressure pneumoperitoneum were recorded. Results: Of the 41 patients randomized for LPPLC, 8 patients were converted to NPPLC due to difficulty in dissection and 1 converted to open in each group. There was statistically significant fall in mean serum bilirubin level in both the groups in the immediate postoperative period (P<0.05). Statistically significant increase in its level was observed after 24 hours in the NPPLC group only (P<0.05). Levels of mean serum serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, and lactate dehydrogenase increased significantly (P<0.05) in immediate postoperative period and a further increase was observed after 24 hours (P<0.05) in the NPPLC group only. The comfort level of surgeon was found to be significantly better in the NPPLC group. Conclusions: LPPLC is a safe procedure, especially in the hands of an experienced surgeon with clinically insignificant systemic effects. But the comfort level of surgeon is better in normal pressure when compared with low pressure. In patients with deranged hepatic functions undergoing advanced laparoscopic procedures, it is advisable to start the surgery with low-pressure pneumoperitoneum. Pressure may be escalated further as per the surgeon’s comfort.

International Surgery Journal, 2018

Background: Postoperative pain after open mesh repair of inguinal hernia is an important challeng... more Background: Postoperative pain after open mesh repair of inguinal hernia is an important challenge. Such type of pain sometimes does not respond to medical treatment including non-steroidal anti-inflammatory drugs and opiates. The objective of the present study was to evaluate the effect of preservation or division of the Ilioinguinal nerve on pain and post-operative symptoms, after open mesh repair of inguinal hernia.Methods: All patients undergoing surgery for tension free Lichtenstein mesh repair over a period of 1 year were included. Patients below the age of 18 years and patients with bilateral or recurrent hernias were excluded.Results: In present study of 42 patients, early mean postoperative pain at day 1 was 1.8 on VAS scale in ilioinguinal neurectomised patient compared to 1.5 in nerve preserved group (P=0.1408). Postoperative pain at week 1 was 1.25 in neurectomised patients compared to 1.32 in nerve preserved group (P=0.7161). Late Postoperative pain and chronic groin pa...

International Surgery Journal, 2017

Background: Inguinal hernia is a very common surgical problem for which, mesh-based techniques, p... more Background: Inguinal hernia is a very common surgical problem for which, mesh-based techniques, particularly the Lichtenstein repair is considered standard. However, problems like foreign body sensation, wound infection, cord fibrosis, chronic pain and recurrence are major concern. Desarda tissue repair (non-mesh technique), which was given by an Indian surgeon, is now being used in many countries because of low cost of procedure with very low recurrence rates. The objective of this study was to evaluate the feasibility of Desarda tissue repair at a tertiary care centre of Central India as a treatment of primary inguinal hernia, by comparing it with Lichtenstein repair in terms of various post-operative parameters.Methods: Patients between age of 18 and 70 years with primary inguinal hernia were included in this randomised controlled trial. Patients with strangulated, obstructed or recurrent hernia, surgically unfit patients and patients having unmanaged urinary obstruction, cough o...

International Journal of Medical Science and Public Health, 2014

Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the birt... more Situs inversus totalis is a rare congenital disorder occurring in 1:5,000 to 1:20,000 of the births. It may be partial, where the transposition is confined to either the abdominal or the thoracic viscera, or complete, i.e. involving both cavities. Change in anatomical position of organs gives rise to abnormal location of signs and symptoms, thus posing a difficulty in diagnosing the ailment, and also demands greater surgical skill. While there is no evidence to suggest that gall stones are more or less common in people with situs inversus, the presentation with left upper quadrant pain may delay the diagnosis of symptomatic gall stones. The approach in the operating room requires modification. We are reporting a case with complete situs inversus who presented with features of chronic cholecystitis and underwent laparoscopic cholecystectomy.

Acta bio-medica : Atenei Parmensis, 2008

Enteroenteric intussusceptions are rarely observed in adults. Most of these are associated with t... more Enteroenteric intussusceptions are rarely observed in adults. Most of these are associated with tumors. We operated a 25-year old female with suspected stricture in the third part of the duodenum. However during laparotomy, duodenojejunal intussusception was found along with an adenoma in the third part of the duodenum associated with a lax ligament of Treitz. The intussusception was reduced and the parts of the duodenum containing the adenoma were resected, followed by an end-to-end duodenojejunal anastomosis. To the best of our knowledge, this is the first reported case of tubulovillous adenoma in the third part of the duodenum presenting as intussusception in an adult.

Annals of The Royal College of Surgeons of England, 2007

Situs inversus is a morphological anomaly of positioning of internal viscera wherein there is a r... more Situs inversus is a morphological anomaly of positioning of internal viscera wherein there is a reversal of the usual 'handedness' of visceral topography. The reversal may be thoracic, abdominal or both. It is estimated to occur in 1 in 5000-20,000 births. 1,2 Though situs inversus on its own is not pathological, it may be associated with cardiorespiratory, hepatopancreaticobiliary, gastrointestinal, neurological, orthopaedic and urological anomalies, some of which may be life-threatening. 1,3 In the published literature, there have been only about 40 reports of open cholecystectomy in the pre-laparoscopic era and 20 reports of laparoscopic cholecystectomy in patients with situs inversus. 2,4,5 The variation from the norm of the sidedness of the gall bladder is attended by differences in presentation, difficulties in diagnosis and the need for modifications in operative technique as reported below. Case report A 57-year-old woman presented to the surgical clinic with a few months' history of intermittent left upper quadrant pain, radiating to the left scapular region and aggravated by fatty food. Imaging by an ultrasound scan and subsequently by a magnetic resonance cholangiopancreatogram showed abdominal situs inversus with gall stones in a left-sided gall bladder (Fig. 1). The liver was oriented in a mirror image of its usual anatomical lie, with the larger anatomical lobe lying on the left side while the smaller lobe crossed the midline to the right.

International Surgery Journal, 2019

Background: Mastalgia is a common problem and 60-70% women encounter it at least once in their li... more Background: Mastalgia is a common problem and 60-70% women encounter it at least once in their lifetime. Many drugs have been used and are been used with varying response, like Tamoxifen, Danazol, primrose oil, topical analgesics and recently Centchroman. The objective of the present study was to compare the three most commonly used drugs in the treatment of mastalgia, namely Centchroman, Tamoxifen and Danazol with a placebo.Methods: All consecutive female patients more than 25 years of age with history of mastalgia for more than 3 months were taken up for the study. Patients were distributed into four groups and administered Centchroman, danazol, tamoxifen and placebo, respectively.Results: In present study of 78 patients, the median visual analogue score (VAS) in Centchroman group were 3, 1 and 3 after treatment of 4, 12 and 24 weeks, respectively with a pre-treatment VAS of 8. Similarly, in the danazol group, VAS at 4, 12 and 24 weeks were 4, 1.5 and 5, respectively. In the Tamox...